Thursday, April 29, 2010

This Week

This week has seen a number of developments… let’s take them in the order they occurred.

Monday was a bit of a scary day. Lisa had a 9 am non-stress test (NST) scheduled, and they are supposed to take about 20 minutes. I figured I would wait out in the lobby until she was done.

9:30 came and went.

10:00 came and went.

10:30 came and went.

At this point, I asked the receptionist if she knew what was happening with Lisa. After a few minutes she told me that Lisa was almost done and the nurse would call me back there soon. “Call me back?” I wondered. “If she’s almost done, then she should come out here, not me go back there.” In those few minutes, my mind immediately thought about worst case scenarios – what if they found something was wrong? What if they couldn’t find one of the babies’ heartbeats? What if they couldn’t find either of the babies’ heartbeats? As they lead me back, I figured that Lisa’s expression (and possible tears on her face) would tell me how serious the situation was.

Thankfully, she only looked concerned. “Baby A isn’t moving as much as they’d like… they’re going to do a biophysical profile (the same test that we do on Thursdays), and if A doesn’t have a perfect score, they’re sending us to Chicago.” Immediately I thought about how hard it would be for my sister Laura if we delivered the twins in the time between when her baby passed away and when he or she is delivered.

Thankfully (again), both our twins scored perfectly on the BPP, so we could head home. [Sigh of relief]

Today was another good day. Everything looked good – twin B’s MCA scores were lower than expected, but Dr. Ismail attributed that to the angle at which they were taken; no need for concern. And [drum roll]… they’ve grown! A put on 8 ounces and B put on 9 ounces in the last two weeks! Twin A is up to 2 lbs, 7 oz, and B is up to 3 lbs, 12 oz! Lisa is 31 weeks and 4 days along today – Sunday will mark 32 weeks. Our next big goal is to get to 34 weeks… then she may have the opportunity to avoid a c-section.

Tim & Laura continue to meet with doctors; they haven’t had a procedure to remove the baby yet. We ask that you keep them in your prayers in the days and weeks ahead.

Thank you, thank you, thank you for all your prayers and encouragement. As we’re very near the turning of another calendar month, we rejoice at how much God has taken care of us and brought us to this point. Lisa and I were dreaming today about how cool it would be if – a month from now – we were celebrating making it to June! =) If we dream, we might as well dream big, right?

Thanks again!


Thursday, April 22, 2010

Life and death

Yesterday, my sister Laura felt like something didn’t quite feel right. She also had a bit of back pain. In order to evaluate what was happening, the doctor had her come in for an ultrasound.

They couldn’t find the heartbeat.

The second ultrasound confirmed what they had thought: their unborn baby – at just over 20 weeks along in the pregnancy, having been diagnosed with two fatal conditions just two weeks earlier – had passed away.

As I write, they are attempting to have a smooth delivery for the baby – hoping they can avoid a c-section, while having a slow enough labor that her c-section from 22 months ago doesn’t cause trouble. Please pray for Tim, Laura, Josiah, and their extended family as we mourn.

Meanwhile, we had another good report today. Though we didn’t get a report on the girls’ growth – technically, such measurements should be taken at least two weeks apart – everything else looked good. Twin A’s MCA levels were far better than they have been before, so we’re especially thankful for that.

Lisa is up to 30 weeks and 4 days. The average length of pregnancy after having the laser surgery is 31-32 weeks. The maximum that Lisa would be allowed to carry would be 36 weeks and 6 days; I think the calendar date would be June 5. As we near the end of April, we are thankfully surprised that things have continued on as far as they have – a month ago, we were just hoping to make it to April. Right now, we’re hoping to make it to May; we hope and pray that in a month we’ll be hoping to make it to June. Every day counts, every week counts.

Needless to say, our hearts are heavy and happy all at once. Solomon said in Ecclesiastes 3:4, “[there is] a time to weep and a time to laugh, a time to mourn and a time to dance…” I don’t think he knew that those two extreme ends of the spectrum could be felt at the same time.

Difficult as it might be to confess this, I must: God is good, all the time. Thanks again for the prayers.


Thursday, April 15, 2010

Welcome Redundancy

Sometimes repetition is bothersome, but it’s not when it’s good news. =)

We had yet another good day at the doctor today. But before we inform you about today, we should rewind a few days back to Monday. As many of you know, this week marked the first week of seeing the doctor twice every week. We’ve added Monday appointments to our weekly schedule, but thankfully we don’t have to drive as far on those days. Instead, we’re able to go a (relatively) short distance (about 35 minutes) to Crown Point. For those appointments, we only have a non-stress test (NST).

“What’s that?” you might say. If any of you know what it looks like when a mother-to-be is monitored for labor and delivery, then you know what an NST is. A nurse puts a round device on the mom’s belly and uses an elastic band to hold it in place. That device listens to and charts the baby’s (or in our case, “those devices listen to and chart the babies’”) heart rate and movement. The goal is to have 20 minutes of consistent measurement, and it seems to be at least twice as hard to do that with twins. Another monitor measures whether (or how often/strong) contractions are for mom.

The NST on Monday went quite well, and the (first) one we had today didn’t go as well as planned. They kept hearing just one heartbeat with the two monitors – apparently the girls were so close to each other that it was tough to distinguish where each heartbeat was.Nevertheless, the nurse seemed satisfied when we left that testing area.

Next, we had another ultrasound to measure growth, MCA levels, fluid levels, and biophysical profile (BPP). Let’s go over those results…

1. Growth – twin A put on another two ounces this week, bringing her up to 1 lb, 15 oz. (just an ounce short of 2 pounds!). We’re glad she’s growing. Twin B put on a whopping 7 ounces this week, bringing her up to 3 lbs, 3 oz. Our doctor didn’t seem concerned at all that there’s now over a pound difference in weight, so we aren’t either. =) As Dr. Ismail said, “Leave the worrying to me.”

2. MCA levels – we were extremely pleased here. They measured the blood flow in the middle cerebral artery (MCA) and use a formula to determine the score. The normal range is 1.7-2.3 for this developmental age. Twin A had a 1.8 score and twin B had a 2.2 score. We’re really happy that they’re both in the normal range!

3. Fluid levels – these were incredibly encouraging results. Twin A had about 9 cm of fluid and twin B had about 7 cm. Remember, these are the levels that we prayed about a while back when twin A had less than (the danger threshold of) 2 cm. Good news!

4. BPP – there’s only a half-hour window to watch both twins perform all 4 BPP factors: muscle tone, movement, breathing, and fluid. Each of those is awarded 2 points for completion, with a perfect score of 8. Twin B scored a perfect 8, while twin A had a 6 – the tech didn’t see her doing any of the pre-breathing. She wasn’t concerned about it, but…

Our doctor wanted to stay on the safe side. So, we went back for another NST to make sure that A was doing okay. The nurse was able to get a much more consistent measure, and everything looked great.

We met with the doctor for a short time, and he was very encouraging again today. “You are going to have two healthy baby girls,” he told us. Lisa is up to 29 weeks and 4 days today. As (I think) I’ve said earlier, the average length of pregnancy after having the laser procedure for TTTS is 31-32 weeks, but our doctor didn’t seem to think that Lisa would be delivering any time soon. He affirmed that if we’re able to make it to 34 weeks and the presenting baby has her head down, Lisa will be able to try delivering the babies without a c-section (“naturally”).

Even with our good news, we continue to have heavy hearts and pray for Tim & Laura. We’re thankful that you’re doing the same.

Ooh, before I forget, we have a few pictures from the last two visits – they’re 4d (I didn’t make that term up, I just go with what they tell me), so you’ll have use your imagination to see the girls’ faces. The first one is straight-on of twin B from last week. The second is a ¾ angle looking down on twin B from last week. And the last one is a ¾ angle looking down on twin A from today. Enjoy!

Thursday, April 8, 2010


Rather than give a traditional update, I thought it might be helpful to put a few events in sequential order over the past week… as you’ll see, there have been some ups and downs.

Saturday, April 3 – Despite our deepest wishes, my sister and her husband (Laura and Tim) didn’t find out the gender of their baby from their ultrasound today. Both my sister Lisa and I have had a boy then a girl, and Laura already had a boy… so we figured it may be a girl. We were bummed with them that they weren’t able to find out.

Sunday, April 4 – It’s Easter Sunday! I woke Kruesie up by crawling into his bed and telling him, “The tomb is empty! Jesus rose from the grave!” We finished the Resurrection Eggs and found the last egg – like Jesus’ tomb – was empty, too. Tim and Laura worshipped with us at our church, and their son Josiah did really well in nursery. We had my parents, Tim, Laura, Josiah, and my sister Lisa, her husband Rob, and their kids – Austin and Kaitlyn – over for Easter dinner/hanging out. It was a blessing that everyone came (and brought the food!) so that our family could see extended family for Easter – otherwise we wouldn’t have been able to see anyone because of Lisa’s bedrest. I finished the day by preaching for the evening worship service.

Monday, April 5 – We found out from Laura that their doctors had some concerns and wanted a level 2 ultrasound. It turns out that there was some fluid in the abdomen of her baby. They set up an appointment at the University of Chicago for 8:30 Thursday morning – the exact same time as US! We were eager to see some familiar (or should I say “family”?) faces there.

Tuesday, April 6 – Lisa got a phone call to inform her that she didn’t pass her 3-hour glucose test either. She has gestational diabetes. =( We set another appointment Thursday morning to meet with a nurse about taking her blood sugar counts 4 times per day and how to manage her blood sugar through changing her diet. Hmm.

Today, April 8 – We saw Tim and Laura as soon as we arrived in the waiting area. They were filling out some paperwork and waiting to get the ultrasound. We were called in first, and Linda began the ultrasound/biophysical exam. The biophysical exam measured movement in each of the babies, pre-breathing, and a couple other things… I don’t remember the details, but I DO remember that each of our girls scored 8/8. I teased that they have a perfect 4.0 GPA. =) Both girls had good fluid levels, the MCA levels looked good, and we found out that A gain one ounce and B gained eight ounces. (More on that later). Lisa had her first non-stress test and those results looked good, too.

We went back out in the waiting area to check-in for the doctor, and we saw Tim and Laura out there. Sadly, Laura had very rough news to share with us. The counselor told them that there was fluid not only in the abdomen but also in the neck and other parts of the body. She said that it was likely cystic hygroma… there’s only a ten percent survival rate for that diagnosis. More discouraging was the fact that there were hydrops throughout the body – pockets of fluid just under the surface of the skin. There’s a virtually 100 percent mortality rate for this condition. The counselor also mentioned the possibility of Turner Syndrome. The pregnancy will continue until her baby is delivered for what will likely be a very short life outside the womb. We hugged Tim and Laura and tried to just be there for them as they shared this sad news. They – and we – would appreciate your prayers for them.

After we saw them off, we saw the doctor to discuss our results. He was very happy. He said that the discrepancy in growth this week isn’t anything to be concerned about. He said that the MCA levels look good enough that we should have at least 2-3 more weeks without any problems. We’re at 28 weeks, 4 days today, and he seemed very relieved about the likelihood of being able to see him next week at (nearly) 30 weeks. A couple months ago that number seemed impossible. Our doctors and nurses were very sympathetic, too, about what Tim and Laura are going through… they genuinely were concerned about how Lisa was doing, and they listened compassionately to the situation.

So our day ends with heavy hearts. We’re bringing Tim and Laura and Josiah before God in our prayers. We explained what was going on to our 3.5 year old son, Kruesie, and he suggested that we pray for them. So we did with him. Later, I told him that that’s the best thing we can do for them right now. We rejoice at our good report, too… but mainly we mourn with our extended family.

Thanks for praying with us.


Thursday, April 1, 2010

Another good day

We had another good day today.

We left the house about 7:30 this morning so that we could get to the University of Chicago by 9. Traffic wasn’t too bad, so we arrived there on time. The reason we arrived so early was so that Lisa could take her 3-hour glucose test. She didn’t pass (“flunked” =) as the doctor put it) the normal 1-hour test, so this was her makeup exam. This meant that she had to stop eating anything last night at midnight. She had blood drawn and took the sugary drink around 9:15. She then found out that she couldn’t drink any water for the next three hours. As you may imagine, this made us a little concerned – water was what stopped contractions, after all. We also wondered how Lisa’s body would survive going without food for 15 hours… no small feat for someone eating for three! Thankfully, all went well and we didn’t have any scares this morning through it all. =) A big answer to prayer.

We also had a good ultrasound. The twins’ numbers all looked good – their fluid levels are still up where they should be and so are the MCA numbers. They measured the girls again and they’ve grown quite a bit – little A is up to 1 pound and 12 ounces, and B is up to 2 pounds and 4 ounces; together, they weigh four pounds. Fun fact: both the girls' femurs (upper leg bone, the biggest bone in our bodies) measured just under 5 cm – which is just under 2 inches! It’s incredible to think that even at such a small size they are considered viable, that is, they could survive if they were born tonight. Unbelievable.

Last Sunday morning, we sung one of my favorite (newer) songs – In Christ Alone, by Townend and Getty. These are the words of the last verse:

No guilt in life, no fear in death
This is the power of Christ in me.
From life’s first cry to final breath
Jesus commands my destiny.
No power of hell, no scheme of man
Can ever pluck me from His hand
‘til He returns or calls me home
Here in the power of Christ I’ll stand.

Beautiful words, yet it struck me that it’s not quite accurate. “From life’s first cry to final breath Jesus commands my destiny.” It sounds good, right? But God’s care and lovingkindness begin even before life’s first breath – we’ve seen it time and time again throughout the pregnancy and again today. It’s the truth that the psalmist proclaims in Psalm 139:13 – that God knit us (and knits these girls!) together in their mother’s womb. We rejoice over that fact – and the good news we received – today.

Thanks for joining us on the journey – we wish you all a blessed, meaningful celebration of Jesus’ victory over sin and death this Easter weekend.