Monday, May 31, 2010

A Weekend to Remember

First, a shameless plug: have you been to one?  They’re incredible and well worth every dollar, hour, and effort you invest.

Second, it’s (as I write this) still Memorial Day.  Our women and men who have served our country deserve more recognition than we give them – and deserve to be remembered every time that we enjoy a freedom they protect(ed).  That’s all to say… thanks!!!

Third, this was a memorable weekend, so there are lots of things that we wanted to update with regard to the girls’ progress:

  • On Friday night, Bella and Gloriana were moved from the NICU to the TCU (transitional care unit).  This is the place where preemies are moved before they head home – thus the name “transitional.”  An added bonus is that these rooms are a bit more private, so they’re more accommodating for pumping… they also have the perk of a bathroom in each room.
  • When I visited on Saturday I was delighted to find that Bella was out of an isolette and into a crib!  Woo-hoo!  This is big progress, as she looks more and more like a full-term baby. =)
  • When we visited on Sunday we saw that Bella had had her feeding tube removed from her nose.  The nurses did this because she has been taking her feedings from a bottle so well that they didn’t need to feed her through the tube anymore.  Additionally, her little system has been working so well that they don’t need to check her tummy for leftover (residual) food from previous feedings.  This is – like being moved to the crib – one of those things that is more significant as an emotionally satisfying milestone than a mere medical milestone. =)
  • Gloriana continues to increase her continuous feeds – she is now fed 3.5 cc per hour on a continuous feed.  The plan is to eventually try her back on a bottle, but they don’t want to push her (very) little system too quickly – we don’t want it to be a matter of two steps forward and one step back.  So we’re patient.
  • And now for the BIG NEWS – the plan is for Belladia to COME HOME FRIDAY!  We are ecstatic to have our (and your) prayers answered that she’s healthy enough to be released from the hospital.  Because she is maintaining her body temperature, eating so well from a bottle (up to 40 cc per 3 hour feeding), and gaining weight (we believe she’s over 5 lbs now), the medical staff is confident that she’ll continue to do well under our care.
  • That news is rather bittersweet – it will still be a while before our little Gloriana will be able to come home.  The nurse practitioner today guessed that it could be another 3-4 weeks.  They want to make sure that she passes the same three tests that are mentioned in the above bullet.  On the one hand, we’re glad that the staff won’t send her home before she’s ready; yet on the other hand, it’s sad that we can’t take both girls home at the same time.  The nurse practitioner conceded that she "could be surprised" if Gloriana makes really fast, major progress, so that’s what we’re hoping and praying for.  Of course, our biggest prayer – as it has been all along – would be that everything would happen “in God’s perfect timing” (which, of course, was so beautifully seen in the delivery process!).

Overall, we’re extremely pleased with how well things are going.  We know that the excitement of bringing Belladia home at the end of this week will also come with new challenges – how to continue to visit Gloriana daily while caring for a newborn who’s not allowed on that floor anymore, adjusting from a family of four to a family of five (with the prospect of becoming a family of six in the near future), and continuing to figure out other logistics (like nursing, pumping, deciding where the best place is to live during this season, and continuing to care for our other two kids who are under 4 years old).

But those are all things that we’ll deal with when we get there.  For now, we rejoice with you over this good news.  And we continue on this journey that we’ll never forget.


Thursday, May 27, 2010

Good Kidney News

A few good things to share with you:
  1. Weight gain continues.  Both girls have put on (at least) a few ounces more than their original birth weight.  This is especially good news considering that babies typically lose about 10% of their birth weight in the first week or so.  Gloriana is up to 3 lbs 2 oz; Belladia is up to 4 lbs 13 oz.
  2. Clothing has been on Bella since Tuesday!  Since she’s been consistently off the Bili blanket, she’s been allowed to wear clothes.  I have to tell you, it makes her even more adorable than she was!  Gloriana still has the Bili blanket to deal with jaundice, so she’s still sporting only a diaper. =)
  3. Bella’s enlarged kidney does not have any blockage around it!  Fantastic news!  We found out the results of the kidney scan today, and the doctor said that it will most likely resolve itself.  (He also mentioned that – years ago – all the ultrasounds wouldn’t have been done, the enlarged kidney wouldn’t have been seen, and it would have gone back to normal size on its own.)  We are very relieved that there won’t be any procedure needed to fix her kidney.

Overall, things still continue to go really well.  On Tuesday I was sitting in the NICU and heard an alarm go off a few beds away from our girls.  It was a much louder, urgent sounding alarm than the typical ones, and about 10-12 nurses/doctors rushed to the baby, suiting up in gowns and masks as they came over.  The mom was visibly upset as she walked away from the area.  I offered – and she accepted – a hug.  I asked what had happened and she said that her baby hadn’t been doing very well.  After the doctor made his rounds, he met individually with the mom in the conference room.  The next day (yesterday morning) that baby’s bed was empty.  It reminded us that there aren’t any guarantees of wellness just because a baby has made it to the NICU… and it also reminded us how much God has blessed us in the first ten days of these girls’ lives. 

We – as always – appreciate your prayers.  Our whole family continues to feel SO sustained by God through this whole season.  God is good, all the time.


Monday, May 24, 2010

Quick Monday Update

Can you believe our girls are a week old?  We’re still just glowing about their safe arrival. =)

A few updates (including some things I should have shared earlier) –

1.     Lisa is back home.  She was discharged from the hospital on Friday, as planned.  She’s a bit sore – and I’m making sure that she’s getting plenty of rest.  We’re thankful she’s doing so well.
2.     Gloriana has had a bit of a setback in her feeding; I think she was up to 8 cc of milk/formula per feeding, but she was having quite a bit of residue.  “What’s that?”  Basically, the nurses check (by using a syringe connected to the stomach tube) how much food is in her stomach two hours after her feeding.  For some reason, she was having nearly the same amount of residue (food in her stomach) as what she was being fed, though it looked somewhat digested.  They cut her feeding down to 5 cc, and then again down to 2 cc.  It could be that her stomach is working a little slowly; they will keep an eye on it, and we’ll keep you updated.  We’re reassured that this is a normal setback for preemies – the nurse practitioner said it isn’t anything to be real concerned about; easy for her to say, right? ;)  She has also been having “Brady’s” (I’m sure it’s named after a doctor who named the condition) – basically, preemies tend to forget that they’re supposed to breathe, and their heartrates drop from 160 bpm down to 40-50 bpm.  It happened a couple times when I was holding Gloriana yesterday; the nurse had me pat her back a bit, and then her heartrate went back where it should.  The nurses are giving her a bit of caffeine in her IV to help her deal with the Brady’s; we were reassured that these are also a normal part of a preemie’s development.  Gloriana also continues to have a Billy blanket to help her deal with very minor jaundice.
3.     Belladia is doing really well.  She doesn’t have any oxygen hooked up to her anymore, which is GREAT news!  She is doing a fantastic job with feedings, and is up to 25 cc per feeding.  She was able to maintain her body temperature for about 4 hours when she was being held yesterday, so we’re very thankful for that, too.  She’s been having some Brady’s, too, so she has caffeine in her IV, just like her sister.  We haven’t heard anything with regard to her kidneys; we’ll let you know when we do.  She still have very minor jaundice and is on a Billy blanket as well.

Overall, things are going quite well.  We appreciate your prayers about Gloriana’s digestive system; her tummy working well will help her put on more weight and also help clear up the jaundice.  We really appreciate all your kind words (and hugs at church yesterday!) – what a joy this all has been!  It still doesn’t seem real sometimes when I think about all that God has done in these girls’ lives. =)  It’s incredible.


Thursday, May 20, 2010

Brief update and some pictures

I just wanted to let you all know about some of the questions you’ve been having, then I’ll post some pictures below.

Kidneys – it turns out both our girls have enlarged kidneys.  We were told that kidney enlargement is on a scale of level 1 to level 4; 1 is lowest and 4 is highest.  Gloriana’s kidneys are both level 1 and aren’t anything to be concerned about.  Belladia has one that is level 1 and her left (which we’ve tracked throughout the pregnancy) is a level 3.  The NICU doctor said that he wasn’t too concerned about it – they are going to test to see whether the urine from her bladder is backing up to that kidney and whether there is a blockage.  If there is some blockage, they would have to do a procedure to correct it.

Feeding – Bella took some breastmilk by the feeding tube around lunchtime, so we’ll have to see how that went for her.  UPDATE: She ended up taking some from a bottle, too – woo-hoo!  Gloriana took 3 cc of breastmilk by bottle (!) and took another 2 cc via feeding tube.  We’re impressed with both of their progress.

This is Gloriana with my hand in front of her.  She's in a preemie diaper and looks like she's swimming in it. =)  This is just a few hours after she was born...
This is Belladia just a few minutes after the above picture was taken.  You can see (just like you saw from the first picture of them) that she's noticeably bigger than her sister.
Lisa was able to hold Gloriana for the first time on Tuesday.  Beautiful girls, aren't they?
My parents visited Tuesday afternoon and held Gloriana for a while...
Here is our little glowworm Gloriana (that's Lisa's finger on the bottom right side of the picture to show how little this peanut is).
This is Belladia sporting her shades as she's under the spotlight to help her deal with some jaundice.  The c-pap that you see under her nose has since been removed.
There are Lisa and I, standing by Belladia's bed; you can see Gloriana's bed in the background.
Aunt Laura is holding Gloriana, who has her shades pulled up and is snoozing away.
This little doll that Aunt Laura brought will likely be used in future updates to show how much our girls are growing - the doll is next to Gloriana here...
...and next to Bella here.
Bella meets her Great Grandma and Great Grandpa Boss.  Notice her dark hair here!
Lisa feeds Gloriana from a bottle.
Lisa holding Belladia, who fell asleep on her chest.
Bella spent this afternoon sleeping on her tummy; the band is holding her shades in place.
Lisa is happy to be holding Gloriana here...
...and the feeling is mutual - does that count as a newborn smile? =)

One last story: lately, we had been praying before every meal (as we always do), but Kruesie has been participating a bit.  In very non-Reformed/Presbyterian fashion (wink, wink), he would jump in with a little prayer of his own.  For example, I might say, "Thank you for the food we're about to eat," and Kruesie would say, "And thank you for the babies."  At the time, they weren't yet born, but Lisa or I would affirm him, "Yes, we thank you for the babies, too."  It's so incredible now to see what we've been thanking God for and to share those images with you. =)

Wednesday, May 19, 2010

Little Miracles

First, THANKS!  We’ve been overwhelmed by your flood of comments/wall posts/messages in the last 36 hours.  This morning I read aloud everything that you all have written so that Lisa could hear all the encouraging things you were sending along – it’s been an incredible celebration!

Second, you want more pictures, right?  I wish that I had some to post, but they’re at the hospital and I’m not.  I left Lisa at the hospital this afternoon so I could sneak home and see the kiddos; we didn’t want them to think we had left them forever. =) I left the camera so that Lisa could take some more pictures and left the computer so that the kids could see her tonight via Skype.  And those were good ideas, except no more pics to post. =( Sorry.  Maybe the next couple updates will have more pictures than words.

Third, I need to explain the title.  In some sense, it’s pretty obvious – it’s what the majority of you have recognized these little girls to be: little miracles.  But there’s more to the story from Monday’s delivery that I haven’t yet shared… and it requires a bit of last week’s story, too.

Many of you know that we started out in Crown Point with our fantastic nurse midwife, Sheryl Behnke.  She was very helpful during the pregnancy with Daylia and coached Lisa through delivery.  We’ve raved to others about her before, and I’m doing it again right now. =)

But when we had the surgery in Cincinnati, we were told that we couldn’t have a nurse midwife; instead, we had to “move up to an MD,” according to the surgeon.  We went a step further and doctored with an MFM – an MD who specializes in maternal fetal medicine (“MFM”).  We had 10 or so weekly ultrasounds/meetings with him in the time between surgery and delivery.

In addition to those weekly ultrasounds, we were also instructed to have a non-stress test (NST) twice every week, beginning at 28 weeks.  Rather than make the long commute to the University of Chicago on Thursdays and Mondays, we merely went to the nurse midwife’s office in Crown Point on Mondays.

And that’s where we had a 9:00 a.m. appointment this past Monday.

We’re glad we didn’t go.  Let me explain.

Last Thursday (the 13th) we had our regular NST, ultrasound, and doctor appointment in Chicago.  Since we knew that we would likely be checked into the hospital the following Thursday (the 20th), I asked if we should just come to Chicago for our Monday appointment – I figured it would be worth the drive since we were getting closer to the due date and it would be the only time that we’d have to drive to Chicago twice in one week for appointments.  The advantage to coming to Chicago meant having a higher level of care and being onsite in case we needed to deliver – we’ve heard that high risk babies who are delivered at the hospital where they will stay (as opposed to being airlifted after delivery) do statistically-significantly better than those who are transferred.  Dr. Ismail agreed to have us come to Chicago on Monday, then discussed the possibility of giving Lisa a second set of steroid shots.  He finally decided that he would give the first one Monday (the 17th) and the second on the next day.  He wanted to keep Lisa overnight after the first one to monitor her blood sugar, because it could spike (because of her gestational diabetes) and cause Lisa to go into labor.  He even talked about doing the set of shots last Thursday/Friday.  We’re thankful he didn’t on those days, because had he done so (and had there been a spike in her blood sugar and ensuing labor) her water could have broken and the vasa previa could have torn, immediately causing the babies to bleed to death.  A big little miracle.

Between this past Friday and Monday, quite a few things happened.  Lisa prepared for two weeks in the hospital and (we can’t lie about it) she probably overdid it.  Making preparations for the hospital stay, maternal nesting (it would be the last time at home before the babies were born), and spending more time with (and taking more care of) the kids were a perfect storm for overdoing it.  We’re thankful that overdoing it didn’t cause her to go into labor, which could have caused the vasa previa to tear and would have immediately caused the babies to bleed to death.  Another big little miracle.

Also between this past Friday and Monday, quite a few phone calls were made.  We were unsure about the wisdom of a second set of steroid shots – call it parental instinct.  We called contacts in Cincinnati (thanks, Dr. Paul!), contacts in Crown Point (thanks, Sheryl!), and anyone else we could think of for advice (thanks, everyone else!) and concluded that we’d be willing to exercise our patient’s option to not have the second set of steroids – lungs are pretty well developed by 34 weeks and there seemed to be little benefit (perhaps even a little harm could be done) with having shots after 34 weeks.  Thankfully, our doctor didn’t push the issue and the residents at the hospital didn’t either – had they done so, we could lost both babies due to a torn vasa previa.

The vasa previa ended up being very severe – I’m not sure how many of you would want to see pictures (our doctor – who is also a professor – made sure I took pictures just to document the severity of it), but let me attempt to describe it: there were two vessels growing into the amniotic sac on A’s (Gloriana’s) side of the placenta, and each one was thicker than a pencil in diameter.  There was another (that hadn’t been seen on ultrasounds) vessel on B’s (Belladia’s) side of the placenta that was just a bit thinner than a pencil in diameter.  Each of those three vessels were about three inches in length.  I can’t remember whether I mentioned this in yesterday’s post, but our doctor told us that if one of the vessels tore, it would only take about two tablespoons of blood loss in each twin for them to lose half of their bodies’ blood volume.  As I said, had Lisa gone into labor, both twins could have bled to death immediately.  A HUGE miracle.

But there’s more.  When we were initially checked into the hospital, we had the attitude of wanting to prolong the pregnancy as much as possible.  I think it was so engrained in our minds that “every week counts, every day counts” that we really believed it.  Plus, Lisa wasn’t showing any signs of labor (not many (any?) contractions), so we figured, “What are the odds that her water would break without showing signs of labor?”  But we thought more about it… and one little interjection may have made a doubly vital difference.  At about 8 p.m., our doctor seemed pretty comfortable about coming back in the morning to perform the c-section.  I used a phrase that he used often in the past few weeks with regard to prolonging the pregnancy; often, he would say, “You could convince me to wait until 36 weeks before delivering the babies.”  I said, “You could convince us to have the surgery tonight if that’s an option.”  “Okay,” he said, “we’ll have the surgery in an hour, I’ll tell the anesthesiologist.” 

What difference could 12 hours have made?  It may have been the difference between life and death for our girls.  In the middle of the surgery, our doctor said, “Lisa, it’s very good that we decided to have the surgery tonight – there’s some blood in the amniotic fluid, which indicates the beginning of placental abruption.”  A quick webMD search shows that a placental abruption is the breaking away of the placenta from the wall of the uterus, and it causes – you guessed it – premature birth.  The blood in the amniotic fluid indicated it could have been very little time – perhaps the hours when Lisa would have sleeping and waiting for the c-section in the morning – just a very little time until the onset of labor and ensuing breaking of her water.  You know what the result would have been; we’d be on the very opposite end of the emotional spectrum right now.  A shake-your-head-in-wonder-and-amazement-of-our-great-God miracle.

Now you know why I ended up sleeping twelve hours on Tuesday night. =) All that emotion and stress and elation adds up.

So, how are these miracles doing now?  Really well.  Bella (baby B – B is for Bella) continues to have a very small amount of oxygen given to her, along with the standard feeding tube, vitals monitors, and IV.  She had an IV into her umbilical cord to start, but now that’s been taken out – that means that we can finally hold her! =) She spent today and yesterday under a spotlight to deal with a little bit of jaundice, which is very normal for preemies.  She’s been sucking on a pacifier, which is a good developmental sign.  She had a bit of Mom’s milk and formula put into her feeding tube for nourishment, but she wasn’t a big fan of the bottle today.  They’ll likely try again tomorrow and may even try a bit of nursing, too.

Glori (or it is “Glory” – hmm, y or an i for the abbreviation?) is a little fireball.  She is still holding her own without any help with oxygen.  She began sucking on a pacifier soon after birth; again, very good news.  They’re deciding still how soon it will be until she tries to nurse.  She’s wearing a blanket to help deal with slight jaundice and looks remarkably like a glowworm – remember those? =) She’s been held quite a bit since yesterday afternoon, and that’s a huge blessing from such a little girl.

Some of you asked about the VSD in Gloriana… it turns our that both girls have a small hole in each of their hearts.  I understand that Gloriana’s is a little bit bigger than Belladia’s, but it sounds like no immediate action is needed; they’ll likely keep an eye on them and see whether surgery is necessary in 3-6 months.  Surgery wouldn’t be a big deal, as it’s rather routine.

The ultrasound of the kidneys (renal ultrasound) was scheduled for later this afternoon, and it will probably be read in the next day or so.  In the meantime, we know that both girls are having wet diapers, so the kidneys (if nothing else) are functioning quite well. =)

How about Lisa?  She’s incredible.  Sometimes guys talk about marrying out of their league, but it’s not an exaggeration for me.  Seriously.  I couldn’t be more proud of her.

Yesterday morning she felt very ill – we figure that the medicine from the c-section affected her quite adversely.  And understandably so – Lisa doesn’t ever take Tylenol at home, and even caffeine makes her a little shaky.  Imagine, then, what happens when you put the strong narcotics of an epidural and the post-surgery morphine into her system.  Of course, she wanted to go see the girls first thing yesterday morning, but the room was spinning so much that she couldn’t get on her feet.  Poor thing.  But she got back to her regular self yesterday afternoon and doted on the girls the rest of the afternoon. =)  (Yes, she “dotes, devoutly dotes,” to quote Shakespeare.)  My parents joined her in that yesterday afternoon, with my sister and grandparents doing so today.  Despite a bit of soreness, Lisa is doing quite well – needless to say, the kids LOVED seeing her on Skype tonight.

As you can tell, we’re cherishing it all.  The plan is for me to rejoin Lisa in the hospital tomorrow, and then I’ll take Lisa home on Friday.  We’ll likely take Lisa’s parents to see the girls on Saturday and figure out a plan to see these girls as often as we can.  As I mentioned earlier, we’re on the extreme end of the emotional spectrum – as our little one’s name implies, God’s glorious grace brings joy.  Thanks for reading (and praying and perpetually smiling and passing on the amazing news) and rejoicing with us.  The over 2000 words in this post just scratch the surface of how great our God is.  Miraculous, isn’t it?

Tuesday, May 18, 2010

Beautiful Healthy Girls

They’re here!!!

Here’s the short version (with the long version below) – we have two healthy, beautiful girls!  Baby B was born first – at 9:50 last night.  Baby A was delivered at 9:51.  You’re wondering about names and sizes, right?  B is named Belladia (“bella-dia”) Faith, which means beautiful day of faith.  She weighs 4 lbs, 11 oz and measured 18.5” long.  Little A is named Gloriana Joy, a reminder how God’s glorious grace brings joy.  She’s a little peanut, weighing 2 lbs, 15 oz and measured 15.75” long.  Both cried the moment they were delivered – the best sound in the world.  They are both doing quite well in the neonatal intensive care unit (NICU) – neither need ventilators or incubators, and we give praise to God for that!

What happened yesterday? (This is the long version of the story.)

We had our Monday afternoon appointment in Chicago rather than Crown Point yesterday.  Both girls looked good on the NST and scored perfectly on the BPP.  Part of the ultrasound included checking (what had been) a vasa previa that was first detected in Cincinnati while we were there for the surgery.  On the ultrasound, they found that the vasa previa was still there and was very prominent.  At first we thought that this simply meant that a vessel was across the cervix and that Lisa would be unable to deliver naturally.

But then we found out that it’s much more serious than that.  A vessel had grown out of the umbilical cord and had grown into the amniotic sac.  The resulting risk is that if her water (amniotic sac) were to break on its own, the vessel growing into the sac could tear.  Since this vessel is connected to the babies – it’s their vessel, not Lisa’s – a torn vessel would mean one (or both) of the babies could immediately bleed to death.  It was much more serious.

After getting checked into the hospital, we saw a steady stream of residents, doctors, senior residents, anesthesiologists, and nurses.  The more we thought about the seriousness of the situation, the more it made sense to get the babies out sooner rather than later.  The risk of death wasn’t worth the reward of a few more days of growth in the womb.  At 8:00 they scheduled a 9:00 c-section.  A flurry of activity followed.

Lisa was wheeled over to surgery while I put on scrubs, a hairnet, a mask, and booties.  I then held Lisa’s hand for a while as they worked on the delivery.  Hearing Belladia cry as she was born was incredible.  We were surprised at how BIG she looked, too!  Thankfully, I was able to take pictures of everything that was happening – to follow in a future update. =)

The c-section continued and baby Gloriana was delivered moments later.  She is little, but both girls are absolutely gorgeous.  I get tears in my eyes just thinking about them.  Incredibly our little Gloriana scored a 9/10 on the Apgar test, while Belladia scored an 8/10 – both scores are very good, as a 10/10 is nearly impossible to achieve.

While Lisa was in recovery (and snoozing) from 11 p.m. – 1 a.m., I snuck over to check out the girls in the NICU.  They each have a very small feeding tube inserted through their mouths so that they can maintain (and gain) weight.  They also each have an IV line to get preventative antibiotics into their systems.  Belladia had just a little help with oxygen, but she seemed to be doing quite well.

This morning they were both having an echocardiogram to check on the health of their hearts – we hope to find out by this afternoon whether Gloriana’s hole in the heart (VSD) has healed.  They will also both have ultrasounds on their kidneys – Belladia has had an enlarged one throughout the pregnancy, but they wanted to check out both sets of kidneys.

As of a few minutes ago, the estimated arrival time home is their due date: June 27.  I guess we’ll be hopeful that it will be sooner than that.

THANK YOU so much for all your prayers and concerns.  Before I kissed each of our girls goodnight last night, I told them that they were little miracles, that so many people have been praying for them, and that I was delighted to finally meet them.  They are precious… God is good, all the time. =)

Thursday, May 13, 2010

Exciting News

Another set of good reports today and quite a bit of clarification, too.

First, the good reports.  The girls continue to look good, as they both scored perfectly on their BPPs.  We also had another measurement of growth today for the twins.  Some of you may wonder how they measure growth for unborn babies – others know because you heard me explain it one evening in church a few weeks ago =).  Basically, the ultrasound tech measures some body parts, and then those measurement numbers are put into a formula that estimates how far along (gestational age) the babies are.  Then the babies’ weights are estimated based on how much the average baby weighs at that particular gestational age.

Because estimates are involved, there’s some leeway in terms of accuracy; some of you may have been told you were having 9 pound babies based on the measurements, but then it turned out to be a 7 pound baby.  Long, skinny babies weigh less than estimated; short, chunky babies weigh more than estimated.

After that explanation, you might be wondering how our babies measured today.  Two weeks ago, baby A weighed 2 lbs, 7 oz, and baby B weighed 3 lbs, 12 oz.  Today, baby A is up to 2 lbs, 13 oz (a 6 oz gain) and baby B is up to 4 lbs, 12 oz (a 16 oz (1 lb) gain).  We’re glad they’re both growing and are a little disappointed that A has fallen farther behind – she weighs nearly 2 lbs less than B.

Second, we found out some clarification.  Last week we were told that the babies with TTTS are often delivered between 34 and 35 weeks.  We didn’t really find out why, so we (as many of YOU) have been wondering what the reasoning is behind that.  It turns out that babies that are 34-35 weeks along have a virtually 100% survival rate.  After 35 weeks, twins have about a 5% chance of developing complications; twins who have been through what ours have (surgery, bed rest, gestational diabetes) have higher rates of complications.  You might wonder, “Why aren’t ALL babies delivered between 34 and 35 weeks then?”  Dr. Ismail has been asked that, and he told us his answer: “In normal pregnancies, intervention isn’t needed because your body naturally delivers when it’s time; in complicated situations, it’s better to intervene when the babies are still healthy.”  Makes sense to us; especially after all they’ve been through already, we’d hate for anything to go wrong at this point.

Another detail: another set of steroid shots.  Yes, Lisa received those about 8 weeks ago, but they said that she should get another pair of shots.  Because Lisa has gestational diabetes (and because steroids can cause spikes in blood sugar), they wanted to keep Lisa overnight to monitor her.  On further thought, they decided it would be best to keep her in the hospital from when she has her steroid shot until when the babies are delivered.  So…

What does this mean practically?  It means that Lisa will go up to Chicago (rather than Crown Point) on Monday for the NST and BPP.  She’ll also receive a steroid shot, and then she will be closely watched – “closely,” as in, “checked into the hospital and monitored.”  We imagine that the girls will then be kept on the monitors continuously in order to make sure that they (along with Lisa) are doing well.  While we’re unsure of a specific delivery date, she would likely deliver within two weeks or so of when she enters the hospital.  We’re still working on details with regard to where the kids will stay, where I (Jeff) will be, how often our family will visit Lisa, and when (if given the option) we’ll schedule the delivery of the babies.

Lots to pray for. =)  We’re thankful for good news that the girls are growing.  We’re praying that A will miraculously catch up – or at least hit a major growth spurt so that she’s not so little. =)  We’re glad that we have clear direction in terms of what will happen next, and we ask for prayers for wisdom as we discern the details.  We pray that the kids will understand a bit of what’s going on so that it’s not too hard for them to be apart from Mommy for a while.  And we pray that Mommy will be able to survive without seeing the kids very often. =)

We’re getting there.  Thanks for being there beside us.  We'll keep you updated.  God is good, all the time. 

Thursday, May 6, 2010

Still looking good

An update about my sister before we let you know how today’s appointment went (although the title gives it away!) – on Monday, Laura was induced at Northshore Hospital in Evanston, IL.  Thankfully, this time it went much more smoothly – we think that because of the doctor’s willingness to give more medication, the induction went as it should.  Laura gave birth to Virginia Rae at 9:13 p.m., and she weighed 8 ounces and measured 6 inches.  I had the chance to see Tim and Laura that night and saw how relieved they were to hold their little baby in their arms.  I was able to hold her, too, and so were my mom and grandparents.  We rejoice at the answer to prayer that they would be able to hold her and continue in their grieving process.  Tomorrow we’ll have a private burial service with the family, then there will be a visitation from 5-7, with a short memorial service to follow.  I’ll be there on behalf of my immediate family – under doctor’s orders, Lisa is staying home on bed rest.

As far as an update for Lisa, things are “still looking good.”  Between the NST and BPP, each twin scored a 10 out of 10!  That simply means that they’re both still doing well.  We didn’t get growth measurements today – we have to wait until next week for that.  When we met with Dr. Ismail we asked about a birth plan.  We learned a few things:

·      If Lisa were to go into labor tonight, we would go to the University of Chicago.  The doctors would do everything they could to stop labor.  It’s still a little too early to deliver these girls.
·      If Lisa were to go into labor after 34 weeks (a week from Sunday, May 16), we would travel up to Chicago.  The doctors would assist in the delivery.  (Dr. Ismail said they would “leave us alone,” but when I pressed him on that, he said that he meant that they wouldn’t stop the labor.)  =)
·      We tried to confirm that 36 weeks and 6 days was still our goal.  He told us that he had just attended a conference about TTTS and was told that the optimal time to deliver is between 34 and 35 weeks.  We were really surprised at this, especially since that’s only 10-17 days from now.  He said that after that point the babies are just “putting on fat.”  Although that may be the case, we’d rather have 5 or 6 pound babies than 3 or 4 pound babies… so we asked if we’d still be able to aim for 36 weeks and 6 days.  “If you want to go beyond 34 or 35, you will have to be under my eyes,” Dr. Ismail told us.  That means being monitored in the hospital.  We’re mulling that over, and we’re planning on having “a big talk” with Dr. Ismail two weeks from today.  Please pray for wisdom for us as we juggle multiple factors: medical advice, patient options, how our nearly-2-year-old and nearly-4-year-old would handle being away from mom, how delivering early would affect already small babies, and how to (ideally) avoid a c-section.

Overall, we’re really thankful.  Thankful that Tim and Laura could hold their baby and mourn.  Thankful that our girls continue to do well.  Thankful – with the rest of the medical staff – that we can say, “It’s been another week… 32 weeks and 4 days now, wow!”  Thankful that you’re there alongside us.  Thanks.