April 2009
My son was 15 months old and we decided to start trying for another baby....well... I had my IUD removed in March because we were talking about getting pregnant again... I didn't realize that I would get pregnant so soon. I found out I was pregnant in the middle of April. My first appointment with my doctor was just a sit down appointment where she asked me questions about my medical history, etc. During the appointment she asked about history of twins and I don't know if that is what got me thinking about twins or what, because my sisters are fraternal twins. I kept thinking "I'm probably having twins" but then thought "that's stupid, you're not having twins" right after. Well, at my next appointment, the doctor did an ultrasound. I was only about 9 weeks pregnant, so she did the trans vaginal ultrasound. The first thing she said was "Guess how many are in there..." I couldn't believe that my suspicions were correct. I thought, "no way, I AM having twins!" Thinking they would be fraternal, like my sisters, b/c that is what runs in families.... The next thing the doctor said was that she didn't see a membrane so she would be sending me to an ultrasound technician to have a complete ultrasound done. She said, "this may be a type of twin pregnancy called 'monoamniotic monochorionic' which is high risk." I asked what that meant. She said "we will cross that bridge IF we come to it.... don't go look it up on the Internet when you get home" WHY DO THEY ALWAYS SAY THAT?! OF COURSE I looked it up and thought for sure my babies were going to die they minute I saw 50% chance of survival....
May 2009
At my complete ultrasound, the ultrasound technician wouldn't give me details but he did say he saw two yolk sacs... but he also said he couldn't find a dividing membrane. When I read more stuff on the Internet, I think on the monoamniotic.org site, it said something about if there are two yolk sacs, there will also be two amniotic sacs... so I felt relieved, I thought, for sure there must be a dividing membrane, they just aren't seeing it. Well, no, the ultrasound tech was either wrong or it just didn't work out like that for us, because there was only one amniotic sac. The doctor told us that the ultrasound did not show a membrane and that they would need to be monitored closely and that I would go inpatient at 24-26 weeks to be monitored.
June-September 2009
In the middle of all of this, my husband decided to go back to his old job. That meant changing insurance companies. I got back to my insurance through my work and had to change doctors. I knew what doctor I wanted to go to, he was a perinatologist who was highly recommended. Of course the people at his office didn't know what momo twins were b/c they are so rare. I called to make an appointment and explained the situation to the office workers. They said "twins, no big deal" basically. When I finally had my appointment with him, the nurse practitioner came in instead of the doctor. She did my appointment and when I brought up the plan about going inpatient and weekly ultrasounds and everything, she looked like she had no idea what I was talking about. She said "no, we don't need to do all that... it's just twins...." I said "No, it is monoamniotic twins, they are in the same sac and they can get asphyxiated by their cords." She then decided to go ask the doctor, probably thinking I was some over worrying pregnant mom. But when she came back, she must have realized that she didn't know everything. She said "Oh, yes, I spoke with the doctor and you are right." Finally, I met the doctor. He was great, he had just delivered another set of monoamniotic twins a few months before (apparently they were not actually his patient, but he was on call when she delivered) He actually knew what monoamniotic twins were and that they were very rare and needed monitoring and early delivery. I went inpatient on September 19, 2009, thinking I would be inpatient for up to 6 weeks, not knowing I would deliver my babies in just 8 days.
September 27, 2009
My mom and my sisters were taking my nieces and nephews to Disneyland to celebrate their birthdays (my mom's bday and nephew's bday) The night before I thought "these twins are going to want to come tomorrow..." just b/c everyone was actually doing something and I wouldn't have visitors to the hospital that day. And, of course, during my morning NST, baby A started to have decelerations. She would recover but then her heart rate would go back down again. My nurse said "your doctor just called... he said don't eat breakfast, he's going to come in..." I burst into tears, I knew it was time, and I knew it was still too early. The girls were 28 weeks and 1 day gestation. I called my mom and my husband. They were planning on meeting my mom and sisters at Disneyland. My sister-in-law had already left to take my son to Disneyland, so my husband was able to come to the hospital without him. Everyone came to meet me at the hospital and that is when my doctor showed up too. He had been watching my NST from his computer at home. He saw the decelerations and called the nurse, that is how cool my doctor was! So I was prepped for C-section and my babies were born at 12:00 noon (both of them had the same time on their birth certificates, they were seconds apart). Their cords were knotted together twice and were wrapped around Baby A's neck twice. Both of my daughters were intubated after birth b/c they were having apnea.
NICU experience
28 weeks is a pretty good time, the chances of survival go up to about 80%. I felt pretty helpless though, all I could do for my babies at this point was pump my milk! Baby A was the one having decelerations. On the first day, I was more worried about her. Day 1 was the honeymoon phase... On day 2, Baby B started to have problems. She first developed a pneumothorax. They had to put in a chest tube. Then a few hours later, her other lung also developed a pneumothorax and she needed another chest tube. Her oxygen saturations continued to drop and she needed to be put on the oscillator ventilator and nitric oxide. She developed pulmonary hypertension and pulmonary interstitial emphysema. The doctor said her lungs looked really bad for a two day old preemie. After the nitric oxide was started, she did start to improve. After a few days she was switched back to the conventional ventilator and then extubated to room air! But then she had to have a PDA ligation because her kidney function was not good enough to give her indocin for her PDA (like her sister got). (Even since then, there have been studies that Indocin and neoprofin for PDA closures are causing Necrotizing enterocolitis so that is not always the treatment of choice today). Both of the girls were off and on Bubble CPAP for weeks. Then it was just working on feeds. There were a few scares that they weren't tolerating their feeds, they got worked up for sepsis a couple times. The NICU experience is kind of a blur now....even though I am now a NICU nurse, I forget a lot of their experience until something similar happens in my job.
December 2009
After 11 weeks in the NICU, my daughters came home about a week before their actual due date. We were very lucky that there were no major issues (aside from Baby B's first few days of life) Baby B has some lung issues and paralyzed left vocal cord from the PDA ligation. She sounds raspy and can make a good "wookie" sound when she is whining. They are crazy, wild 2 1/4 year olds now!
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