31 Ultrasounds Later...

 

    I have always loved babies, and so I was thrilled when, after 6 years together, my husband agreed we were ready to have one of our own!
    

    After a fairly uneventful pregnancy, and a fast but fantastic water birth, we were blessed with a beautiful boy – Hudson.  A delicious, fun-loving, bright, adventurous child - and thus a good advertisement to sell hubby on the idea of having more! I promptly started to hint that another child would complete our family.

   As we also had a 13 year old daughter from my previous relationship, a new baby would make 3, so it would be a bit of an adjustment…but we wanted Hudson to grow up with a sibling close to his age…and hopefully a daughter so Adam would have a son and daughter of his own.

    Not one to leave things to chance, I followed my cycle with a vengeance. I ate all the stuff to “make a girl”, we took all our zinc and folate and everything else that was recommended…..then New Years Eve…a few drinks and a fun night out and…Success! A positive test 8 days after ovulation! We could hardly believe it.

    I was soon tired and nauseous, but we were thrilled and excited. After a nasty bout of the flu at 10 weeks, I dropped in to see my Ob before my first scheduled appointment – just to check all was ok.
    “Let’s just listen to the heartbeat and check there is only one” he joked. I laughed absently.
   As I lay on the bed looking at the blob on the screen, I couldn’t understand why the Dr was giving me the peace sign with his fingers.
   “There’s 2.” he repeated.
    “What?” I was confused.
    “2 babies.”

    Well that moment changed our lives forever!
 

   10 week scan
   
      As I lay there gob-smacked and freaking out, the Dr went on to tell me that the babies were Monoamniotic/Monochorionic identical twins, due to the egg splitting 8-13 days after fertilization. So I had known I was pregnant before they even became twins! Splitting just one day later could have meant conjoined/siamese twins. He continued explaining they have no dividing membrane – they share the same amniotic fluid – and are given a 50-70% chance of surviving the cord entanglement they create by twisting and turning around one another. Only 1% of all identical twins are MoMo. As they grow, it gets more and more dangerous, as the larger the baby the less room there is, and thus they can actually compress each others cords and cut off the vital supply of blood and nutrients from the umbilical cord. They also have a much higher rate of defects and anomalies. Thus we would have all the risks of a normal twin pregnancy… and much much more.

     The Ob declared I should probably not tell anyone I was pregnant and wait for nature to take its course - a likely miscarriage. Needless to say I decided he was not the right Dr for me. 

    On shaky legs I left the clinic and phoned my husband – his first day at a new job. A memorable day for sure! We weren’t sure if we should rejoice or cry. We did a bit of both.

    We started seeing a maternal fetal specialist, with fortnightly ultrasounds. There were so many decisions to make - how much monitoring, when to deliver, when to start steroids for their lungs etc.. There is so little research on these twins - they are so rare, making studies hard to conduct. Through the one support group in the world (www.monoamniotic.org) we learnt of the most successful treatment plan – and we fought for it every step of the way. Our new specialist agreed to allow us to be part of the decision-making process. She was wonderful, compassionate and positive; a pioneer in her field and world-renowned. In a tragic twist of events, she took her own life when I was 19 weeks pregnant. We were saddened and bewildered. 

    Assigned a new specialist, we fought all the battles again, and a plan was roughly laid out: weekly scans from 24 weeks, then by 28 weeks to be inpatient at the hospital to be monitored daily. Then if all went well we would deliver by c-section at 32 weeks (a vaginal delivery was out of the question due to the danger created by the cord entanglement, as well as the risk of cord prolapse). We were given the option of termination due to the stressful nature of the pregnancy, and the uncertain outcome and risks…but we had already fallen in love with our little blobs!

    When MoMo’s survive they are known to be the closest twins of all as they have been in physical contact since conception, they have been seen holding hands and sleeping forehead to forehead in the womb…. and then similarly once born. Some of the ultrasound pics are amazing. 2 little bodies wrapped around one another in a tight cuddle……2 faces looking eye to eye at one another…..we couldn’t wait to see our girls share this bond. Through our 31 ultrasounds we were indeed witness to much cuddling and spooning - and some kicking and poking! 

    The weeks slowly passes – my concerns allayed with frequent MFM appointments, and a home hand- held Doppler for reassurance.

    At 28 weeks I became a resident on the maternity wing. I cried for days – missing my children, my husband and my home. Frightened for my babies and daunted at what lay ahead. My poor husband had the task of running the household, cooking, cleaning, working full-time, taking kids to school and day care etc etc .…as well as making sure he visited me every day without fail! He was a true hero – my rock. My wonderful mother brought Hudson in twice a week to spend time with me, and my daughter Xani often came after school and sat on my bed and kept me company.

Hudson admires Mummy’s baby belly

    We were told not to set up a nursery as it would make it too hard if we lost one or both the twins, so I spent time pouring over catalogues wondering what if anything I might need. We discussed what car to buy to accommodate our large family…and we discussed whether we would get the same car if only one baby survived. We discussed whether we would want to try for another baby if they both died. We could hardly believe the things we were discussing…..
  
   I had CTG’s 3 times a day to check their heartbeats, an ultrasound every 2nd day to monitor the cord entanglement (which was evident from 12 weeks), and steroid injections weekly to prepare their tiny lungs for their early arrival. 

    Finally my 5 week stay in hospital was coming to an end - we had reached 32 weeks with few scares, only to be told the NICU was full and we would have to wait another day. After a sleepless night, we awoke to again be told all of Brisbane was full, and we would be flown elsewhere – to just await the announcement.

    As we ate breakfast suddenly midwives arrived with a gown and the news 2 beds were now free and we were to deliver our babies immediately.

    I was terrified, so the lack of time to ponder what was about to happen was probably just what I needed; as well as some expert hand-holding and brow-stroking from Adam. I had previously had 2 natural drug-free, full term births – so this preemie, high-risk c-section was daunting to say the least!

    In no time at all our 2 tiny girls were born within minutes of each other – the girls screamed as they entered the world, and continued to breathe on their own! Harper 1.9kg and Cleo 1.5kg – tiny but perfect. They got an 8 and a 9 on their apgar scores. They never needed oxygen, or any meds at all. They were even brought straight to us (after a quick once over) for a cuddle….I cried and cried as I never expected to see their little faces before they were covered in tubes, and put in humidicribs. I really had never let myself believe they would make it…. It was an incredible moment!

Cuddles a few minutes old – what an emotional moment!

    As the cords were examined a shocked silence fell over the room. The girls had survived horrific entanglement, with a true knot at one point. We delivered them just in time…..they were truly our miracle MoMo’s.
 

 The cords.....true knots at the top – twisted and tangled all the way – breathtaking..

    They were in NICU overnight, then much to everyone’s amazement moved straight to Special Care. They had gastro tubes for feeding…but breastfed from 33 weeks once a day…by 34 weeks it was twice a day…  I pumped hourly to increase my milk supply….day and night. Let-down was so hard to achieve without my babies…often I wondered if I had even had babies as I rarely held them, there was no nursery for them  and I hardly fed them. But we were lucky - we saw many other families facing much harder journeys in the nursery.  Still, the Special Care experience can hardly be described…it is an exhausting rollercoaster ride, of guilt and worry. But for us it was a strange relief to see them in the crib with their monitors and tubes! This to us was the best possible outcome of a treacherous pregnancy.    

        

First twin kangaroo cuddle – lucky Daddy!      

    After only 30 days in hospital, Cleo and Harper came home and have never looked back.

    After 2 previous singleton, natural, yoga-filled, water-birthed pregnancies and babies, this fully monitored, medically overdosed, terrifyingly uncertain pregnancy with a caesarean and long term hospital stay, plus NICU and SCN for our premmie babies….sure was a test on our marriage, our strength , our positivity, our emotions, and our ability to look beyond and into the future.

We made it and will be forever grateful we were lucky enough to be blessed with our miracle twins.                                                     

 They even shared a pram as they were small enough to lie in it together...

                               

    Today: our “Twirlies” as they are affectionately known, are now nearly 5. They are like chalk and cheese and yet they are alike in so many ways. They giggle and play all day long...and we struggle to get them to stop chattering in bed each night. The early years were so hard – with 3 under 3, and a teen as well, and all the feeding and sleepless nights exhausting! But now having 2 is even easier than one as they do everything together and are the best of friends!

   Growing up so fast.....

Miracles in the UK

There I lay with a 6 month beautiful bundle of joy and my husband said "I would like another" I smile and say, "in another 5 years", he looks back "I think I will be too old in 5 years. I want to see my children grow up. Look how close Riley and Tia are." (Grandchildren of a friend that are 15 months between each other) I look at him and say "yes, that would be lovely, they would be so close they would be like twins." (Famous last words)

Only the month after I take a pregnancy test which was positive, we were excited. 6 weeks into the pregnancy I started experiencing severe cramping, the doctors sent me for scan as they thought the pregnancy may be eptopic. We went into the scan and they were looking and my husband says "I bet its twins". I hit him and say "don't be so silly", the sonographer laughed and said "do twins run in your....oh!" Both me and my hubby looked scared at her "what's wrong?" we asked. She looks up, "I need a second opinion. I think I can see two fetal poles". "TWINS?!?!" I gasped and we were sent outside for 45 minutes. I remember thinking "I'm only 20, how am I going to cope with twins and a daughter under 2?"

45 minutes later we were called in and they said after looking over the pictures determined there were two fetal poles. My husband says "so we are having twins?" The sonographer looked back and said, "yes, Mr. Reynolds you are having twins. You need to come back in two weeks to be monitored". We agreed and left. Two weeks later in the same spot feeling just as nervous as before we were called in, they looked over and stopped. They told us there was a possibility that the twins were coinjoined and that I would have to come back in 2 weeks for a definite answer.

I left feeling numb I didn't know what quite to say or think. I dodged the subject with my husband till the next scan at 10 weeks. Again same position than before watching the clock tick over more anxious than either of the times before, again we were called in and at the end of the scan she said "Good news, they are definitely not conjoined but I want you to go for a scan in two weeks with a specialist as I can't seem to find a membrane". We sighed with relief but without realising what she had just said was bad.

I got home and curiosity got the better of me and I googled it, after reading all the horror stories. I sat there and cried. My husband sat beside me and asked what was wrong. I showed him and he said there may still be a membrane and not to worry. Having a daughter of 7 months gave me something else to concentrate on between being sick with morning sickness and feeling so tired of course. 12 weeks I sat in the same spot completely overwhelmed again she scanned them over and she looked at me again. "Urm, I'm going to clean you off and I think you should come and sit down." She cleaned my stomach, I rearranged my clothing and she looked at me and said, "I can confirm you are carrying Monochorionic Monoamniotic twins, they are extremly rare and in the UK have less than 50% survival rate. They are in the same amniotic sac and can easily tangle in each others cords which will result in fetal death, they can cut each others blood supply which will result in fetal death and also TTTS which can be handled but isn't 100% that it works. The negatives out weigh the positives and I suggest you get a termination."

On the way home we drove in silence as we parked outside our home in Broadfield, West Sussex (UK) my partner held my hand and said "I will support whatever decision you make." I sarcasticly smiled and got out the car. That night I tried to speak to a few close friends about it, neither knew what to say and told me to do what I thought was best. It was not much help at all. I then, I don't know why, searched in the tool bar MoMo twins and found the facebook group called MoMo Twins: Pregnancy, Birth and More. I spent 2 1/2 hours reading everybodies stories and it gave me a glimmer of hope. I turned to my husband and said, "Who am I to play God with two people's lives? I am not God and don't wish to be so. I am going to let nature take its course... If we come out with two, awesome, with one, so be it, and none, at least we would had tried. I can't give up on them." The next day I received my first consultants appointment at the local hospital where the consultant suggested that I go to 36 weeks and have them naturally and only have a section if there's trouble." I left feeling confused as she said the opposite of the specialist I saw, that night I lay in bed thinking about things. The next morning I decided to call East Surrey hospital (45 mins away) where I saw the specialist and asked for all my appointments there and with a more experienced specialist.

We continued our two weekly scans and all was going well until 18 weeks when I collapsed during a routine scan. I was rushed to accident and emergency and they did all sorts of tests and came back with that they thought was a blood clot on the lung. Over night they gave me blood thinning injections in hope it would flush the clot and the next day I was taken down to radiology where an Indian doctor sat me down and said, "You need to be aware that you are having radiology with gamma rays, we think your babies may have developed all its features BUT there's a chance they may have not and doing this may cause mutation." I asked, "what if I don't do this?'" He responded, "It's likely you won't be able to carry on with your pregnancy." I asked for a few minutes and thought of my options, I came to the conclusion that I would rather risk them being mutated than terminating them as I had I already felt them. I called back the Dr. and said "I will go ahead with procedure" I sat and hugged a huge machine while its took pictures of my lungs. I went back to the ward and anxiously waited the results. 5 hours later a Dr. came to me and said "they couldn't see any clot and they thought it may had flushed out."

Back home all was okay and carried on normally till 28 weeks. I was sat in my living room watching TV while my partner was in the bath  and I started to feel my stomach contracting; having a singleton before I knew what was happening. I left it a hour before I called down my hubby to take me to the hospital. We got there and they monitored me and said "if we can't stop this we need to organise an air ambulance to take you to St. Georges in London as we don't have the facilities here for two 28 week old fetuses". They gave me some medication which calmed them down and 2 hours later stopped. They told me not to go out by myself and do minimal walking and things around the house to avoid preterm labour. At the next consultants appointment she sent me for steroids straight away and said I needed a iron transfusion as my iron levels were dangerously low. The next Thursday I went in at 7am they started pumping the iron into me and at 8pm I was still there. A nurse came in and I asked "excuse me, do you know how much longer it will be as I've been 12 hours". She turned and sternly said "girls like you take up room in the delivery suite because you cannot be left in a chair. It will take as long as it takes". She walked out came back 10 minutes later, "so are you going to breast feed your twins?" I replied "I don't think its good idea to be up all night breastfeeding twins and be up early with a 14 month old."  She stared at me and said "Well, do you know you are going to kill those babies because formula will not digest in the system properly? I had a meeting with my team and we decided when and if you should have a section and we haven't agreed to it."  I looked at her and said "my consultant booked it months ago". I sat there holding back the tears and she then said "when that is finished I will take you to the NICU so you can see how they will be!".

Fifteen minutes later she left me at the door of the NICU and I went in and saw all these babies connected to machines and broke down and left the hospital and went home. The next day I called my consultant to say what had happened and she assured me the next day that the section had been confirmed and nothing to worry about. 1st of December came, delivery day, I was super excited when I looked out the window to see a blanket of snow outside.  We called a taxi who were hesitant to come and told us they would charge us double which my husband said "I don't care, we're having babies."

I got dressed in the gown, was sitting waiting patiently when I saw a smartly dressed man with a brief case who looked out of place on the ward. He was walking towards me he said "Miss Plant?" I looked at him vaguely "yes?!?". He said "I'm sorry to inform you we are unable to do your elective section today due to no space in the NICU at this current time." I got really upset I said "Do you not know how important this is? Do you not understand the consequences?" He looked down and replied, "I'm afraid I have done all I can." I asked "at least you will give me a scan right to monitor the blood flow?" He stated, "No, Miss Plant, we are unable to scan you today please make your way here tomorrow and we will try and fit you in". I went home rather angry but tried to sleep as much as I could.

The next morning I wake and look out the window and we had 2 feet of snow, we call the taxi who again is reluctant to come and said this time they would charge double and a half! Again we responded "We don't care, we are having babies." We drove to a family friend's to drop our daughter off as we went to turn around we were faced with a hill. The taxi did not want to go up but luckily there were 2 strong men trying to dig out their cars that James begged to help. We finally got up the hill with help from two local men and James when we get stuck again up a smaller hill, poor James had to push the taxi up by himself and faceplanted in the snow but like a good sport got back up without a word. It took us a hour and a half but we got to the hospital again. We got dressed for the section when I saw the smartly dressed man again. I looked at James and I said "I can't believe it, he better not be coming here." He stood at my bedside and I looked up, "Miss Plant, we are unable to do your section today due to lack of staff due to the snow. I have considered getting you to another hospital as we realise the importance but we cannot get any ambulances safely here. Please stay and we will see what we can do in the morning." James hugged me tight and said stay here and I will come back tomorrow. I was left 7 am till 7 pm with no monitoring, food or water, then the staff changed and a head midwife came and monitored me and gave me a sandwich and again before bed and showed me to a private room.

At 5am I woke to a knocking at the door and she said I've come to monitor you...I remember thinking all I want is to sleep. As she started to monitor she said "That's not good. Okay stay here I need to go get someone". 10 minutes later a group of people ran in with a scanning machine my little miracles heart rates were 200. They said "We need to get you up to delivery suite now, these babies are coming". I cried "please call my husband, I can't do this alone". They took me up to the delivery suite and the heart rates calmed down but the consultant said they need to come today. They were wheeling me out the room to theatre when James arrived as we went to exit the room I heard "there's not enough staff in the NICU". I shouted 'Noooooo!' And the anesthesiologist smiled and said don't worry "they will be here soon". After a hour I went down to theatre and Maddison Sophia was born at 10:30 on the 3rd of December, weighing 3.15lbs, and Mia Sienna 2 minutes later at 10:32 weighing exactly the same. Their cords were looped and tangled and the cord was wrapped round Mia's neck. Thankfully there was no deformities due to the gamma rays. After a 22 day stay in the NICU Maddison and Mia came home on Christmas day 2010 :)

My Momo Miracles

I had never thought I was going to be a mother.  I'd been diagnosed with polycystic kidney disease when I was twenty-one.  Due to the kidney disease I had high blood pressure, and I also have chronic migraines.  I had been told by every doctor for ten years that I should not have children.  Not that I couldn't have children but that I shouldn't have them.  I told myself that I didn't want children so as to not have to confront the idea of not being able to have them.  Then, about six months after getting married,  I found myself pregnant and everything changed.

After embracing the idea of being a mother, I was then devastated when I had a miscarriage at the beginning of my second trimester.  We tried again right away but were unsuccessful.  Due to my health issues (and the increased chance of multiples) we decided against fertility treatment and just left it up to Mother Nature.  After four years waiting, I finally found myself pregnant in September 2010.

While waiting for our first real ultrasound (around nine or ten weeks,) my husband and I were amused by the couple who come out into the waiting room very excited that they were having twins.  My husband jokingly said, "What if we are having twins?" Not amused, I said, "Don't even say that.  That is NOT going to happen."  

Ten minutes later I found myself lying on the table, stomach covered in ooze when the tech exclaimed, “Oh wow, its twins!”  Thinking (or hoping) she had made a mistake I asked if she somehow got the other lady’s ultrasound mixed up with mine!  But no, there was no mistake.  I was carrying twins.

The doctor could see right away that the separating membrane was missing and he referred us to the best--and, I think the only--perinatologist in the state.  My biggest fear was that the twins would be conjoined and I spent every minute of the next couple weeks worrying about it.

Upon meeting my perinatologist, I knew I liked him.  He had such a peaceful, quiet, reassuring way about him that I felt very comfortable.  He soon confirmed that the membrane was missing and diagnosed it as a momo pregnancy, NOT conjoined.  My relief was tempered when the doctor began explaining exactly what a momo pregnancy entailed.  Hearing that my babies only had a 50% of even being born, I had flashbacks to the pain of my miscarriage.  How could I go through that again?  The doctor explained that there were options but I had already decided that, no matter what, I wasn't giving up on the baby (now babies) that I had waited four years for.  Regardless of the odds stacked against us, I just felt that these babies were meant to be.

The first half of my pregnancy was miserable yet uneventful.  I literally spent most of my time trying to keep food down and being unsuccessful.  It was the middle of winter and my perinatologist was 100 miles away so I went into my high-risk ObGyn for check-ups, along with many long drives to see the specialist.  Each appointment, I had to hold my breath until I heard the two heart-beats and saw them on the monitor.  While I felt that the babies were doing well and would be fine if I just stayed positive, I had a difficult time bonding with the babies growing inside of me.  I needed to build a wall to protect myself in case things didn't work out.

At 22 weeks, my blood pressure spiked and I was hospitalized in an attempt to prevent pre-eclampsia.  We all knew that 22 weeks was far too early to deliver but it was a possibility.  After several days in the hospital and some serious manipulation of my blood pressure medication, we did get things under control.  I was discharged to home on modified bed rest until I was scheduled to go inpatient at twenty-eight weeks.  However, at my twenty-six week appointment with the specialist the blood flow in the cords looked dangerously constricted so I was quickly admitted and began my inpatient stay.  

The first few days in 'Mommy Jail' were stressful.  I was immediately given steroid injections to stimulate the babies' lung development.  The pressure in the cords was rather high, indicating  something (a knot) was restricting the blood flow.  At one point, Baby A dropped off the monitor and the doctor nearly delivered them at twenty-six weeks four days.  Fortunately, upon hearing that, the boys decided to settle down and from that point on, their numbers got better every day. 

 I was monitored for three one-hour blocks each day, which translated into lying flat on my back for the better part of every day and night as the nurses chased the babies around my stomach trying to get a good read.  I also had an ultra-sound every second day to monitor the blood flow in the cords.  My husband and I soon settled into a routine where he spent half the week with me in the hospital and half the week at home going to work.  Things were looking good until, around twenty-nine weeks, my blood pressure began to rise again.

After several days of trying to get my blood pressure under control, everyone could see it wasn't working.  I was officially 'pre-eclamptic', I had become swollen in places I didn't know could swell and had to spend nearly all my time in bed, lying on my left side.  The day I reached the thirty week mark, the doctor came in early and--to no one's surprise--said things were just getting too dangerous and it was time to deliver.  Within the hour, after a flurry of phone calls to family back home and a quick shower, I had an IV put in and was ready to be wheeled into the operating room.

At 12:14 p.m. February 27, 2010 Casey Li came into the world, weighing 2 lbs. 4 ozs with the umbilical cord wrapped around his neck twice.  At the same time Casey was brought out, Foster John's feet came out with his brother.  Seconds later, he too was welcomed into the world weighing 2 lbs 5 ozs.  The doctor had everyone in the room come look at the umbilical knot the boys had created, not quite believing the mess they had made of it.  Each baby had a four-member NICU team who, after letting me look at each baby for a second, quickly had them intubated and whisked them away to the NICU.  

 Umbilical cord knot

It was nearly 8:00 p.m. before I was able to crawl into a wheelchair to see my babies for the first time outside the two seconds I'd seen them in the OR.  Not even the drug-induced fog I was in could contain my joy and fear upon entering the NICU and seeing them for the first.  They were impossibly tiny, yet perfect in every way.  They were even breathing on their own with just room level oxygen!  

 Casey Li  4 days old.  First ‘kangaroo care’!!

I had always felt that my children were going to be fighters, but even I was surprised by how tough they turned out to be.  My doctor attributed it to being stressed in the womb, which forced them to develop quickly and be resilient.  After dropping to 1 lb 15 ozs, the boys soon began to gain weight steadily.  The only setback they suffered was, after about a week, both boys were desatting regularly so they were put on a nasal canulla for a couple weeks.  Other than that, they made great progress every day, while I used my NICU time to learn as much as I could from the best caregivers around--the NICU nurses.

  Foster John  10 days old

We were told to expect the boys to go home around their due date, which had been May 6th.  By the beginning of April, it was clear the boys wouldn't be in the NICU that long.  The doctors said they usually never discharged a baby weighing less than five pounds, but our boys were doing so well they didn't need to stay any longer.  As one doctor put it, "They are the valedictorians of the NICU." 

 

On April 15, 2010, after an eight week stay, our boys were finally discharged.  At the time, both boys were 3 lb 13 oz and were too small to fit into a car seat so we were one of the few people ever to use the special 'car beds' the NICU had.  The boys actually had to ride in those for more than a month before finally getting large enough for a regular infant car seat!!

The first few months at home with the boys were a bit of a roller coaster.  While we were lucky and the boys were exceptionally healthy for preemies, they were still preemies and still faced preemie problems.  We were under strict orders not to take the boys anywhere or allow many people in and out of our home for at least six months so I became rather stir-crazy.  Neither boy slept well, grunting and fussing even when they did sleep, and we struggled with terrifying spit-up/choking episodes for months.  Our days were filled with visits from the county nurse, many visits to the pediatrician, trips out-of-town to see specialists, visits from our Family Outreach counselor, and even physical therapy evaluations.  Still, somehow we managed to get through every day. 

My boys are now two and doing incredibly well.  We have graduated from the Family Outreach (Early Intervention) program and the boys are developing very well.  The only stumbling block we’ve had recently is with speech.  They are a bit behind in learning to speak English but have mastered their own language “Twinglish.”  We have started therapy and have been learning sing language, which is helping them communicate without getting frustrated.  They have now started making up their own sign language, which is a fun challenge to decipher. 

 I could not be prouder of my little men.  Every step of their journey to be with us was quite a challenge and they proved to be such fighters!  Their strength amazes me.  Late at night, I sneak into their room to watch them sleep and remember them as tiny 2 lb preemies who couldn’t even keep themselves warm and often find myself crying.  I am so very, very blessed.

 Foster John (left) & Casey Li (right) 2 years old!

There's more than one!

Simon and I were very excited about our first baby scan at 11 weeks.  We couldn't wait to see our little one for the first time. Just before the scan started Simon told the OB that my sister has triplets so it would be interesting to see if we were having twins (or more!). I confidently told the OB that we were just having one baby thank you very much! As soon as the scan started Simon and I could see a baby and something else.... The OB announced "There's more than one!". There was a lot of nervous laughter and exclamations such as "no way!", "really?", "are you sure", “there’s only 2 right?”, etc. My legs started to shake as the shock set in. Almost straight away the OB told us he thought there was no dividing membrane and they looked like what are called monoamniotic twins. He then spent a while trying to work out whether they were conjoined.  I think I almost fainted.  He said he was sure that they were not conjoined but explained that this type of twinning is extremely high risk. Suddenly our low risk singleton pregnancy had turned into something very different.....

  

Treatment Plan

My OB refused to tell me the mortality rate (well, that’s telling you something!!!).  I reviewed the research myself and no one agrees on what the mortality rate is or the best way to manage this type of pregnancy because it is so rare and not much research has been done.  It is routine in the US for mothers to be admitted to hospital for inpatient monitoring from viability but that is not the case in Australia and I did not go inpatient.  I had regular high resolution scans that increased with frequency towards the end of my pregnancy.  I worked until I was 28 weeks pregnant and then I was on (self imposed) bed rest until delivery.

Coping with a High Risk Pregnancy 

I didn't know whether I was going to have 2, 1 or 0 babies in my future so it was hard to know whether to be happy, anxious, sad or....just feel nothing. I didn't know whether I should have a baby shower. Celebrating their impending birth when their chances of survival weren't great was a little odd.

I made a decision to try to be optimistic and ignore the horrible statistics. My babies were healthy according to the scans and I'm healthy so there's no use worrying! I hated people telling me to not get my hopes up and telling me not to buy baby furniture until after they were born. I wanted to pretend there were no risks - that's how I coped. My OB would tell me all the risks at every appointment leading up to viability which depressed me every time. Once I reached 26 weeks he became more optimistic and told me he was confident I would make it to the magic 32 weeks.

However, reality would set it, especially when we went for scans. I had 10 high resolution scans that took 1-2 hours each. I had a panic attack at every scan (a real one – I’m not exaggerating!). The first one was the worst - I had to take 6 breaks in one hour. From then on I closed my eyes for the majority of the time and I distracted myself by eating and drinking. Even after the sonographer assured me she had found 2 heartbeats I would still be very, very anxious. Seeing them was extremely emotional and overwhelming. All of the scans came back with excellent results. The flow of blood from the placenta to the babies was always good which reassured us that any knots weren't restricting the flow of nutrients.

However, good scan results didn't guarantee that we were going to take home two babies. My husband and I had a few awful but necessary conversations about what we wanted to do if one or both didn't make it. We had a plan in place and we had even picked out special names. Not that we didn't want to use "Phoebe" and "Sophia" but we wanted special names with meanings that were appropriate for the situation.

The Final Countdown

During the last 4 weeks of my pregnancy I had weekly scans and OB appointments. The last two scans showed that Sophia, the smaller girl was quite a bit smaller than Phoebe and had not grown much in the 33rd week. Week 33 I had an appointment with a different OB as mine was on holidays. This other OB told me with confidence that I would make it to 34 weeks and both babies would be fine. I asked him over and over again at the last appointment whether Sophia was going to be ok because I was so worried about her but he said she would be fine.

I tried not to obsess too much about feeling the babies move but I couldn't help making sure I felt both of them kick each day towards the end. The problem with babies in the same amniotic sac is that it is very hard to tell which baby is kicking and whether it is just one or two kicking! I would sometimes wake in the middle of the night just wishing the babies would move. So I would get up, walk around and eat something just to feel them move. Once they got going I tried to relax again and go to sleep. However, it is hard going to sleep with two babies all excited inside you!

We visited the hospital for antenatal classes and asked all sorts of questions - how often can we see our babies, who can touch the babies, how long are they are likely to be admitted for if they are healthy, should I bring clothes/blankets for them, what happens if they need to be transferred to another hospital, which type of breast pumping equipment is available?  I also got a tour of the Special Care nursery to get a feel for the place and I started to picture myself breastfeeding in the feeding areas. All this information helped us to prepare us for what was to come... 

Phoebe and Sophia's Birth Day 

The girls were born healthy via cesarean January 2010 measuring 2008 grams and 2318 grams. Immediately after they were born my OB inspected the umbilical cords and said "someone was looking after these girls". There were several knots in their cords and I believe God was definitely looking after us!

They had APGARS of 9 and were only in humidity cribs for 19 hours. They didn't need continuous O2 but they had breathing apnoea for a week. Apnoea is when they forget to breath and need to be given O2 briefly. They were fully tube fed formula (and a tiny amount of breastmilk) for 3 days and then we started to slowly introduce breastfeeding.  It’s amazing that we had all the risks but ended up with our perfectly healthy children.  We felt truly blessed.  Words cannot describe the relief we felt when they came out screaming. We couldn't stop smiling (except for when I was vomiting from the anaesthetic!).

The substitute OB that saw me the week before the birth rang my OB from Hawaii (he was on holidays!) to ask if my girls were alright. He was quite concerned about whether he had made the right decision to let me have them out at 34 weeks rather than 33 weeks. Turns out he was right but gosh - talk about "obstetrician's bluff!"

Straight after surgery I was able to hold Sophia for about 10 minutes. They would've let me hold her longer but I was feeling very dizzy and nauseous from the anaesthetic and chose to give back Sophia for fear of dropping her! About 2 hours after birth I was wheeled into the special care nursery and got to stroke Phoebe and Sophia's heads for 5 minutes each. My husband took lots of videos and photos of the girls so that I could look at them while I was recovering in my room which helped enormously. I didn't get to hold Phoebe until 29 hours after birth.  The first time I held her was so magical and it brings tears to my eyes 2 years on!  I know some mums don’t get to hold their premmie baby for weeks after birth so I was just utterly grateful it was only 1 day for me.

Our Special Care Experience

We loved special care. Probably because every time we went there we got to see our gorgeous girls! I loved the smell of the antibacterial lotion they make you wash your hands with because I associated it with seeing them. I also loved the smell of the baby shampoo in the nursery and bought a bottle at the pharmacy so I could smell that gorgeous baby scent when I wasn't with them.

Phoebe and Sophia were in special care for 3 weeks. For the first week I was also in hospital and Simon was staying in my room. Simon would visit the girls every 3 hours to feed them through the nasal gastric tube and I mean EVERY 3 hours. He was so in love :). I couldn't go every 3 hours but tried to get there 2-4 times a day. At first we were only allowed to cuddle them every 6 hours but as they gained strength we were able to cuddle them every 3 hours. It sounds strange to restrict physical contact with a baby but it really wore them out. Going home at the end of the first week was hard. We had to leave them behind :(. Every mum has that moment...commonly known as the 3^rd day blues where things get a little emotional.  Well, I had my moment the second time I had to leave the hospital and go home to two empty bassinets.  I was crying uncontrollably and asking why I had to leave them behind.  Luckily a kind nurse and the mother of the little girl next to Phoebe comforted me and assured me they would be well looked after overnight.

At first we came back to the hospital for two feeds a day, then three, then four and then I was in there all day doing 5 feeds during the day. We then stayed overnight at the hospital for 2 nights to show they were able to be fully bottle and breastfed 24/7. We took them home at 4 weeks old.  When they came home they were pretty easy to look after.  They fed, they pooped, they slept.  Yes, there wasn’t much sleep for mum or dad but they were content most of the time.  Little did I realise that this was the “easy” stage!!!  I will leave the reflux, colic, RSV, gastro, bottle and breast refusal, overtiredness, overstimulation, etc. for my personal blog :).  I really wish someone had told me about silent reflux - it's so common in preemies! 

Two Years On

My girls are now loud, vivacious 2 year olds that are just like every other two year old...except there’s two of them of course!  You would never know they were a high risk pregnancy or premature.  They are healthy and happy - we are so incredibly blessed.

"This can't be happening!" – The Riso Twins Story

My husband and I decided to start a family sometime in early 2008. Like any other naive couple about to embark on the journey to parenthood we figured it would be relatively easy. I mean, we spend most of our teenage years trying NOT to get pregnant so logically, once we threw caution to the wind it should happen fairly quick, right?.......WRONG! Here's where that title phrase made its debut appearance....."This can't be happening!" Unfortunately, it was.

So, after about a year of disappointment we sought the help of a reproductive specialist. After countless blood tests, MRI's, sonograms, surgery, numerous medications and several medical procedures we still weren't pregnant. After each failed cycle I kept thinking "this really can't be happening." The desire to become a mother had grown so strong that it took over my life. We decided to try IVF (in vitro fertilization). So, after one round and many tears I finally got my Second line! We were pregnant!  Blood tests all came back normal and my first sonogram confirmed one healthy baby….or so we thought.

Cut to 10 weeks pregnant. I went to my OB for a routine sonogram. Little did I know that on this day my life would be forever changed. He placed the wand on my belly and was quietly scanning around. Then, out of nowhere he said "I need to do an internal sono, I think I hear TWO heartbeats." My initial reaction was, yep, you guessed it, "This CAN'T be happening. My Baby has TWO hearts." haha. I honestly didn't think he meant twins. I mean, I saw the sono screen. There was only ONE sac and as far as I knew it was impossible for there to be more than one baby in them. So, the internal sono began and he confirmed what he originally thought...."it's twins" he said. But his voice wasn't enthusiastic...in fact his whole demeanor changed. He excused himself from the room and said he needed to make a phone call.

After he left my husband and I tried to wrap our heads around the news we just received. I was excited yet nervous because I knew something wasn't right. When he returned he explained that I was to leave his office and immediately make an appt with the maternal-fetal medicine specialist office. He basically said that he suspected I had what is called mono-chorionic, mono-amniotic twins. I was told the next doc would explain this further.

So, of course, I didn't what anyone in the 21st century would do...I "googled" it. As I began to read the various websites that popped up I couldn’t help but think, as you probably already guessed, "This can't be happening." Information flew across the screen in a blur. Phrases such as  "50% chance of survival, cord entanglement, and twin to twin transfusion syndrome" flooded my brain. It was all too much to process. I cried my eyes out for days, ok more like weeks. I emotionally detached myself from the pregnancy, which I regret today and will touch upon more later on. Friends and family were under strict orders NOT to purchase anything for the babies. A friend bought me a journal for me to write down my experiences and feelings....that journal remained blank....as I convinced myself not to do it because, well, I didn't want to remember anything if something was to go wrong (something else I totally regret today.)

Then, I decided to google "momo success stories" and again, information flew across the screen. Only this time, it was stories of other women who were in the same situation as me. Some pregnant still, some with babies in NICU, and other with older “momo” children. For the next few days, I browsed their stories and as I completed each one something in me changed. All of a sudden there was hope! I COULD be one of those women some day! So from there, I began to plan. Planned my inpatient stay, made a registry, ordered furniture and so on.

Unfortunately, at this point I began having problems unrelated to the momo diagnosis. I went into preterm labor and lost a lot of my cervix. At about 16 weeks pregnant I had a cerclage and was put on various medications to stop the contractions. I was admitted to the hospital twice for observation but allowed back home on strict bed-rest for the remainder of the journey. That was a nightmare in itself! It didn't end there.  Then, my AFP test results came back stating that the twins had a 1 in 5 chance of having a chromosomal abnormality; one that would result in death immediately after they were born. "Seriously now, this really can't be happening" was all I could think. I declined any further testing as I couldn't handle any more bad news and I knew that no-matter what, I was going to do my best to get them here safely even if it was only for a few minutes.

Finally, the day had come. It was early June when I officially turned 24 weeks pregnant. This was the beginning of the inpatient portion of my journey. The next almost 6 weeks are a blur. I am not going to lie it was hard. I was still on strict bed-rest so I was confined to a hospital bed all day. I didn't have my own room so parades of women would be brought in for a few days and eventually go home with their families or a bouncing new baby in their arms. Yet, there I laid, still weeks away from uncertainty. Visitors came and went as did most of the summer. I was on continuous monitoring so not only was a stuck on my back I had three different machines attached to me at all times (two for the babies, and one for my contractions.) The highlight of my days were the 10 minutes in which I was allowed to shower. In the end however, it was more than worth it.

Now, It was August 4th and my husband had brought me a Burger King chicken sandwich just as he did every Monday night, as it was my guilty pleasure! I was enjoying my dinner when my OB busted through the door with a bunch of nurses and residents.  "What is the matter with you?" he said. "Why didn't you buzz us?" I was so confused. I didn't need them...or so I thought. "Your contractions are 2 minutes apart and the babies heart rates are struggling with every contraction. It's time to get them out he said. Up to labor and delivery you go." I had no idea how to feel. I was so excited, relieved, anxious, and scared. I was only 31 weeks 6 days. I had no idea what to expect and we still didn't know if they were genetically normal. So up to L&D I went. I was prepped for surgery while I called my parents and told them the time had finally come. As I sit here and type this I can't help but tear up as this was a day that I truly never expected to see.

The only way I can describe the whole birth is surreal. As soon as the OB pulled out the boys I remember yelling over the curtain, "Are they O.K?" I will never forget his response...."Yep, they are fine and have all 20 fingers and toes!" It was at this point when I heard a little voice begin to cry and thought to myself, "This can't be happening!" Except this time, it was a happy phrase. It WAS happening. I was in such disbelief. I got to kiss them both on their heads before they were whisked away to the NICU. I couldn't believe it, they were SAFE! I knew the next few weeks would be hard as well but I didn't care...I was a MOM!

Carson Joseph was born weighing in at 4pds 1ounce and 16 ½ inches long.

Mason John was born at 3pds 15 ounces and 16 ½ inches long.

The next few weeks consisted of me recovering, preparing the nursery, going back and forth to visit the twins, and finally having a baby shower....or as I called it, my "welcome to the world Carson & Mason party"; A much more appropriate title in my opinion.

The NICU journey for us was rather uneventful.  The boys suffered from the basic preemie issues such as breathing and eating. They were both jaundice and contracted a minor infection while there but it was easily treated with antibiotics.  Below are some pictures from our journey. 

(Above are pictures of the boys first week of life. Both are intubated here.  Mason is the top picture and Carson is the bottom picture. )

After four of the longest weeks of my life the boys came home and completed our little family. They were the tiniest little angels! Shortly thereafter we were hit with the realization that they were both colic with severe acid reflux...but that's a story for another time and another blog ; ). 

(Above is the boys very first picture together on the day they can home from NICU. Those are preemie onesies on them and they still look huge. Now I look at preemie clothes and cant remember them ever being that Tiny!)

That brings us to today. My boys are happy and healthy at almost 19 months old. They are up to date on all of their milestones and gaining weight like it’s their job! They are definitely all boy; running everywhere and climbing on everything. Being a multiple mom is hard but worth every single second!

So, for all the expecting momo mommies out there hang in there. Miracles CAN happen. Don't focus on the future what-ifs, focus on the now. Read to the babies, sing to them, make a registry, paint a nursery, buy some cute baby clothes, because when things DO turn out well in the end you will regret not doing it. Stay strong and always remember "Worry does not empty tomorrow of it's sorry; it empties today of it's strength."

The Overstreet Twins ~ It was Meant to Be!

August 2007
My husband and I were shocked to find out I was pregnant in August 2007. We had a 3 year old son and an 18 month old daughter and we didn't plan on having any more children. I had some issues with birth control after having my daughter and actually had an appointment to have an IUD placed at the end of August. Imagine our surprise to be pregnant. After the initial shock wore off we were both very excited to have a 3rd coming. It was simply meant to be....

My first appointment @ 9 weeks went well. Having been through this two times before, I went to the appointment alone thinking it was going to be no big deal. When I had the ultrasound to see the baby's heartbeat the tech asked me if this was my first pregnancy. I laughed & replied "No, my third and it was a surprise." Then she laughed and said "Here's another surprise, this is your 3rd & 4th!" I said "HOLY SH**!! I saw the two little heartbeats on the screen and couldn't believe it. I called my husband at work and he thought I was joking. I think we were in shock, again, for about a week. We were then referred to a perinatologist at Maternal Fetal Medicine for a routine first trimester screening the next week. That's the first time we heard the words "monoamniotic" and "high-risk". The only thing we knew about twins was that you could have identical or fraternal. We certainly got a crash course at that appointment. I remember getting home and doing some research on the computer (big mistake at the time). I was terrified by what I read.  I called my Ob/Gyn and he was able to calm me down, telling me that we were in this together and that I had to be strong. I didn't have facebook at that time and I looked for support groups but couldn't find any. I joined a twin website and my first post was "Pregnant with monoamniotic twins and scared", to which I got NO replies. I was even more scared and felt so alone. After two days I finally got a reply from a woman who told me that her hairdresser's cousin had monoamniotic twins and she was kind enough to pass my info on to this momo mom. This was the first person I was able to ask questions, a million of them, via email, and I am so thankful for her. She also told me about monoamniotic.org and I finally felt like I could relate my questions and fears to others who would understand.

We went back to MFM at 12 weeks and we were told that they thought the twins were possibly conjoined, another blow. The next appointment at 14 weeks the doctor suggested we abort the pregnancy because the cords were already tangled and it was going to be "an emotional roller coaster".  I was so upset and refused to see that doctor ever again. At our 16 week appointment we got the confirmation that there was no membrane, but the  good news that the twins were not conjoined, they were just moving in tandem because of the cords. Our MFM doctor was great and very informative during the 16 week appointment. This is when we learned of our treatment course, what to expect and when. The 18 week appointment brought the news that we were having girls, and that one of them had club feet, a small blow that my husband and I took in stride. From 18 weeks until 24 weeks I was seen by MFM every 2 weeks for ultrasounds and Doppler studies. MFM wanted me to begin inpatient monitoring at 24 weeks but my Ob/Gyn pushed to start inpatient at 28 weeks. We had 2 small children at home and the thought of leaving them and my husband was devastating. I also had a full time job and my husband was working full time and doing an accelerated Master's Degree program at night. We agreed on a compromise of outpatient monitoring from 24 to 26 weeks, and checked in to the hospital at 26 weeks for inpatient monitoring with a scheduled c-section at 32 weeks.

The first 2 weeks of my inpatient stay were the hardest of my life up to that point. Being there alone was awful.  My husband could only visit on the weekends because of our kids, his job, and his school. With the help of our family and friends we managed to work out a routine for the kids. Because my husband had class until 11:00pm three nights a week, the kids slept over my sister's on Tuesday and Wednesday, and she took a half day from work every Wednesday so she could bring them in for a visit and dinner with me. Wednesdays were the best. My parents and my mother in law took turns keeping the kids overnight on the weekends so my husband could sleep over with me at the hospital every Saturday night. So I saw my children every Wednesday, and my husband would bring them in early every Saturday to spend the day, then my sister would pick them up from the hospital so my husband could stay over with me. Then my sister would bring them back to the hospital on Sunday mornings to have breakfast with us, and my husband would leave with them around 1:00pm every Sunday. Sunday afternoons were the hardest for me. But that was our schedule and it worked.

During my stay I spent a lot of time at the nurses station, read a ton of books, used my laptop (wish I had Facebook back then), made a great friend with another pregnant mom on the unit, watched TV, napped, had tons of visitors, walked around the whole hospital, got a tour of the NICU, had Reikki, massages, a pedicure, and tried to relax as much as possible. I had a refrigerator in my room which was great for midnight snacks. I had a goal calendar marked for 28 weeks, 30 weeks,  and 32 weeks. It always felt great to scratch one of them off. I also started a CaringBridge website to keep all of our family and friends updated and to help pass the time.

Medically my inpatient stay consisted of one hour monitoring sessions 3 times a day. The monitoring sessions would usually go longer than an hour because it was hard to get both babies on the monitor, and keep them on. It became a routine of having an ultrasound with almost every monitoring session because the girls' hearts would beat in unison and the nurses could never tell if they had both babies on. I also had Doppler studies and growth scans at the MFM office every 2 weeks until 30 weeks, then once a week until I delivered. I called it my field trip for the day and I enjoyed being taken over to the MFM office in a wheelchair. My growth scans showed a slight difference in the size of the babies, so I was encouraged to drink Ensure for almost all of my stay. I was able to walk around almost the whole time I was in the hospital, up until the last 2 weeks. The girls never had any serious decels, but one of them had a scary accel around 29 weeks that lasted about a minute and the doctors were called in to see if they needed to deliver the girls. She recovered and it didn't happen again. On Valentine's Day I woke up at 4:00am with very painful contractions. I was 30 weeks and was sent down to labor and delivery for the day but thankfully they were able to stop the contractions. At this point I was put on complete bed rest because walking around irritated my uterus and started contractions.

My c-section was scheduled for Leap year, Friday, March 29th, 2008. I was 32 weeks 1 day. The day before, one of the neonatologists came to tell me that there was no room in the NICU for my babies, they were full. I was very upset. My Ob/Gyn was upset too. So we had to wait it out one last weekend, the longest weekend of my life, until Monday March 3rd, 2008 which brought me to 32 weeks 4 days.

March 3rd, 2008

Teagan Kathleen was born at 1:45pm, weighing 3lbs 15oz and 16 inches.

Taryn Cynthia was born at 1:47pm, weighing 3lbs 14oz and 16.5 inches.

The NICU was another emotional roller coaster, but in the end it was worth every bit of emotion. We have two miracle babies that have taught us more about life and love then we ever imagined. It changed our lives for the better. I have made life long friends with the nurses who took such great care of  me and the girls. My husband and I learned more about each other during this pregnancy and birth of our girls than we ever knew before, and for that I am so thankful. Small things that others may take for granted are cherished by us. We learned that you can't be afraid to ask questions or challenge a doctor, they don't know everything. If something doesn't feel right, don't be afraid to speak up? Always go with your gut. Most important, we learned how to be advocates for our children.  If you find a great doctor who knows about monoamniotic twins, you will be in great hands.

At this point our girls are almost 4. Sometimes I can't believe it. My husband and I joke all the time about having four kids, especially having twins. And then we say....it was simply meant to be.