Friday, December 16, 2011

No guarantees, but hope

Yesterday was the throwdown of facts, but I figure I should follow it up with a little reflection and answering of questions that I’ve gotten.

The title of this post I really think sums up where I am.  I know there are no guarantees, it is entirely possible to end up with no or one living, breathing offspring.  But that knowledge doesn’t keep me from having hope.  And I have every hope in the world that both of these babies will be able to thrive and grow and survive to be born.

Perhaps the goal of being born alive seems like pretty low standards to many, but it’s huge.  It’s the biggest thing that there can be.

Question one has been dealing with sanity.  As I have reflected on here, I endured some pretty high levels of stress and worry during the weeks between Aurelia’s death and the twins’ delivery.  I tend to internalize and keep the crazy fairly well wrapped up on the inside.  Positive: Paul, my OB and myself all realize this and have discussed this.  I think this is huge.  Being aware of the issue goes a long way.  Also, having had a easy, straight-forward pregnancy with Trajan provides some reassurance.

That said, we thought it would probably be worthwhile for me to check in with the grief counselor and talk through what I’m processing.  Have a message into him, but probably won’t actually talk to him until the new year. 

Another positive is I have an obstetrician who has had a lot of experience with demises.  Like she knew I was crazy before I did last year.

Question two is how is Paul doing.  I’d have to let him give his own official answer, but from the outside he seems to be accepting it as not the plan, but something that happens in life and so we will take it as it comes.  He’s made jokes about whether I know that they’re both boys and the need for a minivan and the like.  He’s often of the type that laughing is better than crying.  I think he’s actually made more progress towards accepting this as a reality than I have.  He made me crack up with the line, “gestating is hard work” earlier today.

Question three is what are the risks really.  We have talked about that a bit with the doctor.  Note, we have not seen the perinatologist yet and won’t for a while.  There definitely are causes for concern: multiples gestations are always a risk, pregnancies spaces less than twelve months have preterm complications, I have a fetal demise history, I have a preterm labor and preterm delivery history and the pregnancy happened with an IUD in place.  Any one of these five things apparently would classify us as high risk.  Add to it that I have had an auto-immune response to pregnancy/lactation that has consisted of my parathyroid shutting down and my multiple antibiotic anaphylactic allergies and I’m sure you can tell that I’m any doctor’s dream patient!

That said, my OB has actually been very positive.  She says that she doesn’t think I am likely to have a preterm labor problem.  She says that she thinks my cervix is competent.  She says while she has dealt with a lot of women with demises, only one who had comorbidities has had a recurrence.  She says we are unlikely to walk the same path.  She says that while she does feel confidence, we will be following very closely on the safe rather than sorry philosophy of thought. 

Area one of risk: miscarriage.  Having the IUD out helps this a LOT.  While it is in, the miscarriage risks are very high and stay high into the second trimester.  She says that the data is very limited, but it seems that the majority of the additional risk when the IUD is out is confined to the first twelve weeks.  She also seemed to think that having confirmed cardiac activity was a VERY good thing.  Another positive is how similar in size and development both babies have been, this is apparently huge.  She gave me a percentage, and knowing my math nature, you’d think I’d remember it, but I’m unsure.  It was I believe about a 15% chance of miscarriage at this point?  But don’t quote me on that.  What you can quote me on is that it is elevated from a typical pregnancy, but significantly less likely than a positive outcome.

Area two of risk: fetal demise.  Having Aurelia’s death switched back to an uncertain event at the last appointment actually decreases the risk of this a lot.  Fetal demises are more common in twins, but we are aware of the possibility and will be monitoring.  I’m going with lets all agree that we have had our share of statistically improbable events and so this won’t happen.

Area three of risk: neonatal death.  No one has mentioned this and I don’t feel the need to try something new, so I’m not going there.

Now for a final light note.   Chiron and Aurelia were amazingly awesomely obvious as heart and eggplant. These two are harder to name and I've only been sent with the one picture from the two ultrasounds instead of the half-dozen from last time.  I can now completely see the alien in profile that KJ found, but I also thought I'd take a picture in a different orientation to maybe make the panda head clearer.  Not sure if it helps, but here:

Meg, those are the two eyes right, and the nose is the center?

The plan is to tell siblings and our parents over this weekend and the beginning of next week.  Luckily, we are blessed in them and so are anticipating support, love and whatever we need.

Sigh.  I just realized I left out an area of concern which is very true and very near to all of our thoughts.  That's prematurity.  From our experience and people we met in the NICU, we are painfully aware of the risks of prematurity.  I'm honestly considering trying to seek out stories of twins who didn't need NICU time, but it really does get filed into the area of what will be will be.  I am much more informed and aware of the risks of preterm labor than the average twin mother, so I think the best we can do here is remember that while there are no guarantees, there is hope. 


  1. Ah ha! Now I see the panda head!

    I had been wondering along the same lines as KJ, that surely seeing the heartbeats was a good thing and that you would now be looking at a far lower risk of miscarriage.

    I like the sound of your OB, from her ability to detect bat sh!t craziness before you even can yourself, to her general positive outlook. I think you're in good hands?

    Well . . . . don't go looking on my blog for the good news about twins and prematurity BUT the three sets of twins in my life other than my own didn't need any NICU time! None of them. My next door neighbour even went overdue with her boys and had to be induced! My niece and nephew are probably close to the record of the heaviest twins ever delivered in our local hospital.

    And, as my consultant said to me frequently in my pregnancy with R, THIS is a DIFFERENT pregnancy. I used to say that to myself like a mantra. And there is most certainly hope and I'm hoping for you with all my might!

  2. That's it! The panda face. I've also given them their own theme song. It's to the tune of Poker Face by Lady Gaga. Pa-pa-pa-panda face. Pa-pa-panda face.
    It's just popped into my head. You're welcome.

  3. Came across another stat. Was googling "likelihood consecutive sets of twins" and this one random quoted statistician in the article said 1 in 1600.

    Twins predispose to twins, but it still is typically less often than singleton and doing it back to back is more unusual. Though both news stories I saw with consecutive twins were conceptions within a year of the birth of the first, so maybe that's a factor?

  4. Loved reading this. And yes, totally a panda face. Kung and Fu.. because they're fighters.

  5. Oh dear. I know that crazy you are talking about. It's hard to put the PTSD behind you and treat this as a new pregnancy, new ball game but I hope that you can.

    Also, the similarity in size is a wonderful thing. Mine were measuring differently from the moment we found out I was carrying twins.

    My fingers are crossed that everything goes perfectly smoothly for you this time.

  6. Your clear mind and sense of calm blows me away.
    I say...take these stats and stick em. It's like being struck with lightening twice.
    You've already set the grade in so many areas....let the stats rest a while while you grow some healthy babies.

    My Christmas wish. May your belly grow to the uncomfortable size of a small mini van and may your vagina feel like you are carrying one. May your little girls be born with lots of dark hair and round sweet cheeks.

    So I guess to add to the questions. Mom. Are you going to try for anothah ? Why not go for another set. Just space the next set out a few years. That will of course mean no sex whatsoever.....because it sounds like you could have phone sex with your husband and get pregnant with twins.

    Thanks for the answers. I saw the panda....I just saw the alien first. Mine looked like a cat. So weird.

  7. Karen, I was out to dinner with a friend and she had to take a call and so i read my email and that made me laugh and sputter so that she made me explain to her why and then she did as well!

    I think you've got the right attitude: focus on what I can do and screw it to anything else.

    I imagine we are done with this round. It's already going to be interesting enough logistically. And I mean all logistics. Cars, breakfast room table, activities, work. I'm a consultant and while I've worked my schedule pretty well, I do have to travel several weeks a year (in pieces).

    Like the idea of the potential to grow to the point of misery. I've been 37 weeks with a singleton and Aurelia/Chiron were only 24 when she died and almost 30 when born, so I really don't know what it's like to be truly huge.

  8. Oops, form failure.

    I get that that big is NOT fun, but I'd like to get to determine the misery on my own. And no, I don't think this takes away my right to complain.

    And again, the phone sex comment wins. But honestly, at this point, it's gotta be clear there's some crazy fertility on both sides.

  9. I can't imagine how vulnerable you must feel right now. Best of luck with the babies. My sisters are twins and they required no NICU time back in the 1990. They were born right at 37 weeks.

  10. My twins had no NICU time--I know several other sets who had none as well. Scary stuff, a twin pregnancy, but many end up happy and healthy. Fingers crossed that yours will as well.

  11. My sister and I both had twins, hers came at 34 weeks with 6 days NICU and mine came at 35 with 4 and 8 days NICU. So some NICU time, but not much. They all had no real trouble breathing and just needed to get bigger and learn to eat.

    I found your blog while reading Pleasantly Furious and your back to back twins comment intrigued me! We will be trying again sometime this spring and I am looking forward to a singleton pregnancy. . . very hesitant that I'll have twins again.

    I hope you have happy and healthy remainder of pregnancy.