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.