The Plan...

First of all, thanks for thinking and praying for us this last week, and especially today.

Our appointment started with a VERY long ultrasound, which took about an hour and a half. I don't know if you know this, but pregnant people aren't supposed to lay flat on their backs, because all the extra weight in your abdomen can press down on the blood vessels, blocking blood from flowing back to your heart. If your heart can't get blood, it can't pump it out to the rest of your body, and your blood pressure drops. Pretty sure this happened to me about 10 minutes into the ultrasound. Not only did my back hurt, I was nauseated, hot, dizzy, and miserable. After multiple position changes, extra pillows, taking my top layer and my boots off, a dose of Phenergan, and a cold washcloth on my face, I felt much better and we could continue. Both babies were really active during the ultrasound, Baby A moreso than Baby B because of her large swimming pool of amniotic fluid she has to move around in. (Not good, but still kind of fun to see her flipping over again and again.)

The doctor came in before the ultrasound tech had even left the room and told us we had a lot to talk about... which was no surprise to us. She gave us more information about monochorionic (one placenta) twins than we ever knew there was. She then talked about twin-twin transfusion syndrome, which she agrees is what we have. She went through all the stages and possible interventions. Our babies are in stage III according to our ultrasounds. This means there's an unequal amount of amniotic fluid between the two -- Baby A having too much and Baby B having not enough (stage I), they are unable to identify the bladder in the donor twin because she's not making enough urine (stage II), and there is MILD abnormal blood flow through some key blood vessels in the donor twin (stage III). Thankfully, the recipient baby is not yet showing any evidence of heart failure/fluid overload, which would put us in stage IV. To put this all in perspective, the doctor today told us that if we chose not to do anything to treat the TTTS, our babies would have a 95% chance of dying. Not what any parents (even the ones who have only been parents for 3 months) want to hear. Yikes.

For stages I and II, doctors usually just watch the babies really closely and may not even perform any interventions. For stages III and IV, the best treatment is the laser surgery I referred to in one of my other posts. I didn't know this, but when the doctors in Grand Rapids and Ann Arbor talked to each other over the last week, they had penciled us in to have this surgery on Monday because they thought we'd probably be interested. They were right! We are planning to return to Ann Arbor on Sunday night, because we have to check in to the hospital at 6am on Monday morning for surgery. I'll stay one night overnight and hopefully go home on Tuesday.

Because this surgery is the only procedure that treats the underlying cause of TTTS, it was what we were hoping they would do for us. Still, nobody wants to hear that they have to have surgery. I've never had any kind of surgery before, so besides being afraid for my babies, I'm afraid for myself! I think I'm the most worried about the spinal... it just sounds painful... and I almost passed out in nursing school watching one get put in. Of course, I'm willing and ready to do anything to give my girls a chance, but that doesn't make it less scary. Please keep the prayers coming for Nate, me, and the cute little girls growing inside me. The surgery is not without risks, and it is not a guaranteed fix... but it's our best bet. 10 days ago, we thought having one baby was the most exciting thing in the world. Today, we think having just one baby seems like the most devastating thing that could happen. We have quickly surrendered to the fact that all we can do is trust in God to heal our baby girls. By the way, here they are!

Love,
The Vander Ploeg 4