Our ultrasound was at 8:30am yesterday, and it basically confirmed the same things as the other day. Baby A had fast bloodflow through her brain, although not as fast as the last time we needed the blood transfusion. For the first transfusion, her bloodflow was 3 times as fast as the average, and yesterday, it was 1.8 times as fast as the average. Because of this, our doctor offered us another blood transfusion, knowing that it probably wasn't as urgent as the last time. Between the three of us, however, none wanted to just wait and see how it was next week, so we decided to go ahead with the blood transfusion again. She had spoken with blood bank and they were going to "try their hardest" to make it happen yesterday, so we wouldn't have to spend another night in Ann Arbor. Before we even left the ultrasound, one of my doctor's partners was able to set up the blood transfusion with blood bank, OR, anesthesia, etc. for 2:30pm. Have I mentioned how amazing our doctors are?
I hadn't eaten or drank anything since midnight, and by the time we left our ultrasound at 10:30, I only had four hours until surgery... sooo... no breakfast or lunch for me. Luckily, my doctor at least let me have a glass of water. With 3 hours and nothing to do, Nate and I grabbed our laptops and sat down in the cafeteria to kill some time. 3 hours... in the cafeteria... starving... smelling delicious food and watching everyone around me (including my husband) eat. Let's just say I was happy when it was time to go back upstairs.
We were in preop for just over an hour before rolling to the OR. Nate was able to come in with me again, but unfortunately, I didn't get a chance to take a picture of him in his beautiful white jumpsuit. If there is a next time, this will definitely be on my priority list!
Once I got into the OR, they used the ultrasound to figure out the plan of attack. They scanned for what seemed like forever before figuring out how they were going to enter the umbilical vein. The babies' positions were not cooperating (baby A was breach and baby B was head-down). After moving me in many different directions, they were finally able to get into the vein and get a blood sample. Even though the bloodflow wasn't as fast as the last time, we found out that baby A was just as anemic as last time... her hematocrit was, again, 2%. Because of the "success" of the last procedure (ie., it improved her bloodflow for 3 weeks), they decided to do the transfusion into her abdomen again. This meant another poke and lots more position changes to be able to access her abdomen, since baby B's face kept getting in the way. We appreciated that they didn't want to poke our daughter in the face with a needle!
Once they finally had a clear shot into baby A's abdomen, they poked again. I had asked the anesthesiologists (there were 3 of them) for less pain medication than the last time. I asked, and I received! That poke was probably the most painful thing I've gone through so far. Luckily, I requested more pain medication, and they were able to get it to me quickly. They ended up transfusing 36 mLs of blood into baby A before cleaning up and rolling me back to recovery.
Since I had only gotten half the amount of pain medication as last time, recovery was much smoother and much quicker than last time. Nate grabbed me Subway and Reese's PB cups (a necessity) from downstairs, our doctor came back with the ultrasound machine to reassure us that our babies still looked good, and we were on our way home.
TTTS and TAPS have unpredictable disease courses... so we don't know for sure if we will need another blood transfusion or not. Since the last one improved things for about 3 weeks, Nate and I are kind of planning on needing at least one more before the babies are born. If we don't end up needing one, it will be a happy surprise. Either way, because of the expertise and our comfort levels with our docs in Ann Arbor, we have chosen to continue being seen there, at least until things stabilize for a long period of time. Our next appointment is February 11th.
As always, thank you all for praying for us and for our little girls. We are overwhelmed by the prayers, comments, and support you all have given us.
Love,
Nate & Sara and the little peanuts too :)
Good luck with your next appointment.
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