Post holidays

Back to Baltimore. And we have growth!! [insert numbers]. We didn’t get to see any doctors today, but both babies are still growing at their own rates. And Baby B is fighting like a champ!!!

On the way up there, we almost had an accident. I was driving (not the reason!!!), and all of a sudden traffic came to a slamming halt. I swerved, did a back and forth maneuver to make sure everyone behind me knew something was happening ahead and to STOP, please don’t hit me. Glad I did–a suburban two cards behind me went up on the median and would have hit the car in front of him …. the car behind me, which would probably have hit me. Needless to say, my heart was a-pounding.

Maybe because of the adrenaline??? But little Baby B was more active than we’ve ever seen him. I loved it :). He was actually stretching and kicking his legs out. We’ve only ever really seen him in his tight fetal ball, boxer pose with his fists. His constant movements make the technicans jobs more difficult, but I don’t care, I want to see him fight, move, squirm.

Second 20 week appointment

Outlook isn’t good for baby b. First doc recommended doing cord coagulation immediately. We brought up Miami and the study there. After he explained the surgery they do for iugr, which he then told us he could do as well and would do it if we wanted, we decided against it. The surgery basically divides the placenta and baby b would end up getting even less share/percentage than he’s getting now, which is tiny, So he would die regardless.
He then threw a wrench in things b/c he’s leaving tomorrow for two weeks so if we wanted to do either surgical option it would have to be done today or tomorrow morning. We decided to go to lunch and come back to talk
To the other specialist. So glad we did.
We decided that we couldn’t be forced into a decision today, we couldn’t feel comfortable with one. And we are no longer considering the laser surgery to separate the babies b/c it’ll only result in death, so that’s out.
We decided to wait two weeks. We’ll have our Xmas plans as planned and have time to come to peace with whatever may happen.
If in two weeks baby b is still growing, although extremely slowly, we’ll keep waiting. We are doing this b/c even though he’s in like the 3rd percentile, all functions are there and he’s healthy. I can’t live with the decision to clamp  the cord right now and completely end his life.
Dr Harmon, the second doc today agrees with us. He said baby b could still fight it out, that he’s already been fighting. He also said, and thus makes the decision easier, that b/c baby b has such a small placental share, that if he were to due in the next two weeks, he’s not super likely to affect baby a, causing neurological damage to him or causing his death. That makes me feel good and makes it easier to wait for now.
In two weeks I’ll be at 23 weeks. If we can wait another week, we’re at what’s considered viability. If baby b is still alive and healthy, we’ll wait again. Ideally we’d need to get him to 1+ pounds.
If in two weeks he hasn’t grown at all, and actually declines, we’ll do the coagulation. At that point we’ll have to b/c he’s not likely to grow anymore at all. And that’s what we’re going to use the next  two weeks to come to terms with.

20 weeks

Today I go see my new doctors in Fairfax at Perinatal Associates. Before I go, I just know they’re calling it a ‘first ob appointment,’ so Scott doesn’t go with me. Big mistake.

Since we’re at the 20 week mark, they do the full 20week scan. We don’t get good news.

Baby B has not grown, and he’s now 49% smaller than his brother.

What do we do??? Because I’m only 20.5 weeks, it’s way too early for either baby to be viable, so just letting it play out is risky…..so do we preempt? If so, baby A gets a full chance of survival. If we don’t intervene and wait, then we could possibly make it to viability. but with no growth in 2 weeks….that’s unlikely. If we don’t intervene, wait, and baby B dies, then baby A becomes at risk of death and/or severe brain damage.

Already dealing with the possibility of losing one baby is bad enough…the possibility of losing one and having one with brain damage is killing me. I just can’t do it.

We’re going back to Baltimore in 2 days. We’ll see if their numbers confirm, or if this was a fluke with different equipment and different sonographers.

We think we have 3 options, though the third option isn’t something Baltimore likes to do, maybe if we ask they have to do it???
assuming that Baby B truly has achieved no growth, the chances he’ll live are slim to none. So based on that, we have to make our decisions.
1. We preemptively do umbilical cord occlusion: http://www.obgyn.umm.edu/ttts/therapy.html#umbilical. This is where they basically clamp his cord and he dies in utero. B/c he gets clamped, his death shouldn’t affect baby A.
2. We continue waiting to see if anything happens. This poses several risks….if Baby B were to die say Thursday, and my next appt isn’t till the following week, Baby A will most likely die and/or suffer severe brain damage. At this point, neither baby is viable so they can’t do an early delivery yet b/c neither would survive. Even if I could make it to 28 weeks or so, Baby B probably wouldn’t survive if he’s still not growing.
3. We get the laser surgery. This would sever all blood vessel connections between the babies. If Baby B were to die, his death would be like in #1 above and shouldn’t affect Baby A. If he’s to continue growing, he gets to fight it out on his own. Of course, getting the surgery isn’t without risks to both babies b/c it’s intrauterine surgery.
At this point, not having talked to any other doctors, we’re leaning towards scenario #3. The laser surgery is the course of action with TTTS, which I still don’t have, but it’s also the plan we can live with right now….we give both babies a fighting chance. And if the one cant make it, the other isn’t affected. This to me is so much more acceptable that option #1. Of course, we don’t know yet if we can get the laser surgery. But there are several studies being done right now trying to figure out what’s the best situation with my exact scenario. The study divides the participants into two groups: one group gets the surgery, the other group waits. Pretty much the outcome will be the same with both….one or more baby will die.