Day 23: 32 weeks

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Today was my third “goal” during my pregnancy.. there was no more actual due date. We had short term goals.. 1st make 24 weeks, then get to 28, and then 32 weeks and you will be ok. When me made it past 24, I felt like a superhero. No signs of ttts, babies were growing and healthy and I began, for a short window, to celebrate my pregnancy. I worked hard on changing my mindset and envisioning my boys in our life. I started a nursery and my husband painted a beautiful room and put together cribs. I needed to see it. I needed to believe with every piece of me that they would be here. I would never give up on them.

As we became close to 28 weeks, my body began to change. My belly shifted to one side. I became short of breath and gained 10 pounds in a few days. I had so much pressure that it was almost impossible to walk. And then came the contractions. By your third pregnancy you have a good idea of what to expect. This was not normal. We were about 27 weeks and I knew I had to at least get to 28. 28 weeks is a vital stage for lung development. By this time, tiny air sacs known as alveoli are developing and surfactant is excreted. I knew my babies would face cardiac and kidney problems because of twin to twin transfusion syndrome and if they had to fight lung issues as well the outcome would likely be poor.

Our condition changed within a few days. We ended up in labor and delivery with significant contractions at 27 weeks and were faced with a difficult decision. The boys went from a healthy environment to now full blown stage three ttts. Peter was swimming in 3 times the amount of normal amniotic fluid and his heart was starting to fail, having to pump again all the extra pressure. Maurice was now “stuck” having no fluid at all.. his bladder was no longer visible on ultrasound because it completely stopped working. He was in kidney failure. He also stopped growing and his heart was struggling from the additional stress.

After my ultrasound , our incredible doctor, Dr. Alverez – Perez called Dr. Quintero before speaking to us. They came up with a plan. We could either deliver right now or fly to Miami and have a surgical procedure. If we delivered now there would be an 80% the babies would survive. When he told us this all I could hear was a 20% chance they wouldn’t. We also knew the likelihood of long term complications was high. If we had the surgery, there was a 80% chance we could make it to 32 weeks. The main risk with the surgery was losing one or both of my boys. During the procedure they would separate their blood flow. We knew Maurice likely had less of a placental share ( because of where his umbilical cord was and also because of his small size). If his main blood supply was coming from the connecting vessels he and Peter shared, there was a very good chance he would not survive. If we did nothing and just waited we would likely lose both our boys. We were past the technical ” cut off” for surgery which is 26 weeks but Dr Quintero still agreed to do it.

When we went to Dr Quintero and Dr Alverez, I promised myself I would trust them. I knew we were in the best hands and I would do whatever they recommended. Both of them agreed that surgery would give our sons the best chance.. so that’s what we did. I am forever thankful to my husband for supporting this and every hard decision we had to make. They gave me medication to stop my contractions and I flew praying I would not go into labor. In less than 24 hours were in Florida being operated on by the man who developed this life saving procedure and the instruments used during it.

It was not easy…Physically and emotionally. I prayed during the surgery. I watched on a screen as a laser burned vessels connecting my boy’s blood.. I held my breath thinking it may be the last time I see them. A few hours after surgery, it was time to check the boys. I remember being too afraid to watch and just stared at my husband. Dr Quintero jumped up .. so excited. The boys very ok.. actually better than ok.. Maurice’s bladder was visible and his kidneys were working again. This indirectly meant he was able to get good blood flow and there was a chance he would start to grow again. Peters fluid level was also normalizing  and his heart improving.  It was a miracle.

I had a few complications and ended up in the ICU for about a week. We would be monitored closely everyday. When we were ready to go home 32 weeks seemed real again. We could make it. At the very least we surpassed 28!!

A few days after coming home.. the symptoms came back. I knew it was time. We were 28 weeks and 5 days when we went in for our visit .. and discovered ttts returned.  We quickly ended up having an emergency c section.

My boys came out crying.. their lungs were strong! I could hear them as I laid behind a paper blue curtain. They wouldn’t let me see them but I could hear them. I know the surgery is what saved our boys. They were in heart and kidney failure and if they also had underdeveloped lungs the outcome would  have been very different.

We did not make 32 weeks the way we planned… but in life what can you really plan. We are here and our past already seems so far away. I look at their cribs everyday .. I sit in their rocking chair and can almost feel them in my arms .. everyday a little stronger ( Maurice is officially 2 pounds and Peter 3.4) and little closer to home!

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