Well I have had a little reminder this week of what many of my clients go through on a daily basis – sleep problems. As most of you know I have twin boys Ewan and Joseph (read the previous blog item for the story around those two, it’s a bit of a tear jerker). Well on Sunday night Ewan learnt how to climb out of his cot. Not content with this great achievement, he gave his brother a personal tutorial and within five minutes they were both marauding around the bedroom laughing hysterically much to the consternation of my mother who was babysitting.
On Monday hub and I headed for Ikea to purchase two new beds, afraid that our little bundles of joy (otherwise known as the demolition squad) would break their necks. Ikea was as usual the ultimate nightmare shopping experience. Carl decided that the best plan of attack was a commando style in and out mission. Fine except it was Bank Holiday Monday and it was not possible to quickly fight your way through the crowds. Instead I had to listen to a lot of tutting, derogatory comments about slow overweight people and a sharp rebuff when I suggested we might stop to buy a portion of Swedish meatballs (the only usual highlight of an Ikea trip). We did however, make a fantastic breakthrough. We found a helpful member of staff. Having shopped for ten years at various branches of Ikea (Wembley, Leeds, Warrington and now Manchester) this was the first time that we had come across such a person. She advised on the best value for money expanding mattress, checked stock availability and smiled throughout. We were surprised, amazed and delighted. After a couple of hours armed with our purchases of 2 beds, 2 mattresses, duvets, pillows, duvet covers, matching curtains and a garden bench (don’t know how that happened) we made for home.
Of course the follow up to a trip to Ikea is also extremely unpleasant because you then have to build the furniture. There was clearly a sense of urgency because by this time it was 5.30 and the twins go to bed at 7.00. On top of this Carl had decided to recoup some of the £325 Ikea bill by flogging the cots on EBay so these had to be washed down, photographed and dismantled by Ben, Caitlin and I whilst Carl huffed and puffed with his illustrated instructions.
Finally at 7.15 the beds were assembled, the duvet and curtains were ironed and in situ and the twins were introduced to their new sleeping areas. Oh the joy on their little faces as they bounced up and down on their new trampolines! We started the by now famous Baby Sleep System routine. They had a bath, we read a story, they had their milk, we tucked them in and left the room was so that they could blissfully fall asleep on their own. Five minutes later as we settled down to a well deserved beer and the latest episode of Doctor Who we could hear a regular thudding and sounds of general hilarity. “They will get fed up in a minute and go to sleep” said the half of our partnership who is not a Baby Sleep Expert. Half an hour went by and there was no sign of the party in the twins’ room coming to an end. I went upstairs and put Ben and Caitlin in bed. I calmly told the boys to get into their beds whilst trying not to screech about the scene of devastation which met my eyes. They laughed, ignored me, climbed on the window sill and hid behind the Bob the Builder black out blind. At this point I started to follow my own advice and firmly put them back in their own beds. I had barely reached the door when Ewan had climbed into Josephs’ bed. I returned him. This time I made it to the door before Joseph got out. I returned him using my key phrase ”time to sleep, night, night”. After around 20 returns, I roped in my 7 year old son, who occupies the room across the corridor. “Shout me if they get out of bed”. Caitlin then started to howl because she wanted to be the policeman. By this time my patience was wearing thin and she got screeched at to get in bed. Finally after 2 hours of running up and down stairs (I can’t understand why I am a stone over weight) the twins gave in and fell asleep. All was calm and I got to finish my beer. That night as I headed for my bed, I peeked in. Joseph was lying in the gap between the two beds (must have fallen out and not woken) and Ewan was asleep in the middle of the bedroom floor with his bum in the air (who knows how he got there). I put them back in bed and headed for the land of nod.
The following day I was violently awakened at 6.30 by Caitlin screeching up the stairs “the twins are out of bed”. Having been deprived of the police job the night before, she was determined not to be sidelined in the morning. After 30 minutes of listening to screeching, arguing and the twins blatantly defying Caitlin’s crowd control attempts I struggled out of bed. During the course of the day another concern entered my head. My boys as you would expect if you had read my book have a 2 hour nap every afternoon. I use this time to service my Forum. If they were not going to have this sleep I was in big trouble. Of course 12.30 arrived and the last thing on their mind was sleep. Who could nap when there was so much fun to be had? I spent the next 2 hours running up and down stairs consistently putting them back in bed. I had tried peeking through the door, but they were onto me and kept shouting “hiya”. My poor clients got some short responses to their questions that day.
The following afternoon I hatched an ingenious plan. I would put travel cots up and they could sleep in them for the midday nap. If they did not fall asleep immediately then it would keep them from marauding in the bedroom. At 12.40 I was back downstairs. Ewan had worked out how to climb out of the travel cot! I put him in bed. Two minutes later I am back downstairs to find that Ewan had got out of his bed and climbed into Josephs travel cot – agggghhhhh. Again I was up and down the stairs like a Stannah stair lift. This time they fell asleep after 45 minutes.
I have to say that things are improving. Last night they only got out of bed three times and didn’t disturb us until 7.30 this morning (although the bedroom did look like a battle re-enactment). The naps are now happening with Joseph in a travel cot and Ewan in his bed. I am optimistic that after another week of consistency I will have got there (and hopefully be 7lbs lighter). Let’s hope.
Friday, 1 June 2007
Twin to Twin Transfusion Syndrome - we beat the odds
In the summer before my eldest child was due to go to school, I got a bad case of empty nest syndrome. I had always wanted three children but, after the birth of our second child Caitlin, Carl and I decided that as we now had a pink and a blue one we would stop. One morning we got up at 5.30 am and hired a stall at a Manchester car boot sale. We sold all our baby stuff and then went off on a shopping expedition to buy ourselves some new clothes. Boy were we to regret that one! However, as the dreaded school start date approached for Ben, I started to get more and more broody. Not only was he about to go to school full time, but I knew that my baby girl was only a year behind him. Through May and June I started to nag, cry, negotiate and black mail my poor husband to try for another baby. Carl was reluctant. “What happens if it is twins? he tried in a desperate effort to put me off. “Don’t be ridiculous” I said. There are no twins in my family. Eventually Carl gave in “Go on then we will give it a go”. Five weeks later whilst on holiday, I disappeared into a public toilet in a designer outlet retail park with my pregnancy testing kit. Upon reappearing I made Carl check that there was indeed the confirming cross in the second window. Carl went rather a funny colour and bought two shirts in the next ten minutes which were not to his normal taste (i.e. blue) and which I have never yet seen him wearing. I of course was deliriously happy and the prospect of Ben going to school did not seem so bad after all.
Another week or so went by and I started throwing up (nothing new, but it did seem worse than I had remembered). I then started to get quite serious pain on one side of my stomach. I began to worry that the pregnancy was ectopic. I had had to have an ovarian cyst removed in my 20’s which had resulted in me losing a tube, so I knew that if this was the case, my chances of having another baby would be reduced to zero. I headed off to my GP and he made me an appointment for an early scan at 7 weeks. A week later we duly trudged to the hospital and I positioned myself on the bed. The scan began and within a few seconds, we heard the dreaded words “Is there any history of twins in your family”? The pit of my stomach hit the floor as she turned the screen around and there, clearly visible were what looked like two little runner beans. Carl made a very funny noise from his chair in the corner. This turned into a hysterical laugh. I was momentarily quite worried about him. I suddenly had a horrible thought “there are only 2”? I asked. “Yes only two” she said. We left the hospital in a bit of a daze.
It took a few weeks, but we were gradually warming to the idea of doubling our family in one foul swoop. My mum had lifted a huge weight from my shoulders by volunteering to work part-time and child mind for me so I could continue to work two days a week. This addressed the financial worries that we were really concerned about because she was going to work for free. We had recently moved house so space was not really an issue and we had numerous offers of baby equipment, clothes etc from friends. By the time I had my 12 week scan I was feeling quite relaxed about the whole thing. The scan went well and there was no sign of the problems to come.
As the weeks went by I began to get very very large. At first I put it down to the fact that I was having twins. I was however, acutely aware that it must all be baby as I threw up practically everything that I ate. A couple of days before the 20 week scan I began to harbour a secret fear that something was not quite right. My stomach was much larger than for a 40 week single baby. On the day of the scan a series of events began that were to make the next 3 months the worst of our lives. The lady doing the scanning was clearly concerned the minute she saw me, due to my vast size. When the scan started she said very little. Eventually I asked if everything was okay. She said that she could see no sign of a stomach and a bladder on twin 2 and that twin 1 was swimming in a massive amount of fluid and also seemed to have some abnormalities. In addition, there was a 2 week size difference between the 2 twins. I burst into floods of tears and Carl sat in shocked silence. The sonographer said that we needed to speak to the Consultant and she left us alone for a few minutes. In this time we decided that we wanted to see a specialist and that this had to happen quickly. If the situation was as bad as it looked then we needed to review our options as soon as possible. We were very lucky to get an appointment at St Marys two days later.
On Friday we set off for Manchester. I had not slept for two days, but had had good support from friends, family and my midwife who had come to the house to see me. We met the consultant and his team of midwives and radiographers. He did a detailed scan which took about 40 minutes and then took us into an ante-room. He explained to us in simple language and with diagrams that I had a condition called twin to twin transfusion syndrome which was fairly rare and only affected identical twins. In basic terms it meant that one twin, the donor (in our case twin 2) was passing blood to the other twin, the recipient. This resulted in twin 1 becoming anaemic, having little amniotic fluid and stunted growth and twin 2 receiving too much blood, resulting in heart problems and a massive increase in amniotic fluid. The syndrome had 5 levels of seriousness and mine was right near the top. If the fluid was not removed and continued to build up, I would either go into labour between 20 and 25 weeks or one or both babies would die in the womb. He then explained our options. We could do nothing and the babies would almost certainly die, we could terminate the pregnancy or we could opt for one of two treatments. The first of these was to start on a course of amniotic reduction. This would involve inserting a needle into the sac of twin 1 and removing the excess fluid. The consultant said that this sometimes only needed to be done a couple of times and the fluid increase stopped. The second option was to consider laser surgery. This involved splitting the blood vessels in the placenta to give each baby an independent blood supply. St Mary’s did not offer this but they could refer me elsewhere. The chances of success for both procedures was around the same – 33% chance of 2 healthy babies, 33% chance of 1 baby surviving and a 33% chance that both would die. He left us alone to make a decision. Our feeling at the time was one of optimism. Okay this was not great news, but at least there was some hope, whereas an hour ago we had had none. We decided to opt for the amniotic reduction which could be started immediately and we would still have the opportunity to take the laser surgery if it was unsuccessful. The procedure was far from pleasant. The needle insertion hurt and the fluid was drawn off with a syringe the size of a small bicycle pump. On that occasion 6 pints of fluid were collected in jugs and thrown down the sink.
When we got home I set about researching everything I could about twin to twin transfusion syndrome. I soon became quite depressed. There were endless accounts of people losing their babies either in the womb or in special care baby units. The medical research was complicated to understand and I spent hours deciphering the results of medical trials comparing laser surgery with amniotic reduction techniques. In the next few days I could feel the fluid building up again so knew that the initial treatment had not worked. I returned to St Marys after a week and had 4 pints taken off. This time the consultant made a little hole between the 2 amniotic sacs to try and equalise the fluid around both babies. The Christmas holidays arrived and I returned a further 2 times to have another 8 pints of fluid removed but it was becoming obvious to everyone that it was not working. The worse thing was the counting of days. Every day was closer to the magic 26 week point, where a baby’s chance of survival begins to improve significantly. Somehow I knew that if I didn’t exercise another option quickly, my babies were going to die. On the day after Boxing Day Carl and I asked my consultant to refer me for laser surgery. I was still only at 23 weeks.
Through my research I had concluded that the success of the surgery seemed to depend on the experience of the surgeon. I had tracked down the doctor who had performed the most in the UK and he was based at Kings College Hospital in London. We therefore asked St Mary’s if we could be referred there rather than their usual choice of another London hospital. This was actioned and the surgeon agreed to see me four days later. It was terrible packing to go, but we knew that the situation was probably about to be resolved one way or another. We knew that if both babies were still alive after a week following the operation then the chances of them surviving were good. If it didn’t work then they still weren’t really viable and I convinced myself that this would make me feel better about taking the risk. I was a mess and I couldn’t do the waiting game and the amniotic reduction treatment anymore.
The Harris Birth Right centre at Kings is an exceptional facility. I was seen and assessed by at least 4 top doctors specialising in various fields of foetal medicine. Once they had established that I was not likely to have a heart attack during the procedure and they had done a comprehensive scan to check positioning, condition of the babies etc. I met the top man himself. He had come in from his Christmas Leave to do the laser surgery. I was given a local anaesthetic via patches on the skin. It must have been a fairly hefty dose because what followed should have really hurt, but didn’t. A hollow pipe was pushed into my uterus to the right of my belly button and a camera and a laser were passed through it. The Professor then used a conventional scanner and the camera to plan his assault with the laser. He passed the laser across the placenta burning a line across it. He then went back and ‘mopped up’ any blood vessels that he had missed. I had expected that the whole op would be more scientific and that more work would be done on assessing which vessels were connecting the two babies. I suppose luck plays a big part and this is why the procedure has such a variable success rate. When he’d finished he asked us if we wanted to see the babies’ faces via the camera. I declined and looked away. I didn’t want to see the faces of babies that might shortly be dead. Carl had a good look though.
Once all the equipment had been taken off I was sent to lie down for an hour. They wanted to scan again to check there were still two heart beats, before they discharged me. That was a very long hour and I can’t describe the agony of the wait. Eventually it was confirmed that both babies were still alive and I now had a 44% chance that at least one of my babies would still be alive in a week (why is everything pregnancy related always described in percentages?). We went back to our hotel, Carl went for a takeaway and I phoned my mother.
The following week was a nightmare. I spent every second trying to work out whether I was being kicked and by how many babies. Sometimes I was certain that there were two and other times I felt nothing for a couple of hours. Blind panic would set in and then I would feel the tiniest movement and convince myself that one baby was dead. All the time I was still coping with a demanding teaching job and a five and a three year old. I look back and wonder how I held it together. At last the hospital scan day arrived. The Consultant and his staff looked as worried as we did when we walked in. He said nothing for a couple of minutes as he scanned. Finally the silence was broken and he said “there are two babies and they are doing much better”. Carl and I couldn’t believe that we had beaten the odds. I don’t think the staff did either.
I continued to go for regular scans at St Marys for the next few weeks. Everyone hoped that I would get to 35 weeks and then steps would be taken to deliver the twins. At about 30 weeks I began to relax. I knew that statistically my babies would have a great chance of survival from this point and I needed to get my head together and plan for the arrival. We had dared not prepare a room, buy a pram or a bigger car until now and it all needed to be sorted. Over the next 2 weeks we spent money and got excited. On the 14th March I went to move my nana into her new sheltered old persons flat. Her warden came up to talk through the tenancy agreement whilst we enjoyed our pie and cake lunch. I had just taken my last mouthful of lemon bun when I felt a small pop. I went to the toilet and realised that my waters had broken. My babies were coming and I was at 33 weeks and 3 days gestation. I tried to tactfully let my nana know, but unfortunately at 80 she is a bit deaf. By the time the message got through, most of the flats on the top floor must have known. The warden who was an ex Inspector with Greater Manchester Police asked if I wanted an ambulance. I told him that I was fine and that my babies did not arrive quickly (36 hours and 12 hours to be precise). It was 1.30 in the afternoon. They carried on going through my nanas paperwork whilst I sat on the toilet and organised my family. Carl was contacted, told to get from Macclesfield to Whaley Bridge, pick up the hospital bag and then collect me from Stockport. My dad was dispatched to pick up Ben and Caitlin and my mother was summoned from my brothers to come and talk to me whilst I waited for my husband to arrive. My nana continued to discuss rent and trough her lemon bun! At 2.00 I was beginning to get a little concerned. The contractions hurt and were coming very quickly. My mother had been delayed, my nana was still eating (as she is apt to do in stressful circumstances) and Carl was still on his way to Whaley Bridge. The warden was still covering the finer points of tenancy agreements but was obviously getting worried. 15 minutes later my mother arrived in a panic stricken state and offered to drive me to the hospital. The thought of my mothers driving, caused me to wonder if I could drive myself, but the next contraction confirmed that I couldn’t. Carl was now in Disley and stuck in traffic. He screamed down the phone to call an ambulance. The residents of the sheltered accommodation assembled in the foyer to witness me threaten to kill the ambulance man if he made me get in the wheelchair he had pushed in for my convenience. The urgency of the situation was realised and the blue light and the siren went on. At the hospital there was a massive furore as a labour room was set up. People arrived from all over the place and at one point there must have been 30 people in the room. The time was 3.15 and my husband was not among the assembled.
Funnily enough, despite the chaos I really felt quite calm. For the first time in seven months I felt like I had some control over the situation. My babies were both head down and I was determined that I was going to give them a great start in life by delivering them myself with no medical intervention. I even checked with my midwife before accepting any pethadine to make sure that this would not increase the chance of them having to be ventilated. Carl at this point fell through the door clutching my notes. At 3.25 I announced that I was going to push and delivered Joseph William Dean at 3.28. He was 4lbs 1oz and the most beautiful baby I had ever seen. His head was just a little bigger than a tennis ball and he was breathing on his own. I was having a lovely cuddle and felt in a state of complete bliss. In the meantime the consultant was getting very worried. He had been desperately trying to stop twin 2 from flipping round, but with the extra room suddenly becoming available, twin 2 had decided to have a go at ballroom dancing and had gone transverse. He announced that I was going to need a caesarean. No way was I going to have major surgery when I had successfully delivered one twin. “I can do this” I said. “My contractions have stopped and when they restart I will push this baby out”. The monitor showed that the baby was not in any way distressed so the Consultant gave me the chance to have a go. When the contractions started I pushed like I have never pushed before. At the same time I performed a sub conscious gymnastic twist which must have worked because two little feet appeared in the daylight. “I really need you to push now” a slightly hysterical voice said from the bottom of the bed. I gave another almighty heave and Ewan Alexander Dean was born at 3.58. He was 4lbs 2oz and looked exactly the same as his brother. I had another little cuddle and both boys were put in incubators and taken to the Special Care Baby Unit (SCBU). I was taken to a private room and so avoided being surrounded by mothers who had their babies with them. A couple of hours later I went down to the SCBU to see my two little boys who now looked liked the Borg characters from Star Trek due to the numerous wires. That first night was hard. Carl had gone home and I was on my own. I tried to sleep, but didn’t manage it. The following day a decision was made to transfer the twins to another SCBU that had spare beds. Again we were lucky and they were sent to Macclesfield hospital.
The next four and a half weeks were a bit of a blur. I was euphoric that my babies were here, but it was peculiar that they were not at home. Ben was in full time school and Caitlin did 4 short days at nursery so I managed to go to the SCBU everyday. Ewan made quicker progress and I brought him home after 3 weeks. Poor Joseph was apt to go blue when he sucked on a bottle and so had to stay in an extra week and a half. Eventually, however the day came when they were both at home.
Since then we have managed very well. The boys are now 16 months old and a delight. They slept through the night at 12 weeks and rarely cry. They still have a few ongoing problems. They both have a heart condition, but it is hoped that they will outgrow it. Joseph still has to see a physiotherapist every few months. For a while we thought he might have cerebral palsy (a common side effect of twin to twin transfusion syndrome), but everyone now seems quietly confident that he hasn’t. In the meantime I make sure that I enjoy every minute that I spend with them. They are a miracle and I thank God every day that they survived.
Another week or so went by and I started throwing up (nothing new, but it did seem worse than I had remembered). I then started to get quite serious pain on one side of my stomach. I began to worry that the pregnancy was ectopic. I had had to have an ovarian cyst removed in my 20’s which had resulted in me losing a tube, so I knew that if this was the case, my chances of having another baby would be reduced to zero. I headed off to my GP and he made me an appointment for an early scan at 7 weeks. A week later we duly trudged to the hospital and I positioned myself on the bed. The scan began and within a few seconds, we heard the dreaded words “Is there any history of twins in your family”? The pit of my stomach hit the floor as she turned the screen around and there, clearly visible were what looked like two little runner beans. Carl made a very funny noise from his chair in the corner. This turned into a hysterical laugh. I was momentarily quite worried about him. I suddenly had a horrible thought “there are only 2”? I asked. “Yes only two” she said. We left the hospital in a bit of a daze.
It took a few weeks, but we were gradually warming to the idea of doubling our family in one foul swoop. My mum had lifted a huge weight from my shoulders by volunteering to work part-time and child mind for me so I could continue to work two days a week. This addressed the financial worries that we were really concerned about because she was going to work for free. We had recently moved house so space was not really an issue and we had numerous offers of baby equipment, clothes etc from friends. By the time I had my 12 week scan I was feeling quite relaxed about the whole thing. The scan went well and there was no sign of the problems to come.
As the weeks went by I began to get very very large. At first I put it down to the fact that I was having twins. I was however, acutely aware that it must all be baby as I threw up practically everything that I ate. A couple of days before the 20 week scan I began to harbour a secret fear that something was not quite right. My stomach was much larger than for a 40 week single baby. On the day of the scan a series of events began that were to make the next 3 months the worst of our lives. The lady doing the scanning was clearly concerned the minute she saw me, due to my vast size. When the scan started she said very little. Eventually I asked if everything was okay. She said that she could see no sign of a stomach and a bladder on twin 2 and that twin 1 was swimming in a massive amount of fluid and also seemed to have some abnormalities. In addition, there was a 2 week size difference between the 2 twins. I burst into floods of tears and Carl sat in shocked silence. The sonographer said that we needed to speak to the Consultant and she left us alone for a few minutes. In this time we decided that we wanted to see a specialist and that this had to happen quickly. If the situation was as bad as it looked then we needed to review our options as soon as possible. We were very lucky to get an appointment at St Marys two days later.
On Friday we set off for Manchester. I had not slept for two days, but had had good support from friends, family and my midwife who had come to the house to see me. We met the consultant and his team of midwives and radiographers. He did a detailed scan which took about 40 minutes and then took us into an ante-room. He explained to us in simple language and with diagrams that I had a condition called twin to twin transfusion syndrome which was fairly rare and only affected identical twins. In basic terms it meant that one twin, the donor (in our case twin 2) was passing blood to the other twin, the recipient. This resulted in twin 1 becoming anaemic, having little amniotic fluid and stunted growth and twin 2 receiving too much blood, resulting in heart problems and a massive increase in amniotic fluid. The syndrome had 5 levels of seriousness and mine was right near the top. If the fluid was not removed and continued to build up, I would either go into labour between 20 and 25 weeks or one or both babies would die in the womb. He then explained our options. We could do nothing and the babies would almost certainly die, we could terminate the pregnancy or we could opt for one of two treatments. The first of these was to start on a course of amniotic reduction. This would involve inserting a needle into the sac of twin 1 and removing the excess fluid. The consultant said that this sometimes only needed to be done a couple of times and the fluid increase stopped. The second option was to consider laser surgery. This involved splitting the blood vessels in the placenta to give each baby an independent blood supply. St Mary’s did not offer this but they could refer me elsewhere. The chances of success for both procedures was around the same – 33% chance of 2 healthy babies, 33% chance of 1 baby surviving and a 33% chance that both would die. He left us alone to make a decision. Our feeling at the time was one of optimism. Okay this was not great news, but at least there was some hope, whereas an hour ago we had had none. We decided to opt for the amniotic reduction which could be started immediately and we would still have the opportunity to take the laser surgery if it was unsuccessful. The procedure was far from pleasant. The needle insertion hurt and the fluid was drawn off with a syringe the size of a small bicycle pump. On that occasion 6 pints of fluid were collected in jugs and thrown down the sink.
When we got home I set about researching everything I could about twin to twin transfusion syndrome. I soon became quite depressed. There were endless accounts of people losing their babies either in the womb or in special care baby units. The medical research was complicated to understand and I spent hours deciphering the results of medical trials comparing laser surgery with amniotic reduction techniques. In the next few days I could feel the fluid building up again so knew that the initial treatment had not worked. I returned to St Marys after a week and had 4 pints taken off. This time the consultant made a little hole between the 2 amniotic sacs to try and equalise the fluid around both babies. The Christmas holidays arrived and I returned a further 2 times to have another 8 pints of fluid removed but it was becoming obvious to everyone that it was not working. The worse thing was the counting of days. Every day was closer to the magic 26 week point, where a baby’s chance of survival begins to improve significantly. Somehow I knew that if I didn’t exercise another option quickly, my babies were going to die. On the day after Boxing Day Carl and I asked my consultant to refer me for laser surgery. I was still only at 23 weeks.
Through my research I had concluded that the success of the surgery seemed to depend on the experience of the surgeon. I had tracked down the doctor who had performed the most in the UK and he was based at Kings College Hospital in London. We therefore asked St Mary’s if we could be referred there rather than their usual choice of another London hospital. This was actioned and the surgeon agreed to see me four days later. It was terrible packing to go, but we knew that the situation was probably about to be resolved one way or another. We knew that if both babies were still alive after a week following the operation then the chances of them surviving were good. If it didn’t work then they still weren’t really viable and I convinced myself that this would make me feel better about taking the risk. I was a mess and I couldn’t do the waiting game and the amniotic reduction treatment anymore.
The Harris Birth Right centre at Kings is an exceptional facility. I was seen and assessed by at least 4 top doctors specialising in various fields of foetal medicine. Once they had established that I was not likely to have a heart attack during the procedure and they had done a comprehensive scan to check positioning, condition of the babies etc. I met the top man himself. He had come in from his Christmas Leave to do the laser surgery. I was given a local anaesthetic via patches on the skin. It must have been a fairly hefty dose because what followed should have really hurt, but didn’t. A hollow pipe was pushed into my uterus to the right of my belly button and a camera and a laser were passed through it. The Professor then used a conventional scanner and the camera to plan his assault with the laser. He passed the laser across the placenta burning a line across it. He then went back and ‘mopped up’ any blood vessels that he had missed. I had expected that the whole op would be more scientific and that more work would be done on assessing which vessels were connecting the two babies. I suppose luck plays a big part and this is why the procedure has such a variable success rate. When he’d finished he asked us if we wanted to see the babies’ faces via the camera. I declined and looked away. I didn’t want to see the faces of babies that might shortly be dead. Carl had a good look though.
Once all the equipment had been taken off I was sent to lie down for an hour. They wanted to scan again to check there were still two heart beats, before they discharged me. That was a very long hour and I can’t describe the agony of the wait. Eventually it was confirmed that both babies were still alive and I now had a 44% chance that at least one of my babies would still be alive in a week (why is everything pregnancy related always described in percentages?). We went back to our hotel, Carl went for a takeaway and I phoned my mother.
The following week was a nightmare. I spent every second trying to work out whether I was being kicked and by how many babies. Sometimes I was certain that there were two and other times I felt nothing for a couple of hours. Blind panic would set in and then I would feel the tiniest movement and convince myself that one baby was dead. All the time I was still coping with a demanding teaching job and a five and a three year old. I look back and wonder how I held it together. At last the hospital scan day arrived. The Consultant and his staff looked as worried as we did when we walked in. He said nothing for a couple of minutes as he scanned. Finally the silence was broken and he said “there are two babies and they are doing much better”. Carl and I couldn’t believe that we had beaten the odds. I don’t think the staff did either.
I continued to go for regular scans at St Marys for the next few weeks. Everyone hoped that I would get to 35 weeks and then steps would be taken to deliver the twins. At about 30 weeks I began to relax. I knew that statistically my babies would have a great chance of survival from this point and I needed to get my head together and plan for the arrival. We had dared not prepare a room, buy a pram or a bigger car until now and it all needed to be sorted. Over the next 2 weeks we spent money and got excited. On the 14th March I went to move my nana into her new sheltered old persons flat. Her warden came up to talk through the tenancy agreement whilst we enjoyed our pie and cake lunch. I had just taken my last mouthful of lemon bun when I felt a small pop. I went to the toilet and realised that my waters had broken. My babies were coming and I was at 33 weeks and 3 days gestation. I tried to tactfully let my nana know, but unfortunately at 80 she is a bit deaf. By the time the message got through, most of the flats on the top floor must have known. The warden who was an ex Inspector with Greater Manchester Police asked if I wanted an ambulance. I told him that I was fine and that my babies did not arrive quickly (36 hours and 12 hours to be precise). It was 1.30 in the afternoon. They carried on going through my nanas paperwork whilst I sat on the toilet and organised my family. Carl was contacted, told to get from Macclesfield to Whaley Bridge, pick up the hospital bag and then collect me from Stockport. My dad was dispatched to pick up Ben and Caitlin and my mother was summoned from my brothers to come and talk to me whilst I waited for my husband to arrive. My nana continued to discuss rent and trough her lemon bun! At 2.00 I was beginning to get a little concerned. The contractions hurt and were coming very quickly. My mother had been delayed, my nana was still eating (as she is apt to do in stressful circumstances) and Carl was still on his way to Whaley Bridge. The warden was still covering the finer points of tenancy agreements but was obviously getting worried. 15 minutes later my mother arrived in a panic stricken state and offered to drive me to the hospital. The thought of my mothers driving, caused me to wonder if I could drive myself, but the next contraction confirmed that I couldn’t. Carl was now in Disley and stuck in traffic. He screamed down the phone to call an ambulance. The residents of the sheltered accommodation assembled in the foyer to witness me threaten to kill the ambulance man if he made me get in the wheelchair he had pushed in for my convenience. The urgency of the situation was realised and the blue light and the siren went on. At the hospital there was a massive furore as a labour room was set up. People arrived from all over the place and at one point there must have been 30 people in the room. The time was 3.15 and my husband was not among the assembled.
Funnily enough, despite the chaos I really felt quite calm. For the first time in seven months I felt like I had some control over the situation. My babies were both head down and I was determined that I was going to give them a great start in life by delivering them myself with no medical intervention. I even checked with my midwife before accepting any pethadine to make sure that this would not increase the chance of them having to be ventilated. Carl at this point fell through the door clutching my notes. At 3.25 I announced that I was going to push and delivered Joseph William Dean at 3.28. He was 4lbs 1oz and the most beautiful baby I had ever seen. His head was just a little bigger than a tennis ball and he was breathing on his own. I was having a lovely cuddle and felt in a state of complete bliss. In the meantime the consultant was getting very worried. He had been desperately trying to stop twin 2 from flipping round, but with the extra room suddenly becoming available, twin 2 had decided to have a go at ballroom dancing and had gone transverse. He announced that I was going to need a caesarean. No way was I going to have major surgery when I had successfully delivered one twin. “I can do this” I said. “My contractions have stopped and when they restart I will push this baby out”. The monitor showed that the baby was not in any way distressed so the Consultant gave me the chance to have a go. When the contractions started I pushed like I have never pushed before. At the same time I performed a sub conscious gymnastic twist which must have worked because two little feet appeared in the daylight. “I really need you to push now” a slightly hysterical voice said from the bottom of the bed. I gave another almighty heave and Ewan Alexander Dean was born at 3.58. He was 4lbs 2oz and looked exactly the same as his brother. I had another little cuddle and both boys were put in incubators and taken to the Special Care Baby Unit (SCBU). I was taken to a private room and so avoided being surrounded by mothers who had their babies with them. A couple of hours later I went down to the SCBU to see my two little boys who now looked liked the Borg characters from Star Trek due to the numerous wires. That first night was hard. Carl had gone home and I was on my own. I tried to sleep, but didn’t manage it. The following day a decision was made to transfer the twins to another SCBU that had spare beds. Again we were lucky and they were sent to Macclesfield hospital.
The next four and a half weeks were a bit of a blur. I was euphoric that my babies were here, but it was peculiar that they were not at home. Ben was in full time school and Caitlin did 4 short days at nursery so I managed to go to the SCBU everyday. Ewan made quicker progress and I brought him home after 3 weeks. Poor Joseph was apt to go blue when he sucked on a bottle and so had to stay in an extra week and a half. Eventually, however the day came when they were both at home.
Since then we have managed very well. The boys are now 16 months old and a delight. They slept through the night at 12 weeks and rarely cry. They still have a few ongoing problems. They both have a heart condition, but it is hoped that they will outgrow it. Joseph still has to see a physiotherapist every few months. For a while we thought he might have cerebral palsy (a common side effect of twin to twin transfusion syndrome), but everyone now seems quietly confident that he hasn’t. In the meantime I make sure that I enjoy every minute that I spend with them. They are a miracle and I thank God every day that they survived.
Subscribe to:
Posts (Atom)
