Thursday, June 23, 2011

20 weeks and 5 days pregnant (the kicking is intensifying)

I realized yesterday that it had been several weeks since I shared a pregnancy update pic of Meghan and her ever expanding belly, so I thought it was about time. Tonight's post is going to be very short because a) we don't have any new news on the babies, b) we've been doing nothing but unpacking and working, and c) I'm just plain exhausted.



We've also received a ton of pics of our girls over the last couple of weeks, so here's a few of the recent ones.

Sophia (Baby A)



Isabelle (Baby B)



Madelyn (Baby C) - she's already saying, "Dad, get that camera out of my face!"

Wednesday, June 22, 2011

A Welcome Retreat

A couple of posts ago, I mentioned that I'd be sharing some highlights of the lighter side of this pregnancy.  For anyone who's been reading over the last couple of weeks, you're fully aware of all the drama surrounding our battle with TTTS.  Now that we're on the other side of it, at least for now, I want to start sharing how fun being pregnant with triplets can be because, honestly, we're exhausted from pregnancy drama.

Having triplets, while in the beginning was the scariest idea I'd ever encountered, is now something that I'm looking forward to more than anything in life (besides getting married to Meg of course).  It's a lot of fun getting to share our story with everyone.  We also get a lot of attention from family and friends.  It's not that we didn't before, but there's something about having triplet babies that gets people excited, because, let's face it, it doesn't happen everyday to a family or friend circle.  I've never been one to seek out being the center of attention, but it's really provided us with a great excuse to communicate with everyone on a more frequent basis, because in reality, people are just plain busy with their own lives and this pregnancy seems to interest everyone enough to make the extra effort to stay in touch, which is a good enough reason for me.

Also, because I'm being honest here, I'm not going to shy away from the fact that receiving a ton of gifts for our babies has been wonderful!  Besides the obvious benefits of having an entire village contribute to the preparation of three baby girls, it's been a wonderful excuse to get together with friends and family that you usually only see over the holidays, if that.  So far, Meg has actually had two baby showers.  One was thrown by her friends and co-workers at her school in VA and another one was just thrown by her family in Erie this past weekend.

We are so thankful for all of the gifts that we've received.  It's actually pretty amazing.  We have a huge truck and we couldn't have fit anything else in the back when we were leaving Erie to head to Naperville.  Also, there was so much stuff in VA that we just had the movers pack it up and haul it to our new home from the first shower.  Everyone in our lives is truly amazing and we are forever greatful for your thoughtfulness.

Well, I wasn't in town for the shower in VA, but since Meg and I were making our trek from VA to Naperville together, I participated in the Erie shower, which was really neat.  Fortunately, I still had one of my small cameras packed with me for the trip, so I was able to capture a few shots from the party.  A few of them are below, but the rest are at http://www.jeremydebauche.com/babyshowererie.

















Saturday, June 18, 2011

The Miracle of Normalcy (by Meghan)

(Today, Meghan decided that she wanted to guest-post to the blog.)

We've made it to the one week point!  Yesterday was an important doctor's appointment and post surgery milestone.  As we were there in another marathon sonogram, Dr. Quintero, our surgeon from Miami, was calling Dr. Gallagher on the phone to see how we were doing.

I'll share the good news with you first. All 3 babies have heartbeats. All 3 have normal dopplers.  The previous abnormal ones were the clue we were in stage 3 of TTTS.  All 3 babies have normal organs.  All 3 babies have a normal level of amniotic fluid, which was not the case prior to surgery.  Sophia (Baby A) is having some abnormal heart problems, but they are all moderate to mild now and not life threatening.  This is a huge improvement from last Thursday when she was in congestive heart failure and dying.   The cardiologist we met with assured us if there was no improvement from now until birth, she would still be fine and these last few things, an enlarged heart, a thickened ventricle wall, and some regurgitation, would probably rectify themselves over time, if not in-utero, then after she was born.   The doctor also told us that because the problem was so acute (developed extremely rapidly) and was taken care of so quickly, he thought we should hope for the best: to have 3 healthy, normal baby girls.

Then the doctor hits us with this statement, "We (our surgeon and our maternal fetal medicine doc) agree that now you're back to a NORMAL triplet pregnancy." Normal?  So many things started going through my mind about the miracle of this statement. One week and a day ago we were told to terminate our twins to save Madelyn (Baby C). One week ago their lives were literally saved.  So many people had to come together, like dominoes all in a line falling in order one after the other, in order for this miracle to have happened.

We talked with Dr. Gallagher about this at the end of our last appointment.  When you realize you have just been part of a miracle, you start reflecting on all kinds of "what ifs."  What if Dr. Barbash, an important neurologist at Holy Cross, hadn't come into our lives?  This doctor was happy to help Jeremy and me connect via video conference since he was out of town.  It was great.  After each appointment, we would come back to Dr. Gallagher's office.  Dr. Gallagher and I would sit in front of his web cam and Jeremy was on his.  Then, through this technology, Jeremy could see the sonogram pictures on our doctor's desktop and he would talk us through what he saw.   We really enjoyed this feature since we've been apart so long.  But then Thursday, June 9th happened, and I have to think if it weren't for this technology would our girls still be alive?   Jeremy was able to participate in that devastating conversation with the doctors at CHOP.  He was able to hear the doctor's explanation of our exact stage of TTTS and hear her expert opinion with all the technical details.  He was able to ask questions, as was Dr. Gallagher, and the 3 of us were able talk together after the doctor left the room about what we would do.   If this hadn't happened, if Dr. Barbash and Dr. Gallagher hadn't taken time out of their busy schedules to make sure to connect with someone in Philadelphia to get this set up, our girls wouldn't be here.  I would have had to leave that room and somehow explain to Jeremy in non-medical terms what the doctor had said.  I was in such a state of shock I don't think I could have done that.  If we hadn't talked to Dr. Gallagher afterward who told us he would never advise us against a second opinion, if we hadn't all been on the same page, things wouldn't have happened so quickly.  Our girls probably wouldn't have made it until Monday.  Looking back, without that technology to keep things happening in real time, we would not have made it to Miami the next day to have surgery and then the weekend would have meant no surgery until Monday.  When we were in Miami they told us they have only had 5 surgeries in the last year and a half on twins at stage 4 of this disorder because many times the hearts have stopped beating by the time the families arrive.  Dr. Barbash and his excitement about how this technology can change the medical community played a major role in saving our girls.

Dr. Gallagher, another key player in this miracle, is our MFM as many of you know. He is the one who noticed the problem.  He is the one who sent us to CHOP because he was concerned. He was the one who didn't waste any time getting us to experts who could diagnose the problem further.  He is the one who G-chats and emails and gives us his cell phone number and spends endless amounts of time outside of office hours checking in with us to make sure we're doing ok.  He is the one who has collaborated with every other doctor we've come into contact with during the course of the last few weeks. He has been our champion and made us feel like we were the only patients he had.  We will never find another doctor like him in Naperville.  What if we hadn't found Dr. Gallagher? I'm pretty sure we wouldn't be back to a normal triplet pregnancy, we may not even still be pregnant at all.

Here's a good-bye picture of Dr. Gallagher and me.



That brings us to the Facebook page for TTTS and Kristy.  We all know what would have happened if Jeremy didn't join that group and asked for Dr. Quintero's phone number.  Then a perfect stranger wouldn't have called the doctor so quickly and given him our number.  Since that day, Jeremy's grandmother has written to Kristy to thank her, and they've actually become friends on FB.  Isn't it amazing how our lives have become intertwined?  When our girls make it, it will be just as much because of Kristy as it was the doctors.

I don't know how to explain how amazing Dr. Quintero is.  We were in his life for two days.  In that short amount of time he took us from needing to accept the death of our twins, to offering an option for life, and then pulling off the miracle he offered.  That was all done in the first day though.  On the second day, he took time to come in and sit on my hospital bed on his day off talking about the surgery and our prognosis.  The whole time he was rubbing my leg and offering comfort as well as a doctor's advice.  He was a greater-than-life doctor who was very sure of himself and his capabilities as well as a kind, gentle man who understood how we were feeling.   In two days he changed our lives forever.

That brings me to all the amazing people who, in a few short hours, started rallying more people than I'll ever realize into prayer for us. As we sat in the hospital bed, we both enjoyed reading and sharing the text messages, blog posts, FB posts and messages, and emails.  The surgery was scary, but I wasn't scared.  I was calm.  The waiting afterward was scary, but we couldn't help but think we were going to have good news the next day.  Since that day, each sonogram has brought more hopeful news.  In just one week we've gone from our twins being close to death to our twins again being part of a normal triplet pregnancy.  Thank you to all of those of you who prayed and continue to pray.  You have strengthened Jeremy and me more than you'll know.  It's hard to measure what would have happened if we didn't have so much prayer, but those who have faith don't require concrete measurements.  We know you were all part of our miracle and our return to normalcy.

In order to avoid adding any more to this particular post, I'll just include one more photo of me and some of my girls at our last friend dinner in DC.

Friday, June 17, 2011

Mount Eagle Will Miss Meghan

For those of you who have never met my wife, let me tell you, she is an amazing woman.  The first thing that probably jumps into your mind is, "Well, of course she's amazing.  She's carrying triplets!"  Well, yes, that's one of the reasons, but there are so many more.  Besides being a great friend, being completely adorable, and making you feel completely at ease, she also has passion, specifically for education.

When she graduated from PSU about 10 years ago, she started off as a 3rd grade teacher.  She only taught for one year.  One of her co-workers knew that she was questioning whether or not she had made the right decision by getting into teaching.  Her co-worker's husband worked at a consulting company called Bearing Point.  She decided that she would give consulting a try and leave the classroom.  Well, it turns out that she missed the classroom and the kids.  She found herself going to Sylvan Learning Center after work, just so she could be with the kids.  She missed them so much, she decided that instead of putting up with a lot of the frustration she encountered in her first year, she would re-dedicate herself to fixing the problems which made her leave in the first place, which were primarily focused around reading education.  She went back to school, got her master's degree, and has been teaching at Mt. Eagle Elementary school as a reading specialist for the last several years...and she loves it!

Apparently, they love her there, too.  On her last day of school, the teachers gave her a book titled Mount Eagle Will Miss Meghan From A To Z.  Now, I'll warn you, I've typed up every letter of the alphabet they used to describe Meg because I want her to remember this time and I want our girls to be able to look back one day and read about how loved and appreciated their mother was.  So, don't feel like you need to read them all because they're really more for us :)



A is for always smiling.

B is for Bear Rock Cafe, where you spent hours on your day off (not mention simultaneously recovering from a stomach bug) to help fourth grade make sense of the language arts standards and create an intricate schedule only to have it snowed upon my Snowmaggeddon 2010!

C is for collaborating about student's needs and discussing reading and speech/language and how they are closely linked.  Thanks for challenging me and making my understanding of accommodations and the DRA.

C is for your contagious enthusiasm and love of reading and teaching.  I always appreciated when you shared new resources and strategies and helped me incorporate them into my classroom.

D is for DeBauche...and all the DeBauche daughter weddings you will be having.

E is for exemplary, which you are...an exemplary educator, an exemplary leader, an exemplary woman, an exemplary friends...

F is for your friendship which I have been fortunate to have.  I will our runs and walks, our talks, dinners, and all the support you have given me.  Thank you so much for your friendship.

G is for Go Penn State!!!  and for getting  me ready for my first year of teaching!  Thank you so much for everything you did to help me prepare for this whirlwind of a year.

H is for hooking me up with both a tutoring job and a summer curriculum job.  Thanks for networking!

I is for the way you have inspired me to be a better educator.  I will miss you and the way you love your job and our students.  It has helped me to never give up, to keep trying and to love our kids even when it's hard.

J is for joyfully coming to work everyday.   No matter what, you had a smile on your face and an optimistic outlook on the day.  Thank you for making my first year as a reading teacher a joy!

K is for keeping the kindergarten team on the kicking path.  We will miss your kind, karing, kool face.

L is for always lending an ear for fourth grade as we shaped our language arts block.

M is for mentor because you were an amazing one to me.

N is for never slowing down...you are always on the move!

N is for your never ending energy.  I'll miss you speed walking down the halls.

O is for our desire to have children and some of the struggles we both faced.  I enjoyed our talks and will miss them.

P is for positivity because you always turned my frown upside down.

Q is for all of the questions I come to you with every day and the patience with which you answer.  I have learned so much from you, Meghan.

R is for our reading team.  You and I had a lot of crazy times squeezed into a lot of overloaded days and I wouldn't have done it with anyone else.  You will forever be my favorite reading teammate.

S is for the shock I felt the first time I heard you curse.

T is for triplets!  You are truly going to be a tremendous mother to all three!  In time they will be toddlers, teens, and then Brides-to-Be!

U is for your unbelievable support.  I could not have survived my first year of teaching without you!

V is for very cute as I'm sure your babies all will be.

W is for walking fast...even these babies haven't slowed you down.

X is for your extremely positive attitude that makes everyone's day brighter and inspires me to try to stay on the sunny side of life.

Y is for your smiling face that I always enjoyed as we passed each other in the hallway.  I'll miss seeing you around the school.

Zzzzzz's are what you will need when the babies arrive!

Z is for zooming all your teaching skills to help 2nd graders have an awesome writers workshop.  I'll miss your gentle admonitions when the kids try to get out of hand "2nd graders we have to get in line..."

Thank you Linda Layton, Jessie Bagnall, Chrissy Gibbs, Tara Murphy, Barbara Anzalone, Sarah Trevino, Devon Parks, Katie Keier, the Kindergarten team (Shiela, April, and Jordan), Hannah Aldridge, Beth Reidy, Jacquie Heller, Margo Trollinger, Amy Stoffel, and Zeba Ahmed.

Wednesday, June 15, 2011

Moving On

Today, we moved out of la Casa de DeBauche and moved in to the Irwin-Hayes B&B, at least through Friday :)  Sarah and Zac, fresh off of moving into their own new place, managed to prepare a room for a temporary vagabond and his pregnant wife.  Turns out it's also all-inclusive with bagels and taffy!



Yes, we're finally moving on from our little condo in Arlington (closed today) and into our ready-for-five sized home in Naperville.  While I've thoroughly enjoyed our old place, no tears were shed as we turned off the lights and shut the door on a place where many memories were made.  All eyes are focused on the future and our new home and all the plans that we have in store.

Before we leave to start our new lives together in Illinois, we have a couple more appointments this week, focused on follow-up from the laser ablation surgery.  One of them was today at Children's National Hospital in downtown Washington DC.  The focus for today was on fetal echocardiograms, as babies A and B were definitely having their own respective heart issues prior to the surgery that we hoped would correct themselves once their shared blood vessels were severed.  We've already had two ultrasounds this week, post-surgery, so we knew that we had a pretty good shot at seeing all three heartbeats again.  After about an hour-long sonogram session, we met with our fetal cardiologist to review the findings.  In her words, she said "Babies B and C look normal," which in itself means that baby B, Isabelle, seems to be getting the blood flow she needs without her connection to baby A, Sophia, which was a major concern based on her seemingly low share of the placenta.

Sophia's situation, while not completely reversed, is looking much better, too.  While they didn't specifically measure it, we were watching the ultrasounds and we saw no significant, or visible fluid in her abdomen or around her heart, which was a big improvement from just Monday.  She still has mild cardiomegaly, which is an enlarged heart, probably due to her having to pump so much fluid through it prior to the surgery.  A small side effect is that she also has a slightly enlarged right ventricle wall.  She still has moderate regurgitation, meaning that with each heartbeat, as the blood flows through each chamber in heart, the ventricular valves actually let a little bit of blood flow backwards.  I'm sure I'm not explaining this with the most accurate medical vernacular, but I left the sheet in the car and I'm too tired to walk out there to get it :)

Our last BIG appointment comes this Friday with Dr. Gallagher.  It's for our week 20 check-up.  It should a pretty long appointment, as they should be checking to make sure we're not missing any vital organs.  If there's a way to find something positive from all that we've gone through over the last week and the infinite amount of sonogram appointments, it's that we've gotten to know our girls pretty well.  We've seen that they all have 10 fingers and 10 toes!  We've also seen their brains, spines, livers, and eyelids.  Through the ultrasounds, we've also gotten a small glimpse of their personalities while watching them interact with each other inside the womb.  Now, maybe I'm reading into this too much, and it will definitely be interesting to compare notes later on when they're interacting with each other outside the womb, but Sophia (A) is definitely the most active.  She seems to be pretty uncooperative with the sonographer.  Isabelle (B), is currently the smallest of the three.  Watching her today, she seems to already be trying to talk.  She's pretty active as well, but slightly more cooperative than Sophia.  I'm sure it has something to do with their close proximity, but boy do they punch and kick each other a lot.  Madelyn (C), seems to be uninterested in her sisters.  She pops in from time to time on the ultrasound, but she's living in her own little world and is the most cooperative of the bunch.

Obviously, I'll provide a detailed report after our appointment on Friday, but today was another day full of good news and another day of reassurance that we made the right decision last week.

One last thing before I sign off for the night, we felt our first kick this morning!  We don't know if it was Isabelle or Madelyn, because their feet both seem to be in the same location today, but Meg noticed a flutter in her belly at the exact same time I had my hand resting on her belly and felt a small bump pushing out of her skin.  How cool is that!

 

Tuesday, June 14, 2011

Another Step in the Right Direction

We're back in DC today, just a few days removed from having, hopefully, what will turn out to be life-saving surgery for our triplet girls.  It's still amazing when I actually stop, take a breath, and reflect on all that has happened since Thursday afternoon.  Just a few days ago, we had our hearts ripped out with the possibility of losing our girls, only to have it restored a day later by what I will forever refer to as miracle surgery.  On Saturday morning, we had our first post-surgery ultrasound to determine whether or not babies A and B could survive without their shared connection.  As I wrote previously, they did.

Today would be another stepping stone of many to come in getting these girls to a viable age.  Now that we're back home and we're classified by our doc as a VIP pregnancy, we'll have more appointments than you can possibly imagine.  Thank you BCBS!  Even though we weren't scheduled to see Dr. Gallagher until Friday for our 20 week check-up, he made time to squeeze us in between rounds this morning with his residents and an early morning surgery.  I'm not sure if we'll ever find another one like him, as we'll be starting with a new MFM and new OB next week when we finally get to Naperville, IL.

In order to make this appointment, we had to start our day off pretty early.  Meg decided that she would use her cell phone as an alarm clock for us in the morning and left it plugged in all night, by the bed, to recharge.  On the nightstand, she also had her nightly glass of water.  Well, at 5:00am, in a way that only she could wake us up, she reached over to grab her phone (still plugged into the wall), with a full glass of water sitting on the power cord, pulled it over to herself on the bed, and catapulted the water into the air, landing all over EVERYTHING!  While I'd normally laugh at something like this, when you're expecting to sleep another 30 minutes and you're awoken to, "Honey, get some towels fast!" it's really hard to appreciate the comedic value of the situation at the time.

Maybe it was the gross overestimation of the time required to get to the other side of town on her part which added to some early morning frustration, but things got better as the morning progressed.  We actually arrived at the doctor's office early.  So early in fact that there was no one there for at least another 30 minutes, so we ended up sitting in the hallway outside the doctor's office like we were camping out for Jimmy Buffett tickets.  We're sitting on the floor, because there are no chairs in the hallway, and I spot a big window that seemed to be providing a good amount of soft light to the area.   You know what happens when you have a beautiful model, soft light, and a camera.  "What time is it?  It's picture time."  I can only imagine how much my wife can't wait for me to have three little subjects to chase after instead of always having to be my primary photographic subject.  Yes, I had a camera with me.  Doesn't everyone carry a camera with them at all times?  If you don't, how do you expect to capture something like this?



or these two?





or a classic like this?



 I do have a couple pieces of advice for photographing pregnant women:

a) Make sure they're well fed or else you'll get this... (shared with her permission)



b) Also, make sure they're well rested, or you'll never catch them with their eyes open...



Someone recently told me after looking at these photos of my wife that I definitely "married up." I would tend to agree.


As you've probably surmised by now, by the lack of complete focus on the ultrasound, all three heartbeats are still beating strong.  Without going in to each and every measurement, we're starting to see improvements in a few of the areas that were causing concern before the surgery.  On Wednesday, we'll be going to the Children's Hospital to have a fetal cardiologist look at their hearts and then back to Dr. Gallagher on Friday.  Meg is still feeling great, though she is starting to see a bit more swelling in her ankles and feet if she's up and about for too long.  It doesn't have anything to do with the surgery.  It's just that she's 19 weeks and 3 days pregnant and happens to be carrying an extra 30 pounds of weight on her little legs.

Also, over the next week, in addition to sharing updates from the upcoming doctor appointments, I plan on sharing some of the lighter side of recent events surrounding this pregnancy.  Things were so serious for a few days, for good reason obviously, that I want to share some examples of how fun this pregnancy has been. 


Lastly, I have one more request for our prayer warriors.  I was recently catching up on a couple of my favorite triplet blogs and read a series of posts from a fellow triplet dad who recently lost all of his babies when his wife went into pre-term labor at 22 weeks.  If you remember, 24 weeks is the minimum age for viability and survival in the NICU.  Obviously, every day extra inside the womb is better than outside the womb, but it served as a stark reminder of how much of a risk that pre-term labor really is, especially for high-risk triplet pregnancies like ours.  Please pray for the Bear family and their three angels and please pray that we can avoid pre-term labor and, at a minimum, will have the ability to recognize when or if it's happening and get to the hospital in time.


Monday, June 13, 2011

She Finally Wore My Shirt!

There are a lot of things I've done over the last few weeks to make my wife proud, but let's just say that this year's birthday present wasn't one of them.  I had to make an executive decision this year and I choose to go the route of "gift of meaning," instead of "gift of desire."  It turns out that I probably should've done both, but with everything that I've been putting into the house outside of work, and the many hours I've been working into the evening, I made a decision and went with it.

Basically, I decided to get Meg a couple of "triplet mom" t-shirts.  I'm sure it seems like such a slack gift, but knowing how cute my wife is, I just thought she would look adorable in these triplet mom shirts.  Plus, I'm super-proud that she's having triplets and I want people to know the sacrifice she's making.  When she opened the gift, she had one of those, Well, these are really cute, but where's the real gift? looks on her face.  She at least tried them both on for me and, yes, she did look adorable...in my opinion, at least.  Well, they've both been relegated to sleeping shirts--not meant for public viewing.  I get it.  Really, I do.  On Saturday morning, she happened to have one of the shirts with her in her suitcase.  She knew how much I'd been wanting her to wear it so, in addition to getting to hear all three babies' heartbeats in the morning, she told me that she would wear my t-shirt through the airport and for the rest of the day as my superhero dad reward.  Personally, I think she secretly wants to wear it all of the time, but is just afraid she'll spill on it because, well, she's spilling stuff on her shirt more often these days.

I'll let you be the judge.



Dr. Quintero let us fly home on Saturday, so as quickly as possible, we bought our return flights home from the hospital room, hopped in a cab to the Miami Airport, and were able to sleep in our own bed last night.  Meg's mom and dad picked us up from the airport and we met our good friends, Sarah and Zac, for dinner.  When we arrived home, we entered our soon-to-be-old condo and noticed that we had been visited by the Onesie Fairy.  She's real, I promise. There were little onesies, grouped in threes, all around our condo.  It was a great surprise and a nice reminder of what we worked so hard to save.

Now, it's Sunday night and we're getting ready for our first follow-up ultrasound in the morning.  Dr. Gallagher is squeezing us into his schedule in the morning because we are a "VIP" pregnancy the rest of the way through.  VIP or not, I'm already trying to figure out how I can keep myself distracted from worrying about all of the hurdles we need to overcome to get these girls to a viable age.  Meg has been having small pains for the last several weeks, but she also knows that most pregnant women aren't comfortable at this stage.  Especially, women with three babies in the oven.  When we checked out of the hospital yesterday, they gave us this sheet of things to look for when trying to determine if you're going into pre-term labor.  Here's the list of things to watch out for:

- Menstrual-like Cramps
- Low Backache
- Pressure
- Abdominal Cramping
- Leaking fluid
- Feeling bad
- Contractions

So, some of these are pretty obvious, but Pressure, Backache, and Feeling Bad?  What pregnant woman doesn't feel those things from time to time.  Now, every time she feels even the slightest symptom, we're worried about whether or not we need to drive to the hospital.  For women who've had children before, you probably learn to notice the difference between what to ignore and what to pay attention to.  For a pregnant mom of triplets, who has never had children, it's actually tiring being so worried all of the time.

I know that there are a lot of people who are interested in our next round of ultrasound results, so I'll make sure to share them tomorrow when I have time.  We have to get up really early to get to the other side of town, so I'm going to wrap this up and grab some shut-eye.  I really do want to thank everyone for all of your continued prayers.  It's amazing how much relief it provides when you know that you have the equivalent of a small town behind you, pulling for your success.

Saturday, June 11, 2011

Ever Seen Three Babies Doin' the "Happy Dance?"

We have. Just a few minutes ago in fact.

This morning was the "moment of truth." The sonographer, Massey, walked Meghan and me back to her room to take a first glance at the result of the surgery. We readied ourselves, as much as we could, for what could be the best or worst news we've ever received. The sonographer looked all around her belly and exclaimed "I see three heartbeats!" No four words ever sounded so sweet. Of course we held each other's hands and cried tears of joy. Massey then proceeded to take all of the measurements she needed to start keeping track of each babies' progress so that Dr. Quintero could compare it to the pre-surgery measurements. It was the most amazing sight I've ever seen. For the entire pregnancy, I've only seen still images of our girls that were shared with me over e-mail and video conferencing. All of our girls were extremely active this morning. It's as if they knew that there was a reason to celebrate. We saw lots of waving, kicking, and, I swear, what looked like a "thumbs-up!"

So far, all signs are pointing in the right direction. What still has yet to be seen is how much of the placenta is dedicated to Sophia and to Isabelle, independently. I'm not sure how much I explained about how TTTS works in previous posts but, basically, both of them each had their own blood supplies, but they also had blood vessels shared between the two that altered how much blood each was getting. The trick to success with the laser surgery is to remove the blood vessels that connect the two and then hope that their independent blood supplies are strong enough to sustain themselves. We'll continue to monitor the girls and make sure that the negative effects of TTTS slowly begin to reverse themselves. Only time will tell at this point and this is the one thing we have to hope and pray developed correctly as each baby started to grow, because it's what each will need to survive and grow to term.

Meg sure has been a trooper through this (pic below) and so has Madelyn. To her, this has been just one big inconvenience and a lot of extra fussiness over her two sisters.



I also wanted to include a shot of the entry point for the surgery. We asked the sonographer how Dr. Quintero was able to perform this surgery so easily when other said they could not. She described it as definitely being a more difficult surgery due to the fact that it was an anterior placenta and that, in this case, it was as if Dr. Quintero had to paint a picture on the ceiling, which is not easy. Well, he is definitely our Michaelangelo!



As I wrap up this post, I can't stop thinking about how close we came to taking the acvice of the doctor at CHOP and choosing to "selectively reduce" babies A and B--our girls.  Meg and I keep pointing this fact out to each other because I think we're still in such shock/awe that the option to keep all three girls was never presented by, what some consider, an amazing children's hospital.  I'm sure they have helped a lot of families, but if I've learned anything from this experience that I can share with you in hopes that you never have to feel what we felt on Thursday night it's this--Don't be afraid to ask for a second opinion!  You need to be your own advocate and do your own research.  Don't be scared of what you might read and don't use that fear as an excuse to keep you from learning as much as you need to to feel confident that you can have a meaningful conversation with your doctor.  I think most people have a ton of respect for our doctors and wouldn't want to risk insulting them by second guessing them.  We have this innate feeling that, because they're doctors, they must know everything about our specific situations.  Don't get me wrong, they're very smart and capable, but the medical field is changing and improving all of the time at a very fast pace, which is good if you can keep up with it.  The fact is, most doctors are actually busy treating patients and don't have to time learn and master every technique and treatment plan.  On the same token, don't fool yourself into thinking you don't need your doctors, because that can be just as dangerous.  Be an advocate for your own care.  Speak up!  Good doctors will respect the fact that you care enough about what's happening to you to ask questions and learn more.  If you do, you may just earn yourself a new nickname, like the one my wife has given me--"Superhero!"

Hope Restored

As I sit here watching my wife get the first bit of good sleep she's had in a while, I can't stop thinking about how many people we know, and even more that we don't know, who reached out today with well wishes and prayers. Honestly, I couldn't keep up with it. I don't think there was a single five-minute span, from the time we arrived in Miami to right now, where we haven't received a phone call, a text message, an e-mail, a comment on my blog, or a comment on facebook. And if I wasn't able to reply or call you back, please don't think your message wasn't received. I've read EVERY single one! When Meg wasn't in surgery and when she's been awake, I've been reading her the comments and prayers that you're sending. They all put huge smiles on our faces. We are so thankful to have all of you in our lives.

It's almost midnight at the end of a day that I hope will be one of the most important in our and our girl's lives. I still can't believe that just a little over 24 hours ago, we were trying to get used to the idea that we were definitely not going to be the parents to triplets and that there was nothing we could do. And while it's still a possibility because, face it, triplet pregnancies are risky as-is, we both know that we've given our girls the best chance to survive. It's now in their and God's hands.

If you're just reading this blog for the first time, I'll try to provide a quick re-cap of where we've been. About a week and a half ago, started showing some concern about two of our triplets possibly having TTTS. He set us up with an appointment at Children's Hospital of Philadelphia (CHOP) for the following week. Meg went for her weekly appointment with her MFM, Dr. Gallagher, this past Wednesday for weekly monitoring. It looked as if the TTTS was relatively mild. She drove to Philly the following day, Thursday, for a full-day assessment. The result of that assessment was that she had Stage IV TTTS, which is very advanced, and that surgery was not an option due to multiple factors related to how the babies were situated in Meg's belly. The safest option that was presented was to intentionally terminate, or selectively reduce, babies A and B to give baby C the best shot at survival. This is where things got interesting. After a series of events, described in my previous post, I booked us tickets to Miami for an appointment with Dr. Quintero.

Meg and I both started our Fridays very early to catch our respective flights so we could arrive in Miami at the same time. We met in baggage claim with a huge hug and a release of all of the built up anxiety, sadness, and excitement that had been filling our hearts over the last week. We grabbed our bags, hopped in a taxi, and went straight to Jackson Memorial Hospital. As soon as the plane hit the ground and I checked my phone, I already had a text message from Dr. Quintero's assistant, Micha. Dr. Quintero's team had already reserved a slot for us in the OR, in case surgery was a possibility. His team had already reached out to our other doctors to gather as much info as they could prior to our arrival. They also called our insurance provider to get the possible treatments pre-approved, so we wouldn't have to worry about the financial component. Micha met us in the lobby and brought us straight to our room.

The next several hours progressed at a frenzied pace. His team performed their own ultrasound scans so they could provide their own diagnosis and assess how they would potentially enter Meg's belly with the laser. A few hours later, Dr. Quintero came in to discuss our options. The first thing he shared with us was that laser surgery WAS an option! There were five other options, but the only one that felt right to us was to perform the surgery and give all of our girls a chance at life. He shared a bunch of stats with us about each option, but we knew in our hearts that we were not going to give up on our girls. Having chosen the surgery, there is a 65-75% chance that all of our girls will make it! Considering that less than 24 hours prior, we were already thinking about the fact that we were going to have to get rid of our triplet stroller, return the extra cribs, and take back two out of the three dresses that Meg had bought for our little girls, 65-75% offered a lot of hope.

Meg was in surgery for a couple of hours. When he was done, Dr. Quintero came to talk to me to tell me that everything went extremely well. He was able to laser the blood vessels that connected the twins that were causing the TTTS. Getting through the surgery was the first milestone. The next milestone is the ultrasound in the morning to verify that all of the babies still have heartbeats. I'll post again later when we know the results.

Friday, June 10, 2011

The Fight Begins NOW! (this time, we need big prayers)

I'm not exactly sure how to begin this post, so I'll do it with the facts.  Meg and I are both extremely exhausted--physically, mentally, and emotionally.  The result of her day-long visit to CHOP was that they have diagnosed her as having Stage IV TTTS.  Typically, she would be in surgery the next day, but from their perspective, she's not a candidate for the laser surgery that could repair the blood flow between Sophia (Baby A - recipient) and Isabelle (Baby B - donor).  The doctor has given this diagnosis due to the fact that their placenta is implanted on the anterior of the womb.  It also wraps around her uterus in a way that, when combined with Madelyn (Baby C), makes it extremely difficult to access the umbilical cord, which they need to be able to reach to do the surgery.

They ended up providing us with three options--none of them leaving us with three healthy girls.  While not a direct recommendation, because, in the end, the decision is ours to make, the option that would give Madelyn the greatest chance at survival would be to selectively terminate Sophia and Isabelle.  All I can tell you is that I was none to thrilled with those options, as you can surely imagine.  We knew going into this that we may have some tough choices to make, but to be honest, the pregnancy has just been going so well, this just feels like a sucker punch in the gut.  I never really thought we'd have to make a decision like this.  Obviously, one of the options is to do nothing, but that option pretty much guarantees that both Sophia and Isabelle would succumb to the disease on their own.  Somehow, choosing to terminate them now, versus letting them struggle, actually reduces the risk to Madelyn.  Still, it just doesn't seem real and it's not a decision that we want to make.

Rewind about a week.  When we first found out that Meg may be diagnosed with TTTS, I started researching.  I found the TTTS Foundation and joined the TTTS Foundation group on facebook.  It's about 2300 members strong.  Since this is mostly a disease that affects twins, and there are more twins than triplets, it made sense that there would be a relatively large group.  I wasn't expecting this many people though.  I posted a question inquiring into anyone's direct experience with CHOP.  There were a lot of positive comments.  I also received a private message from someone who had been to CHOP and had a similar diagnosis to Meg, not with the exact same diagnosis, but basically, they wouldn't operate on her.  She then shared how she flew to Miami to meet with Dr. Quintero for a second opinion.  Dr. Quintero pioneered the selective laser surgery technique used to treat TTTS and the staging classifications that are used to diagnose TTTS worldwide.  He performed the surgery and her twins survived.  (Thanks Kristi if you're reading this)

Now, back to the present.  I'm not giving up on our girls that easy.  I realize that there's no step-by-step guide given to every doctor to treat TTTS.  I also realize that it's impossible for every doctor to be an expert in all aspects of their field, but that doesn't mean that we have to settle for anything less than best treatment for our girls.  I'm ready to fight for them and I'll go down kicking!  I want to be their dad more than anything else in this world.  We have so much love for these girls and they deserve the best chance to experience it.

As soon as I left the virtual meeting with Meg, Dr. Gallagher, and the doctor at CHOP, I immediately got on the TTTS facebook group and asked for Dr. Quintero's phone number.  Well, people never cease to amaze me.  The same woman who shared her story about CHOP and experience with Dr. Quintero saw my post, immediately replied, and actually called Dr. Quintero on his cell phone.  He called me about 30 minutes later.  I shared the results of CHOP's diagnosis and he asked, "How quickly can you and your wife be in Miami?"  The answer--tomorrow morning.  That's right.  As soon as I got home tonight, I booked flights from both DC and Chicago to arrive at the same time in Miami tomorrow morning.  We'll pick up our bags, get in a cab, and head straight to Jackson Memorial Hospital.  How amazing is that!?!  Within two hours of getting the worst news of our lives, one of the world's leading surgeons was calling me on my cell phone after hours telling me to get my wife to his office.  Amazing!

Now, I'm not advocating always second-guessing your doctors, but my heart was leading me in a different direction and that's where we're headed tomorrow.  Also, I realize that everyone's situation is different and that results may vary, but it's provided us with at least one more day of hope when just six hours ago, we had none.  I had no idea how amazing, and potentially life-saving, networking on FB could be.  Honestly, most days I use FB as a way to keep up with what's happening with friends and family, as well as for its entertainment value.  Today, I used it as a tool that could potentially save my daughters' lives!

From the bottom of my heart, I want to thank everyone for all of the phone calls, e-mails, texts, etc. that everyone sent today.  I also want to thank you for all of the prayers.  I don't truly understand how prayers work and whether or not your prayers will be answered by the survival of our girls or if your prayers are what led my heart to not give up and search for more answers and possibilities for our babies today.  Either way, I'm grateful to each and every one of you.

Well, my cab to the airport is coming to pick me up in about four hours and I haven't packed yet.  I can barely see the computer screen.  And I have no idea what tomorrow will bring.  The only thing I know for sure is that, in nine hours, Meg and I will be together again.  I'll get to kiss her lips, hug her belly, and hold her hand through whatever life has in store for us next.

I'll try to keep you updated as we know more.

Also, just so you know, I'm going to keep posting my favorite photos of my wife until I have anything baby-related to share.  It shouldn't be too big of a deal.  She's pretty cute :)

Thursday, June 9, 2011

A day with CHOP (and an ask for a prayer)

It's 8:50am ET on a Thursday morning and Meg and one of her moms, Jo Anne, have already been at Children's Hospital of Philadelphia (CHOP) for almost two hours.  Based on what Meg told me, as well as what some of the other triplet moms shared, who've had experience with CHOP, she'll basically be in appointments all day until around 3:30-4:00pm.  At that point, a doctor will come in and very informatively and bluntly (which is a good thing), give us a formal diagnosis of her TTTS and discuss the different treatment plans.

All in all, this is a very important day in our lives, and more specifically, the lives our girls.

Meghan went to her weekly "high-risk" doctor, Dr. Gallagher, yesterday and there have been some changes in measurements over the last two weeks.  Sophia (Baby A) and Isabelle (Baby B) have too much and too little amniotic fluid, respectively.  They measure the largest vertical pocket of fluid in each sac as a way to help diagnose which stage of TTTS Meg currently has.  The goal is to have between 3-8cm.  If you have more than 8cm, which Sophia has (8.8cm to be exact), that means that she's getting too much blood and producing too much urine.  Depending on the severity, it can lead to prenatal heart failure.  If you have less than 3cm, which Isabelle has (1.1cm to be exact), that means that she's not getting enough blood and resources.  When that happens, you typically have difficulty seeing the bladder on the ultrasound if the baby isn't producing enough urine.  Well, they can still see Isabelle's bladder, so that's a really good thing.  Also, for the first time, there is starting to be a larger discrepancy in the relative size of Sophia and Isabelle.  They've always been a few days apart the entire pregnancy, but it looks like that gap is widening.

Let's not forget about Madelyn here.  Her results were normal.  Having her own sac and umbilical cord means she doesn't have to worry about anything like TTTS.  Obviously, when there's something going on in the belly that's not right, it means everyone's at potential risk.  Specifically, for pre-term labor.  The good news on that is, Meg's cervix is still really long.  Around 20 weeks (Meg will be 19 weeks tomorrow), they really start actively monitoring the cervical length.  They checked hers out yesterday and she's showing no signs of shortening.

I'd be lying if I told you that I haven't been thinking about today's appointment almost every minute of the last week.  My days are packed at work.  So, I'm having no trouble keeping myself busy, but I definitely find my mind wandering during my meetings and thinking about my wife and our girls--all of the time.

I hope they have strength.  I hope they have fight in them.  I hope they realize that they have a huge web of family and friends that want nothing more than to see their cute baby faces.  I hope they know that they have two parents who are willing to do anything and everything to make sure they have best chance.  And, I hope they know that even though we've never met them that we love them more than anything else in life.

Now, I'll be the first to admit, it's been a while since I've prayed.  Honestly, I think the last time was when I prayed for my friend, Errick, who is battling cancer.  Meg reminded me this morning that you can't just pray when you want something.  Well, I prayed last night and maybe I need to take time each day to do so if I want them to be more effective.  So, just in case my prayers go unanswered because I don't pray everyday, if you're the praying type and you have a few extra prayers to spare, please send them our way.  I would definitely appreciate it.

With all that's been going on the last two weeks, there haven't been a lot of new pics.  Believe me, I'll make up for it when the girls get here.  So, I'm sharing one of my favorite pics of me and Meg.  I'll make sure to keep you all updated as we find out more.

Sunday, June 5, 2011

And your name shall be...

No more Baby A, Baby B, and Baby C.  Our girls are far enough along in the belly-baking process where they deserve more formal names.  Plus, referring to them as babies "A, B, and C" makes them sound like they're part of some formula or SAT test question, like "Train A is going east at 40 mph and Train B is going west at 60 mph..." You get the picture.

Meg and I went back and forth many times about whether we wanted our girls' names to have similar sounding endings, such as "a" or "n".  We also were thinking about some more traditional Irish names, since Meg's family is Irish.  By the way, my heritage is Belgian, so I wasn't really sure where to start with that one.  We finally decided that we wanted them to all be a little bit different and we all wanted them to have names that had the possibility for cute-sounding nicknames.

Well, we ended up with Sophia, Isabelle, and Madelyn, who will all, most likely, be called by their nicknames (which we've already decided)--Sophie, Izzy, and Maddy.  Personally, I think we did a great job coming up with these names together, though Meghan did a lot of the legwork, providing me with her favorite options, and then I provided my vote for my favorite combo.



Now that they all have names, they feel like they're just a little more real. "Baby A" just seems so clinical, but "Sophie" makes me want to pick her up and squeeze her.

We still haven't come to an agreement on the middle names, but I don't think we're too far off. I have a feeling that Meg's going to be getting a lot of rest pretty soon, so she'll probably have plenty of time to give it more thought.

On a side note, don't be confused if you come back to the blog and it looks completely different.  When I decided that I wanted to start a blog, it was in the middle of the night one morning when I couldn't sleep because all I was thinking about was the fact that we were just told we were having triplets.  I did a brief amount of research on blogs and just picked a fun blue background with crazy monkeys, because, honestly, I thought we were having three boys.  I don't really like the background we have now, so I'm going to switch it up a little and possibly change the format.

So, let us know what you think about the names! We love comments! 

I realize that I don't personally know many of you that read this blog, but that doesn't mean that we don't want to or don't care about what you have to say.  It feels good to know whether or not you're enjoying how I'm sharing this journey.
 

Friday, June 3, 2011

Ever heard of TTTS?

We had, but honestly, had never done much research on it.  Why spend any time on all of things that could possibly go wrong with a triplet pregnancy, because there are quite a few, if you don't need to.  Well, now we need to.  For those that haven't heard of TTTS (probably the majority of you) it stands for Twin to Twin Transfusion Syndrome.  The net of it is, Baby A is already stealing from Baby B.  Naughty girl!  Of course, she doesn't know she's actually doing it.  It all has to do with how the blood vessels develop in their shared placenta.

Let me take a step back for anyone who may be just now joining us on this journey.  Two of our triplets--Baby A and Baby B--are identical and Baby C is fraternal.  Identical twins can have their own placenta, which can sometime fuse, but ours definitely do not.  They share one placenta.

I'm not going to bore you and attempt to educate you on TTTS.  If you're really interested, you can check out the Twin to Twin Transfusion Syndrome Foundation website.  Tons of great information there, organized and shared by Mary.

What I will do is promise to share more information as we receive it about our specific situation.  Right now, all three girls are growing at the same rate as they have through the entire pregnancy.  All of their heartbeats are strong.  The only real telltale sign that we need to be concerned is that it doesn't look like Baby B has anywhere near as much amniotic fluid surrounding her as Baby A.  This fact, alone, doesn't necessarily mean that Meg will need surgery, it just means that she needs to go see a TTTS specialist to determine if surgery is required at this point, or if she can manage the effects of TTTS through rest and proper nutrition, which can actually be done based on what I've read, in certain circumstances.

If she does end up needing surgery, it'll most likely be a laser surgery.  At this point, I'm not exactly sure what would be done, but we'll find out soon enough.  Meghan has an appointment with a specialist in Philly next Thursday, so we'll know a lot more after that.

Meg is actually very calm about all of this.  I, on the other hand, am no where near calm, at least on the inside.  I'm actually pretty worried about our girls, whether I should be or not.  All I know is that, at 18 weeks, I love these girls more than I could have ever imagined just a few months ago.  It's kind of strange how it happens actually.  It kinda just creeps up on you where, one day, WHAM, you feel this overwhelming sense of love for these little people you've only seen on a video screen.  I'm sure everyone with kids knows exactly what I'm talking about.  But for the rest of you who might be scratching your heads a little, all I can say is, "just wait."  Well, that is if you actually want to have kids one day.

I think I'm starting to sound like my mom and dad, so I'll end it here until we know more and I'll leave you with the most recent pics of our girls.

Lastly, Meg and I have pretty much decided on names for our girls, which I'll be share in a subsequent post.  I need to have something else to write about in a couple of days.  Can't spill the beans all at once :)

Baby A (aka "The Resource Hog")



Baby B (aka "The Giver")



Baby C - How crazy is it that you can see all of the organs and bones developing? Look at the spine and brain!