Wednesday, February 22, 2012

Mo-Mo? Oh, That's BAD

On the drive back to work, I had a TERRIBLE realization. I have a very good friend, let’s call her Z, who likes things JUST the way she likes them. She has for years talked about wanting twin boys. Z had mentioned to her OB that she wanted twins and her OB had sat her down and basically read her the riot act on how twins were NOT going to happen for her and she just needed to get over that idea now and get used to the fact that she might have ONE baby. Z was somewhat hurt by this, but I think it was a good wake up call for her. And it probably didn’t hurt that right around this time, a good friend of hers had twin boys. I remember Z calling me to her cube and showing me a registry with 2 carseats, 2 cribs, 2 of just about everything and saying incredulously, “Do you KNOW how expensive twins are? I mean, two of all of this stuff. My gosh!” I think watching her friend go through a twin pregnancy and visiting her during the first couple of weeks after birth, it made Z a little more willing to give up the twin plan. However, I was very worried that she would be hurt to find out that I was having twins. I mean, I remember when I was single and friends would tell me they were pregnant, I was always happy for them. But it also felt like the universe nudging me. You don’t have much more time, better get on it. And without being married, or even having a boyfriend most of these times, it just felt like everyone was getting what they wanted but me. Like everyone was passing me by. And it was NOT for lack of trying or wanting it on my part. It was just that Glenn hadn’t shown up yet. So, the thought of telling Z worried me a lot.

That day at my desk, I Googled monoamniotic twins. Know this: if you have some health issue that you are wondering about, Google is a very bad idea. You could have a hang nail and come away thinking that you were dying of gangrene. Google is not conducive to calm and anti-inflammatory health results. I found that mo-mo (the short hand for monochorionic-monoamniotic) twins is a very high risk pregnancy. In general, the outlook is about 50% for mo-mo twins. Basically, being in a sac without any barrier between them, twins can float all over the place. They WILL have their cords get entangled to some degree.

The trouble comes if there is any impingement or compression on the cords. If they just tangle up, cool. But, as they grow, the tangles can turn to knots. And eventually, those knots can get tight enough to cut off the blood flowing through that cord to one or both of the babies. And there is NOTHNG anyone can do about it. There is no way to reach in and untangle them. There are very scary procedures like draining most of the fluid out of the sac to try to reduce their movement. But, in general, there is nothing that can be done until they reach about 26-28 weeks, when they can viably be delivered. At best, you make it with healthy babies until the viability date, and then enter the hospital for round the clock monitoring for signs that one or both babies is in distress and then have a crash c-section. There were all these women that had logged their stories. Most of them were successes accompanied with pictures of healthy little kids (and sometimes absolutely frightening pics of a tangled knotted mass of umbilical cords from the delivery) and stories of 4 months in the hospital on bedrest and then 2 months of NICU for the babies. And those were the success stories. There was one heart-breaking story of a woman whose twins had cord compression at something like 23 weeks. She was told there was nothing they could do, so they watched the vitals disappear from the screen and then she was induced into labor and required to give birth to her two dead children. She was spent and feeling horrible when they were “born” and wasn’t able to see them. By the time she recovered enough to want to see them, they had already been sent away. These stories terrified me and I prayed fervently that there was a membrane between them. In all my free time, I would envision them with a small little line between them, and the two little beans growing together, but separate.

So, that night, when Glenn and I talked about it, he was quite adamant that he didn’t want to tell the general public until we knew for sure, one way or the other, whether they were monoamniotic. We agreed to tell close family members, as we needed some prayer warriors praying for that thin line between our two babies. We talked about when to break the news and since we both felt that in person was the only way to go, we had to wait that whole week to tell my parents. My dad was working out of town and wouldn’t arrive until Friday night. Then we would tell his Dad and Jean the next day. Luckily, this was all happening the week of Glenn’s birthday, so we were able to arrange meals with both sets of parents without arousing too much suspicion.

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