I was only ten weeks into my pregnancy when I found out I was expecting twins. I had been enjoying a normal pregnancy without difficulty. I was in very good shape, ate right, exercised, took my prenatal vitamins with folic acid and saw my doctor every two weeks.
On July 14, 28 weeks into my pregnancy, everything went terribly wrong. That day, at my doctor's appointment, a sonogram showed that one twin was bigger than the other. The bigger twin had too much amniotic fluid, a condition known as polyhydraminos. The other twin was smaller and had little fluid. My doctor decided to send me to St. Joseph's hospital to be monitored for what I thought would be a couple of hours or so.
I arrived at the hospital an hour and a half after my initial appointment. At this time my doctor said I was four cm. dilated and having contractions. The doctor tried to stop my labor with a dose of magnesium sulfate. Within half an hour I was up to six cm. A sonogram showed that the babies were becoming very stressed inside and there was no stopping the labor. At this point I didn't think it was possible for a baby born this early to survive. It was the most terrifying day of my life.
My doctor had also discovered that I had another condition known as twin-to-twin transfusion syndrome. This occurs when one twin receives too many nutrients and blood via the placenta. As a result, the other twin starts to starve and is therefore smaller than the other. Surprisingly, it is the bigger twin who is in greater danger. Due to fluid overload and polycythemia (too many red blood cells), the larger baby is at risk for things such as congestive heart failure. Due to a lack of red blood cells, the smaller twin becomes very anaemic, and fails to thrive and grow.
Two hours after arriving at the hospital my babies were born. First Megan, at three pounds, and a minute later Cassidy, at two pounds, six ounces. I heard their little cries and I knew that somehow they were going to make it.
Moments after Megan was born her lungs collapsed and she needed to be intubated. This involved placing a tube down her throat and placing her on a ventilator to help her breathe. Her lungs had not produced enough surfactant, the substance normally produced within the lungs that keeps them inflated and prevents them from collapsing. Treatment with surfactant can save the lives of premature babies suffering from Respiratory Distress Syndrome (RDS).
Megan responded to a single dose of surfactant and came off the ventilator within three days. Cassidy's lungs had produced enough surfactant because her body had been so stressed in utero. This stress actually helped her lungs to produce enough surfactant to keep them inflated.
Both babies, however, needed to be placed on and off another machine called the Continuous Positive Airway Pressure (CPAP). CPAP provides positive pressure through nasal prongs that go into the nostrils and down the back of the mouth. If a baby forgets to breathe, the CPAP will provide air pressure to help the baby take that next breath and give her a rest.
Megan and Cassidy relied on the CPAP machine for almost two months, and wound up spending two and half months in the St. Joseph's neonatal intensive care unit.
The days in the special nursery were good and bad. Their condition sometimes seemed to change from minute to minute. Just when it seemed like they were stabilizing, we would get that dreaded early morning phone call that something new had gone wrong. They developed infections and had to undergo spinal taps. They developed heart murmurs, and Retinopathy Of Prematurity (ROP). Their hands, feet and even their heads became like pincushions. Numerous I.V. sites were placed for fluid, nutrients and blood transfusions. Blood was drawn daily to check for various things.
Even though your head tells you all this is necessary your heart breaks to see your children go through so much pain.
Megan's weight dropped to two pounds, six ounces, and Cassidy's dropped to one pound, fourteen ounces. To see my babies at one and two pounds was a terrifying experience. They also had a condition known as Apnea and Bradycardia. Apnea is when a baby stops breathing and Bradycardia is a low heart rate. I watched my babies stop breathing and turn dusky gray too many times to count. With gentle stimulation they would usually come out of it, but sometimes they needed extra oxygen to help them.
They are still on apnea monitors at home, where for almost one month we have been free of alarms. Megan now weighs almost fourteen pounds, and Cassidy almost thirteen pounds. I'm proud to say they have only been breastfed. I never thought it would be possible to breastfeed two babies. Milk production truly is about supply and demand.
The prognosis for Megan and Cassidy is excellent at this point; they have not suffered any long-term effects of their prematurity. They are healthy, happy babies. They are outgrowing the Apnea and Bradycardia of prematurity. The heart murmurs and retinopathy have resolved. Even though they are now eight months old, their gestational age is only five months old, which marks their developmental stage. By the time they reach one year the gap will start to narrow. By 18 months they should be caught up to other 18-month-olds.
Their big sister, Madison, is two years old and is a great help to me at home.