Wednesday, February 4, 2009

The Waiting Game...over...for now

I have spoken to Dr. Watson on the phone and have seen him in person, but I have yet to see Jessica. She remains in the recovery area at this point. What I have been told...

The procedure was technically difficult because of the course of the amniotic membrane dividing the babies. For this reason, it took a little longer than expected. She had accumulated a notable amount of fluid, even just since yesterday. (I infer that it was a good thing we did not wait any longer.) Dr. Watson indentified 8 abnormal vascular connections and ablated them all. Afterwards, they removed 2.5 liters of fluid.

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Now that I started typing this, Jessica finally just arrived to the room! WHAT A SIGHT! She looks great. She said she was scared when she was going to the OR; when she arrived, there was a cast of thousands. Everyone was very professional and kind. She remembers little; the most painful part was getting the IV (which they trouble placing) and removing the drape. Immediately, she felt (and I see that she in fact is) significantly less swollen.

With her back in the room, we now await Dr. Watson. I spoke to my dad earlier, and Jessica's parents are on the phone now. It was great for us to hear Emmy's voice. In the last few days, she has gotten wise to the multiple ways adults say goodbye. She has also realized that she cannot get off the phone until she says them all. As a consequence, she now (abruptly) ends conversations with, "I miss you, bye-bye. Talk to you soon, bye-bye. I love you, bye-bye!", dropping the phone and running away before you have a chance to get a word in edge-wise. It reminds me a bit of my niece Sarah, who learned at a young age that the easiest way to get out of a conversation with me would be to take the phone to her father and say, "Daddy, your brother wants to talk to you."
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Dr. Watson just popped in. He said that they will plan to recheck the ultrasound tomorrow morning (as well as checking her cervix at that time). He believes that her going as far as she went with 9lb, 14.5 oz Emily bodes well.
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Questions with some answers, which raise more questions:
I read a recently published study entitled "ELA (Endoscopic Laser Ablation): When are We Out of the Woods?" It looked retrospectively at stillborns following ELA to find out when they were lost. 10% were lost within 48 hours of the procedure, and by four weeks, 90% of the babies that were going to die had died. (Obviously, the latter group likely represents babies that were going to be lost regardless of what happened.) Practically speaking, I think this means that we do not know when to stop being concerned. The best we can hope and pray for is for the babies to keep growing and for the fluid issue to resolve on its own (ie, not requiring repeat ELA or amnioreduction). We will just have to take it one day at a time, not knowing what the next ultrasound may show. If both babies are born alive, even then we may not know whether or not they sustained any neurologic damage or will have developmental problems.

For two people who wanted to plan ahead for the big change of having twins, our hands are tied. But, we embrace this with joy...as long as we don't know, it means we haven't lost our two youngest daughters.

4 comments:

  1. Thanks for the update. We are so thankful that you have each other, and we have you in our lives. I will call Dad and read him this report, since he is at home.
    Faith can move mountains, and prayer can do wonders. We will learn to take each day at a time.

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  2. Hey guys - thanks for such thorough reporting, Chad. I just want to let you know I'm thinking about you and keeping you in my prayers. I'm glad to hear the good news that Jess came out fine and that so far so good with the babes. I'll be anxiously tracking as things progress. Peace to you. Love you! Mara.

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  3. Chad and Jessica - Thanks for updating the blog – we have been checking it today and were so glad to read the “so far, so good” news. It is a blessing to see your persevering faith. This one thing we know to be true: weak faith in a strong object is infinitely better than strong faith in a weak object. We are praying that you continue to find comfort in the only One who is truly strong -- not in the man-centered faith that shifts like sand.

    "It is He who remembered us in our low estate, for His steadfast love endures forever; and rescued us from our foes, for His steadfast love endures forever; He who gives food to all flesh, for his steadfast love endures forever. Give thanks to the God of heaven, for his steadfast love endures forever."
    Psalm 136:23-26

    We love you both and will continue to pray for “the babies in Emiwee’s mommy’s tummies!” (courtesy of Ava) Matt, Cari, Cade, and Ava

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  4. All of us at UNMC are thinking of you guys and wishing you and your babies the best.

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