"To eat is a necessity, but to eat intelligently is an art." - La Rochefoucauld

Thursday, July 13, 2006

21 Weeks 4 Days (4 weeks of bed rest)

Kevin and I learned a very valuable lesson about the pregnancy process yesterday. We went to U.M. yesterday to get another opinion and to also possibly consider switching health care providers. Before our consultation with the doctor, we had a three hour ultrasound. The tech conducting the u/s was very thorough. She did each measurement 2-3 times. The u/s machine was also very clear and detailed. Once we completed the u/s the tech told us that Jake was 15.9 ounces and Ben was 11.2 ounces!!!! So in less then 24 hours, we got a completely different measurement. This puts the boys at a 29% weight discordance. The lesson we learned is that technology is NOT always accurate and NOT to put too much stock into these measurements if everything else seems to be ok. We believe that U.M.’s measurements are more accurate because they really took their time with each measurement as opposed to the Beaumont group who flew through our u/s. We were so happy to hear Ben had gained more weight then we originally thought.

We are not sure if we are going to make the switch to U.M. yet but they did have some interesting observations about our case. The doctor told us he is not sure if we have TTTS because our fluid levels have stayed stable. He seem to be leaning toward IUGR but also said we will not know for sure till the babies are born and they can dissect the placenta. To test the placenta, they actually pour milk through it to see if the milk crosses between the vessels. If it does, then this would indicate Twin to Twin.

At this point, no doctor can tell us why we have these discrepancies between the two babies. The doctor at U.M. believes something is causing Ben to lag behind. He told us not to compare the boy’s weights but to rather watch to see if Ben is growing on his own curve. His biggest concern was Ben’s abnormal doppler. Ben’s S/D ratio (systolic/diastolic ratio) is elevated to 7.5. What this means is that his umbilical blood flow is facing more resistance then it should. This is probably an indication of why he is growing at a smaller rate. This finding is also indicative of IUGR and not TTTS. So now our biggest concern is the doppler vs. the weights and amniotic fluid. If its not one thing, it’s another!!!

Where does this leave us now…bed rest, high protein diet, and serial monitoring. Pretty much exactly where we were before. It’s such a mystery and only time will tell how this will play out.

If you get a minute and want to read a wonderfully touching TTTS success story, check out the 2nd link attached to our blog. This family documented their entire journey and it is a great inspiration to us!


MarvelousMark said...

IUGR = Intrauterine Growth Restriction.


Amanda B. said...

Thanks for keeping us up-to-date on your progress. Ever since your diagnosis, I have been doing my own research on TTTS. This past Wed. we had a Nursing Grand Rounds on TTTS...I wasn't able to attend, but got the info that Dr. Cromblehome provided. Again, if there is anything I can do to help, I would be more than willing. I do actually take care of a lot of babies with IUGR. Take care and hope to hear from you soon!

Renee said...

Wow Danielle! You are talking like a scientist now! Hannah's early arrival was also a mystery and doctors could only "guess". We really didn't know why. It sounds like you are dealing very well with the ups and downs of your roller coaster ride. Getting many opinions helps you see the entire picture of what you are dealing with. Keep your spirits up! We're thinking of you!


Dave said...

Keep hanging in there, I can remember how stressed we were at this time last year (well, august).

Rhonda said...

You are doing amazingly well, considering. Having walked this road, I know how hard it can be. Take one day at a time and have faith. I sent an email to your hotmail account. Please contact Dave and I if you want to talk.

Laura and Andre said...

We are follwoing your progress on a regular basis and every step forward makes us very happy.
We have you guys in our thoughts everyday and have learned quite a bit about TTTS.
The next homework:


Jenny Marie said...

The fact that your little one is as big as he is at this gestation is really good. I am just a lurker here but have been very interested in your story as I lost a twin to IUGR this year. My babies were born at 27 1/2 weeks. I had a C-Section because my IUGR twin had reverse diastolic blood flow through the umbilical cord by that time. She had stopped growing altogether. My little boy was "big" at 2 lbs 12 ozs. My little girl was only 10 ozs. She lost down to 8 ounces after birth and lived 2 days (they always lose weight after birth as I'm sure you're aware). I did an IUGR search on blogger and found your blog.
My surviving twin spent 2 months in the NICU, and is now doing well and very healthy. Just wanted to let you know you're not alone. I went through a hellish pregnancy, not unlike what you're experiencing and could never find anyone with a similar situation.
I just wanted you to know that although I am a complete stranger, I am sending prayers your way.
If you're interested, here is the site of twins born with a severe size discordance (IUGR) who are doing well now. They are over a year old now. I spoke w/their mother often when I was going through my pregnancy and they were such an inspiration to me. I found them in the forums at twinstuff.com. Here they are:

The March of Dimes website has been very helpful to me, too. You may have preemies when this is all said and done so it may be helpful to you, too.

Sorry this is so long. Just wanted you to know that someone "out there" knows what you're going though. I may have lost my baby but she was extremely tiny and probably one of the most severest of IUGR cases. Again, I think it's an excellent sign that your babies are the size right now. Keep the faith and God will handle the rest.

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