We were frightened today. Things blurred and were agonizing for several hours for Nicole after Dr. Harnsberger became very concerned that Twin-to-twin transfusion was occurring. This comes after another discovery that one of the twins has only one artery and a vein whilst the other has the standard two arteries with a vein connecting him to the blood supply – meaning, his umbilical cord did not fully develop. This discover was made soon after our last update. One third the time when one twin has less arterial blood supply it points to other defects with the baby such as a cleft lip or webbed feat. Our son seemed to be developing normally and seemed to be growing in size and stature with his brother so we appeared to be in the safe zone there. However, it remained a possibility that one of the boys would develop whilst the other struggled to gather the needed fuel for development, and this possibility would jeopardize the struggling brother. The doctors wanted to keep a close eye on their development, but, so far so good. However, when Scott stood up abruptly with great concern during the ultrasound exam today, it seamed another possible complication had arisen. He called the high risk doctor and scheduled to have Nicole go directly there for a more thorough examination with their equipment. Dr. Lam, who specialized in twin-to-twin transfusion before moving to Chattanooga did find that one of the boys had only 2.3 cm of fluid surrounding him while the other had a generous 8cm. Had the disparity been 2 to 8, we would have been off to Cincinnati immediately to the Fetal Care Center where they can perform a fetoscopic laser procedure. While the results vary widely after this surgery, it appears that at least one of the twins will have a 90% chance of survival while both will have a 70% chance. Without the proceedure, TTTS has a 60-100% mortality rate.
At this point, both Dr. Lam and Dr. Harnsberger will be seeing Nicole weekly. They will have to respond immediately if the transfusion progresses. It is not a certainty that it will. It appears to be a probability, but not inevitable. Further complicating things, Dr. Hunt, the surgeon that performed the tracheal dilation suggested that it was likely that Nicole would need a tracheotomy prior to delivery. As I write this I feel weak with fear. We feel feel helpless to help our two little boys. So we have to rest knowing that they are in God's hands and that God is love, come what may, He is Love. Outside of his control, there could be no rest, no comfort, no consolation. Just fear. And while perfect love casts out fear, I feel it must be a process for His love to purge a fear from one's heart. I called Nicole today from Knoxville and asked that we go ahead and name the boys. I wanted them to have names so that we could pray for them by name. I wanted them to have names so we could personalize it further, and should tragedy overtake us, so that we could mourn the loss of a son, a real son, a real human. Please pray that our days, in the end will be marked by cries of joy rather than cries of pain. And while pain is part of this process, as it is with all human suffering, may life, may the life of River and Bryce May be a celebration for many, many years to come. River is appropriately the one with the greater blood supply. The name River is so full of spiritual meaning for me, there are so many existential lessons I draw from the river. Bryce after the National Park, because Bryce is a place that captures our imaginations with a thousand giant fingers pointing to the heavens as if God drew hands of stone to point us where our only hope lay.
Frank and Nicole May
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