I began writing this blog late one night a few weeks after Ethan was born, and just brought myself to finish it. I was not in a good place and thought getting all of this out might help me to have some closure. It has been one year since the day we said “Goodbye.”
Houston is a place I never want to return to, yet I think about often. Often, as in every single day, and some days every waking hour of the day. Some days are better, some are worse.
In early August of 2014, we got the joyous news we’d been hoping for- a positive pregnancy test. It was our first attempt, and we couldn’t have been happier. That is, until we got our second big suprise. We went to the doctor for our first ultrasound at eight weeks, on August 28, 2014. Right away on the monitor above our heads, we saw our babies for the first time. Yep, you read that correctly. Babies with an ‘s.’ Two little peanuts floating in the mommy-sphere that was my womb. First shock, then awe, then “oh, it all makes sense now.” I had been enduring terrible, God-awful morning sickness from the moment I hit the six-week mark in the pregnancy. Hurling every morning, afternoon, and night. Feeling like I was on a sideways, backwards, upside-down, 24-7 tilt-a-whirl. Two babies totally made sense. All the hormones…all the puke. We were, of course, still ecstatic.
We broke the news to both of our families that same day, because news like this couldn’t wait any longer. They were, of course, ecstatic. We all couldn’t be any happier- we thought.
Everything was going fine in the pregnancy, until we reached the 11-week mark. I had been having some minor spotting, which everyone seemed to think was completely normal with twins. A few days before we were scheduled to have our second (12-week) ultrasound, the bleeding got a lot worse. Marcelo and I both rushed to the doctor, panicked, worried, and thinking the worst. We were devastated before we even got the news. Scared, shaky and emotional, I waited to hear what I already knew. The ultrasound tech sort of laughed. I thought, how can she laugh at a time like this. How can she show any semblance of happiness right now? Then, we heard the most shocking news. It wasn’t what we thought after all. All three of our babies, hearts beating perfectly, heart rates just where they should be for their gestational age. Yes, you read that correctly. Our three babies. Again, shock, awe, and happiness that we somehow evaded the news we were SURE we would hear at that appointment. The bleeding was caused by a small subchorionic bleed, likely due to the rapid rate at which my uterus was expanding. Sigh. It was time to call the family again. Surely no one would believe us.
It took a while for us to get over the initial shock that we would be parents to three babies. We would be literally outnumbered, constantly covered in spit up and poo, and we would most certainly never sleep again. Then we hit the comfort stage, where we began to settle in to the idea of being parents of higher order multiples. Not one baby, not two babies, but three! We were like members of some exclusive club that not many get to belong to. We wondered why God had chosen us to receive such a blessing. And on the first try. We were really starting to get used to the idea that we’d soon jump from a couple to a family of five.
My OB/GYN referred us to USF Health for the remainder of our prenatal care, so that the babies and I could be closely monitored. We saw maternal fetal medicine specialists, and had way more ultrasounds than you’d get with an average pregnancy. I was at the doctor often. I was rapidly expanding, my belly measuring about 3-4 weeks bigger than it would be with an average singleton pregnancy. Everything was moving right along.
A week after finding out that all three of our sweet peas were little boys, at one of our ultrasounds, the nurse said she was going to step out and talk to the doctor. The doctor (Dr. Jerome Yankowitz) asked to speak to us in his office. We had no idea what was about to hit us.
Our first maternal-fetal specialist, Dr. Odibo, mentioned early on that because two of our triplets were identical twins who shared a placenta, we were at risk for a condition called twin to twin transfusion syndrome, or TTTS. When Dr. Yankowitz called us into his office, he asked us what we knew about our babies. I said, Dr. Odibo had told us about the possibility of TTTS. He told us that based on this most recent ultrasound, he had some suspicion that our twins may be affected by TTTS.
Being given this sort of news was like nothing I had ever experienced. The unborn babies inside me, who had yet to see the world, had something wrong with them. Dr. Yankowitz told us about a doctor in Houston who may be able to help. He wanted to see us a few days later to see if things were getting better or worse, or staying the same.
At the end of the week, we saw our specialists again, and the decision was made to fly to Houston that Monday, November 17, to see a specialist who may be able to save our babies.
We booked two very expensive last-minute flights to Houston to fly out Sunday afternoon. Whatever it took…I would have spent the million dollars I didn’t have it meant giving our sons a chance. This was my first dose of feeling and understanding what it means when you’d do anything for your children. Our appointment was set for bright and early at 7:30 a.m. Monday.
We arrived in Houston that Sunday evening, and had dinner at Olive Garden, because it was either that or Mexican. Mexican or Tex-Mex food was the ONE thing I wanted absolutely nothing to do with from the very start of my pregnancy. Marcelo even said something about Chipotle one day after work and it practically made me hurl. I remember not eating much, because I was just too anxious about the appointment the next day.
We checked into our hotel room and spent some time talking, crying, and praying aloud. For some reason I thought that praying aloud together would work better, so we had been doing that every day. I just wanted all of my babies to be alright, and I’d try anything, say anything, give anything.
Monday morning came and we had the longest ultrasound to date. The ultrasound checked the anatomy, blood flow, heartbeat and cord placement of babies A, B, and C. We went to a small meeting room to talk with Dr. Moise about the results and our options.
I remember feeling the blood draw away from my face as he gave us the news. Baby C was 50 percent smaller than his brothers. Baby C has reverse blood flow through his umbilical cord. It was called Selective Intrauterine Growth Restriction. The chance of Baby C making it to even 23 weeks (viability) was slim. I’ve never felt a bigger knot in my stomach. I never gripped my husband’s hand tighter.
Dr. Moise drew some sketches on the dry erase board behind him. When the egg split, creating identical babies B and C, C’s umbilical cord wasn’t attached well to their shared placenta. It was off to the side, on the edge, and therefore he had an unfair share of the placenta and the important nutrients his little body so desperately needed.
The options? I wouldn’t consider them options. We didn’t want to have to choose either option. I didn’t want to be the one going through this. I wanted to have good news. Were my prayers not heard? This wasn’t supposed to happen. Why do I have to choose?
Dr. Moise provided us with a couple of scenarios, along with statistics to back them up. Option 1: we let nature take its course and see what happens. If baby C survived, all three babies might have to be born as early as 23-24 weeks, and their chances of surviving after that, and not having long term health problems? Not good. If baby C did not survive, it was highly possible baby B would pass as well, because of the shared connections they had through the placenta. Option 2: I undergo a radio frequency ablation procedure to essentially “cut off” baby C’s connection to the placenta, thus giving baby B (and Baby A) the greatest chance of survival. The statistics for fetal survival after this procedure were good, although there was a small chance that it could result in the death of both babies. Yes, essentially we would be sacrificing one of our babies in order to save two. Of all the options we were presented, this gave us the greatest chance of saving the most babies. Did that make it an easy choice? Did we decide on a whim? Nope. Did we feel good about the option we chose? No.
NEVER. Never in a million years would I have thought this type of procedure was OK or acceptable if it wasn’t happening to me, if it wasn’t our babies. Do I really think it’s OK now? No. Was I really OK with it then? No. But did I have a lot of options? No. Do I live every single day of my life wondering “What if?” Yes. Do I feel guilty? Yes. Do I blame myself and my body? Sometimes, yes. We were dealt some pretty shitty options, and we had to make a decision. We chose what we thought was the best one.
That night was full of prayers, and lot of crying, and very little sleep. I’ve never cried so hard in my entire life. I told baby C I was so so sorry. I must have told him a hundred times. I told them all how much I loved them. I prayed to God that we were making the right choice. I hugged my belly and tried my best to make sure those babies knew how loved they were.
We checked in to the hospital the following day for the procedure. Every person that comes into the pre-op room asks you to tell them what procedure you’re having done. “Radio frequency ablation.” Although inside I was telling myself, “I’m sacrificing a baby to save the others.” There was no sugar coating it, no pretty way to put it. But Marcleo and I agreed, we were dealt a terrible hand, and used all the information we had to make the best decision possible that was supposed to lead to the best outcome.
The procedure was over, and after a few hours in recovery we were sent home. We wouldn’t know how baby B fared until the following day at our follow up ultrasound. We went to dinner, then checked in to our new hotel. I felt awful and I couldn’t sleep the entire night. We were huddled together on a tiny full size bed and I kept tossing and turning all night, I just remember having a bad feeling all night.
It was Wednesday morning, November 19, 2014, and we were in the ultrasound room. We saw baby A, heartbeat going strong. As the technician moved the wand we saw Baby C. No heartbeat. I knew I would have to face this, but I wasn’t really prepared for it, and it didn’t hit me until then. The technician moved the wand again, and we saw it, but she didn’t say anything. She stepped out of the room. We knew what it was. Baby B’s heart looked just like Baby C’s. Still. Marcelo and I squeezed each other’s hands and didn’t say much.
Afterward, we met with Dr. Moise in the same room. He couldn’t give us a reason, he didn’t really know. He said, sometimes these things are beyond us. He told us how truly sorry he was as he held our hands. I never thought things would end up this way, that this would happen, even though we knew there was a tiny percent chance it could happen. The worst had already happened, we never thought it could get worse.
Dr. Moise said Baby A would most likely be fine, but I needed to be closely monitored to make sure my body didn’t go into labor due to the passing of the other babies, who I would carry until the day I delivered Ethan.
We called our parents to update them. I wanted to get the hell out of Houston. I went on Southwest and swapped our flights for direct flights out that same day. We came home.
I was on pins and needles the rest of my pregnancy, but particularly on the days I had sonograms. I couldn’t take any more heartbreak. We had a couple of scares, and ended up going to the hospital once around 33 weeks because I was having some contractions. But mostly because I wasn’t sure I had felt Baby A (Ethan) move that day. I HAD to make sure he was OK. Hearing his heartbeat that night was the best sound we had ever heard.
The days and weeks following Houston and leading up to Ethan’s birth were full of ups and downs. We were grieving the loss of our two babies while still trying to be excited for our little Ethan’s arrival. There were, and still are plenty of tears. I think about my two babies every day and I will always wonder. I will wonder what if we hadn’t had the procedure. I will wonder what they would have looked like. I wonder if Ethan ever recognized they were gone. I wonder if I should have seen them when I delivered Ethan, although my doctor told me there wasn’t really anything to see. I will wonder who they would have been and what they would have grown up to be. I will never stop loving them or wondering.
To my sweet beautiful Babies, “B and C,” Nathan Thomas and Zachary Daniel. I so wish I didn’t have to make any of those choices. I so wish you could be here with us and Ethan. I wish I could have seen your faces, held you tight, and kissed your sweet heads. I wish I got to hear you cry, and rock you to sleep and read you Goodnight Moon like I do Ethan. I wish you weren’t taken so soon, but I pray that I will see you one day. Mommy and Daddy will always love you and we will always think of you.