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Dear Subscriber,
This week's edition of "Live and Learn" is on a pretty
serious topic: pre-natal ultrasounds. Everyone should
get one, and sooner rather than later. There are a
thousand reasons why this is true, but just listen to
our family's story and I think you will get the
picture.
Ali and I were very fortunate. The first month we
tried to get pregnant, we did. And since we were
about as "low-risk" as you can get, we opted for one
of Stanford University Medical Center's mid-wives
instead of having a traditional doctor. Their mid-
wifery program is tops, and the consensus is that for
low-risk pregnancies, it's a better way to go.
So everything is going according to schedule, except
that Ali's tummy is a little larger than expected.
Still, they are pretty sure we are not having twins or
anything like that. We are scheduled for the standard
20th week ultrasound, but Ali gets anxious and we end
up getting it one week early.
That may have made all the difference.
Not knowing the rules, I had brought our video camera
to the ultrasound session hoping to immortalize the
first glimpe of our new baby on film. When it came
time to start the procedure, I pulled the camera out
of the bag and asked if that was ok. Our doctor
explained that for liability reasons the hospital does
not allow that, just in case something abnormal is
found. Then she said, "for instance...". She was
looking at the ultrasound screen when she said that;
looking at our baby. Ali was already crying at this
point and I'm wondering what the heck is going on, and
then the doctor finally finishes her sentence, "I'm
seeing two babies!"
That is incredible news, and a real relief after she
had startled us there for a second (well, actually
just me since I learned later that Ali was crying not
in sadness but in joy because she knew she was seeing
twins). Ali had always wanted twins, but since there
are no twins on either side of our family, we didn't
think there was much of a chance. What we didn't know
was that *identical* twins are not hereditary.
Sometimes the egg just splits, and everyone in the
human race has just about the same chance of having
identicals because of that.
But then came the other half of the story. Our doctor
could tell from a glance that "Baby A" (now known as
Ainsley) had a lot more amniotic fluid in her sack
than "Baby B" (now known as Sierra) did. That was a
quick tip-off to our knowledgable perinatologist that
the girls had a condition known as Twin-to-Twin
Transfusion Syndrome (TTTS). Twins with TTTS share
their blood supply, and inevitably one of their hearts
beats the slightest bit more strongly, creating an
imbalance. If untreated, one twin will eventually
have too little nutrition (prohibiting growth), while
the other will have too much blood (overloading the
heart, liver, and kidneys). Either one could die
because of this, and since they are connected the 2nd
twin is also left with little chance of survival. And
even in cases where TTTS is untreated but both twins
survive, temporary or permanent physical/mental damage
is likely.
Around 10-15% of identical twins will have TTTS, so it
is quite common, but until fairly recently, nobody
knew what it was. Those children simply went
undiagnosed and untreated, usually with dire results.
Fortunately, there are now excellent treatments
available if the condition is caught early.
The most common treatment for TTTS is called Amniotic
Fluid Reduction, and doctors are not sure *why* it
works. The *way* it works is they insert a needle (a
very large needle, as Ali will attest) into the
amniotic sack of the "recipient twin," the one with
the excess amniotic fluid. They extract most of the
fluid, and then keep careful observation on the twins,
repeating the procedure as often as necessary. The
best guess on why this usually works is that the
"donor twin," the one with the stronger heart that is
giving away her nutrients, gets all cramped up in the
corner by the recipient twin's larger sack. So when
that sack is reduced in size, the donor twin has more
room to stretch out and grow. That explanation sounds
kinda silly, but I have it on good authority from the
medical geniuses at Stanford that this is how it
probably works.
So within 30 minutes of our first ultrasound, Ali had
the (dis)pleasure of undergoing an Amniotic Fluid
Reduction. Again, we were fortunate. The girls
responded very well to this treatment, and we only
required one other Amniotic Fluid Reduction during the
course of the pregnancy, around 26 weeks. Ali was
able to carry our twins all the way to 35 weeks (we
had been told to target 30 weeks as our absolute top
goal), and after a short stay in the NICU (a little
over a week), the girls were about as healthy as any
newborns could be.
But the story probably would not have had such a happy
ending if we hadn't gotten an ultrasound, and an early
one at that.
Recently I spoke with a mom who is one of our
customers. She has identical twin boys, and they had
TTTS. She only received one ultrasound (at 25 weeks),
and her doctor didn't catch it. Amazingly, both boys
survived, but they both have physical and mental
disabilities as a result of TTTS. With several years
of dedicated therapy, it is likely that they will
actually be able to reach their original potentials
(the healing capacities of young children are
extraordinary; I have heard some doctors speak of this
in almost magical terms). They are very fortunate,
considering the failure of their doctor.
Alison and I are thankful every day for the excellent
care our little ones received while they were still in
the womb. Doctors make mistakes sometimes (they're
only human), and that cannot be avoided. But what
mothers (and fathers) can do is demand to receive
ultrasounds, and to get them earlier rather than
later. It could make all the difference.
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Have a wonderful weekend!
Sincerely,
Paul
Paul & Alison Martin
Noss Galen Baby LLC
www.NossGalenBaby.com
Copyright, Noss Galen Baby LLC 2005
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