They Aren’t Sick Anymore....My Twins Angels

By Colleen

I remember being at work and my husband calling and asking if the IVF office had called yet with the results of the pregnancy test.  He couldn't stand the waiting anymore.  He decided to call them.  I really thought that I wasn't pregnant this time.  It felt different than I did when I found out I was pregnant with my first child (a miracle baby).  When my phone rang again and I picked it up, my husband was crying and said "it worked again!!!"  I was pregnant!!!!  The only difference this time… IT WAS TWINS!!!!

I was very scared about the thought of having twins.  My first son, Grant was born at 33 weeks but no diagnosis was ever given as to why.  They just attributed it to preterm labor.  At my first OB/GYN appointment, I asked my questions about how my pregnancy would be handled.  The doctor was very nice and helpful and explained that I would be watched a little more closely because of my history and the fact of multiples.  He explained that I would have more frequent office visits and numerous ultrasounds.  At this time there was no mention of an incompetent cervix.  (I had never even heard the term before).

I was moving along through my pregnancy when I hit 21.6 weeks.  That evening in the middle of the night, I woke up with very mild cramps and a backache.  This was the same symptoms I had when I was sent to the hospital in "pre-term labor" with Grant.  I called my doctor and he didn't think it was anything to be concerned about.  He said if I wanted to I could go to the emergency room or I could meet him in the office first thing in the morning.  Because it was so late, I chose to take his advice and I met him in the morning.  He explained on the phone that he would be sending me for an ultrasound to check my cervix.  When I was in his office did an internal exam to make sure nothing strange was going on.  The strange thing that was going on was I was dilated and baby "A" water membrane was bulging through into the vagina.  He sent me to a hospital that has a wonderful Maternal Fetal Medicine group.

Now at 22 weeks, the specialist told me that there would be no chance for survival of the twins.  He explained that now with the history of my first son, I was believed to have an incompetent cervix.  He said that they could try to lay me in a trendelenberg position in hopes that the membrane would retract back into the uterus.  (He said that it is rare for that to happen).  He explained the term cerclage and said that would be my only hope in keeping the babies in the womb.  I needed to get to at least 24 weeks for the twins to have any chance.  He explained that because the membrane was hanging down, there was a good chance that an infection could have set in, which would make the delivery of the twins a must.  Antibiotics were started and I laid with my head below my feet for the rest of the day and into the next when they had scheduled to do the emergency cerclage.

After the cerclage was placed, the doctor felt good about it holding.  He said the cervix was thin, but there was enough that wasn't dilated for them to work with.  I spent six days in the hospital waiting to make sure no infection was present.  The doctor said that the first 3 days after the cerclage is done was the most crucial.    I was sent home on complete bed rest only allowed to go to the bathroom and one shower a day.  My follow up appointment would be the day that I would be 24 weeks along.  I made it to that milestone, 5/4/00.

My doctor wanted a complete ultrasound the morning before my appointment with him.  We did that at the hospital before my appointment and the twins (boys I forgot to tell you) were doing great.  Baby "A" was measuring to weigh 1lb 4oz and Baby "B" was thought to be 1lb 9oz.  They also did the internal ultrasound to check the cervix.  The stitch was still holding and there wasn't much change unless it was actually a little better.  We then met with the specialist.  He was very pleased with the ultrasound.  He said that the cervix looked better than when they first put the cerclage.  My husband and I were very relieved and excited. 

By the time we got home we had spent about 6-7 hours at the hospital (were the doctors were located).  We arrived home about 6:00pm.  By 7:30pm that evening, I felt a low grade fever coming on.  It was only 99.4.  I called the specialist anyway because I was scared it was an infection.  She said that maybe I was dehydrated from being down there all day.  She suggested I force some liquids and then take my temperature in one hour to see what it was doing.  By 8:30pm, I was having contractions 5 minutes apart and the fever was 100.8.  I chose to go to the hospital.

After an examination, my water hadn't broke and the cerclage was still holding.  They were very concerned about the fever being a sign of infection.  (I had no other symptoms though).  My contractions had gotten as close as two minutes apart.  The administered drugs to stop the contractions.  Nothing was working; it was only slowing the contractions down to about five minutes apart.

The next morning they decided to take the stitch out because they didn't want to risk it tearing and me hemorrhaging.   These babies were coming.  Around 3:00pm, an amnio was done to see if Baby "A" had an infection.  The results weren't back yet, but I was starting to feel the pressure and the need to push.  Adam James was born first on 5/5/00 at 5:07pm with Troy Jeffrey shortly to follow at 5:11pm.  Both babies were whisked away to the front of the OR to a team of neonatolgists and nurses.  The neonatologist came over to let us know that there was nothing that they could do for Adam.  He did have an infection and was not responding to the epinephrine to get his heart rate stabilized.  (The amnio confirmed the infection in the amniotic fluid as Ecoli.)  They asked if we wanted to hold Adam.  Without hesitation both my husband and I said yes.  His heart was still beating.  Adam died in our arms only living one hour and 23 minutes.

Troy was taken to the NICU.  Later that evening, we were taken to see him.  I had never seen anything so small.  All of the tubes and wires.  The doctors didn't expect him to make it through the first night.  That first night should have told us what an emotional roller coaster we would be riding when the doctor came to my room at 4:00am with bad news.  The next morning we spoke with the head neonatologist who couldn't have said enough "we are hopeful, but NOT optimistic."  We had no idea what the next 27 days had in store for us.   The ups and downs, steps forward and backwards.

Troy's lungs seemed to be his major problem (of course there were lots of others).  They were so immature.  His right lung was collapsed most of his life.  At one point he got a yeast infection in his lungs.  At that point, the doctor said that they were glad that it didn't get into his blood because an infection in the blood for a baby of this size would be fatal.  That always stuck in my mind.  He conquered that yeast infection, but the next infection would soon follow.  Troy started acting differently.  Not as active as normal and his vent settings needed raised.  The doctors suspected he might have another infection.  They began him on antibiotics until the blood tests came back.  Their suspicions were correct.  Troy had an infection in his blood.  Ecoli.  (The same infection that took his brothers life).  All that was going through my mind was the statement from the doctor "an infection in the blood is fatal."

After 12 hours by Troy's isolate, he seemed stable enough for my husband and I to go home for some rest.  At 12:00am that sound you don't want to here…the telephone rang.

"Colleen, this is Dr. K….., Troy isn't doing very well.  I think that you and your husband need to get down here."

When we arrived at the hospital, they were breathing for Troy and had been for 45 minutes.  He was rejecting the ventilators.  There was nothing more they could do.  I looked at the doctor and asked her "when do we say enough is enough?"  She said that she felt that we had reached that point.  I didn't want my sweet angel to suffer anymore.  My husband held him first and then I held him.  Those little eyes were just staring up at me.  (That is what I still see in my mind every day)   I really think that he new we tried everything and didn't want him to suffer anymore.  Troy died in our arms.

Grant is only two and doesn’t understand what happened to the babies.  He only associated with Troy being very sick and in the hospital.  Now we just tell him "your brothers aren't sick anymore, they are twin angels in heaven."  Someday he will understand all of this.

As the saying always goes…. Everything happens for a reason.  Well I am not sure what that reason is and I am sure I will never know.  I try to think of my sweet boys in heaven playing with all of the other little preemies who were just to small to fight.  I am sure my boys are watching over us.

My husband and I are very grateful for the short time we had with Adam and the 27 days with Troy.  We feel that if it hadn't been for our 2-year-old son Grant, we may have not made it this far.  People ask me if I will try to have more children and at first my answer was NO.  But as time goes by, I think I will find the strength to try again.  Being that all of our children were conceived through IVF, it is not that simple to just try again.  I hope soon I will be ready to make that commitment.  Now that the doctors know that I have an incompetent cervix, I am hopeful that an early cerclage will help me carry a baby to term.

Please feel free to e-mail me and know that you are not alone.

Jefcol@aol.com   

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