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Talk about every stage of pregnancy, from early symptoms to preparing for birth.

Twin-Twin Transfusion Syndrome

320 replies

MrsStevo · 11/04/2011 15:25

Hi!

I wanted to share my experience of the most horrendous week of my life and find out if there is anyone else out there in the same / a similar boat?

My MCDA (identical) twins were diagnosed as having Twin-Twin Transfusion Syndrome (TTTS) at my 20 week scan last Tuesday (5th April). The doctor established this because one twin was smaller than the other, had virtually no amniotic fluid around it and was stuck to the wall of my uterus, not moving. It had a heartbeat but no bladder could be seen (as no fluid for it to drink / urinate). The other baby was swimming around in waaaaay too much amniotic fluid. The doctor thought I was at stage III of the condition (Stage V being babies have already died) so very serious.

So, I was referred to Birmingham Women's Hospital (I live in Lincoln) and had an appointment there on Wednesday afternoon. The (amazing) consultant - Mr. Bill Martin - scanned me and confirmed TTTS. He said he thought I was actually only stage II but basically said the only chance babies had was for me to have Fetoscopic Laser Ablation Surgery - keyhole surgery where they go into the sac that the bigger baby is in and laser / cut off some of the blood vessels in the placenta that the babies share so both babies have their own half. Odds are 40% chance of both babies surviving and 80% of one surviving. Plus added risk of early labour / waters breaking, infection etc.

Long story short, I was admitted to Birmingham Hosp on Wed PM and had the surgery at about 9am on Thursday. I was terrified - had to have spinal anaesthetic, be catheterised, wear a surgical gown and it was done in a big operating theatre with literally 15-20 people in it. However, my consultant was just amazing - so re-assuring and acted as though it was something he did everyday. He and his colleague were even chatting away about holidays whilst they lasered away.

After the surgery we (DH and I) had to wait for 6 hours before they would scan me again to see if the babies had survived the surgery. At the time, that was the longest 6 hours of my life. We had the scan at about 5pm and both babies were alive - the doctor said they looked healthy and it was the best outcome they could hope for. However, they also said that the next week is a crucial time and, if babies survive the week, then that is really good and indicates they both have a good chance of making it.

So. Here I am 4 days post-surgery with 43 hours until my next scan (they're doing it a day earlier in Lincoln so I can see my consultant there). I feel completely lost and totally in limbo. I don't know what to do with myself (aside from rest, feet up etc etc) but am just trying to stay sane. I'm trying my hardest to keep myself away from Dr. Google so I don't freak myself out by the statistics.

The biggest things I worried about right now:
Will both babies survive? I can't imagine my life without having twins in it now -these will be our first babies, having had a miscarriage last year.
IF they do survive, will they have any neurological damage as a result of surgery - cerebral palsy is a risk. How will we cope if they do?
I'm vegetarian - should I be on protein suppliements to promote healing / good blood quality etc?
Is there ANYTHING I can do to make the odds better?!

Oh. It is just a horrible time. My DH went back to work today (although he wants to be at home with me as much as I want him to be) so I'm alone with just my overactive mind (and a pesky cat) for company.

I wanted to write about this experience on here in case anyone has any pearls of wisdom or wants to share their experience of this horrible condition. Or, if anyone on here happens to be an expert in this condition, perhaps they can pump me full of optimism with a bunch of statistics that everything will be ok?

Thanks for taking the time to read / listen.

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twinnies26 · 25/08/2011 13:09

Hi Silverangel - great your little ones are out of incubators and in cots now! :) Glad they are doing well and great you are getting some breast time with them, i'm sure it's hard for them to suck still as they're so little but it's great that you can have them close and bond even if it's just for a short while! I'm going to get a Medela pump too, and yes they are expensive. I think Mr.s S bought hers secondhand and it has worked out for her....i might look into that too and then just replace tubes etc.. or sterelise like mad.

I really hope the girls can come home really soon! you must be dying to get them home :)

How are you feeling? All recovered from the CS?

xx

twinnies26 · 25/08/2011 13:10

oh and silverangel how is your back now? Pain gone now that your girls have arrived? Mine been really at me for the last 2days....

CakeForBreakfast · 25/08/2011 16:34

Hello all,

Twinnies Its so funny you talking about discomfort, in the last week or so, I have really become uncomfortable! I never had lower lumbar pain with either previous pregnancy but its pretty bad now, also the SPD and absolute worst of all is that I can't eat like a horse anymore! There is just not enough room and I get queasy!

The bump itself is painful at times too which is new from the other pregnancies, It feels like I am a bag of pointy spanners and the distortions of my belly when they stretch and push out is starting to freak out dh! Still, I'm not complaining!

I waited until 28 weeks and now am buying a few small bits and pieces, i have bought some tiny baby sleepsuits and vests, nappies, an extra bouncy chair, new steam steriliser, thats it so far I still need to get plenty more! I'll get as much of the big stuff second hand.

Silver I'm so glad the girls are in cots now, how are you finding things - do they get through sleepsuits and clothes at a rate of knots?

Thinking of you all
Cake

twinnies26 · 25/08/2011 17:19

Hi Cake

haha yes i have crazy distortions going on in my belly too and he thinks the same! - it's very strange! when they both do it at the same time it's really uncomfortable too! They're really like an octopus at the moment!

I admit i'm getting quite tired and have been very lazy today, been on the couch since 1pm - watching tv, being online and knitting - not done that in ages!

I guess i better get going and finally get the basics in anyway - have done lots of research, the laptop is full of folders on the desktop but i've not bought anything yet! Oh... did you buy premi clothes?or just normal newborn?I've looked at some but not bought as no idea how to predict what size they might be!I guess should buy bigger and they can grow into them?!

Good luck on Friday! Hope it all goes well :)

xx

CakeForBreakfast · 25/08/2011 19:22

Twinnies I have bought some "tiny baby" sleepsuits and vests so far (up to 6lb) as I know my consultant wont want me to go much past 34 weeks and the average weight is 4lb-ish, so I am thinking even if they are in incubators for a while, they will still have room to grow after. I remember my first was born at 6llb 10 oz and she was absolutely swamped by 0-3months, absurdly too big, so just a few tiny baby and newborn sizes will be useful I think.

I do have to have a good think about electric express machines though I really don't know what to do about that, have you looked at prams yet?

twinnies26 · 25/08/2011 21:23

Hi Cake

Thanks for the tips about sizes! I plan on getting a few things early next week - I'm starting to compile my hospital bag now incase the babies decide to make a surprise appearance at some point!
interesting about 34 weeks, it must be the 'cut off point' as we were told we will never go past that as well.

Spent abit of time researching pumps a little further today. I am in Ireland so my info may not be entirely relevant to you - but i spoke with a company called 'medicare' (could be over with you too?)about renting hospital grade pumps and from what info i received it seems to rent one for two months is almost the price of a new Medela. The lady told me the best Medela pumps for twins are the 'pump in the style advanced' and the medela 'free style pump' (but this one is ridiculously expensive). I just can't decide on whether to buy from ebay secondhand or get a new one. The hospital grade pumps for rent were medela 'symphony' and i've actually forgotten the other name...it's somewhere on paper!

Re prams - i saw a lady with twin boys in a pram/buggy that interested me a few weeks ago and started chatting to her. Her buggy seems to tick all the boxes for us. It's called mountain buggy urban jungle duo. Only problem it's pretty expensive new so we are hoping to get a friend to help us source one secondhand from the greater London area (no secondhand market for that buggy in Ireland). Am keeping an eye out on ebay for deals! It's an all terrain buggy which suits us as we live up a lane. The buggy is very narrow so can get through all doors - 73cm wide i think. I like the idea of the twins being side by side and being able to interact with each other. Link is below.....

mountainbuggy.com/en/buggies/double/duo

Let me know how tomorrow goes!

X

CakeForBreakfast · 27/08/2011 20:42

Hi all,

Scan was fine yesterday which was nice. It wasn't a growth scan, just well-being, dopplers and all that all fine so good to go on to another week! hooray

xx

twinnies26 · 27/08/2011 22:00

Yay! Go twins and Cake :) xx

MrsStevo · 29/08/2011 22:13

Hi all!! sorry for being so out of touch... we've been fairly busy!! The girls are doing so well though and are absolute poppets - couldn't wish for better!

Don't have time for a FULL catch up with everything but so pleased to hear that your scan went well Cake and that you have crazy belly distortions twinnies - that can only be a good thing! And Silver - lovely to hear that Sophie and Alice are doing so well. Really hope you get to take them home soon, I remember all too vividly how claustrophobic and frustating being in SCBU is.

Vis a vis expressing contraptions, I would suggest you check what equipment your hospital will provide in the event that your babies end up in special care. Ours had a super-dooper double electric Medela pump that I had sole use of whilst I was in there. I had already bought the Medela Pump-In-Style (double electric, comes in a rucksack for ease of transportation) and didn't need it at all in hospital. I have used it since I have been home and found it to be excellent - BUT I spent about £60-£70 on it (off ebay) and I'm no longer using it as I stopped breastfeeding and expressing this week. So I have had about 3ish weeks use out of it and, to be honest, I would have saved money had I rented one. If I had been able to continue then it might've been worth its money ... and I might yet need it for baby no 3 in the future!

Pram-wise, I couldn't rate the Baby Jogger City Select any higher. It is fantastic in every respect - very manoevreable, lots of room for stuff underneath and versatile in terms of fitting car seats and carry cots.

Must dash - girls need feeding again! They certainly keep me busy....

Lots of love and healthy-baby wishes to you all x x

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twinnies26 · 30/08/2011 19:37

Hi all!

Great that everything is running smoothly in your household Mr's. S The girls must be getting so big now! They're almost 5/6 weeks old now?!time flies eh? How are the girls sleeping for you?Have you got a system in order now?Sounds like you are in control anyway!

We're doing well for now! growth scan today,the girls are still small just below the 'normal range' but despite this they're happy to let us keep going until 32 weeks- then they'll review it all, maybe we'll get 2 more who knows!- so not long to go 3-5 weeks!

Cake we're getting there slowly but surely! :)

xx

CakeForBreakfast · 02/09/2011 15:21

Hello all,

Just thought I'd give a quick update. I had a scan today which made the consultant gurn and churn his expression.

One of the twins dopplers is not yet abnormal, but might be showing an early indication of the placenta not delivering as well as it should to that baby. I'll go back in next Tuesday for another scan and if it hasn't improved on its own then they will probably be delivered within 24 hours! Eeeek, babies! I had the first steroid shot today and next tomorrow.

I am currently 30+4 and the twins estimated weights are 3lb 4oz and 3lb 7oz.

We will have to wait and see what next Tuesday brings, the grandmas are on tenterhooks!

Hope you are all well.
xx

twinnies26 · 02/09/2011 17:31

Ooohh Cake sorry to hear that :( i really hope things rectify themselves for you by Tuesday and your little ones will stay inside a little longer! I'll be thinking of you alot over the weekend and on Tuesday. You never know you might avoid delivery as sometimes these things can correct themselves in a matter of days - Good they are getting the steroid shots in quickly for you anyway.

Your twins are a good weight anyway! I'm 29+5 today and on Tues my babies were a whole pound less than yours - 2lbs 5 and 2lbs 7.

Keep us all posted and good luck!!

xxx

silverangel · 02/09/2011 18:33

Hi everyone, haven't read the latest messages as on phone not laptop but just wanted to say Cake, if you do have to be delivered your two are a good weight, mine were 3lb2 and 3lb5, and they are doing fine. Hopefully you won't have to be delivered but, if you, don't panic!

All going well with the girls and hopefully they will be home in the next ten days, not so well on the breast milk production but I'm persevering!

Will catch up on everyone's news properly later!
Xx

CakeForBreakfast · 03/09/2011 10:35

Thanks for all the reassurance ladies, If next Tuesday they do need to come out I will be just over 31 weeks then, thats not so bad really.

SilverAngel can I ask, how long have your girls been in hospital now so far, how long in the incubator? (You were between 31-32 weeks when you delivered weren't you?).

How is the breastfeeding going? Well done for perservering, I'm not entirely sure I will be that diligent!

Twinnies It sounds like you and your girls are doing well, on the babycentre "average fetal weight chart" your babies weights at 29 weeks seem very close and almost spot on for 50th centile! Is your consultant still saying they are under??? I wonder what references he is looking at!

MrsStevo How are you doing?

Off to the hospital now for my second steroid shot, will update you again (hopefully) on Tuesday afternoon

silverangel · 03/09/2011 12:36

Hi Cake, we will have been in five weeks on Monday and fingers crossed home next weekend so nearly six weeks altogether. They were in incubators for three weeks, then went into water beds which are heated things that go in the cots and they came off those last night into regular cots.

I think the problems I have had with breast milk production are a) they were only 31 weeks (31+2) and b) I was kind of left to my own devices in Ashford re expressing. They were delivered on the Monday and I didn't start expressing until the Saturday when we were back at Farnborough which I'm sure can't be a good thing. The volume I was getting up went up a little bit but then I got mastitis and it doesn't seem to have recovered since. I started taking domperidone but that hasn't helped either. The advice is to express every three hours including through the night to establish supply but I stopped that as it wasn't going up and I was getting more and more exhausted and it was actually going down. I had always decided I was going to try and breast feed but if it didn't happen I wasn't going to beat myself up about it. At the moment they are on 1/4 breast milk and 3/4 nutripem which is a high calorie formula to boos their weight and they will be prescribed the nutripem when they come home as well so will probably stop the expressing altogether then.

I hope you can keep them in a bit longer but if not hope the delivery goes well and any questions please ask away!

Also, just a thought if you do deliver and you need ickle clothes Boots and Mamas and Papas are the best for small sizes and the sleepsuits with feet, long arms and the bits you can fold over to make scratch mitts. The feet keep the wires in place and the scratch mitts are good to stop them pulling their feeding tubes out.

Xx

MrsStevo · 04/09/2011 00:58

Hi cake - sorry to hear your news as I know that situation is far from ideal but, as the others have said, try not to fret as 31 weeks is pretty good going and if you've had the steroids then they'll be fine I'm sure. And they are good weights - Sophia was 3lb 6 and,although she looked absolutely tiny on arrival, she is doing so well now and you'd never know they'd even had TTTS now. Big fat fingers crossed for your scan on Tuesday, I hope they get to keep cooking a bit longer but it will be amazing to meet them if they do arrive next week. Keep us posted, I would love to know how you're doing and hear when your little people arrive. I am actually really excited for you.

Silver - WELL DONE on persevering with the breast feeding and expressing. It is bloody hard work physically and emotionally - particularly when you have to wake yourself up in the night to express. Sounds like you've had shite support in that respect as well which is really disappointing. You sound the same as me in terms of the ratio of your milk to formula - our girls were prescribed the same stuff by the sounds of it. They are on nutriprem 2 now which is the post-discharge stuff (which is prescribed for 6 months and therefore FREE - woohoo!). I must confess that I have given up expressing and breastfeeding altogether now. I managed 5 weeks of combined BF, expressing and formula feeding and it was slowly killing me. Fortunately I have a very supportive HV who agreed with my decision to just formula feed. The girls are thriving so I know I've made the right decision.

We are doing just fine. The girls are now 6lb 14 and 5lb 12, which is still pretty tiny but they look massive to me already!! They are an absolute pleasure and genuinely make every day an amazing one. I think because we went through all the TTTS trauma, I appreciate them so much more than I would have done. I think I'd taken having-a-healthy-baby/babies for granted until then and now I realise how hugely lucky I am. Being a mummy is SO much more fabulous than I'd ever thought....even when they're shouting with hunger at 4am!

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CakeForBreakfast · 05/09/2011 18:35

Hi all,

Silver and MrsStevo you sound like you are doing so well. I love hearing about how all the babies are doing!

I am hoping tomorrow my consultant lets me go a few more days but I won't overly fret if he doesn't, as we've all said, 31 weeks is not a catastrophe.

Did you find the babies actual birth weights similar to their estimates, or were they over/under?

MrsStevo you sound so happy with your new role! You are a bit of a supermum as there are so many new mums of single babies who are in a permanent panic (I was one with my dd1), but you sound like YOU are also thriving as well as helping your girls to. Can I ask a question about nighttime formula feeding, when the babies wake up in the middle of the night for milk, do you go and prepare bottles from scratch, do the babies cry and cry until they get fed, or do you have preprepared bottles for nighttime. This is an area I haven't ever been in before!

Silver I can't believe you had mastitis and still persevere, thats love and dedication! I have had blocked ducts in the past and that was bad enough, but mastitis! Wow. Tough lady.

Twinnies I will also be thinking of you tomorrow for your scan

silverangel · 05/09/2011 20:50

Woohoo - my babies are coming home tomorrow!!! We were expecting them to come home by this weekend but tomorrow was a surprise. We are excited and terrified all in one go!

Cake and Twinnies let us know how you get on tomorrow, will be thinking of you. I will check in when I can, I have a feeling I'm going to be very very busy from tomorrow:)

Mrs S - keep up the good work.

Xx

silverangel · 05/09/2011 20:52

Forgot to say Cake, our estimated weights were just about bang on x

CakeForBreakfast · 06/09/2011 14:16

Hello,

I'm home again after today's scan. The 'dodgy' reading has not gotten worse, it was a tiny bit better, although still just on the borderline of dangerous. But it means I get to keep them in until another reassessment on Friday.

Phew! Now that we've got this short reprieve, I realise how tense I was beforehand, I'm exhausted now!

Silver that is wonderful news on your girls coming home, that is even earlier than your original due date isn;t it, they have done well!

Twinnies How was the scan today?

xx

twinnies26 · 06/09/2011 20:22

Hi ladies!

not logged on as laptop was gone with my little sis for a few days!

Cake was wishing you lots of good luck for today and thinking of you! and I am so glad that things have picked up! Good girls!! :) here's hoping Friday will also bring good news and you will get another few weeks in!

Silver - am so thrilled your little girls will be home tomorrow! Wishing you and your new family all the best :) How exciting to have them safe in your arms in the comfort of your own home! You will def have your hands full for the next while trying to establish a routine and system!

Mr.S - i love hearing your twin reports! Like Cake says you sound like you have it all under control and are enjoying every moment of being a new mum!

We're doing well, just a biophysical today and the twins seem to be happy in there for now! Next week we will book a date for c section, it's looking like Oct 4th , but will know for sure next week! So a month today and that would get us to 34 weeks + 2 - of course we'll have to see if we get that far but fingers crossed!

xx

twinnies26 · 08/09/2011 14:40

Cake good luck tomorrow, am thinking of you!

Silver hope all is well upon your arrival at home!

xx

CakeForBreakfast · 09/09/2011 16:55

Hi all,

Thought I would mention todays scan was fine. Babies are now behaving as they should so I can go until next Tuesday! Yay! Consultant wont let us take anything for granted though, next scan will be growth and he has yet again warned that if growth or dopplers are not good then he will deliver! If they are fine however then he will book me a section date! (I will be 32 weeks by then.)

Hope you and all babies are well.

xx

twinnies26 · 09/09/2011 18:14

YAY!!great you have managed to avoid delivery yet again :) - every day they can stay in is a bonus and again remember even if they arrive next week 32weeks is not bad at all considering what we have all been through!

My section date will also be booked on Tuesday! - so we'll both have a date on the horizons then.

Good luck Tuesday - you never know you might get another week or two yet!

xx

MrsStevo · 10/09/2011 15:26

Silver - FANTASTIC! So pleased your girls are home. How are you getting on??

Cake - brilliant that your babies are behaving again! They are so very clever. Your consultant sounds a lot like mine - he made it clear at each scan that the next one could be the last one. Are you scanned twice a week now? SO pleased for you being 32 weeks!! That's fantastic. WELL DONE on your excellent growing skills. It will be so good to have a date for your C-sec, something to work towards.

Twinnies - YAY for you too!! Fantastic that your bambinos are doing well too. Let us know what your date is.

Vis a vis night-time feeding, I use a cold-water steriliser over night. It is basically a big mixing bowl with a lid that I put water and Milton in and have it next to the bed so the bottles are sterilising away and I just get them out and use them straight away during the night - saves trekking downstairs to the kitchen. I make up a thermos of boiling water, another of cold water and have the milk powder next to the bed as well so I make the bottles up as we go and cool them in a measuring jug. Possibly sounds like a faff but it works really well for us as I don't have to get out of bed at all. Generally the girls wake each other up but I park one on my DH's chest and she'll settle for a bit whilst I feed the other. I demand feed overnight so only feed them when they wake up.

Are any of you managing to enjoy the last few weeks of your pregnancies? I've had some time to reflect since the girls arrived and I miss my bump very much and would love to have another baby one day despite everything we've been through. I would love to know what a 'normal' pregnancy is like!!!

Anyway, hope you're all ok! Love reading your updates x x

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