Wednesday, March 30, 2011

Memories of Splits

I recently read the happy news of a friend who is expecting triplets. Triplets! Hooray! Reading his blog about how they found out they needed to upgrade to the triplet stroller brought misty memories for me in terms of my own Discovery Appointment. I think we've all had a moment of daydreaming of what the might be like, wondering how we'd find out, what the doctor would say, if it would be a surprise.....

Could it really be 7 years ago already? How is that possible when I feel like I just left that shocking appointment...

I didn't expect to be pregnant. At all. Due to Poly Cystic Ovarian Disease, my doctor had squashed any dreams of spontaneous conception for me. (Ever get a phone call from your doc telling you it was okay to "engage in sexual relations? It's just as sexy as you'd dream it could be). We had just gone through our first 6 months of unsuccessful treatment and were taking a much needed breather before starting the more intense Injectables phase of our pregnancy plan.

That's when I started to feel kinda funny.

But I couldn't be. Could I? I mean, I wasn't supposed to be. Was I?

March 18, 2004: I woke up and took that first pregancy test. Positve. I stared at it in disbelief. How is it that we had just dug ourselves $5,000 in debt when I had just achieved it without meds? For free?

My doctor was equally leary of my proclaimation of pregnancy and hauled me in for a blood test. Several nerve-wracking hours later they called to tell me "I was very pregnant" and "could I please come in immediately for an ultrasound". Very pregnant? What did that mean, exactly? I didn't know there were gradations of it, like hues of colors. It sounded odd.

First thing the the next morning found me in the office again, undergoing a very in depth (and uncomfortable) internal ultrasound. I was too nervous to look at the screen, but in all honesty that little grain of rice seemed non-human to me. It just sat there at 6 weeks. But my doctor was interested in something, hemming and hawing over what he wasn't seeing.

As I came to find out, my hormone levels were really high. Hence the "Really Pregnant" diagnosis. I have since learned this can mean one of 3 things: either I was a. further along than we thought, b. having multiples, or c. there was something wrong with the pregnancy.

Initial measurements correlated with my 6 week estimation, so we knew a. was ruled out. My doctor was now looking to answer b. Thing was, he could only find one sac. And only one baby inside that one sac. One baby. One sac. Couldn't be multiples. He kept mumbling this through the ultrasound: "There's only one sac here, and only one fetal pole", and I grew more and more annoyed at his apparent disregard to the fact that I was okay with that. One baby was fine with me. Heck, any baby was fine with me. Geesh doc, show some love. 

At the end of the scan, he retold me about the whole one sac/one baby thing (really annoyed by that point), and added that the heartbeat was much brighter than they expect to see at 6 weeks. "But that's probably a good thing". Wow, thanks for that encouragement. I left with a diagnosis sheet that had a single check mark on it: Fetal Abnormality.

I didn't realize it at the time, but my doctor was already writing this one off. This ultrasound was a test, and I had failed; I wasn't further along than expected and try as he might he couldn't find another sac or baby. Option C seemed to be the likely culprit. Something had gone wrong in the many divisions of cells.

He scheduled me for another ultrasound in 7 days. "Just to check". In the meantime (and since he already had a thought that we were facing problems), he suggested that I not tell anyone I was pregnant. He clearly did not know me. I told everyone who stood long enough to listen, and even a few people who didn't.

7 days later I marched back into the office, this time with Dan in tow. As with before, I found myself unable to look at the screen, afraid of what I'd see. Or what I wouldn't see. I was waiting for news, but there was silence. Both doctor and Dan were staring at the screen. The doctor, with a furrowed brown; Dan with an open mouth.

"What did I see before?" my doctor inquired.

"" was my meek response. Was this a trick question?

"Well, you're having twins."


 (Remember that extra bright heartbeat? It was baby B stacked against A.)

"Make that....(moving the scan around a bit)...identical twins."

Hot damn!

".....and....(there's more?)...It appears they may be conjoined."

Crap. Crap. Crap. Crap. Crap. Crap. Crap. Crap.

The rest of the appointment was kinda a blur after that. Statistically, I wasn't having conjoined twins, my doctor assured us. But that scan. Looking at it, it sure was hard to tell for certain, and the fact that when one moved left, the other tugged that way too truly didn't set anyone's mind at ease. There were "things to consider", I was told by my now doom-and-gloom doctor.

This was not the way you would dream of being told about your multiples. I had only just found out about them, and now I faced losing them. I wasn't sure how to take it. Or what to think. To be happy? To be scared?

Both. Overwhelmingly, both.

Long story short (I think I've blogged about this before anyway), I was hooked up with a specialist who deals with obtuse pregnancies like this; we outliers who breed potentially connected kids. There were still more tense weeks ahead before our fears were put to rest, more scans of "not sure" before seeing a definite separate movement between them. But we did see it. Eventually. Turns out our kids decided to hold off on the whole egg-splitting thing until later in the "Splitting Phase".

Science Lesson!:
 If an egg is going to split, it will do so between days 8-12. If it splits on the early side, identical twins can have separate sacs and separate placentas, and appear to be fraternal on ultrasounds.
If they split on the later side, as ours did, they run the risk of being conjoined due to being too close together when the head/spinal cords/abdominal walls form. Ours weren't conjoined, but they are a really nifty side effect of being late splitters: Mirror Twins. They are symetrically opposite of each other.

Of course, after the worry of "Were They Or Weren't They" was removed from the table, we were on to other twin issues that took up space in our Worry Jar. Lots of 'em. Keeping me planted firmly on the High Risk group.

It's hard to believe it all turned out, though. But it did. I have two (presently) sniffling, feverish  and truly delightful sprites dancing around me right now as proof. They're here. They're healthy.

 I give them props; they fought like hell to get here, running a gestational obstacle course worthy of any athlete.

It's all worth it. Every bit of it. And seeing their smiles everyday, I have to think they agree.

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