Houston Visit Part 2

At our appointment yesterday we weren't sure what to expect.  Having had a week of discussing and deliberating our situation, we were hoping for this second appointment to be decisive.  The ultrasound seemed to us to have very little change, the babies also cooperated for some good 3D pictures that will be on facebook when we get home and can scan them. When Dr Moise came in he looked at a few more things and said that our case was clearly an SIUGR case but also that it was a "grey case" for TTTS.  A's bladder function is minimal and because of the low amniotic fluid, the membrane that separates the babies is wrapped around A like a cocoon. Baby B is showing absolutely no issues and is doing perfectly well.  With true TTTS, both babies are experiencing distress including the bigger baby (B) having excessive bladder function and signs of impending heart failure. In our situation, the surgery is not totally out of the question, but with the little bit of placenta that A has, and the fact that B is showing no signs of distress, the surgery would only increase the risk to both babies and greatly reduce A's chances of survival.  Dr. Moise said that there was no reason for us to stay in Houston any longer and that we would continue to be monitored by Dr Schneider to watch for any developing distress in B that would indicate TTTS.  Even though initially we were really hoping for the surgery, the SIUGR diagnosis makes that a much more dangerous proposition. The fact that we don't have to do that for now is a relief. Dr. Moise seemed pleasantly surprised at A's activity level and when we asked him if the 10% chance he'd said last week still stood, he said I'll give you 15%.  I've never been so excited about 5%!  He also explained that if A didn't survive, that the 30% chance of that harming B included death as well as neurological issues. That means a 70% chance of being perfectly fine!  Both of these numbers really encouraged us. After talking numbers with Dr. Moise, Karen (his wife and the program coordinator) brought up that we should consider delivery plans.  A's situation could possibly develop to a point that it would be safer for him/her to be out than it would to stay in.  Unfortunately this will probably be earlier than would be ideal for B to be born.  Since there is no way to deliver only one, we have to consider all of the ramifications for each child and make sure that our regular OB is in consultation with Houston to determine the best possible time.  Oddly enough, maternal weight gain is another key factor in the success of twins and for the first time in my life I've been having trouble gaining weight. They gave me a few tips on what to eat and what to avoid. Much to my surprise they said to avoid fruits and vegetables (my nutrition is covered with all my vitamins) and focus on fats and proteins. I plan to wholeheartedly follow those orders! So we continue to wait and pray and see what the Lord has planned for our little family. Love and much appreciation,    The Chus