Читать книгу Twin to Twin - Crystal Duffy - Страница 14

Chapter 4

Laser Ablation

Two small red pills. Nifedipine was a channel blocker designed to relax the muscles of my heart and blood vessels in order to give baby Katherine a fighting chance. I poured the pills from the prescription bottle into my hand and just stared at them. These two tablets—each no bigger than a watermelon seed—held the fate of my baby. Would they work? Would they do what they were designed to do? Would they relax her little heart, which had been pumping overtime because of the blood transfusion exchange between her and her sister? I held them in my hand, closed my eyes and prayed. Please work. Please help my baby. Please help baby Katherine. Please flipping work.

I had another sleepless night. I was mildly dizzy and had a headache—a common side effect from the drugs. I tossed and turned, checked the clock, attempted to calm myself, tried different positions, got up and paced and started the process all over again. The few times I dozed off, my subconscious worries morphed into frightening scenarios of the next day‘s events. In one dream, I watched as my babies were swept out to sea in a cradle. I swam as hard as I could, but I couldn’t reach them in time. When they disappeared, I dove down into the depths of the ocean to save them, but I couldn’t hold my breath long enough and nearly drowned. I awoke gasping for breath.

Without a doubt this laser ablation surgery would be a life-altering procedure Would our doctors be able to save both our babies from this dangerous disease? If the dreaded scenario occurred, would they be able to save at least one baby?

I had had so many tearful moments since our diagnosis—tears of terror, anger and confusion. But I was beginning to move past that. I realized my worrying wasn’t going to change the problems we faced. And, most importantly, I truly believed that the twins and I were one entity. Whatever I felt, they felt, whether it was joy or sadness and everything in between. If I let myself surrender to darkness, depression and negative thoughts, I feared my outcome would be darkened as well. I had to change. I had to no longer allow myself tears of terror, anger and sadness—no more worries or anxiety, only faith. Positive thoughts of hope and lots of prayers. It took everything in me to overshadow this frightening place and remember the happy moments of my life.

I relived my first moments alone with Abby. It was several hours after she was born. The hospital had gotten quiet: My visitors one by one had trickled out, the doctors were gone, the night nurses were at their stations, and Ed was fast asleep on the couch. My room was dark—only a small light in the side room was turned on. It was just me and Abby. The nurse had placed her in a clear plastic bassinet beside my bed. She was all swaddled up like a burrito—the pink, crochet baby blanket my mom had made was draped over her. She wore a pink and blue striped hospital cap with a little bow strung through the top that my nurse had made. I leaned over the rail on my hospital bed and carefully picked her up.

I held her in my arms which rested on my sore, deflated stomach. She was sleeping. I held her close to my face and breathed her in. Her fresh, sweet and immensely satisfying scent enthralled me. She smelled so delightful—like nothing I’d ever before experienced in my life. Somehow, her smell triggered a euphoric high in me. I sat there cradling her, gently rocking her back and forth and then she wiggled: her feet kicked—just as they had countless times when I was pregnant—as if trying to break free. She opened her eyes, her big beautiful blue eyes, and looked right at me. I gazed into her eyes, completely mesmerized by her power over me. It was in that moment, when it was just the two of us, that I looked at her and knew that there would never be a greater joy. I was holding my baby, this new life that Ed and I had created. She was finally here—this new person that would forever be connected to me. The elation that came from giving life to another human being would be unmatched by any other life experience. I knew for certain that I was meant to do it again someday, and this time I’d be bringing two lives into the world simultaneously. I lay in my bed, envisioned the happy outcome and felt it with my entire being.

I prayed nonstop that night before my surgery:

Lord, please help us and see us through this surgery. I ask that you be with the doctors and the surgeons tomorrow—that your steady hand be on theirs, guiding them as they do what they must do to safeguard the precious lives of my baby girls. Please, please, please.

We arrived at the hospital around 6:00 a.m. for our pre-op meeting with Dr. Miller.

“Right this way, Mrs. Duffy,” said the pre-op nurse. “If you’ll get undressed, and remove any jewelry or make-up then put on this gown. The doctor will be here shortly.”

A few minutes later, Dr. Miller—our high risk-pregnancy genius, in whom I had great confidence—entered the pre-op room, accompanied by a nurse wheeling a sonogram machine. The nervousness I had suppressed over the previous thirty-six hours rushed over me. I recalled Dr. Miller‘s words: “A year ago, I would have done the surgery immediately. But we’ve found that waiting a day after administering this medication will increase the chances that the recipient baby survives the surgery.”

I let myself fully realize what that meant: the danger my babies faced was not only real, but imminent, and with each passing moment, things could get worse. As I thought about the dire situation, I could not help but fear that the darn little red pills had failed to do their job. That my little recipient baby, Katie, could already be gone. The dread only grew when the nurse turned on the machine, and Dr. Miller began moving the sensor around. I felt conflicted—I wanted to know the truth, but I didn’t really. If Katie was already gone, I would be devastated. I didn’t know how I would be able to get through this surgery already knowing the outcome. Ed was right beside me, throughout the entire scan, holding my hand and reminding me to just breathe deeply. Just get through the next couple of minutes.

Peering at the screen, I could make out two shadowy shapes. The sonogram picture bounced around and shifted shape whenever the nurse touched it, making it impossible to discern anything, much less know if it was good or bad. I knew they were my babies, but like the day before, I couldn’t tell what was going on or whether the scene on the monitor was good, bad or inconclusive. I knew Dr. Miller knew, and as he opened his mouth to speak, I braced for the worst.

To my relief, he said, “It looks like we still have both babies.” It wasn’t exactly a ringing endorsement; the status quo had been preserved, but the status quo wasn’t exactly optimistic. Then Dr. Miller‘s slight smile conveyed that the twins’ condition might actually be looking up.

“Look here,” he said to us as he pointed to the screen, “you can see that the ventricles in the recipient‘s heart are showing improved diastolic flow.” The nurse smiled and nodded.

Although I couldn’t completely understand the medical jargon, I knew that hearing “improve” and “heart” in the same sentence was a good thing.

Dr. Miller continued, “It‘s quite remarkable to see this level of improvement after just twenty-four hours of the Nifedipine treatment.”

Thank you, little red pills. Ed grabbed my hand and squeezed. Finally, I thought. Maybe we turned a corner. Things were starting to improve—my calmness and positive energy had paid off. But we were by no means out of the woods yet. Hell, we hadn’t even had the laser ablation surgery yet, nor did we know whether it would even be feasible. But, for the first time since Dr. Bill had given us the dreaded diagnosis, we had a piece of good news. My babies were both alive, and they were already starting to feel better.

After hearing the news, I felt a bit more relaxed—maybe a bit too relaxed. A different nurse came in to start my IV and give me blood pressure-reducing medication—standard operating procedure before the surgery. Thankfully, Ed noted that I had already had a dose of Nifedipine, the same blood pressure-reducing medication the nurse wanted to give me, earlier that morning as one of Dr. Miller‘s instructions to increase the chance that the recipient twin survived the surgery.

“Oh, thanks,” the nurse said nonchalantly. “It definitely wouldn’t be good for you to take a second one, especially since your blood pressure is low already; the last thing we need is for you to have heart problems from an overdose.”

I rolled my eyes in my husband‘s direction and thought, Good thing you were paying attention, Ed.

A few more minutes of waiting and I was ready to be rolled down to the OR. Dr. Miller came into the room again, this time accompanied by Dr. Cooper who wanted to check on me before the procedure.

Dr. Miller asked us whether we had decided what to do if they determined they could only save one of the babies. Ed and I had discussed this the night before. The ethical and practical dilemmas posed by this question were immense. Dr. Miller had explained that, if one of the twins had already died in utero or was in a chronic condition, the other twin would almost surely follow unless drastic steps were taken. Basically, the surviving twin would panic and die if she realized her sister was gone. The only way to stop this from happening was to block the supply of blood and nutrients to the twin that had passed (or would soon pass).

In the little time we had the night before, Ed had consulted our priest, Fr. Matthews, who had met with us several times before we were married as part of our Catholic wedding preparations. The twin to twin diagnosis was terrifying. And I wondered how I could be the one to decide the fate of one of my babies, knowing that it might lead to the death of both babies. Catholic doctrine is not perfectly clear on the subject. Generally, Catholicism opposes any intentional action on an unborn baby that would kill it (even in the case of ectopic pregnancies). But how did those teachings, or any ethical rules, apply in a situation where neither would survive if “nature ran its course” while killing one might save the other? How could someone weigh the survival of one‘s child against the moral opprobrium of killing one‘s other child? It was the worst paradox that a parent could imagine.

Even though there was a slim chance it would come to this, it was a horrifying dilemma. I understood that for some families this may be their best option, which is why Dr. Miller presented it. But for us, we decided that Dr. Miller and his team should try to save both, even if this reduced the likelihood of the healthier twin surviving. But, we said, if there was no chance of Katie surviving, we authorized them to do whatever they needed to save Lauren. Either way it was a nightmare, and I prayed it wouldn’t come to that. These unthinkable Sophie‘s Choice scenarios weren’t what I wanted to discuss before the operation, so I cleared my mind of the possibilities and returned my focus to the positive news we’d heard: both girls were alive and doing better.

Another thought came to mind. They were taking me to the same operating room where I delivered Abby two years earlier. Dr. Cooper scheduled a C-section when Abby was breech and I started having contractions. I was awash with very different emotions this time around. Because Abby was my first baby, everything had been new and I balanced a mix of feelings—mainly excitement, but a tad bit of nervousness too. Throughout my pregnancy with her, I had felt calm, safe and reassured. Of course, I had my worries, as with any pregnancy, but I mainly focused on my pregnancy winnings. I had managed to escape prolonged nausea, stretch marks and hemorrhoids. I was slightly worried about Abby‘s size in relation to my petite frame and how we would get her out safely. It was something we had talked about since the very beginning. I recalled those early appointments with Dr. Cooper in which Abby was measuring unusually big.

“I’m not sure your body is going to be able to labor naturally with this girl, kiddo,” Dr. Cooper said.

I had the vision of doing everything naturally—I had contemplated a home birth to re-enact what my grandmother Ita did seven times—but it wasn’t in the cards for me. I was thankful to have been born in a time of medical advances which saved my and my baby‘s life. Abby had been in downward position almost the entire time and then decided to flip in my third trimester. I knew trying to get babies to flip back around could be a tricky proposition, so when I woke up that stifling hot July morning with labor pains, I knew we needed to take the quick, safe route and have the C-section. Turns out I made the best decision for us.

“We made the right call, kiddo,” Dr. Cooper told me later. “You could have labored for two days and then we still would have had to do an emergency C-section.”

Even with the urgent C-section, I knew that my baby would be robust, that I’d be able to hold her right away and that she’d be going home with us within a few days.

This pregnancy was the polar opposite. It had been a struggle from day one and hadn’t let up since. Every day brought new challenges. I had no idea what to expect. The positive readings earlier that morning gave me hope that the fear and difficulties had crested, but I knew that wasn’t the case. It felt strange to be wheeled to OR #2 where my pregnancy with Abby had ended. Definitively. Safely. Positively. Joyfully. This time around it wasn’t the final destination, but merely one stop along a very long and uncertain road.

Another difference: when they had delivered Abby, I was fully conscious; they just used a local anesthetic. This time, I’d be knocked out and completely unaware of my unfurling fate. Will the surgery have worked? Will they have had to sacrifice one baby for another? Or will they have saved both baby girls? I agonized over the decision Ed and I had made, but tried to stay focused on the little bit of good news we’d received and remembered the incredibly positive outcome the last time I had been in this operating room. I wanted to believe that magic was present, as it had been two years earlier. I remembered Abby‘s first cries—her grand entrance into the world—and our first days with her in the hospital. My last thought before the anesthesia set in was, Things are in God‘s hands and in the hands of Dr. Miller and his team.