disproportionately from one twin (known as the donor) to the other twin (known as the recipient). The transfusion caused the donor twin to have decreased blood volume, and in turn, a slower growth than the co-twin. If the donor twin had poor urinary output, that could cause low amniotic fluid—another big potential problem. The recipient baby, on the other hand, could become overloaded with blood. This superfluous amount of blood would strain this baby‘s heart to the point that it might actually develop heart failure. I took a deep breath. I knew we had a long day ahead of us.
Chapter 3
The Longest Day
Even though the perinatologist‘s office was in the same building as Dr. Cooper‘s office, it felt somehow like we were in another world completely. A world where pregnancies had gone awry. We had been sent to the Texas Fetal Center, which was across the sky bridge close to the children‘s hospital. The center specialized in fetal care for babies with congenital anomalies or genetic abnormalities. During my pregnancy with Abby, I had read all about these centers and all the details of genetic testing for abnormalities and fetal interventions. I knew how lucky we had been both then and now. I had always felt blessed that my pregnancy with her had been uneventful.
We were meeting with an MFM Specialist, who was an expert in diagnosing and treating high-risk pregnancy complications including TTTS. Ed held my hand as we walked into the office; my nerves were completely shot. I was freezing, but my palms were oddly sweaty. I felt nauseated, and a lump started to form in the back of my throat. Breathe, I just needed to focus on breathing. I squeezed Ed‘s hand so tight that his wedding ring dug into my finger. The reception area looked more like the inside of a home—a parlor sofa against the wall and an arm chair to the side. There was a frosted glass window; Ed tapped on the glass. The window slid open and we were greeted by a petite, blonde nurse. She was young, about twenty-three or twenty-four. She wore thick, black-rimmed glasses, had her hair pulled back in a ponytail and wore light blue scrubs with little black and white Snoopys all over. Charles Schultz‘s Snoopy reminded me of Abby. When she was a newborn, during middle of the night feedings, I always had the TV on to help me stay awake. I often watched old reruns of Peanuts since it was the only thing on. One of Abby‘s first stuffed animals had been a tiny Snoopy that sang the theme song when you pressed its stomach. She took that Snoopy everywhere with her. My warm memories of Abby deflected my nerves and calmed me.
“Hi Mr. and Mrs. Duffy, she said. “we have been expecting you. I’m Jessica, the nurse coordinator—we spoke last night on the phone.” She reminded me as if there was any chance I had forgotten. I nodded in acknowledgment. “If you will follow me, please,” she said and signaled for us to enter the hallway.
For the first time in my pregnancy history, I had no wait time. Efficiency at a doctor‘s office was never a good sign. I saw it as underscoring the severity of my condition. We were immediately escorted from the comfortable waiting area and into one of the exam rooms. Jessica pulled out a chair from against the wall so I could sit. She opened up a green binder, which I could only assume was our chart, and scanned the documents. She started a long list of questions. She carefully noted everything we said, smiled and looked up at us.
“I think I have everything I need for now. Our sonographer will be in shortly to do your ultrasound.”
I leaned back in my chair, trying to find a comfortable position—an impossible task when you have a bowling ball under your blouse. There was zero chance of this experience being anything but unpleasant and unsettling.
There was a knock on the door about two minutes later. A young brunette, probably about my age, came in holding our chart.
“I’m going to be doing your ultrasound today,” she said. “If you can sit on the exam chair, we can go ahead and get started.”
I slid off the waiting room chair and hoisted myself on the exam chair. I lie back slowly. I felt like a snail gliding along the leather; if only I could bury and retract into my shell to avoid predators the way they do.
“You okay, sweetie?” Ed said offering me his arm.
“Not really,” my voice was soft and low. “But I just want to get this over with.”
He nodded in agreement.
I opened my mouth and began to say, “I think once—” but the tech cut me off midsentence.
“I need you to stop talking please, so I can concentrate on the ultrasound. I need it to be quiet.”
She lacked bedside manner—to say the least. Come on, chick, I wanted to tell her. I know this is your job and you see “cases” like me all the time, but would it kill you to smile and be nice? We are going through a lot right now.
My ultrasound scans with Dr. Cooper were always quick, lasting only about five minutes, and with Dr. Bill in the past couple of months, they had usually lasted around twenty minutes. But today with tech Barbie, it felt like the scan took forever. I looked up at the clock on the wall and saw an entire hour had gone by. How much longer? Ed and I sat in complete silence as she continued to scan my belly. Scan, glide across, repeat. Scan, glide across, repeat. She said nothing, only grimaced, and meticulously jotted her findings in a notebook.
A few times I interrupted the silence and asked, “What do you see?” or “What does that mean?” Her reply was always delivered in a stoic tone.
“The doctor is really the best one to go over the ultrasound findings with you. I’m not supposed to say anything.”
“Well can I ask, sorry, how much longer is this going to be?” I lowered my head expecting her to bite it off.
“We can take a break if you need to sit up, but it will just delay us.”
“When you are twenty-three weeks pregnant with twins, its painful to be in any position for a long time, let alone on my back,” I said, rolling my eyes.
“Let me just finish measuring the amniotic fluid, and then I can send in the heart sonographer to meet with you.”
Heart sonographer? Oh right, to look at the babies’ hearts—another thing Ed had read about online.
“Okay,” I said. Ed and I exchanged glances, like prisoners in custody awaiting our fate. We resumed sitting in nervous silence and awkwardness until she finished. As I waited, I couldn’t help but think about the other patients there. Was there another mom going through this on the other side of the wall? Another mom and dad scared for the health and safety of their baby‘s life? How many tears were shed in this office daily?
When the tech Barbie left the room, the heart sonographer walked in as if on cue. He was a young guy in his mid-thirties with red-hair and freckles. I wanted to break the ice and say something—a heart joke—anything to try and lighten the intensity in the room.
“Hearts will never be made practical until they can be made unbreakable,” I said smiling gently.
“Excuse me?” he looked at me in utter confusion.
“It‘s from The Wizard of Oz?” Ed said.
“Yes,” I nodded. “One of our favorites—we watch it with our little girl.”
“Oh okay,” the tech said.
He didn’t introduce himself, he just told me that we needed to get started with the exam.
It seemed odd to allow a stranger to massage oil all over my belly—what is normally a very intimate act. Even more than that, I permitted a stranger to peer into the world of my womb to determine what had gone awry before Ed and I knew. And, all the while, we exchanged so few words. Shouldn’t Ed and I be the first to know? Shouldn’t the techs be giving us a play-by-play of the action? We wanted to know what he could see and gather from the ultrasound.
Specifically, what damage had the blood transfusion caused? Were the babies’ hearts okay? And their bladders? Would we have to have surgery? Would this cause the babies any lasting effects?
Ed tried asking again,