Quick Trip

Our second trip to CHOP has come and gone - out the door at 6:45 AM and back home at 1 PM. After a much shorter ultrasound today, Dr. Johnson came in to see us and told us that the babies are pretty much status quo. Good news, I think! Twin A has the same amount of amniotic fluid as last week and Twin B (Spud) had very slightly more than last, but the doc said we shouldn't read into that. A week isn't a long time. The doppler/heart function was also consistent with last week, and both babies still have functioning bladders. So, one more week down. We're scheduled to go again next week, this time in the afternoon. If everything continues as it has the last two visits, we'll be out by 2 or 2:30. No new dents or scrapes in the car this week, another thing to praise God for.

Last night to begin our prayer time Louise read a bit of Psalm 139 - we all agreed it is the "Joe and Tina Dekker Psalm" after having heard them read it in tandem a couple of times in church. We marvelled at how even now these two are known intimately by their Father and they are already made to praise him. Twin A is very active in the womb...maybe a dancer like King David? Anyway, we're giving thanks for another positive report today, and that their baby frames have not been hidden from God in the secret place.

Dr. Johnson still thinks something will "declare itself" in the next couple of weeks - either TTTS or placental insufficiency. So we'll commit yet another week and each day to God and pray that these two will keep sharing (and get better at it) and that Jeanine's womb will be a refuge for them.

17-week pictures

Here are the profiles of our babies' heads at almost 17 weeks. Someone today said they look just like us. I'll let you decide.

What we're praying for

After last night's post I thought it would be good to let you know what we're praying for today.

1. Sharing of the placenta and increased nutrition for "Twin B", or as a friend of mine has suggested, "Spud" (like Spud Webb, the smallish former NBA player). He/she needs to make up some ground in the size department and if the differential increases, both babies may be in jeopardy.

2. Protection of both babies' hearts and bladders - another thing they look for is fully functioning bladder and kidneys.

3. Jeanine's health and nutrition - she doesn't eat much at a time, but need to have good nutrition for the babies to get it as well. And that she won't go crazy on bed rest.

4. Craig's time - that I'll become a "machine" as it were, balancing church and home and being effective in both arenas.

Thanks again for all your prayers!

Home again, home again...

We have arrived safely back home once again. After a marathon of tests, we walked out the hospital doors at 4:30 this afternoon and through our door at 7:15. Lots of Jersey traffic on the way home. So what did we find out? A few things, but also not some things, if that makes any sense. Of course, we went with the worst possible in mind after hearing last week Friday that we had "early severe TTTS". We had a gathering of pray-ers last night and we prayed and sang for an hour. Out the door at 6:15 this morning, to the hospital by 8:45 AM and the tests began at 9:30. As I indicated in the previous post, two people doing one loooooong ultrasound that lasted altogether until about 12:15. We grabbed some lunch downstairs, and then on to the cardiologist at 1:15 until 2:15 or so. Then a brief 20 minutes before being called in for our consultation with "the team" headed by Dr. Johnson, who can be seen on the video about TTTS on the CHOP website, just in case you're really curious. He spoke first about what they're looking for, what constitutes TTTS, and various treatments for it. And then he told us that our babies DO NOT have TTTS...yet. I took that as a positive based on our mindset (see above). There is still a 42% discrepancy in size and he is presently attributing that to their inability to share the placenta. "Twin A" is having "Thanksgiving every day" as he puts it, and Twin B isn't getting much. But that discrepancy number has not changed in the last week. Anyway, after an hour of conversation he said that in the next couple of weeks it will become clear if the current situation will develop into TTTS - which he said is likely - or if it will develop into more severe "placenta insufficiency", or if things will remain the same or improve. Basically, what they told us on the phone last week...it's too early to tell. But...he wouldn't call it TTTS at this point, and certainly wouldn't call it early and severe TTTS. And so for that positive news, we are giving thanks to God!

So what now? For the forseeable future we'll be making weekly trips to Philly. The main thing they'll be checking is the heart function of each of the babies. If the stress on the hearts increases - there is a slight bit of it presently - then that's the most telltale indicator of TTTS. Another thing they'll look for is the kidney function of "Twin B" who has the small amount of amniotic fluid. If the level decreases then there's another indicator. Of course, this is all in pastor layman's language. And in the meantime Jeanine will continue her new bedrest and protein shake routine.

Needless to say, it's shaping up to be a long journey. Weekly trips to Philadelphia for what they've described as about a 30 minute to an hour checkup sounds a bit heavy. 5 months of bedrest for Jeanine sounds that way too. But like I said, we're so grateful that a miracle has begun and we're so grateful for all your prayers. I'll update at least before and after each visit to Philly. If anything else comes up, I'll put it up. Love to all, and keep storming the throne of grace!

So far...

We're almost finished. We spent a little over two hours in ultrasound this morning, 45 minutes per baby with the technician and then about 20 minutes with the doctor. Then we had a little lunch downstairs in the cafeteria before our work with the fetal cardiologist who did echocardiograms on both babies. All that's left is our consultation with the team of doctors who is now (I presume) looking at the information from all the goop work. What have we learned so far? The two babies have increased in size discrepancy, though only slightly. But the word from the cardiologist just a few moments ago is that it's "not terrible." We also know that they are the same sex - but do not know which one that might be. Yes, we're still trying to keep that a surprise. So now we wait for the assessment and hope for a course of treatment. In the meantime, Martha Stewart is cooking something up on the tv behind us and I'm trying to think about a sermon for the week. And we have a fresh dent and scrape on the passenger side of the car, courtesy of getting too close to a vertical support in the parking garage this morning. Welcome to Philadelphia. More to come...

On the Eve of the Field Trip

Tomorrow is our first appointment at CHOP (Children's Hospital of Philadelphia) and it will be an all day affair. We have to be there between 9 and 9:15 in the morning and our last consultation is scheduled for 3 or 4 in the afternoon - a long day of testing, probing, assessing, conversing, praying. Speaking of praying, a group of people - who knows how large - from church are coming tonight at 7 to pray with us. If you think of it, you can join us at that time - 6 PM central, 8 PM atlantic. We've experienced a tremendous outpouring of support from people all over the country and Canada. We trust everything is in God's hands.

An update since my last post, which most of you are aware of. Our perinatologist at last Friday's appointment (5/15) said we have early severe TTTS, which pushed up our visit to CHOP. We have also been in contact with the doctor who pioneered the laser procedure, who consults with patients all over the nation. He lives and works in Wisconsin but talks with anyone who contacts him. He has urged Jeanine to be horizontal as much as possible - i.e., bedrest - and to drink Ensure for the protein boost. He believes that with as sick as Jeanine has been that she is malnurished which may also contribute to the differential in size of the babies. So beginning yesterday she's been confined to the bed/couch and hopefully a lawn chair soon to be in our possession. It's supposed to be in the mid-70s all week so it would be nice for her to get some fresh air.

That's the update for today. I'll try to post things as soon as we know what's happening tomorrow or the next day. Thanks for your prayers!

"I'm sending you on a field trip."

These were the words offered to Jeanine yesterday by Dr. Garber, her perinatologist. On Tuesday she had her 14 week checkup with Dr. Morris, her midwife and then Wednesday her first visit to Dr. Garber who was recommended and referred by Dr. Morris because of the twins. Their ultrasound equipment is a bit higher tech than Dr. Morris (I guess) and they noticed something abnormal. We have pointed out the difference in size between the two babies and also a difference in heart rate. After the ultrasound technician made her report, Dr. Garber came in and told Jeanine that what he suspects is going on is something called "Twin-Twin Transfusion Syndrome" (TTTS). What it means is one of the twins is "stealing" blood from the other one, leading to abnormally large size for one and abnormally small size for the other, and if left untreated has over 90% chance of losing both babies. Not good, right? So Dr. Garber is sending us on a field trip, and has referred us to the Children's Hospital of Philadelphia where the best doctors in the nation work on this sort of thing. You can check out more from their website (www.chop.edu) or from this one (www.fetalhope.org). Both of them give some helpful information about what TTTS is and what to expect in treating it. What sounds like the most likely course of action is to set up an appointment in Philly in the next two weeks and to have the laser surgery (one of three options) done. This form of treatment has the greatest chance of having a healthy pregnancy for one (about 85%) and even for both (about 65%). There is also the slight chance that TTTS is not the case at all and we've been put on alert for nothing. That's only about a 20% chance though. Anyway, we need your prayers. Yesterday was not a good day - in more ways than the baby news - so your thoughts and prayers are greatly appreciated. I have been noting lately the effectiveness of many prayers on behalf of others. Many thanks and much love...

Babies at 13 Weeks

Here are the results of Jeanine's ultrasound on Monday, April 27. As I mentioned in the last post, everything looks good. She has two appointments this coming week, her 14 week appointment with the midwife and her first appointment with the perinatologist (did I spell that right?). Because of the twins she's considered a high-risk pregnancy which is why the midwife is sending her to that guy. Anyway, hopefully you can see the babies clearly enough. I think it looks like one is just kind of reclining there while the other one is all scrunched up. I can imagine their little baby conversation. "Move over." "No way, dude."