We believe in the big man upstairs...

Ah yes, another trip to and fro...blah, blah, blah. I'll spare you the details of the times and traffic and weather conditions. We had a 1:30 appointment today, both of Jeanine's parents made the trip with us but just she and I went in for the ultrasound and fetal echocardiogram. We saw Dr. Mann, whom we saw once before. Things were a little slow today, we didn't get into our appointment until almost 2 and after the ultrasound it took a bit for the doc to come in and give us the results. At any rate, last week the doc said this week's measurement would be very important to see if the weight discrepancy had increased and what that might mean for us going forward. We were both feeling a bit discouraged by his emphasis on the reality of the situation and asked for prayers for the gap between the two babies to be closed. You may remember that two weeks ago, the last time they were measured for size, they were 46% different, Danny Manning weighing in at 325 grams and Spud coming in at 175. Today, the heart functions continue to be solid, the bladders continue to show up and function, and now for the weights: Manning weighed in at 437 grams (1 pound = 454 grams) and Spud was at 261. Now for you quick minded mathematicians, you will note that the size discrepancy this week is just over 40%. Dr. Mann didn't say anything about the decrease in size discrepancy, but seemed quite amazed that over this many weeks the babies have been "holding steady." In her experience and the evidence of the medical studies, patients who have been diagnosed with placental insufficiency of this severity at this early stage have mostly lost one or both babies. She was happy to see that our babies "had not read the book" on this thing yet. We told her that we believe in the big man upstairs, and she said she's right there with us. What a gift to have someone who's so optimistic, at least in comparison to last week's doctor. She said she hopes we keep cooking along! She also remarked that she doesn't think we'll make it past 32 weeks - that the babies will be here sometime between 28 and 32. That's a reality check...daddy duty in two months?!?!

So where are we at? Today's visit put us at 21 weeks and 6 days. We'll go back next week and the week after that (if all goes well) for our last two times to CHOP. At that point we'll be referred back to our perinatologist, Dr. Garber at 24 weeks. Technically, at that point the doc says the babies could be delivered if necessary but there's a huge risk of developmental disabilities if they were to be born then. That risk drops significantly at 28 weeks. After we finish with CHOP at week 24 we'll be going for two appointments weekly here in North Jersey - one at Holy Name Hospital in Teaneck where the fetal echocardiogram will be done, and one with Dr. Garber in Clifton, who will assess the situation and make a recommendation, hoping and praying that nothing needs to be done before 28.

Step by step now...two more weeks in Philly, praying that God continues to close the gap between Danny and Spud (we still don't know gender, just for the record...or at least we're not telling ;)). Then at least four weeks in North Jersey, with two weekly visits: to the hospital and to the perinatologist. And then, God willing, four to eight more weeks until these babies join the outside world! Where does that put us on the calendar? 2 weeks is July 9 (end of Philly), 6 weeks is August 6 (28 weeks), and 4 to 8 more weeks beyond that is anywhere from September 3 to October 1 (Jeanine's birthday). I keep thinking that Labor Day will truly be labor day - September 7, which would be just over 32 weeks. Maybe time to start the baby pool?

Prayers for this week: keep praying that the gap will be reduced! I was doing my calculations in the observation room today, figuring that at a rate of 5% every two weeks, it will take 8 weeks for the two to be at even strength and size. Wouldn't that be a tremendous miracle? Keep praying for Jeanine's appetite. It's still a struggle for her to get down large portions of good protein...but so necessary both for her and the babies. And pray for our transition...Jeanine's parents go home Sunday morning and they've been a HUGE help, both physically and emotionally. Their departure will be a challenge for both of us.

Wow...a long post, but there's so much information today and most of it is good. There's still a long way to go (at least 10 weeks, we hope!) but God has definitely shown up today. Thanks for your prayers, we could not make this journey alone. Next week's appointment will be on Wednesday at 2 PM. Hope to post later that day...

More of the same

Rain, rain, rain...we joked with the doc today that we were starting to build a boat and herd the animals - and babies - two by two. Hehe, funny Craig. Rain: more of the same. Anyway, down and back yet again. 21 weeks (actually 20 weeks 6 days but who's counting?) and still the report is the same. We saw yet another one of the partners today - I think there are 4 and we have now seen 3 of them. Following the ultrasound and testing of the hearts and finding of the bladders and measuring of the amniotic fluid he came in to give us the assessment and said nothing has changed. Baby A (AKA Danny Manning) continues to show all normal signs of health. Baby B (AKA Spud) continues to lag behind in size and has some irregularities with the blood flow through the umbilical chord but still has a functioning bladder and sufficient amniotic fluid. They measured in last week at a 46% size discordance and they will measure the sizes again next week. Today's doc really drove home the point that though TTTS has essentially been ruled out, the significance in size differential is still a very real and potentially severe problem. He indicated that if the differential increases much at all Spud would jeopardize the health and development of Manning. There really aren't any medical interventions they can perform to fix the situation - except hope and pray that the size discordance decreases. Although the news was not new, his way of re-telling of it (in my opinion) made it feel very heavy and made it sound very likely that we would be faced with decisions no one wants to make. Prayer: more of the same. We've been praying for the health of these two little ones and their mama. That has all been maintaining and we're so grateful to God for that! I ask you to change your prayers only slightly - ask God to close the gap. We look forward to two healthy kids (we presently have two pretty healthy kids). Thanks for your many thoughts, prayers, help, and love as always - more of the same! Sometimes more of the same is good. Sometimes a little change is better!

Before the trip

It's raining cats and dogs here again today which makes for an intense drive south. So if you would offer a prayer for safety today we would be grateful. Another 1 PM appointment which means we'll hit the road in an hour. The "after" update may be delayed because of my evening schedule - Jeanine's dad flies in tonight and I have an 8 PM meeting - so do not panic if there is no update. Feel free to call and check in if you wish...or just be patient!

No good title comes to mind so this entry has none

Another week has come and gone. It's really amazing how quickly the weeks go by when focusing on regular trips to the doc. This was our fourth trip and we're thankful to report that there is still no real change with regard to the health of the babies just a couple of days short of week 20. Baby A (aka Danny Manning - a big man who shares - thanks to BJ Smith for that one!) is normal size and has healthy heart and bladder function, weighing in at 325 grams, or just over 3/4 of a pound. Baby B (Spud) is 18 days behind but still with healthy heart and bladder function, weighing in at 175 grams, or just under 1/2 of a pound. Without coming out and saying it, the doctor seems to be leaning toward ruling out TTTS at all. It seems more and more likely that what is happening is something called IUGR (Intrauterine Growth Restriction) due to slightly restricted blood flow in the umbilical chord of Spud. However, as in the past, if the size discrepancy remains the same, we'll have (Lord willing) healthy babies in 12+ weeks. Dr. Johnson also said that if nothing else transpires in the next four weeks, we would be able to discontinue our trips to Philadelphia and montior things with our perinatologist here in North Jersey. So our prayers continue: thanks to God for another stable report for the babies and for continued health and rest for Jeanine; continued prayers for equal feeding from the placenta and maximal blood flow through the umbilical chord for Spud; and continued prayers for the hearts, bladders, and other vital functions of both babies. Jeanine's mom came in from Iowa on Tuesday and she got to join us for the trip today. She said she had never seen an ultrasound before today so that was pretty cool. And she got to trade jabs with the doc who is from Minnesota...a little good-natured midwestern humor between Iowans and Minnesotans. Anyway, thanks for your continued prayers. We're another week closer to our kids arriving!

Spud Wiggly

Another trip south has come and gone. Today's edition was an afternoon affair, 1 PM appointment at CHOP. We experienced our best travel conditions yet and arrived in Philly at 12:45 after leaving home around 10:30. We had a new (to us) doctor today, the other attending physician who works with Dr. Johnson. In the past the ultrasound people began with Baby A. She began with Spud (Baby B) and found him/her (we still don't know) to be quite active - more active than we've seen to this point. Spud's bladder conditions are stable/no change, as are the slight blood flow restrictions they've seen in the umbilical chord. But nothing has gone worse for him/her. Baby A is also still stable and consistent. It seemed that he/she was waving at us from within the womb today, with the right arm up next to the head (one hand in my pocket and the other one giving a high five!). Anyway, we were relieved once again and thrilled to see both babies active and as healthy as they've been over the last month. The doctor also said that was a good sign. No measurements on size differential, but the main concern is still the blood flow, heart function, and bladder function of both babies and that has stayed consistent for another week. 19 down, 21 to go...or for twins, probably more like 16 to go. Unbelievable - we're halfway through, though Jeanine would say we still have that long to go! The bed rest is getting old for her. So here's an updated prayer list:

1. Patience and comfort and nutrition for Jeanine in her resting from the bed...or couch...or futon...or car.
2. Keep praying for the blood flow and the bladders of those two wiggly munchkins.
3. Energy and time for me to do what needs to be done...still...

Thanks all for your notes and prayers and encouragement!