Alejandro and Andres' Story

My husband and I have been married for eleven wonderful years. We both knew we wanted a big family. I wanted three kids, my husband four. He always joked that we would have a single baby, a single baby, and then twins! Well, we already had two boys and knew that we would try again for our third when we were surprised with an unplanned pregnancy.

It was June of 2008, a week after my one year olds birthday when we found out we were pregnant. I was a little nervous, as it happened sooner than expected! A week after taking the test, I went to the doctor for an ultrasound. We found out that we were having twins!! We were nervous about the upcoming chaos, but excited!

From the beginning of my pregnancy, they knew my sweethearts were identical, as they were sharing a placenta. The big scare for us was that they couldn’t figure out if they were sharing a sac. The babies were so close together and always back to back that it was difficult to find the membrane separating them. After about three months, they finally confirmed they were in separate sacs. I was so relieved. I knew my sweet babies would be ok.

In September, we found out that we were having two more boys. We chose the names of Andres for twin A and Alejandro for twin B. The planning and preparations began. We started shopping for a triplet stroller, being that we also have a one-year old, clothes, bottles and a new minivan! We were so excited and things were going great.

Then in late September, at 20 weeks and 5 days gestation, a sonogram showed that twin A had not grown in the past week and that twin B had gained 2 ounces. It also showed that twin A was low in fluid with signs of a small bladder and that twin B had an abundance of fluid and an extended bladder. The doctor informed us that we had level one TTTS. They referred us to a specialist in Houston. They weren’t too concerned and said that we would be seen a week later. O

Over the weekend I researched TTTS.  I became nervous, but hopeful with the procedures available to help stop the effects of TTTS.  I became mentally prepared for the idea of bed rest or laser surgery.

The ride to Houston seemed to take forever. We took our seven year old with us, believing that we would be receiving good news. I went in for a very lengthy ultrasound. It seemed to last forever. After what seemed like an eternity, the room filled with several doctors and I sensed that something was wrong. As the doctor began to review the sonogram he cursed and I knew that something wasn’t right. He then told me that both my boys were fine, but that he would discuss the findings in the conference room.

A nurse was kind enough to watch my son, as my husband and I went to the conference room. It seemed like such a bad dream. The doctor began to tell us that we were not candidates for the laser surgery, as my sweethearts had implanted their umbilical cords 1.2 cm apart. He said that a laser has yet to be invented that can go between cords that close together. Being that I was only 21 weeks, he didn’t feel that amnio-reduction was an option. He then stated that since I had already progressed to stage 3 of TTTS over the week, that selective reduction was the best option in order to save one baby. The other option was to lose both boys.

My husband and I were in shock and were devastated. We went to Houston expecting to save both babies. We were prepared to do anything to save them. We were both crying and from that point on I heard nothing else. How could I terminate one of my children??? I couldn’t understand how they couldn’t help save my boys.

We went home, heartbroken and confused. My mother began researching for other options. I contacted the Fetal Hope Foundation for information. I wanted to find anything else to help my boys, besides the one given us. 

I contacted a doctor in Los Angeles for a second opinion. He reviewed all my information and sonograms. He admitted that laser surgery would most likely result in the death of both boys. He agreed to perform the surgery but said that since my donor twin (Andres) had very little bladder, hadn’t grown, and had two failed umbilical Doppler’s  and  was most likely going to pass away in the coming week that he would recommend I go ahead with the selective reduction.

My ray of hope turned into devastation. My husband and I discussed and prayed for help in this difficult decision, a decision that no parent should ever have to make. I questioned everything…were they sure amnio-reduction wasn’t an option, was there anything else that could be done…we finally decided that we couldn’t lose both boys and that if our only option was to save one or lose both we would have to save the one.

On October 2, 2008 at 21 weeks and 4 days we traveled back to Houston to have the selective reduction procedure done. It was such a quiet drive as my husband and I were both too numb to speak. I was able to see Andres on the sonogram before the procedure. He wasn’t moving very much, but I saw his little heart beating. I begged for his forgiveness at what we were about to do. We then went into surgery and lost our little Andres. It still kills me today as I still feel so guilty for not being able to save him!!

After the procedure, Alejandro showed immediate improvement! His fluid level went down, his heart rate stabilized, and his bladder began to shrink down to normal. I was excited and devastated at the same time.

The rest of the pregnancy proceeded uneventfully. Alejandro was born in January of 2009. He was five weeks early, but was able to come home with no problems. He is a beautiful baby. We were also able to spend time with Andres. He too was beautiful! He was perfect in every way. We had him blessed, got his footprints, and took pictures. He is the angel that died to save his brother.

I still haven’t made peace with what has happened. I am grateful that Alejandro is doing so wonderfully. He is now a healthy, handsome five week old. I still question the loss of Andres. I miss him so much. TTTS is such a cruel disease. I look at Alejandro and can’t help but think of Andres by his side. They will forever be brothers!