Giselle and Ginger's Story

In September 2007, my husband and I were surprised to find that our17 month old was going to be a big sister! My first prenatal appointment revealed 8 week old twins, my second identical twins, and my third appointment revealed two little girls. It seemed like one shock after the next, with blended emotions of delight and uncertainty. My honest first response was not excitement, but rather concern and fear. I immediately thought of my frail health during my first pregnancy, and couldn't imagine my body bearing two children at once! 

As my babies grew so did my excitement -- and my belly, at a surprising rate. I remember my perinatologist mentioning at my 2nd appointment that there was a possibility of some very serious complications that occur only in identical twins. He said we needed to pay close attention to developments over the next several months.The discordance in fetal measurements on that occasion was only 3 days, but if the gap grew, there could be a problem. That night I went home and googled twin pregnancy complications to prepare myself.Reading about TTTS seemedterrible, but as many people do, I thought "wow, I feel sorry for THOSE people" (and had no idea the storm that was brewing). 

As weeks went on I became incredibly ill, to the point where I was struggling to walk up the stairs or even get up out of bed. My skin was so tight I thought it might break, bending my knees was painful, my headaches were so strong I couldn't bear the light of day or any sound. My next ultrasounds showed a 7 day discordance, then 10 days...So I retreated into darkness for most days, laying in bed with a creeping suspicion that I had TTTS. But I didn't dare say it out loud, for fear I might be right. 

By December the pain was excruciating, and I felt as though I was dying. Finally I told my gynecologist I was certain there was something terribly wrong with my pregnancy, so she ordered an ultrasound one month earlier than the next scheduled appointment.Going into radiology, I uttered those terrible four letters and told him I was sure I had it. He repeated the ultrasound 3 times to find a membrane with no success. The ultrasound was to be expedited to my gynecologist and I was sent home. My stomach was in knots for two long days as I awaited my follow up appointment. 

That Friday, my fears materialized the moment I saw Dr. Londono's face. I said, "Do I have TTTS?" She said, "Yes, we need to get you in to see the peri right away." After rushing down the hallway and meeting with his nurse, we found that he made no provision to see me that day. She told me to go to labor and delivery that night to make sure I was not in preterm labor, and that I would see him on Monday. 

When I arrived, my contractions were 1 minute apart. The terbutaline injection was not effective in the least, and the on call obstetrician gave me two options: switch to a different tocolytic (magnesium sulfate) to try to stop the contractions, which might give me pulmonary edema (because we mixed the two). Or do nothing and inevitably miscarry at 22 weeks. I asked him to give me a few moments to think clearly and tried to do so without becoming frightened. With tears in my eyes I asked for the magnesium, but knew in my heart it wasn't going to solve the problem. 

The next morning my contractions appeared less severe, but were still one minute apart. My body felt like it was full of poison, my saliva tasted of metal, and I was given oxygen to help with breathing. I couldn't take it anymore and felt defeated because the contractions weren't slowing. I resigned myself to going home and resting in my own bed, drug free. 

Monday morning came after a long weekend of severe illness. The perinatologist confirmed my diagnosis and phoned the fetal therapy department at USC to make an appointment with a surgeon. There was a surgery I might be eligible for to save at least one of my babies.From the looks of things, he didn't think they would survive. That night the pain was so bad I agonized in bed, tossing and turning and crying, so desperate for sleep. 

At 4:30 in the morning, my husband said it was time to go. I quietly opened the door to our nursery and looked in on my sweet baby girl, wondering if this disease was going to take my life and lives of our babies. In the dark I stood there, weeping over her crib and pleading with God. I whispered, "Mama loves you," dried my eyes and headed out the door. 

On the way to the hospital I felt so melancholy. It was like the whole world was filled with my sorrow as the rain poured down. I kept thinking of the sermon two days before about having contentment in all circumstances, and prayed that God would change my heart. 

Terri Maitino is the sweetest nurse I've ever known. She hugged me the moment I met her and warmed my heart. Dr. Chmait's office had no fancy awards or certificates on the walls. I had researched him online, and for a man of such clout and reputation, this was a humble office. His bed-side manner put me at ease right away and he was very straight forward in explaining my situation. We were only stage one, but because of the polyhydramnios, my cervix had fully effaced. It would be a day or two before I miscarried. He has the highest success rate in fetal outcomes of any doctor I know, 10-25% higher than the average surgeon. 

Three hours later we went in for laser surgery (the only cure toTTTS) and an amnio-reduction. 2 liters of fluid were removed and 8 blood vessels were ablated. My babies survived the first 24 hours.  Dr. Chmait explained that since the disease was cured, it was important that the babies stay inside as long as possible, because their best chance at surviving would come from the nourishment in my womb. Taking them out beforehand would be detrimental to their development. 

The next 11 weeks I was on strict bed-rest, finally succumbing to preterm labor at 33 weeks 5 days. In the labor and delivery Dr.Londono decided to do a cesarean because of my pre-eclampsia, and decelerating heart rates in the girls. 

Giselle Kora Madden was born first, weighing 4lbs 13oz and 18 inches long. She came home to her family after just two weeks in the NICU, weighing 4lb 9oz. 

Ginger Kalina Madden was born one minute after, weighing 2lb 14oz and14 inches long. She came home to her family after one month in the NICU, weighing 3lb 14oz. 

Today they are almost 6 months old and thriving. The only evidence that TTTS struck our home are the scars on my skin. 

To God be the glory -- for His greatest gifts often come in small packages.

Jody Madden