Divine Mercy

Over the past two weeks, God has shown mercy to us all. One week ago, we went for our fifth visit to Cincinnati. Isabella's heart showed even further improvement and she climbed up the staging ladder from a 3c four weeks ago, to a 3b two weeks ago, and then to a 3a last week. The other issues involved with TTTS in Eliana had not progressed further. After watching those things trending in a "going to get worse and worse" direction and knowing historically where TTTS usually leads, that was amazing news.

Yesterday, the babies were evaluated here in Louisville. They were measured well for the first time in four weeks. Isaac weighed approximately 1 lb., 4 oz., Isabella, 1 lb., 2 oz., and Eliana, 13 oz. The things we always look for in assessing TTTS in Eliana (a visible bladder, amniotic fluid level, and normal doppler) again showed no further progression. We met with our in-town Perinatologist for the first time since he sent us to Cincinnati. He was quite pleased with how things are going. He admitted that four weeks ago, he had not been optimistic. HE even used the word "amazed" and communicated the same sentiment as expressed to him by the staff in Cincinnati! He was quick to remind us that we have a long way to go, but I am so very thankful for today.

Isaac

Eliana

Isabella

Elijah demonstrating what Isabella is doing in her picture:)

When I left today's appointment, I was once again humbled at the way God is answering our prayers. I have heard two stories this week of parents who, as I type, are grieving the losses of their babies from TTTS. As I remember them, I feel more and more gratitude for each day God gives us with our babies~ and with each other. And even though I am undeserving, God in His goodness is merciful to sinners. There is no greater miracle!

Andrew and Elijah have been very patient with bed-resting mommy. I was thankful that my parents and two of my three siblings came for Thanksgiving. My mom and sis cooked our meal and my dad and brother decorated our home for Christmas. The boys loved helping with the tree and I was glad they got to do something "normal" (whatever that is:)). Thank you for reading and keeping up with us. We feel carried along both by our Good Shepherd and by His people who offer us prayers and encouragement.

Today's Update

We got great news today. All the babies looked healthy and had normal findings on ultrasound AND Isabella's echo cardiogram showed improvement! She was moved from stage 3c to 3b. Isaac and Isabella are approximately 13 ounces and Eliana is around 9. We are so very thankful. The doctor felt like we can go a whole week until we recheck them. Last Friday, Micah and I both prayed separately and without each others' knowledge that God would amaze us. Today, we are amazed~ that a syndrome that is known for detrimental progression can actually regress! We have many weeks to go, but for today we press on, continuing bed rest and heart medication, celebrating each day with our babies, and giving glory to God for His mercy on us all.

Balancing

Not long ago, I re-read the book A Praying Life for a ladies book club at my church. I had first read parts of the book while traveling all over the country with Micah's job. That was definitely a trying time for our family and I remember easily identifying with the themes Paul Miller expounds in his book. This time around, circumstances allow me to more deeply feel his words... particularly these ideas: 1) Suffering teaches me to pray, 2) I can approach the glorious throne of grace boldly, but messy~ as a child, 3) "God wants us to come to Him, empty-handed, weary, and heavy-laden." ~completely helpless. Then there is balancing praying "Thy will be done" yet in expectation of God to grant my requests. Sometimes I lay awake at night and wander through all that I am thinking, feeling, and desiring regarding the persons moving around inside of me. I am sure if my prayers were a painting, they would more resemble a Vincent Van Gogh abstract with random stokes and movement than a clear, still life (a nice bowl of unblemished fruit comes to mind). I love that as I pray here and there, engaged and exhausted, Jesus always lives to intercede for me. He is constantly fixing my ramblings and~ to follow the art analogy~ making a HD, photographic quality still life from my sparsely applied, impressionistic words.

Last Monday, we spent another day at the Fetal Care Center. At the end of the visit, we got the news that Isabella's heart was showing further cardiomyopathy. Thankfully, there were no physical changes to her heart such as enlarging or thickening, but there was indeed more stress shown in her test results. Eliana still~by God's protective hand~ had adequate fluid levels and a visible bladder. Their Doppler findings were normal. All that said, the doctor told us that if we were only considering the two girls, given the cardiac changes, we would intervene immediately. But, of course Isaac is involved. Having triplets changes decision making with TTTS. Weighing the risks and benefits, we decided with the team to continue to watch them all very closely until it is clear the benefits outweigh the risks. As a mother of sick babies, weighing and balancing risks vs. benefits feels like choosing one child or two children over the other(s). Of course the intention is to do best for all our little ones. There is just not an easy way out. And yes, it breaks my heart.

However, we arrived back again for a follow up on Friday and there was absolutely no change in any of the babies. Micah and I were so thankful God sustained them and there was no more deterioration. So we are holding firm to our plan to watch very closely with bi-weekly visits and intervene with surgery when absolutely necessary or we reach the 26 week mark when the babies could "feasibly" be delivered and therefore cured of the TTTS. They do not do surgery past that point.

We are getting very close with the staff at the clinic and testing facilities. Our Sonographer Gena, just to name one, is the same gal each visit and she is so kind. She remembers our babies names and spends a lot of time laughing at them as they bounce around the screen while she tries to gather each LVOT, PV, AV, MV, etc, etc, etc measurement. I have no idea what all those things are and how you find them in babies from 7 to 10 ounces in size, but she does. Each visit with the docs reaffirms their dedication to us and our babies as well. This past visit, I shared with the surgeon that so many people are praying for our babies- and for him. He smiled and said "That is great. I need that." So, friends, continue to pray. It is times like these that we have no other choice but to seek the Creator.

Specifically, keep praying for healing. From what we know today, pray that Isabella's heart doesn't show any more deterioration. Pray that Eliana continues to have enough fluid and grows well. Pray that through all of this with the girls, God continues to sustain Isaac. We thank God every time we get to come home and put off more risky intervention knowing that overall, the situation is stable enough for that to happen. Pray for all the people we interact with, particularly the doctors who are using their expertise to care for us all. Pray for Micah and I as we travel back and forth and for the boys as they are with different care-givers. They have been loved on through this by so many and for that, we are grateful. May all our prayers combine and reach the Father's ears through Jesus in a beautiful picture of the value and preciousness of life and in an ever increasing dependence upon Him.

One Day at a Time

First of all, we have been prayed for so much~ not just over the past few days, but in our whole adoption process. God has heard and continues to hear and we are so humbled at those who are walking with us.

After a 1.5 hour MRI, 3 hour ultrasound, and another 1 hour fetal echo cardiogram for each baby, we did sit down with the team at the Fetal Care Center in Cincinnati yesterday. First of all, I want to say that this experience has been amazing. We had the ability to watch our babies for hours. Isaac loves to kick and punch and wave. He is growing very well and likes to try to get in all the pictures of his sisters. It is almost like he knows what the docs want to see at any given moment and tries to hide that particular body part from them as long as he can:) Eliana can move from one side of my belly to the other in just a few minutes, trying to avoid pictures:) Isabella likes to straighten her legs out as far as they can go. There were times when she and Eliana would lay chest to chest and you could see their beating hearts in a single image. We watched them count their fingers and toes, measure bones in their bodies, multiple parts of their brains and bellies, isolate their tiny veins, arteries, and heart valves, and do studies on their blood flow, etc. They are~we are fearfully and wonderfully made. And the way God has gifted us to be able to see these kinds of things and get to know our babies even now is so very gracious of Him.

The Maternal-Fetal Medicine Doctor did another quick scan of the babies to show us what exactly he wanted to talk with us about and then gave his recommendations. Instead of just one ~this is what it is and this is what we do~ answer, he gave us several things to weigh. First of all, the girls do indeed have TTTS. He commended our doctor here in Louisville for sending us to Cincinnati so quickly because the girls are in the beginning stages. There is a significant size difference in the girls as well as in their amniotic fluid levels but those things alone do not show enough of a discrepancy to warrant a full diagnosis in and of themselves. However, in Isabella (known as the recipient twin), there is some mild thickening in her heart and some hypertension. Cardiac changes in any of the babies are a big concern. Although the doctor feels that surgery is more than likely inevitable, there are a couple of reasons to wait a bit. First of all, our sweet Isaac is guarding the entry point of where they would need to go in to sever the blood vessels between the girls. It would be a big risk to him to go in at this point. Also, I have a history of preterm labor and most women deliver within 70 days after the surgery. I am 19 weeks this week, so waiting is ideal since the girls are still in the early stages.

In order to treat the hypertension in Isabella and alleviate some stress on her heart, I am taking blood pressure medication. Since TTTS can move quickly, they are repeating the ultrasound and fetal echo on Monday.

Throughout this pregnancy, I have found myself realizing that indeed I need Thee every hour. God has been teaching me to pray "Give us this day our daily bread" and to be thankful for each moment instead of taking this day for granted and trying to see way down the road. I think this is where we are left today~ in conscious dependence on God for each breath, each step forward, and only one day at a time. The truth is, this is where we all live every day. The consciousness part is a gift.

However, I do not and will not do this perfectly and I do not have to. During the MRI, the gal told me in the beginning it would take around an hour to complete. Micah was allowed in the room with me but because of the loudness of the machine, we wouldn't be able to talk. I was disappointed that he couldn't even read to me, as he and I are both reading a new book together. She brought out a box of DVDs for me to choose from so I could watch a movie on goggles while in the machine. I looked through the box and just didn't feel that watching Hannah Montana, Transformers, or some romantic comedy would feel appropriate. The gal then offered some music and headphones. I thought those would help drown out the machine and give me a nice backdrop to be still and pray for the babies. Isaiah 40:11 has been a verse I have meditated on during tough days and wanted so much to have a moment to remember how Jesus carries me in His arms while I lay in this noisy tube. Little did I know, the "soft" station she chose filled my ears with songs such as George Michael's Father Figure, Katy Perry's Hot N Cold, and Elton John's Bennie and the Jets just to name a few. The "spiritualness" just wasn't happening... on my part anyway:) But Jesus loving me and interceding for me never ceased. This is not up to me or about me. It is about what He has done and continues to do. I am fully and completely dependent on Him and He is able.

It is in acknowledging that dependence that I ask you to persevere with us in praying. Jesus could fix this immediately with one word. Ask for Him to do it, but then acknowledging what is true for us today, pray that the medication would treat Isabella's heart condition and that the girls would continue to grow (especially Eliana) without more complications from the TTTS. Pray that Isaac continues to grow well. For Micah, the boys, and me, pray that we trust God with each day. Please pray for the staff at the Fetal Care Center who are closely watching and caring for our babies. They call our children by their names and we truly feel their expertise and desire to see our babies born healthy. God has gone before us and continues to go.


***For those of you who would like more information regarding TTTS or the Fetal Care Center of Cincinnati Children's Hospital, follow this link.

He Goes Before

Isaac

Eliana

Isabella

We got to see our little ones today. I listened to a song by Out of the Grey before I went into the doctor's office called Brave. It reminded me that before Micah and I even walked into the Ultrasound room, God would be there. He was waiting~ and had been there all along. As we arrived, settled in, and watched the monitor, I once again thought, He has gone before us. We saw our three kicking, sqiggling, punching little babies. Seeing their little hands and feet made me smile. Then, when the US Tech panned down to Eliana and did confirm that her amniotic fluid level is quite decreased and that she is still significantly smaller, I really needed that truth. As I cried throught the rest of the US, seeing each one of them thriving yet unaware of the danger ahead, I had to believe that truth.

So what we had prayed for~ that God would keep our twins from TTTS~ He has answered differently than we had wanted. It seems at this point, they do have Stage 1. Our doc immediately called the Fetal Care Center in Cincinnati and by this afternoon, we were scehduled to have several tests this coming Tuesday and Wednesday. The nurse with whom I spoke was very kind and compassionate and assured me that by Wednesday afternoon, we will have their recommendations for caring for our babies. There aren't many things they can do to treat TTTS, but one farily effective, cutting-edge treatment is Fetal Laser Surgery. If the specialists recommend this for us, we would go ahead with it on Thursday.

As you can imagine, we are extremely needy right now. I am going to be following the example of those parents in Luke 15, bringing my babies to Jesus that He might touch them. I ask that you do the same on their behalf. TTTS is a scary disease, but I know that Jesus is able to heal them. He may choose to use the doctors in Cincinnati~ so please pray for each of them. We also desire prayer for the boys as they are with different care-givers. For Micah and myself, I ask that each one of you hold God to His word; that His power is made perfect in our weakness. Even though this road is scary, He continues to go before and will carry us though whatever lies ahead.