Thankful for Our Twins – From One of Our Genetic Counselors

By Vaishnavi Subramaniam — November 21, 2017

4 min read

Standing up in front of the circle at a self-help group*

Hi, my name is Vaish, and I’m a planner.

My life has had a definite trajectory. I met my husband when I was 19 and knew the moment I met him that I would marry him. I finished college, then grad school, and become a genetic counselor. I married said husband, adopted the obligatory two dogs, moved from Los Angeles back home to Minnesota when we started talking about having kids, and bought a house with enough room for the two point two children I had planned to complete The American Dream.

Having worked in the field of high risk pregnancies, I considered myself an educated consumer in the prenatal realm. I knew what tests I wanted and which doctor I wanted to perform them.

All of my T’s had been crossed, I’s dotted, and boxes checked. I planned my pregnancy and was very fortunate to get pregnant right away.

I was terrified the morning of my first ultrasound. I had found out I was pregnant just days after a missed period and had to wait weeks for the appointment. I took a pregnancy test every morning to reassure myself that “it” was still there.

At our appointment, the sonographer studied a black and white screen as my husband and I looked on. We saw the little blob that we had been praying for, then the screen went black, and then the blob flashed back into view. I felt reassured, thinking to myself, “Ok, it is still there.”

And then my playbook combusted. Not a slow smoulder but rather an all out wildfire.

“Twins! You’re having twins!” said our sonographer.

There are no words to describe the emotions that I felt in that moment. Trust me. I’ve searched Thesaurus.com while writing this post. The words simply don’t exist.

Having worked in a maternal fetal medicine office, I knew that twins are automatically considered a high-risk pregnancy. At my ultrasound, they also noticed that the two embryos shared one placenta but had their own amniotic sacs, a situation known as monochorionic/diamniotic (mo/di) twins. This meant that they were identical, but it also put the pregnancy at significantly higher risk than a “normal” twin pregnancy. Suddenly, we were discussing risks of twin-twin transfusion syndrome (TTS) and the possible need to travel out of town for fetal surgery, the increased risk of birth defects, chances of umbilical cord entanglement or compression, problems with amniotic fluid levels, the possibility of early delivery, bedrest, and time in the Neonatal Intensive Care Unit (NICU). And that was just the pregnancy! We didn’t even have time to consider how we would manage to take care of two babies!

Q: How was I going to tell them apart? Would I be a bad mom if I wrote their names with Sharpie on the bottom of their feet?

A: Thankfully I didn’t have to resort to the Sharpie, and no, that would not have made me a bad mom. We used nail polish and then bracelets to tell them apart. Had we had boys, we would have been in trouble…

Q: How do you nurse two babies at the same time?

A: Ask google and work with an incredible lactation consultant.

I struggled with the loss of the hopefulness and joy that I had expected to feel during the pregnancy. I was terribly sick throughout the first trimester, barely managing to get through each day. As the pregnancy continued, I was excited but felt as if we were constantly waiting for the next appointment, the next test, or some form of “bad” news. But we were lucky. Every test came back normal, and we left every appointment with good news.

Most women get two, maybe three ultrasounds during their pregnancy. I had over 25. Not to mention a chorionic villus sampling procedure at 11 weeks with a fetal chromosome analysis and microarray analysis, fetal echocardiogram at 22 weeks, four days as an inpatient due to preterm labor, 48-hrs of a magnesium sulfate IV, and two steroid injections for fetal lung development. All of this was like chocolate sprinkles on my pregnancy cake.

The girls came early, at 34 weeks. I held my babies only briefly before they were whisked off to the NICU. Though they were born healthy, they were small and needed help regulating their temperature, as well as developing the ability to suck, swallow, and breathe at the same time. A few hours after delivery I was wheeled into the NICU see them. They were in incubators and had tubes taped to their faces that went into their noses. They had IVs in their tiny hands, patches monitoring their heart rate and breathing on their teeny stomachs, and a blood pressure cuff and pulse oximeter on their little ankles. There were alarms connected to monitors that constantly went off. Flashing lights and a cacophony of alarms are one thing in an LA nightclub. They’re a completely different, and unwelcome, beast in the NICU.

I spent my first two weeks as a mother sleeping in cots in their hospital rooms. I was lucky that I never had to leave my girls, but instead could live with them in the hospital.

Instead of spending mornings snuggling them in my king size bed, I spent the mornings anxiously waiting for the neonatal team to make their rounds.

Instead of the aroma of decaf coffee from my Keurig, I was woken up by phlebotomists drawing blood from my children.

Instead of postpartum days surrounded by family in the comfort of my home, I was encompassed by infected IVs and a constant stream of medical jargon. I never thought I’d be required to hit the big red button in the hospital room, desperately yelling for a nurse to come help my days-old baby who had stopped breathing.

Then slowly, very slowly, the equipment in the room started to go away. My babies were moved from incubators into cribs, their IVs were removed, they started eating by mouth instead of through a tube, and were eventually cleared to come home.

Once home, the process was far from simple. We had weekly appointments with their pediatrician to monitor their health and weight gain. We met with a lactation consultant multiple times a week to work on nursing. Each day was a blur of doctor’s appointments, feeding babies, and diaper changes.

In time we stopped thinking of their adjusted age for their prematurity (subtracting 6 weeks from their actual age…ie “they are 4 months old but their adjusted age is 2.5 months), and only mentioned their actual age.

Today they are crawling, chattering, and doing all the things that 11-month olds should be doing. Our days are filled with story time, walks to the park, and playdates with friends. And our biggest stress is planning a first birthday for two rambunctious, loud, and happy little girls.

 

 

 

Those stressful days of my pregnancy and the time spent in the NICU seem like years ago but when they do come to mind, a simple look around reminds me of how much we have to be thankful for.

So this Thanksgiving, I am so thankful I had wonderful doctors, sonographers, and genetic counselors taking care of me who really took the time to make sure my questions were answered when things didn’t go as planned! Ultimately, it can be life’s surprises (like having beautiful twin girls) that we are most grateful for!