Normal

Today I returned to work for the first time since losing Taylor and Cameron. Until today, the kidlets didn't know I was pregnant, but I can't hide it any longer; I have a fairly noticeable bump.

At first I observed some shifty eye movements; stomach, eyes, back to stomach, look away. No one said a thing until the quietest of them all cocks her head and says, "Mrs. Forell are you pregnant?" It was downhill from there.

It was actually nice to see such excitement on their faces, instead of a flabbergasted "congratulations, your life is over," when I was carrying our triplets or "I'm so sorry about your twins, but at least your singleton has his/her best shot." That's what I hoped it would be like when people first learned I was pregnant. Thanks, kidlets, you made my day.

On the health front, I visited Dr. H. for my very late prenatal ("you're half way already??I thought we were only at 12 or 13 weeks!"). That's what crazy complications will do for ya, I guess. My extensive blood work came back normal, except that I don't have any antibodies to CMV, which can be common in elementary school-aged children. Dr. H. said not to worry, the chances of it affecting Crunchy are slim. Great, we all know how I do with slim odds.

Because we were so far behind on the routine care, I had to decided at this appointment if I was going to have an amniocentesis. Dr. H. noted that Dr.D's report stated that the babe's nuchal translucency was well within normal ranges, and that his/her nasal bone was visible - all good indicators that Crunchy doesn't have Downs Syndrome. Had this been different, Dr. H. would have suggested I have the procedure done, but considering the trauma I've been through and the 1 in 200 chance of miscarrying the pregnancy, we decided against it.

Dr. H. checked my blood pressure (normal) and did another doppler to hear Crunchy's heart. Once again, our babes clocked in at 160bpm. BUT, it was almost impossible to hear because Crunchy was kicking like Beckham, which overpowered his/her heartrate. Amplified throughout the room, it sounded like someone banging on the wall. Love it:)

My detailed ultrasound is scheduled for April 19, and my next visit with Dr. H. is on the 28th.

In the mean time, we're relishing in hearing the word "normal." No word has even sounded more beautiful.

Nights Like These

I dreamed of them tonight. My twins. This is nothing new, I dream of them often. Tonight, I opened my tear-filled eyes, and couldn't catch my breath. I just stared into the darkness, wondering how all this came to be. 3 weeks ago I was the mother of identical twins AND the mother of triplets. Not many get to say that, but for a short time, I could. How lucky am I?

Unfortunately, more often than not, the questions running through my mind, are more like, how did this become my reality? and is this really happening?. So much has gone wrong, yet I try to remain positive. Surely, things won't go down hill AGAIN, right? But, what makes me so special as to think just because I've been to Hell and back, and I've paid my dues, that it'll be smooth sailing from here on out?

Yesterday I read a blog about a woman who had lost 7, yes 7 babies, all at different stages of gestation. Everyone was sure that this pregnancy was "it". At her detail ultrasound at 19 and a half weeks, no heart beat was detected. She had to deliver her dead baby.

There are MANY infertility and loss stories of women who have had more than their fair share of heartache and pain, and yet only a few are lucky enough to deliver a healthy baby at the end of it all. Will I be one of them? I like to think so. But, I'm sure those women thought the same thing (of their pregnancies).

The Aftermath

First off, we want to extend our heartfelt thanks and appreciation to you who sent emails, Facebook messages, text messages, flowers, and those who called/left voicemail messages or stopped by to extend their love, in the days since we returned from Victoria General. We are truly overwhelmed by the outpouring of love we’ve received from our friends, family and coworkers, as well as people we’ve never even met! We’ve had an overwhelming number of questions about how things went on the 7th, and how we’ve been managing in the days since. If you’re one of the people who’s been curious, please read on.

Most of you know we were at peace with our decision to selectively reduce our twins, Taylor and Cameron. At a check-up the Thursday prior to the procedure, it was discovered that T and C’s heartbeats were 114bpm and 113bpm respectively, while “Crunchy” (nickname of our singleton) was much more within the normal range at 160bpm. And during our ultrasound just before the procedure, Dr. Dansereau noted that Twin to Twin Transfusion Syndrome was already evident. We took these as little signs that we were correct in the decision we had made.

Monday, March 7th found us at Victoria General. Just before 2pm, the nurse rounded the corner and quietly asked if we were ready. Within minutes, we were in a dimly lit room, and I was directed to lie on the table. Cy took his place in a chair to the left of my head, holding both of my hands to his lips, our foreheads touching. Pictures and measurements of all babies were taken. As it turns out, Taylor and Cameron hadn’t moved much, they were still laying one on top of the other, making it difficult to reach Taylor. It was decided to inject the potassium chloride into Cameron’s umbilical cord, with the hopes of the medication taking effect on Taylor, too. We waited for 5 minutes to see if it had stopped their hearts, only to be told that the injection didn’t work for either of them. After searching for another angle with the ultrasound machine, the doctor decided on one, but unfortunately, the needle came up 1.5 cm short.

At this point, it was decided that a more invasive needle was needed. The injection (which takes about 2 minutes to be delivered) was made into Cameron’s heart. Within 5 minutes of the needle being removed, Dr. D said the words, “Baby C’s heart has stopped.” Cy – whose hands were still holding mine and our foreheads still touching – and I began to sob, the nurse held down my legs as I cried out over and over for my baby. Once again, the doctor had hopes that Cameron’s heart would pump the medication through to Taylor, but that wasn’t the case. The fourth and final injection was made into Taylor’s heart, and within minutes, Dr. Dansereau announced, “Both of your babies’ hearts have stopped.”

What should have taken about 10 minutes once the medical team was set up, actually took 1.5 hours. There aren’t words to describe how terrible and heart wrenching March 7th was.

We thought we’d feel relief after everything was behind us, but a level of grief we didn’t even know was possible has invaded our lives. We’re devastated, yet trying our best at going about our routine. We’re happy we’ve given “Crunchy” his/her best chance at life, and have put a stop to any distress our twins may have been experiencing. We have a hard time saying “baby” instead of “babies” when referring to my ever expanding bump. And because Taylor and Cameron are still inside me, I find myself talking to all three of them and rubbing my left side where they’re positioned. It’s all very confusing.

We have absolutely no problem discussing what we’ve been through, so if you’re unsure of what to say or do, there’s no need to “tip toe”. In fact, even though we’re heartbroken and occasionally emotional, we love talking about Taylor and Cameron. They are our babies, and though we’ll never be able to love them and nurture them here on earth, we love them more than anything, and thank them for giving their triplet his/her best chance at life. We won’t be pretending they weren’t – we owe them that much.

As far as “Crunchy” is concerned, Dr. D. said he/she “didn’t even know we were there.” The team was constantly checking on him/her and said all was well.

This Can't Be Happening

After extensive testing at Victoria General, what we feared has been confirmed by our maternal fetal specialist. Please meet our Monochorionic-Monoamniotic twins, Taylor and Cameron. Identical twins, Taylor and Cameron share an amniotic sac within my uterus, as well as a placenta, but have separate umbilical cords. “Momo twins” occur when the embryo does not split until after the amniotic sac is formed (about a week or so after fertilization).

There are many Momo twin success stories, but not so for Momo twins and a singleton. Sadly, the chances of all of our babies surviving are “slim”. If they do survive, they are 12-15 times more likely to have a “severe life-long disability”.

Facts we know about carrying Momo twins and a singleton:
1) Twin to Twin Transfusion Syndrome is likely (one twin thrives while the other slowly starves).
2) Cord Compression will also likely occur. This means that one twin will stop the flow of nutrients to the other, resulting in death.
3) Cord Entanglement. Because Taylor and Cameron don’t have an amniotic membrane and their close proximity (they are lying one on top of the other), they will, to some degree, become tangled in each other’s cords preventing them from moving, developing and eventually strangling each other to death.
4) Because Taylor and Cameron are part of a triplet, and had they been Dichorionic/Diamniotic twins, their gestational period would normally be 30 weeks. Because of their condition all of our babies are guaranteed to be born before this time. That means if all goes well, our babies will be born 2.5-3 months premature.

What does all this mean? It means that as parents of 3 seemingly healthy nearly 13-week- gestation triplets, we have a devastating and unimaginable decision to make. This decision will challenge our beliefs, and will require us as individuals and as a couple to examine our moral philosophies. As much as we want to believe in miracles, we need to think logically of the risks, and be realistic about what carrying these 3 babies will mean, both now and in our future. We also need to think about how hard we’ve worked to get to where we are; nearly 3 years of struggles and loss to have a baby. Can we handle more heartache and to what degree? At the end of the day, we are left with two questions, “Do we carry on with the pregnancy the way it is, and hope all of our children survive? Or “Do we terminate the twins to give their sibling a chance at not only surviving but thriving?”

We know this is sensitive subject for many, us included. We hope you never, ever have to be in our shoes, making life and death decisions in regards to your children. After many, many discussions, lots of tears and the guidance of 2 amazing doctors and 1 counselor, we have decided that we are going to give Crunchy, our singleton his or her best shot at life. On March 7th we will say goodbye and send all of our love and prayers to Taylor and Cameron. And then we will start the process of grieving the loss of our babies and celebrate the chance we are giving to Crunchy.

We understand you may not agree with our decision, but hope you will respect the one we have made. We appreciate the love, support and prayers you’ve all given us, and look forward to being surrounded by such caring individuals as we take this next step in our journey.

On a bitter-sweet note, although we asked not to hear or see our babies when we were in the hospital, we did catch glimpses of Crunchy during his or her examination. Crunchy officially has that little baby profile and we could make our his/her arms and legs. When we first saw crunchy at 9 weeks, he/she was doing tummy crunches, and true to his/her nickname, Crunchy was at it again. Dr. Dansereau said that Crunchy is measuring right on and all appears to be healthy

And We Were Hoping it Wasn't Ectopic...

We never saw this coming; let's catch you up.

January 4, 2011
Although it was too early to rule out another ectopic, we were told there were three black spots in my uterus. We left there with the tech saying "If I were to bet, I'd say it's fraternal twins." Whoa.

January 10, 2011
At 5 weeks 6 days, they were unable to give us any conclusive information. We were told to come back in a few weeks.

Feb. 4, 2011
At 9 weeks 3 days, we received the final word, an ectopic pregnancy had been ruled out. Yay. Oh ya, and we're pregnant with triplets, identical twins and a singleton.

As the technician peered over the radiologist's shoulder and Cy held my hand, Dr.M. showed us our 3 babies. I think my first words were "oh shit". I will never forget the look of bewilderment on Dr. M's face. "We never seen this here before!"

We were speechless and shaking, my heart pounding out of my chest. And then I saw it, our singleton began to wiggle around. My heart melted and I burst into tears.
We left there in a shocked and speechless.

Over the next few days we shared the news with our close family and friends, and spent time letting ourselves get used to the idea of going from Cy and Brea to Cy and Brea Plus Three.

Feb.9, 2011
I went to my see Dr. H., my OBGYN to go over what carrying triplets was going to look like. What I thought would be a regular appointment was anything but. Dr. H. explained the risk of triplets, talked about bed rest, informed me that I would go to an Easter Seals house in Vancouver somewhere between 20-24 to wait out my pregnancy since Ntown isn't equiped to handle such a unique pregnancy. As this was sinking in, he broke the news to me; my twins were a rare type, taking my already high-risk pregnancy to "extremely high-risk". I was told that chance of all babies surviving was slim, and if they did, severe life-long disability would likely be what we would face. I sat silently as he stared me directly in the eyes and said "if you were my daughter or wife, there would be no choice in my mind, the risk for you and them is too great."

I left there with an appointment to see Dr. D., a maternal fetal specialist at Victoria Hospital.

Stay tuned.