Saturday, May 28, 2011

May 19, Women's Hospital

I felt really uneasy about my appointment at Women's Hospital. Maybe it was because the last time I had had an ultrasound I had received the worst news a parent could hear. I tried to reassure myself that this was just a formality and that maybe it would help answer some of my questions. I hoped to be able to see baby A while it was still in the best possible state. The ultrasound tech in Vernon had avoided showing me baby A altogether.

The ultrasound seemed very long and detailed. She explained everything as she went along. It was good to see the baby moving and to hear the heartbeat and I felt somewhat relieved. She gave me a break and it seemed like she was going to write up her report and get the radiologist. She came back in and said she needed to check a few more things. She began looking at what I knew were the markers for down syndrome. She too talked about getting the films from my 8 week ultrasound from Lions Gate. She then went to get the radiologist, Dr. Denise Pugash. Dr. Pugash came in and spent what seemed like an eternity looking at my babe. She began to focus on the brain and seemed very concerned with getting a good image. I could tell something was not right. The scan quality seemed very clear and I could tell the ventricles were asymmetrical. As she and the tech talked back and forth I could pick up on some of what they were describing. Finally, she finished the scan and explained that they both felt confident that this was not, in fact a dichorionic diamniotic twin pregnancy as it had been diagnosed at Lions Gate at 8 weeks. This was a monochorionic diamniotic twin pregnancy - my identical twin girls. She went on to explain that the reason the radiologist in Vernon had a hard time finding a second placenta was because there was only one. She described the typical twin to twin transfusion complications that can happen with mono di twins, and suspected that this is what happened. The one twin had become the donor and the other the recipient. In such cases the donor baby begins to suffer and can eventually die. The recipient on the other hand, often receives and has to process and excess of fluid. When the first baby died, the was a rapid fall in the blood pressure for the surviving baby and she essentially experienced an ischemic injury to her brain. She demonstrated signs of significant early brain damage, and both the radiologist and the perinatologist who spoke to us later felt that the prognosis would be quite severe. They expected the baby to survive, but expected her to be significantly compromised. I was completely stunned. Some form of cerebral palsy is what they suspected.

The perinatologist offered the possibility to terminate the pregnancy, and seemed a little unprepared when I asked how things would proceed for the rest of the pregnancy. My heart ached for this little girl. I knew all to well, the challenges and difficulties these children and their families face. I also know that there is a huge spectrum of cerebral palsy, that the brain is very plastic, and that so many of the children I work with amaze the doctors all the time. And yet, the impression I got from the doctors was that I should expect the worst case scenario. I left defeated and powerless.

There were so many unanswered questions and so many thoughts and concerns. One thing I did know was that my life would never be the same. I do believe in miracles. I have great faith. A feeling of peace had entered my mind two days before and I couldn't quite explain it because at the time I felt like I had come to an acceptance of the loss of the first baby and I had no reason to expect anything else - why did I need this peace? Yet as I sat in the parking lot of Women's Hospital I now knew why. My life will never be the same, because whether we are never blessed to meet Sayde, whether she live only for a short time, whether she survives with mild or severe disabilities, or whether we experience a more profound miracle, this experience will change me and my family for the better. We will all be stronger, more compassionate, more tolerant, and closer than ever before.

I drove home with Keaton the following morning to be with my family in Kelowna.

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