Hi, So about my appointment yesterday. We ended up bring both kids with us and although it was exhausting they were actually pretty good. They didn't do any measurement today just Dopplers (looking at the heartbeats) and fluid checks. I didn't mind I just said" show me 3 heartbeats and Ill be fine" They did. The main things were that the side affects from TTTS are slowly going away, Baby As heart looks good and although its still showing that it was over used by all the blood it looks better then last time. and he is pretty sure still there is no defect. Baby C has a nice vi sable bladder and a good amount of fluid and the funny thing is last time baby B was breech and now she is head down, thats what all that movement was. Baby A was more on the right side and now Baby C has moved her head down more (she is still more transverse) so that Baby A is more in the middle of both babies it confused the doc enough that he had to measure heads to figure out who was who. And the whole time he is trying to talk Gareth is saying way too loudly "I see my sisters!" =) He ran around with a pic showing it to everyone "this is my sister" Although I don't plan on bringing him again for awhile It was a good experience for him. So we broke that pattern we had going on, every other apt has been bad and the yesterday was good too. I'm just thanking God for keeping my babies safe and putting me in the hands of such good doctors.

Oh yeah to add, I decided instead of twin to twin transfusion the best way to say it is twin to twin to twin transfusion because it was between all 3 babies

Doctors apt tomorrow, every other apt hasn't been good, so I'm a little nervous but my biggest question now is the kids, Gareth has been having such a hard time with me leaving all the time but bringing them is going to be alot to handle in the apt when I'm laying on a bed and Nancy has to keep them happy and not getting into stuff. Does anyone know of a good/cheap babysitter in missoula? that would help alot so I wouldn't have to leave them for so long. I actually only bought bras and really cute expensive jeans at motherhood maternity and I spent too much if I had gotten all the shirts I wanted I would have spent triple what I ended up spending (funny how ill never look at the word triple the same ever again ha ha)

Doctors appointment today

So I had my followup doctors appointment today, and I was so nervous. Its a Little over a week from my surgery and I feel Baby A move all the time but the over babies it seems very little, sometimes I get a kick right in the middle, and I all Who was that? So when we got to the apt I ask first off if there were heartbeats. Yes all 3 had nice strong heartbeats! All through the ultrasound I just got happier and thanked God more. all 3 had about the same amount of fluid. Baby C is still smaller but was growing just fine, the doc said she probably wont catch up till birth but as long as she keeps growing there is nothing to worry about. SO our last worry was Baby A's heart, so when the doc came he looked at that first. there is some outer wall thickening, which is because she was getting so much blood and it was trying the strengthen itself, just like all muscles when they are worked they get bigger, this is something that he said normally reverses itself given time and since she is no longer overworked. the other thing that the last ultrasound showed was what we call a hole in the heart. and today the doc said he is cautiously optimistic because he didn't see it at all. so as of today we are good! Then I went and spent Way too much a t motherhood maternity =) I don't know I still think I feel better but I just hate spending money. and I could have spent way more if I had gotten all those cute shirts that fit perfect but I don't need

Oh yeah I am almost 20 weeks along!

Hey this is Mishael, Just want to put a quick update since there is anything new. But
I have a doc appointment on Thurs and the following thurs for the next 4 weeks just to make sure the babies are doing well with everything. Ive been having some contractions but I dont think anything real thankfully, Im really ready to have my husband home. He comes home in 6 weeks.

Still looking good

Mishael was a little worried since she wasn't feeling as much movement. So we took a visit to Dr C. who took a quick look at the babies. All 3 were moving all over the place and doing great! These girls keep us on our toes already!

Latest Update

The day after the surgery Dr Paek did a follow-up ultrasound. The babies all are looking good and a little better. She is not having any cervical changes and no signs of pre-term labor. They did give her some medicine to take to stop labor if she has too many contractions. She will have a follow-up ultrasound in Missoula with Dr Utter weekly x 4 weeks following the surgery. They were impressed with how well Mishael's body is handling everything and how perfect her labwork, cervix etc. looked. Baby A has less fluid (the same amount she had after surgery after they took off 1600ml) and her heart function looks a little better. Baby C has more fluid and is now on the low end of normal instead of too low, she also had a small amount of fluid in her bladder (which is an indicator of how dehydrated she is--before she had none). Baby B also had more fluid so there must have been some transfusing going on with baby B also. She explained she found 2 large connections between baby A-C and 2 small ones between baby A-B and 3 between baby C-B. So there was a total of 7 connections. The doctor seems very optomistic about the surgery and now its a waiting game. They will do a follow-up echocardiogram on baby A probably about 21 weeks. We drove back from Seattle yesterday and arrived back home late last night.

Surgery is done

Maria here again. I'm sitting in the hospital room with Mishael. Surgery went well, I got to be in the operating room and watch the whole procedure. We were able to see the the one of the baby's face's and hands etc. with the camera. It was amazing! The nurses and Doctors have all been absolutely wonderful. I have been extremely impressed with this hospital (coming from an opinionated nurse that's a good compliment!) Mishael's nurse told her that she had 2 of her babies at home too! :)
Anyway, Mishael was sorta freaked out about getting a spinal but after she got settled in she was able to relax a little and watch the surgery and ask questions. The surgeons (there were two of them) were great and explained things as they went. It took about 5 seconds to cauterize the large connections between baby A and baby C. Then they spent the rest of the time looking for connections between baby A and B and B and C. They found a few and cauterized them and also spent some time figuring out where the babies are connected to the placenta. They found that baby C doesn't have much placenta and may not be able to recover but its really hard to say and the Dr said there's no reason to believe she won't make it but there's always that possibility. They were able to disconnect all the babies completely from eachother so if for some reason one of them doesn't make it, it wouldn't affect the other ones. They also took 1600 ml of fluid off of baby A, so Mishael's stomach is a bit smaller now!
Mishael is resting in her room and Eliza is here too. They are family friendly and will allow her to stay in the room with Mishael.
That's all for now. If all goes well she will go home in the morning!

Update on Mishael

This is Maria, I'm posting the latest on Mishael's triplets! I am in Seattle with Nancy (Mishael's Mother-in-law) and Mishael and Eliza. After wandering around a huge hospital trying to figure out where we were supposed to be we sat in a 4 hour long ultrasound appointment. The US tech was very knowledgeable and happy to show us what she was looking at and explain what things meant. Everyone that came in to talk to MIshael knew all about her case and had reviewed her charts etc. and seemed to know what they were talking about.
First, the US tech did a brief overview of all the babies to see where they were and make sure they had heartbeats. They all had good heartbeats above 130. Then she told us they are all girls!! Yay! Then she went back and spent about 45 min a piece on each baby, measuring specifics parts of the babies. She measured all their little blood vessels and arteries and got different views of their hearts and even measured specific bones.
Then the Dr came in and discussed the results and explained everything and answered questions. This is what we learned:

They are definitely identical triplets with one placenta. They have 3 vessel cords (which is better than 2). Two of them have Stage 3 Twin to Twin transfusion syndrome.

Baby A is the recipient and is getting more fluid (blood etc) than she should from baby C. Because of this, her body is in fluid overload and her little heart cannot handle all of the extra fluid. She is very active because she has so much fluid to move around in so she is hard to measure because she is constantly moving. Because of this, they couldn't' get all the views of her heart that they wanted to but they could tell the heart function was compromised. They are actually more worried about baby A than baby C because of the fluid overload. They also said there is a possibility baby A has a heart defect but will not be able to tell until the baby is bigger and they can do an echocardiogram and see more views of the heart. This would be a separate issue than Twin-to-Twin transfusion syndrome but the extra fluid would make it even harder for the baby's heart to function right in addition to a heart defect. Baby A measures with way too much fluid but as far as growth goes is 18 wks 5 days.
Baby B measures 18 wks 2 days and everything looks ok but her fluid is on the low end of normal so there's a possibility there's some transfusion going on there too. They will check the vessels during surgery and fix them if there is some shared vessels between baby B too so they wouldn't have to repeat the surgery later with baby B.

Baby C measures 17 wks, so not too far behind! However her fluid is way too low and she is very dehydrated and has nothing in her bladder and is showing signs of dehydration with the tests. However her bladder is still visible and her Heart seems to be functioning properly at this point.

As a result of these tests, the surgery will occur tomorrow morning. The procedure is done under spinal anesthesia and Mishael will be awake the whole time and can watch the whole procedure on the monitor. They will also put the surgery on a DVD and she can take it home and watch it afterwards! Cool huh? They will keep her in the hospital overnight to monitor for any bleeding or premature labor and then she will have a follow-up appointment on Wed morning and she can go home wed if everything looks good. The next two weeks will be the crucial time to see if the babies will do well with the procedure.

The Dr said the chances of losing the babies is 90% if she doesn't do surgery and the risk of losing the babies because of the invasive surgery is 10%. So the risk is worth it at this point. The Dr said she has only seen a few identical triplets before but surprisingly just did this same surgery on another set of identical triplets on Friday...So far so good, with those ones...

That's about all I can think of right now. I'll keep you updated after surgery tomorrow.

Maria