We were absolutely ecstatic to discover I was pregnant in July 2013. As it was my first pregnancy my GP suggested I go for an early scan. And so a fortnight later we excitedly went for our early scan. The sonographer seemed to take forever before she said anything. We feared the worst and when she finally spoke, our worlds were rocked. ‘Here’s the heartbeat… and here’s the second one’. I was 8 weeks pregnant with twins. How prophetic my registration with the hospital turned out to be. When I’d registered with the National Maternity Hospital I was randomly allocated a Doctor. The lady on the phone had joked he was a twin specialist, but that he sees normal pregnancies too. Everything proceeded as normal and I went for my first hospital appointment in September. Circumstances changed that day when it was discovered I was carrying monochorionic diamniotic twins i.e. identical twins. This, combined with my age, put me in the ‘high-risk’ category.
I continued going to my fortnightly appointments at the Twin Clinic but at 17 weeks a substantial discrepancy in weights and size emerged and the decision was made to scan me every week to monitor the situation. Each week I returned hoping things would improve. They didn’t. Twin 2 was showing worrying signs of Intra-Uterine Growth Restriction (IUGR). Growth discrepancies were increasing and fluid levels were becoming increasingly low. Twin-to-Twin Transfusion (TTTS) was discussed. The markers for Stage 1 TTTS hadn’t been met yet, but we needed to prepare ourselves for the possibility of laser surgery. Each visit I prayed for the words ‘viable pregnancy’ to be used but the situation remained fraught, as there was now resistance in the blood flow. I always had it in my head that week 24 was the magic number and once we reached this milestone things would improve. The stress of the situation was taking its toll so I finished up work in the hope that rest would help matters.
My visits increased to twice a week and finally in week 26 I was given steroid shots to increase lung development. We read this as a good sign but we also understood that getting these shots meant an early delivery had become a distinct possibility. On the 23rd of December my consultant said he wanted to admit me after Christmas for the remainder of the pregnancy for observation. This would hopefully be for a number of weeks and so on the 27th I arrived at hospital with my bags packed and a heavy heart as the thoughts of spending weeks in hospital didn’t fill me joy. None of that mattered once I was scanned later that morning as Twin 2 had reverse blood flow. I was asked when I’d eaten and drank last as I needed to be admitted immediately for an emergency cesarean.
The shock was so immense that I sobbed uncontrollably as I was taken upstairs while my husband informed our families. A team of nurses prepared me for surgery and administered several drugs, (most of which I can’t remember now). We met with the anesthetist and then an NICU doctor who explained at length what would happen both before and during the surgery, but also in the days to follow. He also explained who would be present in theatre and why there would be so many people there. After the epidural was administered I thought my heart was going to explode I was so afraid. I’ve never had such a feeling of overwhelming helplessness and crippling fear. We had been warned not to expect any crying and that the babies would be taken away almost immediately. At 15.15, at 27 weeks and 4 days gestation, Oran was born crying. At 15.17 his little brother Oisin was born…crying. I got to kiss Oran and was shown Oisín who had been put in a turkey bag before they were rushed to NICU. Oran was 1100kg and Oisin was a tiny 845g. I stayed in hospital for 5 days and then the next chapter of our lives began.
My days became synchronized around the doctor’s rounds and getting into the expressing rooms in time for my next pump. I would spend the day with the boys, go home in the evening to meet my husband for dinner after he finished work and then we would go straight back to the hospital for another session beside the incubators. After such a stressful pregnancy I had hoped things would get easier, but any parent who has spent time in the NICU will tell you it is a roller coaster ride. Nothing can prepare you for the alien-like environment that is NICU 1 and 2. The light, the noise, the monitors, even the language spoken there is different. There are good days and bad days. There were days when all I could do was cry, blaming myself for not being able to carry my boys to term, being overwhelmed by everything that had happened, watching other parents ‘graduate’ and bring their children home, share other family’s sadness and watch their pain in the blue light of the NICU. Then there were the good days when you got to see your sons without their CPAP hats on and glance at what their little faces were really like. But mostly it was a long, lonely journey perched in between incubators watching the action around you like a fly on the wall absorbing information. I spent every second of every day beside their incubators and soon learned what bradycardia and desaturation meant (brady and desat) and how not to freak out at the sound of the monitor alarms. We watched the boys get x-rays and have their nasogastric (NG) tubes changed. We learned how to change their nappies, undress them and reattach their monitors, how to feed them precious millilitres of Expressed Breast Milk (EBM) and eventually how to take them out of their incubators for kangaroo care without disturbing the nurses.
Oran’s stay in hospital lasted 68 days. He was born with an Atrial Septic Defect (ASD) and Patent Ductus Arteriosus (PDA). He had several pneumothorax but he made headway at a slow and steady pace. His PDA was treated and closed. He gradually came off his CPAP. His graduation to NICU 2 and subsequent move to Special Care (SCBU) was such a surprise we felt like we’d won the lottery.
Oisín stayed in hospital for 89 days. He also had a PDA and ASD but his PDA closed naturally. He was very fond of his CPAP and stayed on it for most of his stay in hospital. Each day was filled with measuring his weight gain and trying to get him to take his feeds. He was essentially healthy; he just needed fattening up and to breath on his own. He graduated to NICU 2 shortly after his brother, but they didn’t stay together long as Oran moved on to SCBU. This was tough as we had to decide whom to sit with. The dynamic changed again when Oran was allowed home. This was a huge deal, but also very tough as you bring one baby home and leave the other behind. I would spend the day with Oran at home and then rush into Holles St as soon as my husband came home and spend as much time at night with Oisín before driving home in the small hours. Oisín had a number of setbacks while he was in hospital on his own. The final one happened in March a few weeks after Oran had come home. I got a call to say Oisín had spiked a temperature that morning and had a lumbar puncture that afternoon. He was back in NICU 1 and he was in a serious condition. By the time I got there he had a swollen leg and looked so unwell. It turned out he had contracted late onset Group B strep, which can be fatal. He was treated with IV antibiotics, came off the CPAP and finally came home 2 weeks later.
The day we brought Oisín home we felt like the circle had been completed. Our family was reunited and we could now get on with being a family. It was a tricky time as both boys had bad reflux and went on special medication for it. Then there were the numerous appointments. In the 9 months following their release from hospital to Christmas between them they had 59 appointments. Some of these were at home with our Public Health Nurse, but there was also audiology testing (Oisín had failed his hearing test on discharge), eye appointments in Temple St (retinopathy of Prematurity is common in premature babies so they are monitored closely), cardiology appointments in Crumlin (for both), Baby Clinic in Holles St, Physiotherapy for Oisín as he has low muscle tone. The boys are now 2 weeks off being 1 year corrected. In spite of all the obstacles and the rough start they had in life they are the happiest smiliest boys you could ever imagine. We are truly grateful that we live in a country where the medical know-how and facilities exist that kept our boys alive.