Traditions

If you hang around long enough, you'll find out that my favorite holiday tradition is the Fitzgerald Annual Christmas Tree Hunt. The day after Thanksgiving, we all bundle up and head up to the mountains in search of a great tree. The last couple of years we've been stopping in Brevard, shopping at O.P. Taylor's and eating at the Cardinal Drive-In, before Christmas tree hunting.

I wasn't allowed to go this year.

Bless their hearts- my parents agreed to take the girls anyway and they did have a fun day and they even found us a tree. Jonathan & I took the opportunity to go to a matinee- The Blind Side. It was excellent. I've doubled my yearly average of movies seen in the theater. Both movies (Slumdog Millionaire and The Blind Side) have been a worthy experience.

I did get to participate in our other family tradition. The one where we hook Will's computer up to Dad's big tv and share our favorite You Tube videos. Some of the highlights were Flight of the Conchords Issues and the distraught Clemson fan. But the best video of the night was passed along from Uncle Tim somehow. The last verse is what makes this song brilliant.

Happy Thanksgiving

I hope you are enjoying this holiday. Thanksgiving came at a very apt time for us- we are thankful for the hope we now have that we will get these boys here safely. This is not the path we would have chosen, given the choice. But now that this path has been chosen for us, we don't want off.We have a thanksgiving tradition of buying a new Christmas CD for the holiday season. Last year we got the Elf soundtrack. Any recommendations for favorite Christmas CDs?

Sent from my iPod

Finally...A Good One

We had our 1 week post-op ultrasound this morning and the boys looked wonderfully normal. We are so excited with how they have responded to the surgery. Their fluids are still unequal but at 2.2cm and 6.5cm, both fluid levels are within normal range. I think the best part was seeing the membrane floating around Owen and not stuck to him. He looked just like his brother- moving and wiggling around. They weighed 1lb and 1lb 3oz- again within normal range. Owen's heart was not stressed and he showed no signs of anemia. Rhys also looked extremely normal. And I was upgraded from laying down bedrest to modified bedrest. That means I can sit up and move around the house with an occasional outing that doesn't require much walking. It also means no housework, no cooking and no driving. So its going to be an interesting few months.

From here we'll monitor them with weekly ultrasounds until 30 weeks and then we'll go twice a week. I'm still at a huge risk for preterm labor plus all the other elevated risks that are simply due to the fact that I'm carrying multiples.

Plus I'm starting to feel both of them moving. I have an anterior placenta which I had heard causes you to feel less movement. Its totally true. Up until now I've felt much less movement with two than I did with each of my girls. But now I'm starting to feel them more distinctly and I am eating it up.

Thank you to everyone who has brought/sent food or gift cards, who has helped with the girls, who has helped clean our house. You have made this many times easier than it could have been.

Doctor

Jonathan and I were not the only ones getting a medical education this week.
Introducing Dr Kiran

and Dr Sienna!

By the Numbers

22 days
1 set of twins
2 boys!
9 ultrasounds
1 amnioreduction
979 miles flown
900mL + 2.5L of fluid drained from my belly
1 fetal echo cardiogram
13+ doctors from 4 countries
1 laser ablation surgery
30 hours in the hospital
countless prayers from friends and family and
1 God who hears

equals =

TWO HEARTBEATS!

We have successfully made it through phase 1 post op which gives the boys each about an 80% survival rate. We still have a long way to go and will need a lot of help so that I can not overexert myself. On Monday Rhys's heart was starting to show one abnormal pattern, but today his heart looked perfect. Owen's heart looked perfect on Monday but today it is stressed a bit. He is anemic and his heart is trying to deal with this new blood flow and placenta share. It's rare that this happens but not unheard of. It should correct itself over the next few weeks. There is really nothing we can do but pray that it will heal itself.

Thank you for all your support! We are getting ready to leave the hospital and are planning to fly home tomorrow.

Surgery Day

Kelley's surgery this morning went very well. The doctor said that they were able to do all that they had wanted to do. They severed eight connections between the babies, and now we are resting and waiting until the ultrasound tomorrow morning when we will see how the boys have responded.

Kelley is feeling pretty good - a lot better than if she had actually given birth to these boys today!

Thank you for all the prayers that have been lifted up on our behalf. And major props to Brantley Smith (our middle school youth minister 16 years ago!) for being at the hospital at 6 a.m. to pray with us!

Babymoon

Have y'all heard about this trendy thing called the babymoon?

According to Wikipedia, a babymoon is "More recently the term has come to be used to describe a vacation taken by a couple that is expecting a baby in order to allow the couple to enjoy a final trip together before the many sleepless nights that usually accompany a newborn baby. Babymoons usually take place at a resort that offers appropriate services like prenatal massage."

Jonathan & I have decided to dub this our babymoon.

Our babymoon has gotten off to a fantastic start- mostly due to the wonderfully engaging people Houston has provided. There's Amos who wheeled me around the airport- he has five sons and moved here from SoCal b/c of the cost of living just in time to ride out Hurricane Ike. And Aaron at Whataburger who gave us complimentary apple and pumpkin pies. Najma, our ultrasound tech, who while born in India, actually grew up in Iran because her father was a personal physician to one of the king's sons. She herself is an identical twin who's job now is do to ultrasounds on identical twins. We had doctors today from India and the Philippines and were able to reminisce about our time in each country. Fascinating people at every turn.

We had a blind date for dinner with a family that went through this same TTTS and laser surgery a little over a year ago. Their bubbly, energetic, precious 16 month old identical boys were a delight to observe as we consider our future. We connected with them quickly and decided we would have liked them anyways even if we didn't share this awful diagnosis.

We had evaluations all day long at the hospital and we are set for surgery at 7:30am Central/ 8:30am Eastern time. Which means I have to be at the hospital at 5:30 am. We are praying for no complications with the surgery and that the boys will respond well to being disconnected. We are praying to hear two heartbeats on the ultrasound the next morning. Thanks for your prayers! We hope to have a positive update for you tomorrow.

Houston Bound

Today's ultrasound was right where we had hoped- the fluid levels were at the right measurements to qualify us for the surgery but the TTTS didn't show any noticeable progression in the last 48 hours. We are hanging on in Stage 2 which is not as good as Stage 1 but better than Stage 3.

So our plan is to fly to Houston Sunday evening. I will have consultations all day Monday and I am scheduled for surgery at 7:30am Central Time on Tuesday. I'll spend Tuesday night in the hospital and be discharged Wednesday. We plan to fly back midday on Thursday.

God is providing at every turn. It makes me cry to see how much He and the Body of Christ around us are helping us. Jonathan was on the phone for hours this morning trying to find us flights that were cheaper than the $1000 ones we were looking at out of GSP. He finally, finally talked to the right person at United who allowed us to buy 1,000 airline miles (the amount we were short for two tickets) and didn't make us wait the 24-48 hour period for them to post. So we are able to fly direct from GSP to Houston for about $100. We have an empty house that's been offered to us thanks to some friend's in-laws and someone has already offered to pay for our rental car.

I have been so humbled. I know that I am inadequate to do this on my own. But you know what, we haven't had to.

Here We Go

Today's ultrasound did not show the improvement that we had hoped. Owen is strong and looking good but he has very very little fluid around him. Rhys's fluid had increased a little since Monday but he was looking very good as well. Since we did not see the improvement we wanted to see from the amnio, we have decided to pursue the laser ablation surgery. We still have to work out a few details but it is very likely we will be having the surgery early next week.

We had hoped that we wouldn't have to get to this point- that the boys fluid levels would even out on their own or with the help from the amnioreduction. But they didn't so we are trusting God to lead us as we make decisions for the best care for our boys.

We ask that you pray for all of us- Jonathan, Kelley, Kiran, Sienna, Owen and Rhys. My biggest struggle right now is that I can't physically be a mommy to all 4 of my kids at the same time. But a wise friend told me that other people can help take care of the girls, I am the only person who can take care of these boys right now.

Thank you for your continued support and encouragement, your prayers, the food you've brought us, the cfa gift cards you've sent us, the constant reminders that we do not have to walk through this alone. We are overwhelmed by you. Thank you.

TTTS

We have our ultrasound early tomorrow so I'm heading to bed. I wanted to give you a few links about TTTS.

The Twin to Twin Transfusion Foundation has been an amazing place of support and knowledge.

Fetal Hope has been another encouraging site. They have a good description of TTTS on their website here.

Ultrasound #4 Update and NAMES!

Can I just point out that two weeks ago we didn't even know we were having twins? This has been the emotional roller coaster of all emotional roller coasters.

This morning's ultrasound was not as we hoped. Baby A's fluid levels were much less- very hard to find any fluid at all around him. He was still moving well, his heart beat was strong and his cord flow looks good. Baby B's fluid had increased a little bit and as usual he was jumping around all over the place. We consulted with the doctor and he thought it was time to intervene. We decided that we would first try an amnioreduction. An amnioreduction is like an amniocentesis in that they poke a needle and catheter in my belly and pull out fluid. But instead of drawing out 20mL or so for an amniocentesis they pulled out 900ml (almost a liter) of fluid from around Baby B. The procedure went as well as we could have hoped. The doctor said I was a champ even though I almost threw up on him. I'm at home now resting completely until Wed am when we go back for another ultrasound to check their fluid levels. My mom came and got the girls and took them to Greenville to hang out with all their grandparents so I can rest completely.

And now? There are probably three paths we could take.
1. We go in Wed, both babies' fluid levels are good and we continue the pregnancy with close monitoring. Some moms only need one amnioreduction to help even the fluids out.
2. We go in Wed, both babies' fluid levels have improved but over time Baby B's increases again. We can do another amnioreduction or even a few more as needed.
3. We go in Wed, the babies' fluid levels have not improved or have gotten worse, we will start applying to do a laser surgery that is offered at a few places around the country.

We have felt God's peaceful, calming presence in the middle of very emotional ultrasounds and conversations with doctors. We know its because we have so many people praying with us and for us and for our baby boys! We are asking that their fluid levels would even out, that both babies would continue to thrive in the womb even in the midst of such stress, and that we would have wisdom as we continually make decisions that would give these boys the best chance at life.

And so we decided on names for the boys! We wanted to be able to pray for them by name and not just Baby A or B. So I present to you

Owen William Caskey and Rhys Fitzgerald Caskey

Baby A, our donor baby, our little one, is Owen William. Owen is a Welsh name meaning well born or young warrior. Jonathan heard someone talking about this name weeks before we knew we were having a boy, before we knew we were having twins, before we knew we would be fighting TTTS and we loved it. When we saw the meaning, we knew it was perfect for our baby A. William is in honor of Owen's dad (Jonathan William) and Jonathan's grandfather plus many other close family members who share that name.

Baby B, our recipient baby, our bigger one, is Rhys (pronounced Reese) Fitzgerald. Rhys is another Welsh name (we didn't even try- it just happened!) that means enthusiasm or fervor. He has been most enthusiastic in my belly as he's had a large swimming pool to do flips and tricks in. Fitzgerald is my maiden name.

Names

First off I wanted to share Kiran's prayer from the other afternoon.

"Thank you for my brothers I want one more sister Amen."

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We've been trying to pick out names. We don't usually finalize names until after the baby is here but we thought it would be nice to pray for them by name and that it would be easier than Baby A, Baby B, Twin A, Twin B, etc. So...do you have any name suggestions? Andrea actually found Kiran's name for us so I know this is not a futile exercise. Let me tell you our rules
1. No matchy-matchy names
2. No rhyming
3. Not start with the same letter- I'd prefer they not start with a K or an S either but I will bend this part of the rule if we fall in love with a name

That's all. Thanks!

Good News Today

At our ultrasound this morning, we found out that the twins' TTTS had not progressed. By today's ultrasound they don't even qualify for TTTS! To qualify for TTTS, their fluid levels must be greater than 8cm and less than 2cm. Today Baby B's fluid was about the same- greater than 9cm- which is still big but it hadn't gotten bigger. Baby A's fluid was at 2.04cm but today it was 2.87cm. Still small but it had not gotten worse and in fact had increased which is awesome. We are by no means out of the woods with this- TTTS moves quickly and things can change suddenly. Right now I will be monitered with twice weekly ultrasounds to check for fluid changes and to also monitor my cervix. I'm not on bedrest but I am to take it as easy as possible while taking care of two little ones. I am off housework per my doctor (Sorry Jonathan). I'm also eating a high protein diet so bring on the steaks and CFA chicken sandwiches.

The boys looked great and Twin A was moving a bit more which was so good for a mommy to see. We are hopeful that we can get through this pregnancy with no invasive treatments. At the same time, we are still holding those cards knowing that they could become a reality at the next appt.

So many of you have offered help and really right now the biggest help we need is with the girls. I have three appointments next week alone. People who can watch them during my appts, people who can take them to the park or to a playdate or somewhere would be awesome.

And we still need prayer. We are praying that

• the boys' fluid levels would even out on their own!
• the boys would each develop properly
• that I would not go into preterm labor (I'm at a huge risk for preterm labor- twins plus extra fluid)

Thank You

We are overwhelmed by you. You have supported us and encouraged us and loved us. In the midst of a really hard, really trying situation, God has been all over it and has showered us with many little blessings along the way. We are so thankful to be here- close to our family- with a huge support network instead of halfway around the world.

We go for another ultrasound in the morning. This should give us a better idea of where we are headed with this disease. We are asking God for healing, for clarity in decision making, for wisdom for our doctors. We are asking God that we would be found faithful even in the midst of the hardest trial we have faced. We are asking God to purify our love for Him- not based on circumstances but based on who He is- and that doesn't change.

We'll update at some point- we may have a lot to process and pray over tomorrow. Its been an incredibly emotional 9 days and we can't seem to see the end of this roller coaster. We know we are being sustained by the prayers of God's people and being held together by the body of Christ that surrounds us in so many of you. Thank you.

Update on the Twins

By the grace of God, the perinatologist we know got us in for a Level 2 ultrasound today- a month early. We found out that the boys are indeed identical and sharing one placenta. But we also found out today that they are beginning to have TTTS (Twin to Twin Transfusion Syndrome). Its a pretty serious condition but we caught it very early and we have some options for treatment. We will go on Thursday for another ultrasound and confirmation of diagnosis. At that point, if we are indeed diagnosed with this, we will have some big, risky decisions to make.

We just need prayers. We believe in prayer. Pray for our boys- that they would both be healthy and strong. Pray for us as we seek wisdom from our Creator and the wonderful doctors He has surrounded us with. Pray for our girls as they don't understand what is going on but they can sense that things have changed with Mommy and Daddy.