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.