BIG Things Come in Small Packages

One month ago on January 3, 2014, I delivered our twin boys (Coyt and Cannon) at 26 weeks. Cannon passed away just over 24 hours later and Coyt joined him in heaven about 13 hours after that. This is our story of life, love and loss. For whatever reason, I feel compelled to share our pregnancy journey in my very first EVER blog post. I hope it will help another family or mommy that God had similar plans for.

When We Found Out
On August 1, 2013 I took a pregnancy test to confirm that I wasn't pregnant. (I really didn't think I was) Obviously it did no such thing - it was positive! I was shocked and scared, but excited all at the same time. We have two boys- Cross, 6 and Crue, 5. They are only 12 months and 10 days apart, so clearly we waited a while before having the "discussion" to grow our family. And at that, we hadn't officially decided on a timeframe yet. I wanted to think of the perfect way to break the news to Gary. So I stopped at Target on the way home and bought a little something for this daddy-to-be-again:

A blood test confirmed the at-home pregnancy test and we kept our little secret quiet until our first appointment. We did share our news with Cross and Crue who had the most dramatic, yet hilarious, reaction:

Our First Appointment - Another Surprise
On Monday, September 9, 2013, we went to visit Dr. Lamar - the BEST OB/Gyn. We actually saw him in the parking lot when we got to the clinic and he said "Hey guys! How 'bout that!" He was excited to see us again. When we arrived at the clinic Gary said "Let's go check on our children." WHAT?! He said he had a dream the night before that we were having twins. I just laughed...but didn't tell him that I too had a weird feeling that there were two. I will say though, I was much sicker with this pregnancy than with Cross and Crue...I chalked it up to either my being older or that it was a little girl.

We got prepped for the first sonogram. I immediately saw a baby on the screen. My love for our baby was magnified in that moment. Dr. Lamar said "there's babyyyyyyyyy..." - he drew out the last syllable for what seemed like forever until he ended it with an 's'. My reaction, "Did you just say babies?" Tears began to roll down my cheeks as I looked at Gary's blank stare into the monitor and Dr. Lamar still hadn't responded. He then said there were definitely two and he was looking for a third. There was a third yolk sac that just didn't develop. Oh my...I was in shock...I laughed and cried all at the same time. Gary just continued to stare at the monitor, haha. [Crazy side note: my sister had fraternal twin girls just 18 months prior and twins don't run in any of our families! They do now...]

Dr. Lamar confirmed that they were identical twins seeing that there was only one placenta, shared between them. He said these kind of twins are not his favorite because of the risk of Twin to Twin. That's where one twin could take on more blood and nutrients than the other. I remember thinking to myself "I bet the chances of that are slim... God's got this" - and never gave it another thought…for now anyway. We were excited to share our news and humbled that God would bless us with TWO of His children.

We had already gotten creative (thanks to Pinterest) with how we were going to announce our pregnancy to the world (or FaceBook...), but obviously had to make a slight change! I told Gary I had a feeling that I would have to change my chalkboard art. How crazy?!

Ready, Set, Grow!
My prepping for the arrival of TWO began immediately as I prayed constantly for these guys. I remember being in a constant state of humble thanksgiving. Maybe I was doing an okay job as a mom after all for God to trust me to raise two more of His children. So humbled.

My belly grew quickly!

I had absolutely no complaints about my pregnancy (once the 13 weeks of nausea passed). I felt great and even got out and ran a little every now and then. I was more health conscious about this one than I was with Cross and Crue, stocking up on lots of fresh fruits and veggies and eliminating a majority of my caffeine intake. Yep, I sacrificed my daily dose(s) of coffee! My biggest cravings were crunchy tacos (from Taco Casa only), peanut butter with celery or apples, and cheerios for breakfast - EVERY morning. 

We made plans for turning the playroom into a nursery. Ikea has some GREAT organization solutions for Cross and Crue's toys (which would be moved to the family room!)…and they are very reasonably priced! We already had childcare situated for them - my Mom's willingness to keep them (in addition to my sister's twin girls!) was a huge blessing. The planning for their arrival and lives was so exciting! Not to mention, I LOVE shopping so picking out the perfect cribs, highchairs, swings, strollers…ah!...This was too fun.

We looked forward to every appointment especially since we got to see our TWO babies on the ultrasound monitor. It was easier to see the multiple heart beats and it was also important to monitor their growth since they were identical.

Gender Reveal
At 17 weeks we had a routine check-up with Dr. Lamar. At this appointment we asked Dr. Lamar if he would take a look and see if he could determine what our little ones were. We had some close friends planning a gender reveal party for our family (they were literally waiting in the parking lot for the envelope!). Dr. Lamar was confident in what he saw and without letting us know the secret, he slipped it in an envelope and we passed it on to the hostesses. It was definitely a long day after that! SO many people had their fingers crossed that they were girls, simply because there are no Ohmstede girls - ALL BOYS! Gary was confident that they were boys. Surprise! He was right! And I quickly fell in love with the idea of having FOUR boys. I loved being a "boy mom".

The Facebook Announcement

At 19 weeks, we had our "big" ultrasound that measures the anatomy of the babies. This is the routine ultrasound where most learn the gender of their baby. Everything looked great! Now we press on until our next routine appointment at 21 weeks with Dr. Lamar where he would begin to see me every two weeks to make sure I wasn't at risk for pre-term labor too soon.

Our Greatest Fear Becomes a Reality

Over the next two weeks my belly grew significantly! I began to swell and gain weight quickly. My family and friends literally did double-takes at my belly because the sudden growth was so noticeable! All these signs meant something. Something serious.

Monday, December 2, 2013

My check up with Dr. Lamar was at 1:30pm today. What began as an exciting moment to see our twin boys on the "big screen" ended with a phone call to a Perinatal in Plano with a strong recommendation to get us in as soon as possible.

Our twins are identical, sharing the same placenta. There is, however, a membrane separating them into separate sacs. 10%-15% of twins such as ours will develop Twin to Twin Transfusion Syndrome (TTTS). It's a rare and serious disease where one baby takes on a majority of the nutrients (he's called the Recipient) from the placenta, leaving the other baby with very little (he's called the Donor). 

When we looked at the "big screen" to see our sweet boys (Coyt and Cannon), the doctor pointed out that Coyt (the "donor") was nearly suran-wrapped by his sac, with very little fluid. You can see in the video below. Coyt is on the right, barely moving, while Cannon (the "recipient") is bouncing around on the left. It broke my heart to see Coyt so restricted. They call him the "stuck" baby.

Gary and I could both sense the fear in our doctor. What a scary moment! We were asked to wait in the waiting room while Dr. Lamar consulted with a specialist to set up an appointment. Gary told me not to "google" anything…I knew that meant it was serious. I held back the tears. I had a meeting scheduled at work in half an hour that I had to get to. Who was I kidding, I couldn't focus…all I knew is our babies were in serious danger. My boss graciously covered my meeting and without hesitation relieved me of any obligation to return to work that day. 

The appointment with the perinatal was set for that Friday morning in Plano, TX. I was really hoping to get there sooner, but I knew God was in control and if we needed to be there sooner, He would make that happen. And He did, actually. 

I must say from this moment on, I didn't take for granted a single movement that I felt in my belly. I was in a constant state of prayer for Cannon and Coyt. I talked to them out loud often so they could hear my voice and feel my love for them. I was so very scared of losing them.

Tuesday, December 3-Wednesday, December 4

The next 2 days were filled with fear, anxiety, and anger. I was fearful knowing that at any moment we could lose one or both of these babies...and that I wouldn't know until the next sonogram. I was anxious about everything that would follow the loss of one or both babies - How would we tell Cross and Crue? How would I be able to cope with delivering one or two still-born babies? What in the world is God teaching me through this? Then, I would become angry knowing that I have NO control over protecting the lives of our twin boys. There is nothing at all that I can do. I would also get angry with myself for being fearful and anxious. God wants me to put my trust in Him, not dwell on the worst-case scenario. Isaiah 41:10 says "So do not fear, for I am with you; do not be dismayed, for I am your God. I will strengthen you and help you; I will uphold you with my righteous right hand." Philipians 4:6-7 says "6 Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God. 7 And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus." I needed the peace of God to guard my heart and mind. To guard my heart from the pain I felt when I would think about the 'what-ifs", and guard my mind from thinking too far ahead and worrying about tomorrow.

I then realized that I needed to lose the prideful position I had taken in NOT asking others to pray. I wanted to be strong on the outside, even though I was/am very weak on the inside. It is also my personality to not ask for help...just do it myself. (See, God really IS teaching me through this trial. God is awesome.) No one ever said that asking for prayer was a sign of weakness. But when you let your "self" get in the way, preventing you from asking, then you become weak. At least I did. God WANTS us to pray together with other believers.

Thursday, December 5, 2013

Today is the first day I've woken up and not spent my morning feeling overwhelmed and in tears. I felt a great sense of peace. I felt like everything really is going to be okay. Dr. Lamar asked us to come in at 11:20am. He just wanted to confirm again what he thought he had seen, before we made the trip to Plano. It was just as he thought. Dr. Lamar gave me a hug and gave Gary his cell phone number. He was adamant that we keep him in the loop. This very well could be the last time we saw Dr. Lamar for our pregnancy - which was very sad for us. We truly love our doctor. A winter storm was headed our way and we received a phone call from the Plano Hospital who moved our appointment from Friday to today at 4! We jumped in the car prepared to weather the storm.

It took us three hours to make the two hour drive to Plano due to the sleet and snow. The Perinatal walked in to begin the sonogram. After literally only a glance at both babies, he ordered the nurse to make contact with the Fetal Surgery Center in Houston. My heart dropped. We did about 30 minutes of sonogram tests. Dr. Trimmer confirmed that it was Twin Twin. There were a few different treatments for this disease, depending on the stage. He told us he was referring us to a fetal surgery center and asked if we had a preference. He offered Houston, Philadelphia  Colorado, Cincinnati, etc. We chose Houston since it was the closest to home. He said he would make contact with them and send them our ultrasound video. We left and the doctor said he would be calling us within the hour after the consultation with the Fetal Surgery Center.

We received Dr. Trimmer's call as we were checking in to the hotel in Plano. The information we received went something like this: Without a recommended laser surgery procedure, there is a 0% chance of either baby surviving. (Okay God, you've eliminated the decision-making process there...) With the surgery both babies have an 80% chance of making it. They scheduled us to come in Monday morning for an evaluation (this was Thursday night). However, the Houston doctor looked even more thoroughly at the sonogram and called Gary personally to see if we could be there tomorrow (Friday). God had consistently intervened to speed up this process. I was confident that He was in full control. But even trusting in God's plan, I was still fearful of the unknown. 

Friday, December 6, 2013

Gary's dad left Wichita Falls at 3:30 am to meet us in Plano by 8, on the icy roads, so we didn't have to go alone. The plan was to meet with the Fetal Intervention team as soon as we got there for an evaluation. At that point we would know what is next. This evaluation lasted several hours. 

Left to right: Dr. Shami, Jane, Dr. Belfort, Dr Ruanno

After meeting with the team of fetal surgeons (from literally ALL over the world: Brazil, Iran, and South Africa), we had more answers. We are in stage 2 of TTTS. Coyt had very little fluid and his bladder was not visible, a sign that the disease was progressing quickly. Cannon had a significant amount of fluid. Both babies were sick and in serious danger. The surgeons would like to move sooner than later in performing the laser surgery procedure. They would be severing the vessels of the placenta where the babies were connected. This would give them each their own share of the placenta, and would ultimately allow Coyt to begin producing more fluid. They would also remove fluid from around Cannon to give him a more accurate amount. They wanted to move quickly, but because my placenta is anterior, they would have to perform an additional procedure laparoscopically in order to get to the location they need. This procedure had more risk involved for the babies, and slightly for me.

Dr. Belfort felt comfortable waiting until the next morning to see if the fluid levels increase (creating the space they would need to avoid the laparoscopic procedure). They decided to admit me and conduct a scan early Saturday morning. Dr. Shami gave Gary his cell phone number in case we had any questions...so blessed to have a caring team of surgeons. 

Me? I'm failing miserably at staying strong. Statements made by the surgical team during our 2 hour evaluation continue to go through my mind. "We might can save one." "This is a very serious disease." "You have a very high risk pregnancy." "These kids are not currently viable." "One option is to terminate the pregnancy." I was at the point of not even knowing how to talk to God. I just wanted it to be over.

Saturday, December 7, 2013

This morning I woke up super early - like 5:30! My heart was bursting with so many emotions. It was the perfect time to spend in prayer. Funny how that changed things for me. I soon felt an overwhelming sense of peace. I had complete faith that these boys were going to make it, and so was I. Now, maintaining that faith just meant me keeping my focus on Him. I've always taught that to my teenage girls through bible studies and Sunday morning life groups, but I never really had a GOOD example to share. Boy do I now! Sounds crazy, but I am thankful for God bringing me to this scary time because it truly has brought me closer to Him.  

My doctor came in to do the sono and everything was as stable as it could be for stage 2. This was a great thing! It meant that we could post-pone the procedure another day. Each day we could buy meant the boys were getting a little stronger. Sunday and Monday also revealed the babies were stable! We had a fetal echo on Monday and it showed slight leakage in the valves of both hearts, but there was nothing that indicated a need to rush into surgery. More good news! God was giving us more time - this time was so valuable, now that I look back.

My Mom and Dad made it to Houston tonight! They had been stuck in Wichita Falls due to the winter storm. It was very difficult for me to get through the first few days without them there.

Tuesday, December 10, 2013

Last night I began having contractions. They were anywhere from 2-7 minutes apart. Because of the excess amount of fluid, my body thought it was time. Our fetal intervention team came in and said today was the day for surgery. I still felt good about God's plan. I didn't know what it was, but I knew I could trust Him. I was confident that our little fighters were gonna make it.

Fetal Surgery
This was my first surgery and I had no idea what to expect. They had to give me a general anesthetic to put me completely out due to the additional laparoscopic procedure. What normally takes about 45 minutes took my surgeons at least 2 hours. They went in to sever the vessels of the placenta where the babies' cords connected and said it was more complex than normal. They also removed 1.5 liters of fluid from around Cannon! Overall, the surgeons said the procedures were successful. 

Recovery was a different story. I was in severe pain and had a terrible reaction to the morphine. Gary ended up calling Dr. Shami's cell when my flesh turned as white as the sheet. Dr. Shami was there quickly and whatever orders he gave were followed and I was eventually back to normal. I was on magnesium sulfate for the next 36 hours or so in an effort to slow down my contractions. Being on mag is the worst… Side effects for me: extreme increase in body temperature (we had the room thermostat on 60 and I was burning up!), dry mouth, cold-like symptoms (couldn't breath), extreme muscle weakness (not allowed to get out of bed), just plain awful. But the benefit of this stuff is that it aids in the development of the babies' brains. And for these guys, I would do anything. 

They did a scan each morning and each morning looked a little better. Coyt's bladder was now visible! And he was producing fluid…it was so sweet to see him finally have room to wiggle! Cannon didn't have quite as much room to move around after removing so much fluid, but he was still on the go!

Gary bought me these precious Willow Tree figurines, "Two Together".

After a few days more of observation and GREAT progress reports for the babies, I was released on Friday, December 13th to return HOME. I was given orders for 7 days of strict bed rest, and then moderate bed rest until the babies were born. [Moderate meant I could get up to make myself a sandwich if I HAVE to, but make it quick.] Now (at 23 weeks), I am at an increased risk of premature rupture of the membranes (my water breaking), since they literally put a hole in my uterus. I will likely deliver the babies anytime between now and 32 weeks. We will follow up with our Perinatal, Dr. Trimmer, in Plano each week to monitor the babies closely. Our fetal surgery team said we shouldn't be back in Houston;  it was rare that they saw their patients again. 

The 6-hour drive back to Wichita Falls was terrible after surgery, but I couldn't wait to get home and see Cross and Crue. It isn't often that we are away from them. Between my career and their sports, I cherish what little family time we get. Yes, I'm that mom that wants her babies with her all the time - but I don't apologize for it ;). I love my guys...especially my husband, of course. 

Post Surgery & Bed Rest
My first day back home was emotionally very hard. I never realized how much being a mommy and taking care of children requires. Even a 5 and 6 year old! I couldn't help them get breakfast, or get their basketball uniforms ready. And on this day I was going to miss their very first basketball game. I didn't want to hear from everyone else how their game went…I wanted to be there. But I had two other little boys to take care of. Cannon and Coyt needed me right now. I had to remain obedient to the doctor's orders…bed rest. It truly is harder than people think and I don't wish it on anyone. 

Between recovering from surgery, being on bed rest, and also taking nifedipine to reduce my contractions, I was very slow to move and often dizzy. I would get discouraged because I couldn't take a full shower without feeling dizzy and having to cut it short. This is hard for someone who typically washed their hair and ensured smooth legs DAILY! That's okay, this routine was only temporary and far worth it for Cannon and Coyt. 

So many helped us by bringing meals and just sending an encouraging text here and there. We are still amazed at the love others showed our family.

We had a goal to get to 28 weeks, giving the boys a 90% chance of survival at birth. My co-workers made a paper chain made of links with encouraging messages. There was one for each day until we made it to our goal. I cried when they brought it to me! I cried A LOT these days. This was so thoughtful - such a great idea.

Our first follow-up in Plano with Dr. Trimmer was exactly 7 days after surgery on Tuesday, December 17th at 9am. Since Plano is two hours away, we decided to drive down the night before and stay. It was nice not to feel rushed. Dr. Trimmer said things were looking pretty good for our first follow-up! What a relief. Coyt did appear to be a little anemic, but that was to be expected since he was the donor baby. He had "donated" a good supply of blood to Cannon prior to the laser surgery. The boys were very active and even waived at us a few times. We love them so very much.

Another week went by and we enjoyed spending Christmas with our families. Cross and Crue had the best Christmas ever thanks to my amazing co-workers who took it upon themselves to do our Christmas shopping for us. I never even thought about not being able to shop! 

"Above all that has happened, we continue to have faith and are excited to celebrate the perfect birth of Christ. Two weeks post-surgery and we have so much to be thankful for. Who knew fetal surgery even existed?! Many of you have sent prayers, meals, texts/e-mails, financial support and gifts for our boys to open on Christmas morning. I'm not sure how we could ever thank you sufficiently, but please know that your kindness has been beyond what we even thought we would need. We will go to Plano weekly to check on the babies - and after a few weeks we will go twice a week. One baby (Coyt) is anemic. If that worsens, we will have to go back to Houston for a fetal blood transfusion. If it remains the same, it would likely mean a blood transfusion at birth. I believe God will prove to us and the doctors that HE is in control once again, and the anemia will "disappear". I am on bed rest until they are born to give them a greater chance of continued growth in the womb. I am 24 weeks now. The babies will be delivered at the Medical Center of Plano since they have a level 3 NICU. We will get to know the Plano area extremely well over the next several months. Thank you friends and family for loving our family like your own. We love you all, Merry Christmas!

-Angie Ohmstede, December 24, 2013 via Facebook

On Friday, December 27, 2013, we went for our 2nd follow-up in Plano. We were eager to see our boys again, of course. After the appointment we were going to stop at Ikea to purchase the cribs and a few other things for the nursery. I was so excited to get the nursery put together. I had a friend who was going to decorate the nursery for us since I couldn't be up and around. I couldn't wait to see how it all came together! Here was the plan for the nursery, thank you Pinterest! -

We got to our appointment and had to wait nearly an hour. Once we got back, Dr. Trimmer began the scan. We understood all the measurements and numbers at this point. I actually caught Dr. Trimmer referring to one baby as "a" when it was "b"…he said they had to have switched places then. That's weird, they were separated by a membrane…how could they switch places? I then knew something was wrong when Dr. Trimmer stopped in the middle of the ultrasound to hand me a box of kleenex. My heart dropped when he said he was going to make a quick phone call to Dr. Belfort, our head surgeon in Houston, because it appeared that the TTTS had returned and was looking to be stage 4. Dr. Belfort said to get to Houston immediately and not to eat or drink anything as we would likely be heading right into surgery. 

Could this really be happening? My heart was so heavy. I thought for sure that we were in the clear. I didn't want to relive the Houston nightmare. The painful surgery and recovery. The constant worrying if the babies were gonna make it. I didn't think I could handle anymore. We were supposed to have a good appointment, and then stop at Ikea to buy their baby cribs...

I am thankful that we chose not to bring Cross and Crue with us to this appointment, and instead Gary's mom came. God totally revealed himself there. We needed her there with us. We got in the car and headed straight to Houston. My Mom and Gary's dad made plans to carpool down ASAP and arrived in Houston that evening.

More Bad News

Friday evening, December 27, 2013 - When we arrived at the hospital, Dr. Shami was waiting for us. We went into evaluation for what seemed like hours. Dr. Shami didn't say a word throughout the entire ultrasound. When he finished, he gave us the run down. Coyt had severe anemia and had developed hydrops. They were still sharing the placenta somewhere. This put us at stage 4 TTTS, but to repeat the laser procedure again would be too challenging. The membrane that separated the boys had torn and they were now sharing the fluid. That's why they had switched places! I think they just needed to be closer to each other :). Our only hope was to attempt a fetal blood transfusion the next morning on Coyt. They also reminded us that Cannon too was very sick, as his heart had been pumping too much blood and was at risk for heart failure. Dr. Shami ordered the blood and I was prepped for surgery the following morning.

We had to make a very difficult decision before this procedure. There was a chance that Coyt would not tolerate it. Dr. Shami needed to know if we wanted to continue the pregnancy should Coyt not tolerate the surgery (thus giving Cannon a better chance at survival), or deliver them both knowing that Coyt would likely not survive with hydrops and Cannon only had a 50% chance of surviving outside the womb in his state. We met with a neonatologist who shared with us that in her 20+ years she had never seen a 25 week old hydrops baby survive outside the womb. This was the first most difficult decision to make as we chose to continue the pregnancy should Coyt not make it. I can't explain what led us to make this decision, but I know that Gary and I prayed about it and we both had peace with it.

Saturday morning, December 28th - For this procedure, I was awake with only a local anesthetic as they used multiple needles to go through my belly to give blood to Coyt through his umbilical cord and also into his belly. They had given me "sleepy medicine" to help me relax, but had to take me off because I wasn't breathing well. That experience was horrible. I woke up to hearing the surgeons discussing where to place the needle and then feeling the placement of the needles. I quickly became nauseous and the rest involves a bag for me to gag in along with severe back pain from lying so long on the operating table. In the end, the procedure went well and praise God, Coyt was tolerating it! Recovery from this procedure was much better than the last. I did have to be on the magnesium sulfate again, but I'll take it!

We would begin to see results within 3 to 4 days. We had been scared, sad, angry, and confused but at this point we were adamant that we stay strong and have faith knowing that this is part of God's perfect plan. We were totally equipped to handle this through Him. 

Each day (for the next few anyway) there was slight improvement shown in the ultrasound doppler readings. Dr. Belfort broke the news that we would remain in the hospital until Cannon and Coyt made their debut. We kinda figured that already! We grew to absolutely love our nurses. They had a passion for their work and it was evident in every encounter we had. They remembered us from our stay two weeks prior. It was our home away from home.

New Year's Eve News

Today we witnessed one of God's many miracles. When we went for our ultrasound, the hydrops was completely gone! We heard our doctors say "Wow, I've never seen anything like it", "This is a Christmas miracle" and "What a New Year's gift". My heart was full. Coyt and Cannon really are fighters! God's strength is enough and is so real when you fully rely on it! The doctors celebrated with us and also let us know that things can change quickly, but today's news was good. We were scheduled for a fetal echo in two days, on Thursday. I rested well on New year's Eve and started 2014 with a heart full of hope for my precious boys. 

Speaking of precious boys...All this time in Houston, Cross and Crue have been at home in Wichita Falls enjoying time with their cousins. On New Year's Day, Gary's brother Greg decided to drive down to Houston from Wichita Falls to bring them to us. This meant a lot to me. Gary and I both missed them terribly and having them around would give us a sense of normalcy. They arrived and were full of questions! It felt so good to have them there.

What does this button do, Mommy?

We had big plans on Thursday after my fetal echo! We were gonna take them to the children's area of the hospital where they have a huge train display and fountain…and McDonald's of course! Unfortunately, the fetal echo revealed the "at anytime things can change" card. Both babies were very sick, again. 

Shortly after the fetal echo, our doctors gathered in our room to propose a procedure that had never been done in the womb. In addition to another blood transfusion for Coyt, they would remove blood from Cannon and replace it with saline. This is something that a neonatologist would perform on an infant, but in the womb posed risks that were unknown. We were given the option to go through with this experimental procedure, or do nothing and let the pregnancy ride its course. We had no idea what the risks were, and neither did they since it was experimental, but we were so very confident in the work of our doctors and we trusted them to perform the procedure. They are well known throughout the world for their research and work. [Why we love our team of doctors so much: in the next hour before surgery, Dr. Belfort researched this procedure and found 4…only 4!…known cases in the world where it had been done. He has a passion to do whatever he can to save babies - even our babies.] 

I mentioned before the last procedure that we had to make a decision as to whether or not we wanted to continue the pregnancy if Coyt didn't tolerate it. This time we made the decision to deliver them if one of the boys showed any intolerance. They were both showing a better chance of survival than the previous week. I remember looking at Gary and telling him I couldn't lose one. We had to deliver both of them. I was 25 weeks and 6 days, so they were prepared to deliver the babies if necessary. They had a pediatric cardiologist in the operating room who monitored both babies throughout the entire procedure. There was also a team from the NICU prepared to take over if the babies had to be delivered. It was all so very overwhelming.

The surgical team in their pre-op huddle.

The surgery was at 9:00pm on Thursday night, January 2nd. I shared my terrible experience from the last anesthetic with the anesthesiologist so this time he gave me a heavy dose of anxiety meds and only a small dose of pain meds during this procedure. I don't remember a thing and apparently my breathing was just fine. As always with me, it took longer than expected but everything seemed to go well! The babies were still cozy in my belly and stable! Another 12 hours of magnesium for me! 

We've Done All We Can

January 3, 2014 - The next morning Dr. Belfort came in to check the babies. He said the babies appeared to be tolerating the procedure. We would go for another fetal echo today. I hadn't felt Coyt move much at all today. I tried not to worry thinking it was due to the mag and anesthetic. And both babies were on 24-hr heart monitors, so I constantly listened to their heartbeats. We went for the fetal echo, not learning much of anything new. Nothing worse, but nothing to jump up and down about either. The valve leakage was still there but not any worse. 

When we returned to my room from the fetal echo, they hooked me back up to the heart monitors. Within the hour my nurse came in with a strange look…and then another nurse. They put an oxygen mask on me because Coyt's heart rate had dropped to 80. The oxygen helped and his heart rate went back up. Dr. Belfort and Dr. Shami stopped in just to check on me and asked why I had the oxygen mask. When I told them about Coyt they became concerned. "These kids are so sick" said Dr. Belfort. They looked at Gary and I and said they have done all they can. It's now time for us to tell them what we want to do. We either continue with the pregnancy and see how it plays out (most likely losing one or both boys), or we deliver the babies prematurely (26 weeks) and allow the NICU team to take it from there. 

I looked at Gary with tears in my eyes and said "we can't lose them". We decided to deliver the boys and pray. As soon as we said the word, Dr. Shami clapped his hands and said "lets go". A large team of medical personnel stormed in and rushed me to the OR for an emergency c-section. I had never been more scared. I was alone in the OR (except for the chaos of the doctors and staff) literally shaking as they prepped me for surgery. In that moment I thought about all the people who were praying for Coyt and Cannon. It brought tears to my eyes to think that people loved them enough to pray for them. God gave me peace right then and the hope I needed to believe that Coyt and Cannon were gonna be okay. They put me completely under with a general anesthetic and I woke up in recovery. 

Cannon was born at 7:17pm and Coyt followed just 10 seconds later, also at 7:17pm. They took Gary back with the boys. I wasn't able to see them just yet. On a scale of 1 to 10, my pain was a 20 after the surgery. I had never had a c-section and had no idea what to expect, but this was by far the worst physical pain I had ever felt in my life. I was transferred to post-pardum two hours later and Gary came in with pictures of Coyt and Cannon on his phone. They were so precious.

Cannon Ray Ohmstede
2lb 8oz - 14 inches

Coyt Ryder Ohmstede
2lb 4oz - 9 inches

Cannon (left) - Coyt (right)

The next morning I was very slow to move but we made our way to the NICU. I was anxious to meet my new baby boys. I fell in love with them immediately - I actually loved them from the moment we knew they existed, but there's something about seeing them for the first time that magnified that love. I knew they would be hooked up to ventilators and have tubes, etc., so I was prepared for that. I really wasn't prepared for how tiny they were! They were absolutely precious. For both Cannon and Coyt, I slipped my hand into the incubator and pressed my finger firmly against the tiny palm of their hand. They couldn't wrap their hand around my finger because it was so tiny but they wiggled their feet a little. When I went to pull my finger away they each would follow it as if to say "don't let go". I didn't want to leave them!

The neonatologist briefed us on their health. He said last night was a tough night. Neither of their hearts were pumping blood well. Beyond that, there were so many issues he listed, but the medical lingo was so foreign to me. None of it mattered - I knew God was in complete control. We continued to pray for a miracle.

I vividly remember the doctor saying "These babies are both very strong for what they are facing." Cannon and Coyt always seemed to amaze the doctors. They were fighters.

We went back in forth to the NICU throughout the day to love on our boys. That night around 10:15pm, we received a call from the NICU asking if we could come down to answer a few questions. I didn't feel like is was urgent because they weren't adamant that we come.

When we got there Dr. Mandy said they had just had a very scary moment with Cannon. He said he had crashed and they had to bag him and give him 2 shots of epinephrine. He said they didn't think they would get him back but then all of a sudden he started to improve. At first, I didn't realize the seriousness of the situation - God brought him back because that's what He's supposed to do... And everything was going to be fine, right? We stood by Cannon and held his tiny hands, encouraging him to keep fighting. I was so proud of him. 

While we stood there, he began to crash again. A team of doctors and nurses rushed in. As Gary and I stood back, my heart sank. I felt helpless as a mommy. They were fighters, and they were supposed to be okay. We watched them bag our sweet baby and again give him two shots of epinephrine - they brought him back.

Dr. Mandy walked over to us and said they would probably see several episodes like this. He said he couldn't figure out what was causing it. The things that would normally cause these episodes weren't present in Cannon's case. They would continue to work on him just as they had been for as long as we wanted them to. But he also had to give us the option to stop them at anytime. He pulled his computer over to us and showed us all that Cannon had been through in the past 24 hours. He explained everything in such detail as if to reassure us they were doing everything possible. For the third time, Cannon crashed again. Dr. Mandy excused himself and joined the team as they worked to save him again - and they did.

I didn't know what to do. I looked at Gary, heartbroken and in tears, and said "He's not ours". When our battle with TTTS began, I told God, "These our your boys, they aren't really mine - please protect them". I was reminded of that as I watched Cannon fight for his life. Gary and I looked at each other - both waiting to hear the other's thoughts. I said "I can't do it" and Gary said "He's so sick". I knew at that moment that God was telling us to let Cannon go. Gary was right, he was so sick. We couldn't put him through this any longer. I just wanted to hold my baby and it was time to give him to our mighty healer.

Gary signaled the doctor. They began to remove tubes from him. They handed him to me wrapped in a blanket. In that moment time stood still. I felt so many different emotions. I was sad and hurt, of course. But there was also a feeling of peace. You know that feeling when you've sought advice from your parent and felt good about the decision they led you to? I felt like we sought advice from our Heavenly Father and we were led to make the best decision for our child. We were giving Cannon back to our creator, and this time it wasn't just the words of my prayers - It was really happening.

Cannon only lived for a few minutes after that. They were the most painful minutes I had ever felt, but I have the most precious memories. To have had the opportunity to hold this little guy as he fell asleep in my arms only to awake in the arms of Jesus was a great privilege. My goodness, he was beautiful...

I cried until I felt like I couldn't cry anymore - for that moment anyway. I walked over to Coyt's incubator. I told him to be strong, that his brother was in a better place now and we needed him to get better. I just knew Coyt would be okay. I had to be strong for him.  

We went back to the room and the nurses were already aware - there was a broken heart posted to my door. This signaled others to not enter unless they went through my nurse. My only thought for the rest of the night was that I had met my sweet Cannon that morning and said goodbye to him that night. 

The next morning, Sunday, started out with a desire to go see our little Coyt (of course). I wouldn't even let Gary shower! My Dad and sister arrived this morning so Gary and I took them to the NICU to meet Coyt. When we got there, the doctor was insistent that we talk and pulled chairs around. He had been studying Coyt extensively trying to figure out why they weren't seeing any change in his vitals. He had been given various medicines in attempt to adjust the acid level of his blood. His blood pressure, heart rate, etc. had strangely not been affected by the medicines. They had done an ultrasound on his brain and there were several white/gray spots with a pretty large spot toward the front of his brain, indicating damage. Dr. Mandy basically told us that his condition was terminal and even if he miraculously lived, he would have severe brain damage. 

I sat through this conversation completely numb. I had felt such hope for him when I woke up this morning. I was so sure that he'd be okay and that we'd be there for a few months until we could bring him home. How could things be any different if I felt so confident? I now believe God had given me hope throughout this entire journey to keep me from crumbling. I had asked Him to give me strength and He did. He knew what was ahead of us. 

It was time to give Him our precious Coyt. We had options, of course, but they all involved keeping him alive with medicine. God gave Gary and I both peace to let him go. 

They unhooked Coyt from his ventilator and removed the tubes. Dr. Mandy told us that Coyt's heart was much stronger and it would probably take him longer to pass. That didn't make me feel any better. As I held him I continued to pray for a miracle. Maybe he would miraculously improve - and I wouldn't have to say goodbye. God, please let us have one of our babies. I had to accept God's plan for Coyt, and it wasn't any easier being the second time. I took comfort in knowing he would be reunited with his brother.

After an exhausting 12 hours, I just wanted to go home. My doctor agreed to release me the following morning. 

I began to think about all the plans we had for Cannon and Coyt. From the outfit they would go home in to their first day at church, to their first visit to my work. I was so happy that they didn't have to endure the pain and suffering of this world, but I was so broken. I trusted God's plan and I believed in it, I just needed Him to tell me why.  

What God DID show us was that His timing and provision was a blessing in disguise. The very first fetal surgery bought Coyt and Cannon three weeks in the womb and the second procedure bought them a fourth week. The third procedure kept them alive long enough for us to deliver them, meet them, talk to them and hold them. I thank God everyday that I was able to hold them. 

Goodbye Houston
The next day, Monday, January 6th, I woke up expecting to feel eager to pack my things and go home. To go back to where life felt normal. Instead, I woke up with an overflow of emotions at the thought of leaving the hospital without my babies. I admit, it's the first time throughout this entire process that I've said the words "it's not fair". In that moment, God wrapped His loving arms around me and reminded me that I'm not alone. My Heavenly Father who comforts me and gives me strength was and is right there with me. And He has my baby boys. They are no longer sick. They are perfect. They are loved. 

"Worthy are You, our Lord and our God, to receive glory and honor and power; for You created all things, and because of Your will they existed, and were created." Revelation 4:11

Although this marked the end of our pregnancy, our journey doesn't end. I will share the most difficult part of our journey (returning home) in another post. I think this one is long enough. :)