The amazing Amber Cessac, Eden and Noelle (4 - MoDi Identical twins), Selah (3) and Lovelyn (16 mo).
Amber learned 6 weeks into her first pregnancy that she was carrying twins but her OB at the time told her they were DiDi (two placenta's, two amniotic sacs). At Amber's 12 week appointment they check heart tones, measurements and blood pressure, and at 16 weeks they did the same. At 16 weeks, however, she started to experience swelling and began to feel very uncomfortable but they just chalked it up to carrying twins and everything being more difficult with two. Amber went in at 20 weeks, 5 days for her anatomy ultrasound and the sonographer showed her Eden, baby A was flipping around all over the place while Noelle was just sitting there. The sonographer measured Eden and showed Amber all of her limbs and organs but when she went back to Noelle she was silent. Eventually the sonographer left to bring Amber's husband in and when they returned she did another ultrasound quickly to show him. At this point Amber asked if it was normal for one baby to be so active and the other unmoving, the sonographer responded that it was common with twins and the doctor would be in soon to talk to her about how they were growing. Amber immediately told her husband that was not a good answer and started to solidify her sense that something was wrong.
The sonographer got a radiologist who came to speak with Amber, he reviewed the measurements and she remembers seeing that baby B was only measuring 18.1 weeks while she was 20.5 weeks along. Amber remembers the ceiling tiles in that room vividly as the radiologist performed another ultrasound and whispered to the sonographer. When the radiologist finished the scan, he turned to them and said there was a serious problem and explained Twin to Twin Transfusion Syndrome (TTTS) to her. Her OB was wrong and her twins were sharing a placenta. He said that Noelle would pass soon and Eden probably would as well. He offered selective reduction and then sent her to see her OB. Amber cried like she never had before and had a very somber visit with her OB. He was very worried and wanted to refer her out to his perinatologist/MFM group. She was sent on her way, told to wait for them to reach out to her, and in the mean time, to stay away from the internet.
That evening, Amber and her husband told everyone so they could rally around them. The next day woke up knowing she had to do something, if her daughters were fighting to stay alive inside her, she had to fight for them. She took to the internet and very quickly found a local TTTS specialist in Houston, Dr Moise, whose website had tons of information on TTTS. She watched videos, read everything she could and immediately called. She spoke with the nurse coordinator who spent an hour on the phone with her and explained all of her options. Once the nurse realized Amber was local, she asked her to send over her records and come into see them that afternoon. When Amber called her doctor for her records, they said no. They wanted her to see his MFM's first and then, if it was warranted go see Dr. Moise. Amber initially said okay, not wanting to rock the boat but hung up and was immediately overwhelmed with the sense that she had to take charge and she wasn't going to take no for an answer. She called back, got her records and went into see Dr. Moise that afternoon. She had a very lengthy ultrasound and they decided to perform laser ablation surgery within 24 hours.
Eden's deepest vertical pocket was 18cms and Noelle's was 0. Amber was taken for surgery at 6am and after draining about 2.5 liters of fluid and severing 9 or 10 placental vessel connections, her surgery was considered successful. She was monitored overnight in hospital, discharged and put on bed rest for a week, and had weekly ultrasounds thereafter. There were slow improvements in her girls every time the checked in. Amber transferred OB's who monitored her weekly until 30 weeks when she began to also have weekly non-stress tests. Eden's heart was enlarged due to the TTTS but echoes showed that it was okay. At 32 weeks 1 day, Eden failed her biophysical profile and NST, so Amber was sent to Labor and Delivery for 24 hour monitoring and steroids. She was monitored for 3-4 days and then sent home. At 33 weeks, Noelle failed her biophysical profile and NST and the decision was made, that they had already beaten the odds, they may as well get their babies earth side.
Amber delivered via cesarean and she says the entire operating room was a celebration. Eden was born weighting 4lbs 13 oz and Noelle was 3lbs even. Both girls were taken to NICU but were breathing independently from the moment they were born and only needed to stay in NICU to learn to feed and grow. Eden was in NICU for 18 days and Noelle came home after 33. Amber was able to pump and breastfeed the girls until their first birthday and produced so much milk she was also able to donate over 300oz. Amber's girls dealt with a lot of anxiety and heightened emotions their first three years of life but they've been able to work through it and are doing really well today.
When the girls were about three months old, Amber became involved in the online TTTS community to reach other parents carrying twins at risk for TTTS. She and other parents began the online group TTTS Hope and Connections as well as Mono-Di Twins to reach, raise awareness, and advocate for other families through providing support and resources. Amber says she doesn't know why her TTTS went unnoticed for so long and her girls are still here, or why surgery was the perfect answer for them. She says, it's not survivors guilt but in her girls lives she feels the weight of every baby who is lost to this disease.
Amber and her husband knew they wanted to be young parents and wanted to have a big family so they conceived again around the twins first birthday. She called her new OB to let them know she was pregnant and that she needed to have an ultrasound at 6 weeks to make sure there was only one baby and that everything looked good. Amber knew she wanted to have a VBAC but they were moving and she needed to find a new provider. She had a list of people to interview and on her first interview, the OB she met with at 11 weeks said, "Why wouldn't you, VBAC?" She was thrilled to not have to look any further.
Amber carried to 40 weeks, 5 days and went into labor independently in the middle of the night. Her contractions were every 10 minutes through the night but the next day they slowed down to every 20-30 minutes. The next night they got very intense so she called her doula and they went into the hospital. She was only 1cm so while everyone was very supportive, they sent her home. Amber went to her OB the next morning to find she was 3-4 cm and 80% effaced so she went into the hospital. She labored there all day and her care transferred from her provider to the on-call OB. As the new OB checked her she was 6cms and her water broke during the check. As they headed into the evening, Amber had been resistant to the epidural but her doula suggested that it may be a good idea since she was headed into her third night of labor without resting.
Amber chose to go ahead with the epidural but was incredibly uncomfortable once it set in and felt tied down with the catheter, pulse ox, blood pressure and all the extra "stuff" she suddenly had to have. Then her blood pressure started to drop, as did the baby's heart beat. They rushed in to give Amber medication to allow her blood pressure to recover and Selah also recovered but her contractions stopped. The OB came to check and she was still 6cms so she suggested a repeat cesarean. Amber asked for another hour to try. They sat her bed up, she pumped to try to stimulate contraction and hour later she was still a 6. Amber asked to try a little bit of Pitocin to see what happened and they agreed to one final hour. The charge nurse, who had a VBAC herself, said everyone deserves a chance to try and helped position Amber on the bed so she had on leg up and her pelvis hanging down. An hour later she was 10cms and in four pushes Amber was able to push Selah out just as the OB came back in the room. The moments following were so peaceful and they were able to delay cord clamping and measurements. Selah nursed right away and Amber says the experiences sealed the deal on her feeling empowered. She is in control of her body and her babies and feels like she can accomplish anything.
Amber and her husband started the process of becoming licensed foster parents after Selah was born and thought they may foster to adopt and perhaps have other biological children in the future if it was in the cards for them. On Selah's first birthday, Amber had been feeling off and asked her husband to bring home a pregnancy test for her so she could rule it out before they went out. It was positive and she was shocked. She immediately started to worry about how far along she was and how many babies she was carrying. Her husband was really positive and eventually she knew that they would be just fine. Four kids, under four would be a new adventure for them and she was excited. Amber knew she wanted to have another VBAC but they had moved again and she needed to find another doctor. She found a supportive OB and things were going well until she learned that Lovelyn had an umbilical cord with a single artery. She was incredibly worried and overwhelmed with the news and what it could mean and it brought back a lot of emotions from her pregnancy with her twins. Amber called Dr. Moise for info and his opinion and he was willing to scan her for reassurance. She went to Houston for an anatomy scan and everything looked perfect, the MFM her doctor referred her to thought the same and she was able to let go of some of her fears and find peace about it.
Amber had a few extra ultrasounds with MFM's as she progressed and started in-office NST's twice weekly at 32 weeks. She had all scenarios swirling in her mind if something went wrong but none of that had to happen. She went into labor at 39 weeks 5 days in the middle of the night. They decided to take their kids to the Children's Museum the next day where she contracted every 15-20 minutes. Amber continued to labor at home and contractions eventually got to 3-5 minutes. She was 6cms dilated when they checked into the hospital and she labored with her husband. Amber chose not to hire a doula this time, since she'd done it before and says that maybe wasn't the best choice in hindsight. She was determined to do things without medication and the staff was really supportive. The OB broke her water at 8cms and guided baby down as she did it. At around 9cms, things started to get really tough, and Amber realized she wanted an epidural more than anything. She says she didn't regret anything more in that moment than not getting an epidural. They tried to tell her it was too late, but eventually said they would try to get anesthesia to come. She labored through it and once the anesthesiologist finally arrived she was 10cms and ready to push. Amber was worried the pushing phase would take much longer than last time but it went quickly and smoothly and Lovelyn was born without complication, the exact same weight as Selah. Amber was a little disenchanted with her unmedicated birth initially but would do it a gain, just with a doula next time. Lovelyn was breastfed for a year and is such a sweet addition to their family.
Amber says that with four under 4, she took all the pressure off of herself to be super mom and is having so much fun with her girls. Motherhood is where she has found herself. The experiences that she has gone through took away everything the world put on her about who she was supposed to be and forced her to come to this place of surrender and rawness to discover who she was and what she truly believes.