My Journey from Darkness to Light
Crystal Olguin Duffy
I stared at the pregnancy test, willing the lines to appear. Then faint blue, beautiful double blue.
“Oh, my gosh! There are TWO blue lines! I’m pregnant!” I think I might have been levitating off the bathroom tiles.
“Wow! That’s amazing.” Ed’s focus shifted from the blue lines to my face, beaming and melting. We squeezed each other while tears of elation streamed down my cheeks.
We had just returned from Paris, the city of love—my husband had planned the surprise trip and even arranged child care for our 18-month-old daughter Abigail. It was over a bottle of champagne at a French bistro that we had decided to start trying for another baby. It was the trip of a lifetime, at times, if felt like I was living a movie script. A few weeks later we realized that we had returned home with a little Parisian souvenir. We were thrilled that our little girl Abigail was going to be a big sister!
At the seven-week mark however, I began experiencing throbbing and painful cramps accompanied by strong pelvic pressure and heavy bleeding. Oh no, I’m having a miscarriage I thought. Preparing for the worst, I immediately contacted my OB/GYN. I remember my doctor performing the ultrasound and then looking at me and asked, “Was this a spontaneous pregnancy?” What the heck is a spontaneous pregnancy? Is that like the Immaculate Conception? I was so confused and then he pointed to the monitor and said, “Look Crystal—there are two heartbeats, two amniotic sacs—you are having twins!” We had tried for Duffy baby #2 and instead got babies #2 and #3! My husband and I were ecstatic, we felt so lucky to be given this special gift of twins.
The ultrasound unfortunately also revealed a blood clot in my uterus, which was the cause of the cramping, bleeding and discomfort. I was then placed on bedrest for a month with the hopes that with good nutrition and rest—the blood clot would reabsorb the itself—which was exactly what happened.
“I want them to be mine.” I kept saying over and over again. I was so terrified of losing these babies; I can not describe how grateful we were when we were in the clear. I thought our prayers had been answered and I could finally enjoy and relax the rest of the pregnancy.
At around twelve weeks, we received the joyous news that we would be having identical twin girls. Pink, pink, pink everywhere! I asked my husband once shortly after we found out we were having more girls, that he and our Yorkie pup Charlie would be desperately outnumbered—“Are you okay with us not having a son?” He turned and kissed me and said, why do I need a boy? Our daughter Abby envelops anything I could have ever imagined my child to be—she loves me, and shares so many of my interests—soccer, Star Wars, cinnamon toast crunch. Girls can do anything boys can do, and I’m honored that I get to raise her and our twin daughters and instill that confidence and belief in them.” My heart melted and I fell in love with him all over again.
Overwhelmed with happiness, I began the nesting process—this time double time. I was working to prepare for what would soon be a very full and busy household. Between shopping for three matching girly outfits, building a custom closet for the nursery and finishing up home-improvement projects, I was at the peak of healthy, energetic, and excitement. We even snuck in a family trip to SeaWorld for spring break to chase after out toddler at the splash pad.
But at 22 weeks, my physician found something concerning—during a routine ultrasound—it revealed that there was an abnormal amount of fluid around one of the twins. I began to panic, I knew my babies were in danger, especially after I saw how seriously my physicians took the news.
Twin to Twin Transfusion Syndrome
After targeted tests were performed, I was diagnosed with twin-to-twin transfusion syndrome (TTTS), a serious condition that affects 10 to 15 % of identical twins who share a placenta. TTTS occurs when the blood vessel connections between the two babies produce an imbalance, or uneven sharing of the blood. In these cases, the blood from one twin, (the donor) is pumped into the other twin (the recipient), requiring the heart of the donor to do extra work to support the recipient twin and the recipient twin in turn receives too much blood while the donor twin does not get enough. This unequal distribution of blood can lead to severe issues for both babies, and in cases were it is left untreated yields a 95% rate of mortality in the babies.
I was terrified once again of losing our precious babies and overwhelmed by everything. I couldn’t wrap my mind around the tragedy of TTTS when there were two babies in my womb that had been healthy, without genetic defects, who suffered consequences because they shared a placenta. It was heartbreaking situation to be in. My obstetrician immediately referred us to a maternal-fetal specialist, who specializes in high-risk pregnancies. Because our condition had already advanced to stage III TTTS (Four stages total), our MFM determined that the best treatment for us was to undergo laser ablation surgery.
Laser ablation surgery aims to interrupt the blood flow in the vessels that connect the twins through the insertion of a small telescope and a laser device into the uterus. Once the abnormally connected vessels are identified, the surgeon uses the laser to coagulate or seal the vessels. Laser ablation surgery is recommended to the more advance stages of TTTS and can only be performed between weeks 16 and 26 of gestation. I was so grateful that we were diagnosed in that window of time where there was a chance for our girls to survives. Additionally, there are a handful of doctors in the US that perform this dangerous in-utero surgery, I was blessed enough to live 20 minutes away from one of the best MFMs in the country.
Our surgery was scheduled quickly, a day after our consultation, two days after the diagnosis. In total, the surgical team lasered 11 blood vessels and drained an excess of two liters of amniotic fluid from the recipient twin’s sac.
After surgery, I was placed on strict bed rest at home to recover. Later that week, we learned that despite the surgery’s success, there was a further complication—specifically a hole, septostomy, in the membrane separating the twins. Although the hole was initially small, one of the girls apparently tore at it, making it large enough to swim through, and joined her sister, so that they were tumbling around each other. As a result, I was now carrying Mono-Mono twins, meaning my girls were in the same amniotic sac. This rare condition carries with it its own host of complications, including umbilical cord entanglement and compression. For my sake and the twin’s health—my OB admitted me into the hospital for bed rest and strict monitoring, where I would stay for the remainder of my pregnancy until the twins were delivered.
I loaded up on magazines, movies, snacks, pictures of my family and my daughter Abigail, a countdown calendar—even a lamp to make my room feel more like home. I had no idea how long I was going to be there—I arranged for visitors, friends, family to come visit me in the hospital every day. We had a barbeque, baby shower and even a surprise anniversary dinner during my stay at the hospital. I also attended an antepartum support group every week were I met other moms going through my same situation. It was in this group were I also met a musical therapist who worked with me and helped me find a creative outlet to express and deal with everything I was going through. One of the hardest things I found, was being away from Abigail for so long, so with my therapists help I wrote and recorded a song about that called Together Again. It was so special to me because not only did it help me pass the time, but it was also therapeutic in helping me process the stress, anxiety, and loneliness of going through my last month of pregnancy at the hospital.
Our dramatic delivery
On the evening of June 18, 2014, I felt sick and alerted my nurse that something felt off. By the next morning, I was having full-blown contractions. They put me on magnesium to try and stop the labor. But when my OB came to check on me he saw that I had dilated more and said the words that will forever ring in my head. “It’s time—after a month of hospital bedrest—we are having some babies today.”
I went into C-section surgery unalarmed, excited to soon be meeting these little survivor babies of mine. As my OB would later describe, as soon as they started the surgery they knew something was wrong—I was bleeding heavily. I had had a placenta abruption—a rare and dangerous occurrence in which the placenta detaches itself from the inner wall of the uterus. Completely unrelated to my surgery, or the TTTS, it was so unbelievably lucky that I had been in the hospital for observation and continuous monitoring. Additionally, placenta abruption is one of the primary causes of maternal mortality. I remember being in the OR and could sense that something was wrong. Ed, my husband, was asked to leave and I heard one of the nurse say something about a blood transfusion. Never, not once through all of this did I think for a second about my own life being in danger. I had remained positive and strong in my faith through it all. One of the best memories was hearing the babies scream for the first time—their lungs were sure strong and healthy. A team of clinicians stood by, ready to transport the girls to the NICU for care.
Katherine Maria and Lauren Elizabeth each weighed 3 pounds when they were born. They spent 38 says in the NICU at Children’s Memorial Herman in Houston, Texas. They are healthy, happy and rambunctious little toddlers.
As I think back on all of it I still can’t believe what had to happen for us to all be here together. Despite all our complications—my twin daughters and I are healthy, happy, and extremely blessed to have one another. It took not just one but a series of miracles to us to emerge healthy—we are walking miracles.