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Speaker 1: You're listening to Amma mea Podcast. Hi, it's Cassne Lukige here,

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Speaker 1: host of Diary of a Birth, and this summer we've

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Speaker 1: curated your delivery room playlist to bring you even more

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Speaker 1: unmissable birth stories. This summer, we're bringing you our favorite

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Speaker 1: episodes of Diary of a Birth right here in your feet.

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Speaker 1: That's your holiday listening sworded And if you're looking for

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Speaker 1: more to listen to, every Mma mea podcast is curating

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Speaker 1: your summer listening right across our network. From pop culture

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Speaker 1: to beauty to powerful interviews, there's something for everyone.

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Speaker 2: Check out the link in the show notes.

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Speaker 1: Hi, I'm Cassenya Lukich and this is Diary of a Birth.

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Speaker 1: When Marti Cochran fell pregnant through IVF at forty two,

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Speaker 1: she thought the hardest part of her fertility journey was

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Speaker 1: behind her.

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Speaker 2: But she was in for a big surprise.

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Speaker 1: Her single embryo transfer turned into idea into called Twin Girls.

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Speaker 1: Then a routine scan at twenty two weeks revealed a

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Speaker 1: complication that would change everything.

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Speaker 3: Everything had been fine prior with the scans in between

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Speaker 3: thirteen and twenty two weeks, and when I walked in

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Speaker 3: that day to the hospital. You know, they were scanning

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Speaker 3: me and everything seemed normal. At the end of the scan,

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Speaker 3: they said, oh, look, we're just going to bring in

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Speaker 3: a doctor, and you know, we waited for what seemed

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Speaker 3: like forever.

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Speaker 1: In today's episode, Many shares her extraordinary story of navigating

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Speaker 1: one of the rarest twin complications, taps, where one twin

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Speaker 1: becomes dangerously anemic while the other develops too many red

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Speaker 1: blood cells.

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Speaker 2: So let's meet today's maum.

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Speaker 3: My name's Many, and this is the diary of my

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Speaker 3: birth with my twins, Billy and Poppy.

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Speaker 1: You know, your journey to getting pregnant obviously took a

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Speaker 1: little bit of time. But what was your life like

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Speaker 1: before you fell pregnant with the twins.

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Speaker 4: I have been with my husband for a really long time.

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Speaker 3: So we had been together, I think for about six

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Speaker 3: years before we settled on the Gold Coast and bought

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Speaker 3: our first townhouse together, and we had planned to get

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Speaker 3: pregnant pretty soon. And yeah, it took obviously many years,

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Speaker 3: but in that time, I guess we just spent a

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Speaker 3: lot of time together.

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Speaker 4: He's fantastic.

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Speaker 3: We have adopted five birds, and we eventually upgraded to

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Speaker 3: a bigger house on the Gold Coast. We hoped for

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Speaker 3: a child and for the birds as well, so somewhere

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Speaker 3: a little bit bigger that would house the birds and

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Speaker 3: us and hopefully a child.

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Speaker 1: Yeah, when you got pregnant, you went through IVF.

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Speaker 2: They just put one embryo in and yep, lo and behold. Yes.

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Speaker 3: Well we didn't actually find that out until about the

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Speaker 3: ten week so the IVF journey. I was so nervous

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Speaker 3: about that. I really was quite reluctant to do it.

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Speaker 3: But we needed it obviously as I got older. But

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Speaker 3: we had a bit of a triple whammy. So my

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Speaker 3: age was against me. I had suspected endo and also

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Speaker 3: my husband has a male fertility issue as well.

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Speaker 4: Like everything was against us.

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Speaker 3: And yeah, so we found a newer specialist and it

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Speaker 3: went like a dream, Like they got more eggs than

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Speaker 3: they thought they would get. They told me maybe three,

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Speaker 3: like zero to three. We got five. I think they

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Speaker 3: expected maybe one to fertilize out of those, and we

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Speaker 3: got three embryos out of that, and then they implanted one.

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Speaker 3: And at first we thought it was just one child.

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Speaker 3: So I'd had a couple of scans at seven weeks

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Speaker 3: and then at eleven weeks and the child was developing

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Speaker 3: quite nicely. But yeah, we found out at thirteen weeks

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Speaker 3: that that embryo had actually split and we were pregnant

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Speaker 3: with identical twins.

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Speaker 1: Was it that the embryo split quite late in the process.

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Speaker 2: Is that why they can't see it? Or was baby

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Speaker 2: be hiding?

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Speaker 3: So the first couple of scans I had wasn't like

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Speaker 3: a professional ultrasound place. It was with my utility specialist,

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Speaker 3: which is what they usually do just in the early weeks,

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Speaker 3: just to make sure that there's a heartbeat and that

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Speaker 3: you know, you go along and you do your nipped

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Speaker 3: test and.

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Speaker 2: Stuff like that.

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Speaker 4: So they were really quite quick, and I.

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Speaker 3: Think she was just looking for a baby and a

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Speaker 3: heartbeat and didn't go looking for that second because we

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Speaker 3: had one embryo implanted, I was forty two. It was

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Speaker 3: amazing that I got pregnant first round at my age

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Speaker 3: with one embryo. So yeah, I just don't think she

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Speaker 3: went looking for it.

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Speaker 1: So your partner Lee and you, when you find out

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Speaker 1: you're having twins, what was your reaction?

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Speaker 3: Well, if I'm going to be really honest, the first

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Speaker 3: reaction was an internal screaming. No, I guess a few

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Speaker 3: thoughts run through my mind. One was, oh my god,

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Speaker 3: how am I going to cope with twins? My finances

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Speaker 3: went through my head. Complications because I knew, like, we

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Speaker 3: did everything that they told us to do during the round,

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Speaker 3: So I knew that these were identical twins, and so

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Speaker 3: I was scared for the risks you know, to me

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Speaker 3: to the babies. So yeah, I was immediately fearful. But

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Speaker 3: it's interesting what you do in that moment, like lower

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Speaker 3: scanning the one. All I wanted to find out was

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Speaker 3: if the other one was healthy. So I just had

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Speaker 3: that instinct to protect them and that they were my babies,

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Speaker 3: like immediately, even though I was like, oh crap, what

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Speaker 3: am I going to do? So but once we started

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Speaker 3: telling family members and workmates, you know, that fear turned

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Speaker 3: into excitement and we were just like, oh my god,

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Speaker 3: they're going to have a best friend for life.

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Speaker 2: How cool is that? And a connection for life?

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Speaker 4: Absolutely. Yeah, we never understand this, We'll never understand this bond,

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Speaker 4: but they will have it, and it was just incredible.

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Speaker 1: Unfortunately, at twenty two weeks, you did find out that

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Speaker 1: there was a complication.

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Speaker 2: Will you run us through that? Sure?

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Speaker 3: So because we found out quite late in the piece

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Speaker 3: that I was having twins and that they were identical

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Speaker 3: and that they shared a placenta. My referral to the

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Speaker 3: hospital was, I guess a little bit later than normal.

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Speaker 3: So at twenty two weeks I walked into my maternal

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Speaker 3: fetal medicine scan. Everything had been fine prior with the

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Speaker 3: scans in between thirteen and twenty two weeks. And when

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Speaker 3: I walked in that day to the hospital, you know,

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Speaker 3: they were scanning me and everything seemed normal, and then

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Speaker 3: at the end of the scan they said, oh, look,

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Speaker 3: we're just going to bring in the doctor. And you know,

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Speaker 3: we waited for what seemed like forever, and I just

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Speaker 3: had no thought in my mind that anything was wrong,

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Speaker 3: even though I'd read the paperwork.

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Speaker 4: And the recommendations and things like that.

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Speaker 3: And yeah, they told us that they suspected that the

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Speaker 3: girls had twin anemia polycythemia sequence or TAPS.

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Speaker 1: So basically, one baby was anemic and one baby had

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Speaker 1: too much I in.

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Speaker 3: Red blood cells, yeah exactly, Yeah, yeah, so yeah, bloodtoothin,

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Speaker 3: blood tooth thick they say, like lemonade and tomato sauce.

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Speaker 3: That's the kind of consistency of the blood yeah.

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Speaker 1: And what's the treatment for that? How do they help

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Speaker 1: you get to term?

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Speaker 3: Yeah, it's a really difficult thing because one TAPS is

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Speaker 3: really quite newly discovered, like only in the last eighteen

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Speaker 3: years or so, so the best treatment still hasn't been

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Speaker 3: found out. So what they do is really individual to

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Speaker 3: each person. In our case, there were options that were

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Speaker 3: available to me and options that weren't. So in some

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Speaker 3: cases they can do laser surgery to laser the tiny

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Speaker 3: connections in the BLAS center, doing in uterotransfusion, They can

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Speaker 3: birth the babies early, or they can just wait and see.

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Speaker 4: Depending on that. So I had a bit of a combination.

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Speaker 3: They wanted to wait and see how the girls went

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Speaker 3: because in some cases they can adapt to their new

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Speaker 3: I guess environment in the womb. But it did progress

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Speaker 3: and did get worse, and that's where we had to

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Speaker 3: look to treatment.

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Speaker 4: Yeah.

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Speaker 1: So, as I understand it, you had a blood transfusion. Yes,

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Speaker 1: how does that work in utero?

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Speaker 4: Yeah?

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Speaker 3: Sure, So this is very interesting, especially when it comes

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Speaker 3: to twins. So an in utero transfusion for a normal

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Speaker 3: anemic singleton baby is quite common, but in twins it's

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Speaker 3: really uncommon.

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Speaker 4: So what they actually had to do.

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Speaker 3: Was transfuse adult donor blood to my anemic baby and

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Speaker 3: take out small amounts of blood out of the polycychemic

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Speaker 3: baby and replace that with warm saline.

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Speaker 4: So it was a very scary procedure.

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Speaker 3: And the way they do it, so I had an

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Speaker 3: anterior placenter. It was right in front, so easy access

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Speaker 3: to the placenta and umbilical cords. And they go in

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Speaker 3: with a big needle one by one and they go

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Speaker 3: into the placenta and then the umbilical cord and they

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Speaker 3: that's when they.

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Speaker 4: Transfuse the blood.

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Speaker 3: And then obviously they go into the next baby, big

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Speaker 3: needle through the placenter and the umbilical cord and take

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Speaker 3: out small amounts of blood and replace that with warm

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Speaker 3: salty water.

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Speaker 2: And were you awake for this procedure?

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Speaker 3: Yeah, so the first one at twenty eight weeks, that

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Speaker 3: one was actually just done in an ultrasound room. They

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Speaker 3: set up a sterile environment and they actually have blood

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Speaker 3: testing on site, so there's a formula attached to it

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Speaker 3: as well. They find out how much blood they need

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Speaker 3: and the doctors calculate all that. But yeah, I was awake,

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Speaker 3: felt everything. There's only a local anesthetic on your belly yep,

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Speaker 3: just to numb where the injection site or the needles

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Speaker 3: go in. And I had like a little bit of

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Speaker 3: medication to I guess, keep me calm, and medications to

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Speaker 3: stop the uterus contracting and things like that. But I

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Speaker 3: could see and feel everything. So they had the ultrasound

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Speaker 3: screen up so I could see, you know, I just

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Speaker 3: wanted to check that the baby girls were still moving

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Speaker 3: and hearts were still beating and things like that. And

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Speaker 3: Lee happened to be there with me during that one.

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Speaker 3: I mean it was very scary and surreal just to

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Speaker 3: think about it, Like when I think about myself in

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Speaker 3: that ultrasound chair looking at the screen. Yeah, it's just

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Speaker 3: it's amazing what they can do. A bit at the

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Speaker 3: same time, you're thinking, oh my god.

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Speaker 4: Is this my life?

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Speaker 1: So yeah, I mean it's one thing to be pregnant

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Speaker 1: after you know, years of infertility. It's enough to be

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Speaker 1: pregnant with twins. I mean it's another thing on top

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Speaker 1: of that when there's complications.

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Speaker 4: Definitely.

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Speaker 1: So in terms of like your mental health and how

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Speaker 1: you were coping, Yeah, how was that time for you?

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Speaker 4: Yeah? It was very hard.

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Speaker 3: I mean, the thought of having something wrong with your

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Speaker 3: babies in utero. Like I think the first thing I

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Speaker 3: went to was, you know, what did I do? You know, like,

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Speaker 3: this must be my fault, It must be something I ate,

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Speaker 3: something I did in my you know, like pre pregnant life.

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Speaker 3: You know, you think of all the things things and

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Speaker 3: mum guilt sets in really quickly.

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Speaker 4: But really I.

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Speaker 3: Just had to turn to the focus of putting my

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Speaker 3: trust in the doctors. We have such an incredible medical system,

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Speaker 3: especially in Queensland, and access to the brilliant doctors at

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Speaker 3: Martyr Hospital in Brisbane. It's incredible, Like the doctors up

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Speaker 3: there are just world class and what they do is

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Speaker 3: just unbelievable. So I did really feel like I was

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Speaker 3: in good hands. I just had to trust that, yeah,

223
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Speaker 3: that we would be okay. It was definitely hard. There

224
00:11:58,405 --> 00:12:00,646
Speaker 3: were a lot of tears and I just had to

225
00:12:00,726 --> 00:12:03,806
Speaker 3: lean on my supports, like I had to, Like, there

226
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Speaker 3: weren't many.

227
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Speaker 4: People going through what I was going through. It's so rare.

228
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Speaker 3: It only happens in like three to five percent of

229
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Speaker 3: identical twin pregnancies, so yeah, it's it's extremely rare. There's

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Speaker 3: not a lot of people you can reach out to,

231
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Speaker 3: but like I had my family, and then I also

232
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Speaker 3: had a TAP support forum who were just wonderful. So yeah,

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Speaker 3: I sought some help online as well. You know what

234
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Speaker 3: questions to ask and you know what's it like? And

235
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Speaker 3: can anyone tell me if they've had any utero transfusion before?

236
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Speaker 3: So really just reaching out to all the resources I

237
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Speaker 3: could to help get me by.

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Speaker 4: It was just really like survival mode, to be honest.

239
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Speaker 1: I imagine that there was a discussion of how far

240
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Speaker 1: into the pregnancy they would like you to get and

241
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Speaker 1: I imagine that they were suggesting a c section because

242
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Speaker 1: you were higher risk. Did they have a goal for you?

243
00:12:55,686 --> 00:12:59,166
Speaker 1: And can you tell us a little bit about going

244
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Speaker 1: into labor?

245
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Speaker 4: Sure?

246
00:13:01,206 --> 00:13:04,526
Speaker 3: So yes, the goal, and in most cases with taps

247
00:13:04,806 --> 00:13:07,606
Speaker 3: is thirty two weeks. Getting to thirty two weeks usually

248
00:13:07,646 --> 00:13:10,886
Speaker 3: the placenta is not happy by the end of thirty

249
00:13:10,926 --> 00:13:13,526
Speaker 3: two weeks and it's a good idea to birth them

250
00:13:13,806 --> 00:13:16,445
Speaker 3: because it gets riskier. There's no more treatment that can

251
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Speaker 3: be done at that stage. So the aim for me

252
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Speaker 3: was to get to thirty two weeks. Unfortunately, at thirty

253
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Speaker 3: two weeks, I went to my local hospital. They didn't

254
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Speaker 3: have any niicure special care beds available for the girls.

255
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Speaker 3: So they turned me back around, referred me back to

256
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Speaker 3: the martyr and said, let's see what they think they

257
00:13:35,566 --> 00:13:40,285
Speaker 3: should do with you. And they suggested another transfusion, which

258
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Speaker 3: we did at thirty two weeks, very very risky, but

259
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Speaker 3: this time it was in theater with an epidural, so

260
00:13:46,766 --> 00:13:49,285
Speaker 3: I felt a lot safer if something went wrong, they

261
00:13:49,285 --> 00:13:52,965
Speaker 3: could just birth the girls. Thankfully, it was very successful

262
00:13:53,246 --> 00:13:56,766
Speaker 3: and they sent me home the next morning and just

263
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Speaker 3: said it could be any time.

264
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Speaker 4: If we get a couple of.

265
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Speaker 3: Days out of this, it'll be great, and I was like,

266
00:14:01,526 --> 00:14:05,366
Speaker 3: oh wow, like reality just really set in. Then I

267
00:14:05,606 --> 00:14:10,006
Speaker 3: got to thirty three plus two and my waters broke.

268
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Speaker 3: So sitting on the couch on a Saturday night and

269
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Speaker 3: my waters broke, and I went to hospital. Now my

270
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Speaker 3: local hospital still didn't have nick U or special care beds,

271
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Speaker 3: so I stayed a couple of days there with antibiotics

272
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Speaker 3: and there was no labor progressing aside from the water's breaking.

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Speaker 4: So they sent me up to.

274
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Speaker 3: Marta and when I got there we made it through

275
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Speaker 3: one night. The aim was to get me to thirty

276
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Speaker 3: four weeks, so that was the plan. I was like,

277
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Speaker 3: we had it in our minds Oka thirty four weeks,

278
00:14:43,606 --> 00:14:47,126
Speaker 3: I was thirty three plus six and I went for

279
00:14:47,206 --> 00:14:50,326
Speaker 3: a well being scan and everything seemed fine. That was

280
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Speaker 3: at four o'clock in the afternoon. At ten PM, during

281
00:14:54,646 --> 00:15:00,006
Speaker 3: a routine CTG, my baby b had a very high

282
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Speaker 3: heart rate, so they were like all of a sudden,

283
00:15:03,006 --> 00:15:06,966
Speaker 3: doctors and nurses swarming around me and said it's time

284
00:15:07,046 --> 00:15:10,166
Speaker 3: to get the girls out. So my husband was still

285
00:15:10,206 --> 00:15:13,726
Speaker 3: at home an hour away and didn't quite make the birth.

286
00:15:14,126 --> 00:15:15,845
Speaker 2: Oh no, yeah.

287
00:15:16,286 --> 00:15:18,246
Speaker 3: I asked them to hold on, like caut you just

288
00:15:18,326 --> 00:15:21,166
Speaker 3: hold on an hour until he gets here. But because

289
00:15:21,166 --> 00:15:24,166
Speaker 3: we were expecting to birth the next day, he rushed

290
00:15:24,246 --> 00:15:27,366
Speaker 3: up the motorway but still didn't quite make it. But

291
00:15:27,886 --> 00:15:30,406
Speaker 3: I found out later that it was probably like a

292
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Speaker 3: Category one sea section. They were like, these babies have

293
00:15:33,566 --> 00:15:36,766
Speaker 3: to come now, it's really bad, but I didn't realize,

294
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Speaker 3: like they made me feel like, yes, it's an emergency,

295
00:15:40,406 --> 00:15:42,446
Speaker 3: but everything's going to be okay.

296
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Speaker 2: Coming up.

297
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Speaker 3: My husband arrived just as Poppy had been born, so

298
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Speaker 3: Billy was born first and she was the one whose

299
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Speaker 3: heart rate had caused the emergency sea section.

300
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Speaker 2: So by yourself, were you scared?

301
00:16:03,566 --> 00:16:04,286
Speaker 4: Absolutely?

302
00:16:04,486 --> 00:16:06,646
Speaker 3: I burst into tears a minute that they told me

303
00:16:06,726 --> 00:16:09,126
Speaker 3: that the babies had to come right that minute. I

304
00:16:09,366 --> 00:16:14,046
Speaker 3: was frantic, like calling my husband. I just I couldn't breathe.

305
00:16:14,766 --> 00:16:18,046
Speaker 3: It was really awful. At one point when we got

306
00:16:18,126 --> 00:16:20,846
Speaker 3: when I got to theater and I had everyone around me,

307
00:16:20,886 --> 00:16:22,486
Speaker 3: and they ask you all the questions, what are we

308
00:16:22,566 --> 00:16:26,646
Speaker 3: doing today, we're having a c section. I started to

309
00:16:26,646 --> 00:16:29,766
Speaker 3: calm down once I saw my medical team and I asked, someone,

310
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Speaker 3: can you put on my playlist? Because I had organized

311
00:16:33,086 --> 00:16:35,526
Speaker 3: a playlist and it was all my favorite songs, forty

312
00:16:35,526 --> 00:16:38,366
Speaker 3: five minutes of my favorite songs. They said, yep, we

313
00:16:38,406 --> 00:16:41,006
Speaker 3: can absolutely do that. I was like, oh my god,

314
00:16:41,086 --> 00:16:44,006
Speaker 3: thank you so much, started crying again, and then one

315
00:16:44,046 --> 00:16:46,606
Speaker 3: of them put their hand on my shoulder and went, okay,

316
00:16:46,646 --> 00:16:50,046
Speaker 3: let's have a birthday party. And that's where I was like, Okay,

317
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Speaker 3: I feel well looked after now. So even though I

318
00:16:53,046 --> 00:16:55,646
Speaker 3: didn't have my husband, I had my music, I had

319
00:16:55,646 --> 00:16:58,126
Speaker 3: an incredible medical team, and I just really had to

320
00:16:59,166 --> 00:16:59,966
Speaker 3: be grateful for.

321
00:16:59,966 --> 00:17:01,886
Speaker 4: What I did have, not what I didn't have.

322
00:17:02,046 --> 00:17:05,286
Speaker 3: So yeah, and I knew that the babies were going

323
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Speaker 3: to be safe as well.

324
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Speaker 2: So the babies come out did they go straight to

325
00:17:09,326 --> 00:17:09,766
Speaker 2: the NICKU.

326
00:17:10,366 --> 00:17:12,006
Speaker 4: Yeah, so they showed the girls to me.

327
00:17:12,086 --> 00:17:14,686
Speaker 3: Their cords had to be cut straight away and they

328
00:17:14,686 --> 00:17:18,246
Speaker 3: were whisked away. My husband arrived just as Poppy had

329
00:17:18,286 --> 00:17:22,486
Speaker 3: been born, so Billy was born first, and she was

330
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Speaker 3: the one whose heart rate had caused the emergency c section,

331
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Speaker 3: so she was born first, and then Poppy was born

332
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Speaker 3: and Lee just arrived.

333
00:17:31,926 --> 00:17:34,526
Speaker 4: So he was able to follow them up, which was amazing.

334
00:17:35,006 --> 00:17:37,606
Speaker 1: Yeah, that's good. That would have made you feel a

335
00:17:37,646 --> 00:17:38,766
Speaker 1: little bit calmer.

336
00:17:39,006 --> 00:17:39,286
Speaker 2: Yeah.

337
00:17:39,406 --> 00:17:39,646
Speaker 4: Yeah.

338
00:17:39,686 --> 00:17:42,766
Speaker 3: All I could like at that point was about the babies,

339
00:17:42,966 --> 00:17:45,366
Speaker 3: and so he was like, do you mind if I

340
00:17:45,406 --> 00:17:49,166
Speaker 3: go up and I was like, yes, please go, yeah, go,

341
00:17:49,606 --> 00:17:51,446
Speaker 3: and he named them up there and everything.

342
00:17:51,526 --> 00:17:54,646
Speaker 1: So, yeah, tell me about your first time holding them.

343
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Speaker 2: Yeah.

344
00:17:55,846 --> 00:17:59,326
Speaker 3: So I actually didn't get to hold them, what was

345
00:17:59,366 --> 00:18:03,526
Speaker 3: one by one at first? They were in the nick

346
00:18:03,606 --> 00:18:06,486
Speaker 3: you in separate CODs at step ends of the room

347
00:18:06,526 --> 00:18:09,205
Speaker 3: because that's all they had at the time. Yeah, it

348
00:18:09,246 --> 00:18:12,086
Speaker 3: was a little bit sad, but I mean, the facilities

349
00:18:12,126 --> 00:18:14,846
Speaker 3: up there are just so wonderful and the nurses are incredible.

350
00:18:15,366 --> 00:18:17,846
Speaker 3: So I didn't get to hold them until about twelve

351
00:18:17,886 --> 00:18:20,886
Speaker 3: hours after the birth, and that was separately, and it

352
00:18:20,926 --> 00:18:22,486
Speaker 3: was all a bit of a whirlwind. I think I

353
00:18:22,526 --> 00:18:24,846
Speaker 3: was a little bit drugged up still, to be honest,

354
00:18:25,126 --> 00:18:27,846
Speaker 3: and I just couldn't believe everything that happened. I was

355
00:18:27,926 --> 00:18:30,766
Speaker 3: just I think I was just in shock. But I

356
00:18:30,806 --> 00:18:33,286
Speaker 3: do remember the moment that I held them both together,

357
00:18:33,486 --> 00:18:35,646
Speaker 3: which was a couple of days later, and that was

358
00:18:35,766 --> 00:18:39,246
Speaker 3: just the best thing ever, Like they were finally safe,

359
00:18:39,286 --> 00:18:43,446
Speaker 3: they were finally together, they were finally with me, And yeah,

360
00:18:43,486 --> 00:18:46,406
Speaker 3: it was just a beautiful, beautiful moment just holding them.

361
00:18:46,846 --> 00:18:47,126
Speaker 4: Yeah.

362
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Speaker 1: Well, you had, you know, months and months of stress

363
00:18:49,726 --> 00:18:56,086
Speaker 1: and anxiety and stressful birth. To have them safe would

364
00:18:56,126 --> 00:18:57,566
Speaker 1: have just been so special.

365
00:18:57,926 --> 00:19:00,686
Speaker 4: Absolutely, Yeah, it was just wonderful.

366
00:19:01,046 --> 00:19:01,806
Speaker 2: Yeah.

367
00:19:01,846 --> 00:19:05,046
Speaker 1: And the question that I'm sure everybody asks a twin mum,

368
00:19:05,726 --> 00:19:06,806
Speaker 1: did you mix them up?

369
00:19:07,246 --> 00:19:07,526
Speaker 5: I know.

370
00:19:09,366 --> 00:19:11,766
Speaker 4: So well, I guess from the beginning.

371
00:19:12,566 --> 00:19:16,566
Speaker 3: So we actually discovered that the reason that Billy caused

372
00:19:16,606 --> 00:19:19,486
Speaker 3: the emergency C section was because I got an infection

373
00:19:20,166 --> 00:19:23,246
Speaker 3: after the waters broke. So I ended up getting an

374
00:19:23,246 --> 00:19:27,126
Speaker 3: ecoli infection on my placenta which spread to Billy because

375
00:19:27,206 --> 00:19:31,646
Speaker 3: only her amniotic sac broke. So it was really easy

376
00:19:31,686 --> 00:19:34,726
Speaker 3: to tell them apart because she had a line with antibiotics,

377
00:19:34,886 --> 00:19:37,526
Speaker 3: So I know that sounds it's quite sad, but at

378
00:19:37,526 --> 00:19:40,086
Speaker 3: the same time that it was impossible to mix them up,

379
00:19:40,126 --> 00:19:43,326
Speaker 3: so we definitely knew who was who. But even after

380
00:19:43,366 --> 00:19:45,725
Speaker 3: we got home, I never mixed them up. I just

381
00:19:45,806 --> 00:19:48,966
Speaker 3: knew who was who. And I think the way that

382
00:19:49,086 --> 00:19:51,326
Speaker 3: I answer that because everyone says, oh my god, they

383
00:19:51,326 --> 00:19:54,246
Speaker 3: look exactly the same, I just say, I'm their mum

384
00:19:54,326 --> 00:19:57,486
Speaker 3: and I can tell. So they're so different in personality,

385
00:19:57,846 --> 00:20:03,286
Speaker 3: even their laughs, their voices, They've got opposite sides, like

386
00:20:03,406 --> 00:20:04,206
Speaker 3: hair worlds.

387
00:20:04,806 --> 00:20:06,766
Speaker 4: Yeah, just so different to us.

388
00:20:07,566 --> 00:20:08,606
Speaker 2: How old are they now?

389
00:20:08,966 --> 00:20:11,286
Speaker 4: They're two years old? Yeah, that turn too.

390
00:20:11,606 --> 00:20:13,606
Speaker 2: Yeah, and how was your recovery?

391
00:20:14,446 --> 00:20:15,446
Speaker 4: Yeah it was rocky.

392
00:20:16,486 --> 00:20:21,526
Speaker 3: My pain was definitely not controlled in the first few days.

393
00:20:21,806 --> 00:20:24,326
Speaker 4: Yeah, my pain level was just through the roof.

394
00:20:24,366 --> 00:20:27,326
Speaker 3: And the way they explained that is sometimes because of

395
00:20:27,366 --> 00:20:30,286
Speaker 3: the extra stretching and things with twins, the pain level

396
00:20:30,326 --> 00:20:33,166
Speaker 3: can be higher, so it was really hard to get

397
00:20:33,166 --> 00:20:36,446
Speaker 3: that under control. So yeah, definitely, for the first couple

398
00:20:36,486 --> 00:20:38,926
Speaker 3: of weeks, I actually had to go home with pain relief,

399
00:20:39,006 --> 00:20:42,606
Speaker 3: which is apparently not that common, so I need an

400
00:20:42,646 --> 00:20:47,406
Speaker 3: extra extra week with the painkillers. But after that it

401
00:20:47,446 --> 00:20:49,646
Speaker 3: was it was fairly okay, I think.

402
00:20:50,126 --> 00:20:53,166
Speaker 1: Yeah, yeah, well you were sleep deprived and looking up

403
00:20:53,166 --> 00:20:54,166
Speaker 1: a few newborns.

404
00:20:54,446 --> 00:20:55,846
Speaker 4: Yeah, I barely remember that.

405
00:20:56,086 --> 00:20:59,006
Speaker 3: So yeah, pumping eight times a day and you know,

406
00:20:59,166 --> 00:21:03,446
Speaker 3: feeding eight times a day, and yeah, sterilizing.

407
00:21:02,766 --> 00:21:03,766
Speaker 4: And trying to get.

408
00:21:03,566 --> 00:21:07,126
Speaker 3: Maybe an hour and a half combined sleep was Yeah,

409
00:21:07,166 --> 00:21:09,526
Speaker 3: it was definitely a whirlwind, and you kind of forget

410
00:21:09,526 --> 00:21:11,366
Speaker 3: your own needs when you're going through all that.

411
00:21:12,246 --> 00:21:14,326
Speaker 4: And certainly with twins in.

412
00:21:14,446 --> 00:21:16,725
Speaker 3: Nick you and special care as well, you're you know,

413
00:21:16,806 --> 00:21:19,726
Speaker 3: coming back and forth for feeds and doing as much

414
00:21:19,766 --> 00:21:21,366
Speaker 3: as you can while they're in hospital.

415
00:21:21,486 --> 00:21:24,366
Speaker 1: So yeah, well, thank you many so much for sharing

416
00:21:24,406 --> 00:21:28,406
Speaker 1: your story. It's really remarkable and I'm really glad that

417
00:21:28,486 --> 00:21:30,246
Speaker 1: the twins and you are okay.

418
00:21:31,166 --> 00:21:33,646
Speaker 2: And how are they today? Are they wild?

419
00:21:34,126 --> 00:21:35,526
Speaker 4: Yeah, they're amazing.

420
00:21:35,686 --> 00:21:40,606
Speaker 3: So they've just been so determined since the beginning, and

421
00:21:40,886 --> 00:21:42,606
Speaker 3: it's really blown me away.

422
00:21:42,486 --> 00:21:45,446
Speaker 4: How robust and strong they are.

423
00:21:45,806 --> 00:21:49,646
Speaker 3: They're still a little short and little, i'd say for

424
00:21:49,766 --> 00:21:53,686
Speaker 3: two year olds, but they've been so active since the beginning.

425
00:21:53,926 --> 00:21:56,446
Speaker 4: They walked, you know, twelve months.

426
00:21:56,606 --> 00:22:00,446
Speaker 3: They're talking a lot, they love reading books, they're just

427
00:22:00,606 --> 00:22:03,606
Speaker 3: they love climbing over things. Yeah, I guess they're just

428
00:22:03,806 --> 00:22:06,286
Speaker 3: normal two year olds, and to be us were quite

429
00:22:06,326 --> 00:22:09,686
Speaker 3: scared of, you know, what would happen with all the

430
00:22:09,726 --> 00:22:12,926
Speaker 3: complications and how delayed they might be, because that's a

431
00:22:13,126 --> 00:22:14,526
Speaker 3: very real possibility with.

432
00:22:15,046 --> 00:22:16,006
Speaker 4: Twins with TAPS.

433
00:22:16,526 --> 00:22:20,086
Speaker 3: And I think it's really like testament to the treatment

434
00:22:20,126 --> 00:22:23,406
Speaker 3: that we had and the treatment that was available to

435
00:22:23,526 --> 00:22:28,006
Speaker 3: us that it really helped them, especially you know now

436
00:22:28,046 --> 00:22:31,006
Speaker 3: with their development as well. So yeah, I'm just so

437
00:22:31,086 --> 00:22:33,606
Speaker 3: thankful to the doctors forgetting us where we are today

438
00:22:33,686 --> 00:22:36,286
Speaker 3: and they're just lovely little girls.

439
00:22:39,126 --> 00:22:41,966
Speaker 1: Because TABS is such a rare condition, I wanted to

440
00:22:42,006 --> 00:22:46,246
Speaker 1: ask our resident ob and gynecologist, doctor Bromin Devine about

441
00:22:46,406 --> 00:22:47,366
Speaker 1: how likely.

442
00:22:47,166 --> 00:22:48,406
Speaker 2: It is to come across it.

443
00:22:48,486 --> 00:22:52,806
Speaker 6: In Australia, we see monocoreonic twins in about one in

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00:22:52,886 --> 00:22:56,526
Speaker 6: four hundred births. It is more likely if you get

445
00:22:56,726 --> 00:23:00,566
Speaker 6: monokoreonic identical twins with the embryo splits, but they share

446
00:23:00,566 --> 00:23:04,486
Speaker 6: a placenter with IVF pregnancies and that's probably because of

447
00:23:04,606 --> 00:23:06,926
Speaker 6: the way that we manipulate the embryos a little bit

448
00:23:06,926 --> 00:23:07,766
Speaker 6: in the lab or the.

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00:23:07,686 --> 00:23:12,046
Speaker 5: Media that we use. But TABS or twin anemia polycythemia

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00:23:12,126 --> 00:23:17,606
Speaker 5: sequence occurs in about three to fifteen percent of monochoronic

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00:23:17,686 --> 00:23:22,526
Speaker 5: twin pregnancies or MCDA twin pregnancies that we see in Australia.

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00:23:22,966 --> 00:23:26,166
Speaker 6: Now, there's two reasons that it can occur. Sometimes it's

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00:23:26,166 --> 00:23:30,766
Speaker 6: spontaneous and other times it's because we do laser therapy.

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00:23:30,846 --> 00:23:34,006
Speaker 6: So when there's a shared placenta, there are blood vessels

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00:23:34,006 --> 00:23:37,206
Speaker 6: that communicate between the two twins because they've got one

456
00:23:37,286 --> 00:23:40,206
Speaker 6: placenta between the two of them. Sometimes if there's a

457
00:23:40,246 --> 00:23:43,886
Speaker 6: big blood vessel that's connecting them, the twins can have

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00:23:44,206 --> 00:23:47,046
Speaker 6: major shifts in their amniotic fluid and they can become

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00:23:47,166 --> 00:23:49,406
Speaker 6: very sick with the condition that we've talked about before

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00:23:49,446 --> 00:23:52,606
Speaker 6: called twin twin transfusion. One of the ways of treating

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00:23:52,646 --> 00:23:56,286
Speaker 6: twin twin transfusion is to use laser therapy to disrupt

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00:23:56,366 --> 00:23:58,686
Speaker 6: that connecting blood vessel. And one of the things that

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00:23:58,726 --> 00:24:00,646
Speaker 6: can happen as a result of that is you can

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00:24:00,726 --> 00:24:04,966
Speaker 6: get little partial connections or what we call partial anastemosis

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00:24:04,966 --> 00:24:08,446
Speaker 6: in the place where you get a little connection between

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00:24:08,446 --> 00:24:11,246
Speaker 6: an artery and a vein, and that leads to one

467
00:24:11,286 --> 00:24:14,006
Speaker 6: twin giving all their blood cells to the other twin,

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00:24:14,166 --> 00:24:16,486
Speaker 6: so that twin that gives the blood cells is called

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00:24:16,526 --> 00:24:19,926
Speaker 6: the donor, and it gets a very low quantity of

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00:24:19,966 --> 00:24:23,606
Speaker 6: red blood cells and becomes anemic, and the other twin,

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00:24:23,646 --> 00:24:27,366
Speaker 6: which is the recipient, gets a much increased number of

472
00:24:27,446 --> 00:24:31,046
Speaker 6: red blood cells, and that's a condition called polycythemia, or

473
00:24:31,046 --> 00:24:34,766
Speaker 6: that twin becomes polycythemic. Now it's bad to be anemic

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00:24:34,806 --> 00:24:37,846
Speaker 6: and it's bad to be polyscythemic. So the poor little

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00:24:37,886 --> 00:24:40,646
Speaker 6: anemic twin doesn't grow, doesn't get anywhere near as much

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00:24:40,646 --> 00:24:43,686
Speaker 6: oxygen or nutrients, and the other twin can get really

477
00:24:43,806 --> 00:24:48,246
Speaker 6: overloaded with a really sluggish blood flow and get clots

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00:24:48,286 --> 00:24:51,566
Speaker 6: in blood vessels and things like that, so it's dangerous

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00:24:51,566 --> 00:24:54,886
Speaker 6: for both twins. Introu Trine transdus is one of the

480
00:24:54,966 --> 00:24:58,246
Speaker 6: forms of treatment, or a partial exchange transdusion, one of

481
00:24:58,286 --> 00:25:01,046
Speaker 6: the forms of treatment that they do for this condition.

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00:25:01,206 --> 00:25:04,566
Speaker 6: That's done by very specialist obstetricians known as maternal fetal

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00:25:04,606 --> 00:25:07,966
Speaker 6: medicine specialists, and it's usually done at a maternal fiit

484
00:25:08,046 --> 00:25:11,286
Speaker 6: or medicine clinic in one of the big tertiary hospitals.

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00:25:11,486 --> 00:25:15,086
Speaker 6: They have specialist obstetricians who've done additional training in really

486
00:25:15,166 --> 00:25:18,086
Speaker 6: high risk pregnancies and the other thing we do is.

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00:25:18,126 --> 00:25:21,286
Speaker 6: We monitor these twins very carefully by keeping a very

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00:25:21,326 --> 00:25:23,726
Speaker 6: close eye on the blood flow in the brain because

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00:25:23,766 --> 00:25:27,166
Speaker 6: we can see the sluggish blood flow to the polycythemic

490
00:25:27,206 --> 00:25:29,766
Speaker 6: twin and quite a rapid blood flow to the donor

491
00:25:29,806 --> 00:25:33,406
Speaker 6: twin by checking on the blood flows using ultrasounds. So

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00:25:33,486 --> 00:25:36,926
Speaker 6: there's a lot of intense monitoring that's done. And then

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00:25:36,966 --> 00:25:39,046
Speaker 6: sometimes it's just a case of if it's getting out

494
00:25:39,086 --> 00:25:41,126
Speaker 6: of control or it's getting to a situation where it

495
00:25:41,166 --> 00:25:43,966
Speaker 6: would be better for the babies to be born, they will.

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00:25:43,806 --> 00:25:46,326
Speaker 5: Actually make plans to deliver the babies.

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Speaker 1: Earlier, Diary of a Birth was hosted by me kaus

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Speaker 1: any Luk It's with expert input from doctor browin Divine.

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00:25:55,886 --> 00:25:58,046
Speaker 1: If you like our show, don't forget to subscribe and rate.

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00:25:58,206 --> 00:26:00,766
Speaker 1: It goes a long way to allowing us to continue

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00:26:00,886 --> 00:26:04,726
Speaker 1: sharing your stories. This episode was produced by Ella Maitland

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00:26:04,846 --> 00:26:07,046
Speaker 1: with audio production by Tina Mattalov.

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Speaker 3: Mamma Mia acknowledges the traditional owners of the land.

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Speaker 1: We have recorded this podcast on the Gatigul people of

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00:26:20,486 --> 00:26:21,406
Speaker 1: the Eora nation.

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Speaker 3: We pay our respects to their elders past and present,

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Speaker 3: and extend that respect to all Aboriginal and torrest rate

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Speaker 3: islander cultures