I don’t post that much about my personal life on this blog. I also haven’t posted much at all for the last few months. This will be one of the few posts I talk about my own life, and I wanted to share my experience encase anyone else is going through something similar.

In July 2023 my wife and I discovered we going to have another child. We already have two amazing daughters (11 and 13 at time of writing).

Holy Crap!!

This was not expected but when life gives you lemonade. I was due to fly to Australia to see some clients and to put our minds at rest my wife and I decided to pay for an additional Ultrasound scan. For those not in the UK the NHS covers all standard healthcare related scans, procedures, and everything we need. It was at this point we discovered twins.

Holy Crap!!

On hearing this news, I panicked and flew to Australia for two weeks. Thanks to the IBM team for not noticing my panicking and thanks to my twins’ mentor Simon K.

For those who like the technical detail the twins were monochorionic. This means there was a single placenta shared by both twins who each had their own sacks. I thought nothing of this at the time, but this led my wife to having ultrasounds scans every two weeks in Winchester, with another set of scans in Andover.

Shortly after I returned from the Philippines in October the twins were suspected to have Twin to Twin Transfusion syndrome (TTTS). We were transferred over to Southampton Hospital which is the leading hospital in the south of the UK. This led to us having a scan twice a week. The twins were named T1 and T2, where at this point T1 was more presenting then T2.

Twin to Twin Transfusion Syndrome occurs when more blood is being passed to one twin (recipient, T1) from the other (donor, T2). This causes the amniotic fluid to build up for the recipient causing the heart to have to work harder, and the donor to have not enough fluid causing meaning the bladder could not develop. There are five stages of TTTS and for stage 1 no intervention is needed but from stage 3 onwards there is a risk to the pregnancy. The excellent consultants in Southampton were in regular contact with the country leading doctors in St Georges, given this is a relatively rare situation. Maybe 100 cases in the UK a year require intervention.

For a completely different reason, one weekend my wife was concerned so we went to Winchester hospital. They were worried as we were only 22 weeks and so sent us to Portsmouth hospital, as Southampton neonatal was at capacity.

After two days in the hospital, their obstetrics consultant was concerned about the amniotic fluid level, however as she was not an expert in TTTS she referred us to Southampton. The amniotic fluid was 1100% greater around T1 compared to T2. We already had a scheduled appointment the next day in Southampton anyway.

During the appointment in Southampton the Consultants stated the difference in amniotic fluid was unusual. They contacted St George’s in London, and they asked us if they could see us the same day, unfortunately traffic and distance would make this impossible, so we nervously went up the next day.

One thing to note is that St Georges used a slightly different method for dating the development of the pregnancy, making the twins in their eyes a week earlier. This meant we were on the cusp of the twins being older enough to have any chance of survival.

We initially saw a junior consultant who scanned us with an observer in the room, her immediate reaction was to go and get her boss. Her boss took a quick look and suddenly went to get his boss. At this point we had half a dozen consultants in the room, and a couple of midwifes. This included the top fetal surgeons in the country. “There is nothing to worry about today [Wednesday], however we think there will be by Friday so we will operate then if you are willing”.

This knocked the wind out of me. We understood that there was a significant chance of an early labour from the operation and as we were about 23 weeks. This meant a 10% chance of losing one or more of the twins, however if we did nothing the risk was greater then 50%. We didn’t see any other option but follow the advice had have the laser ablation. This involved them putting a camera into the womb and lasered the arteries on the placenta to stop the blood transferring between the babies. We arrived on the Friday; I was given some scrubs, and we went into for an initial scan. There were about 12 people in the scan room, a third were observing because it was a rare procedure, a third were there for the procedure and a third were there encase they needed to deliver the babies. By the time we made it to the surgical suite there was 22 people in the room between the 12 senior doctors, midwives, anaesthetists, nurses and my wife and me. I was the DJ… Luckily they liked my choices.

The surgery was a success and they saw an improvement. We went home with the intention of returning three weeks later. We returned for two follow ups unfortunately on a Wednesday in December they discovered the twins had Twin Anemia Polycythemia Sequence (TAPS). I won’t pretend I fully understood it, but from what I think I understood its similar to TTTS but it’s the blood cells not all the blood. This is so rare that there is one case a year in the UK that requires surgery. We were that case. Two days later we were back preparing for surgery again, 17 people in the room, with a 10% chance that this would cause labour. On completing the surgery, we told it looked successful and we would need to return at the start of January for a follow up, we were told to wait until traffic had cleared before we did the 90min drive home.

We had a nervous couple of birthdays and Christmas scared that early labour could kick in, we were around the 28-week mark.

On 3rd of Jan, we went for our final follow up in London and our surgeon admitted his surprise that the labour was not triggered by the second laser ablation. At this point he made clear again that labour could start any moment from before Christmas. He discharged us back to Southampton, who also discharged us back to Winchester a few weeks later.

Towards the end of January, they twins had an MRI scan while still in the womb. This fascinates me to think they can get an image with two twins who never sit still. This is standard procedure for twins who have a laser ablation for TAPs. The scans showed that T1 was clear, but T2 had an unexplained mark. (Since the birth there have been further checks and there are no concerns)

On the 3rd of Feb the twins still hadn’t shown, and as we were 36 weeks at this point my wife was sent to be induced in Winchester. It is standard in the UK for twins to be induced at 36 weeks. Due to an amazingly busy labour ward my wife was kept in overnight with the intention of having the induction early the following day. I was sent home and told to return at 5am on the 4th.

On arriving on the 4th (Sunday) after finding the Costa (coffee shop) didn’t open until 10am I went to join my wife and about 6am we went into labour ward. At 7:30 they prepped for the induction and at 7:55 she was rushed for an emergency caesarean, with Charlotte (aka T2) being born a few seconds later then Abigail (aka T1). I won’t write here why this happened encase anyone who is reading is currently expecting, but needless to say there are amusing and scary stories from this part. We were thankful we were in the labour ward.

My wife and twins were kept in for eleven days to recover from the birth and the twins did their job or growing, without visiting neonatal. Instead they were on a transitional ward which was a standard ward that allowed mum to be with the twins, but also had additional support of a nursery nurse. Now we are all home and trying to remember how to do this baby thing again.

One final thing, because Charlotte (T2) was born first, she was given the first NHS no (ID no), and Abigail (T1) was given the second one setup. However, someone had added T1’s history to the first no, and T2 to the second. This means for the first few weeks we had a lot of confusion as they had the wrong history assigned to each of them. We hope this is now corrected.

Five hospitals, two laser ablations, an MRI and about a million ultrasound scan it has taken us to get here. It has been a tough six months with these two little buggers, but I wouldn’t change them. Though I’m sure they will continue to cause me to tear my hair out.

Thank you to the multiple NHS teams from all hospitals, your care was amazing and impeccable. Parking got pricey, but that’s a small price to pay.