As a mother of four healthy, full-term girls ages 2 – 7, Sophie Carney, along with her husband and family, entered a whole new world during her fifth pregnancy. Pregnant with identical twin girls, Carney received serious news in her second trimester. A rare condition known as twin-to-twin transfusion syndrome (TTTS) was affecting her babies, causing one twin to grow larger and another to fail to grow. The condition appears in less than 20 percent of identical twins and occurs when the blood flow through their placental connections becomes unbalanced. One twin does not get enough blood while the other becomes overloaded with too much blood and fluid.
The Carneys and their doctors monitored the girls’ growth, and by 24 weeks, heart failure was imminent for both babies. They prepared for a surgical procedure that uses laser to sever their shared vessels and stop the transfusion between the babies. The ablation increased the opportunity for at least one twin to survive to 70 – 80 percent. In a third of cases, both twins survive. For the Carneys, the procedure was successful, though Sophie remained high risk for premature delivery.
In her 25th week, Sophie’s water broke. She was admitted to Saint Alphonsus in Boise. Sophie says that while some caregivers suggested that they could prevent infection and delay the babies’ births until 30 weeks, Dr. Stewart Lawrence counseled her gently that the babies would probably be born within three days. He shared the challenges that they would face and explained how they would care for them. When infection set in and a c-section was scheduled, each baby had a team of healthcare specialists waiting for her, under the guidance of Dr. Lawrence.
Early in their nearly 20-week NICU stay, the twins faced a number of obstacles. At five days old, the smaller baby girl underwent surgery for her small intestine, and her blood didn’t clot. “Everyone was so calm,” Sophie remembers. “I learned later that they thought she would die that day.”
Throughout their NICU stay, Dr. Lawrence became Sophie’s constant source of communication. “He was involved in their day-to-day care, and he knew the big picture, the overall path to their long-term health. I realize that many people do not get this kind of care. Not only is he paying attention to all of the details, he has such a good bedside manner,” she says.
In their last month in the NICU, the babies graduated to the back row, where the more medically stable infants received care, compared to the babies on the front line. Sophie says Dr. Lawrence helped prepare her for their life after the NICU. “He went above and beyond his duty to explain and educate my husband and I about the different immunizations, whether they were safe or not and why they were important, because he cared deeply about the well-being of our babies even once they left the NICU,” she explains. “That being said, he should definitely think about changing professions to pediatrics so we could continue seeing him.”
The Carney’s twin girls will continue receiving care from a team a physicians, though Dr. Lawrence remains a resource for counsel and comfort. “The last time we were in the hospital, we got to see him and he saw the girls laughing and smiling,” she says. “I know they are here today because of him.”