Our Twins

Painful Steps We're taking a walk together, One that I never imagined we'd have to take, And though the path is difficult, With many turns and obstacles, I notice we walk more closely together now. Stephen Werst - October 24, 2001

June 25, 2001. Lisa woke me this morning by shaking me and joyously exclaiming "Honey, I'm pregnant!" What a wonderful way to start a Monday. After trying for over two years, with many, many tests, drugs, and medical procedures, we had finally achieved what we most desired - to have children. After having so many difficulties getting to this point we both believed that it would be smooth sailing through her pregnancy. Of course, we were wrong, though the problems to date could have been much, much worse.

Two weeks after learning of her pregnancy we had quite a scare. Just as she got to work she started bleeding rather significantly. Needless to say, she was frantic when she called me to tell me what had happened. I tried reassuring her by saying that we didn't know for sure that the bleeding indicated a loss of the pregnancy, but I have to admit I was quite worried. We drove to the doctor together, holding hands, both silently fearing the worst.

After waiting for what seemed like an eternity (probably 10-15 minutes), we were finally ushered back to the sonogram room. A few minutes later Steve, who does most of the sonograms, was showing us the heartbeats of our tiny embryos. What a wonderful surprise after such a stressful morning. We both were prepared to see twins the following Monday during our scheduled sonogram, but we were certainly taken by surprise that morning. The doctor explained that bleeding was quite common with multiples and suggested that Lisa rest as much as possible while the bleeding persisted.

Lisa's first trimester, ending September 1st, is now almost over. It has been rather difficult for her. In addition to the nausea and headaches that often accompany pregnancies, she has been bleeding the entire time. Though she has continued to work, the rest of her waking hours have been spent at home either lying on the couch or in bed. This last week the bleeding has finally subsided, and we hope that it has stopped for good. Lisa is starting to do more and more, but she's adding activity slowly. We both look forward to being able to start doing the many things we need to in preparation for the children without having to worry about the bleeding starting again.

Through all the times of our worrying the embryos have been fine. She has had numerous sonograms, and each time the doctor has shown us the healthy heartbeats. Perhaps we have been too sensitive to the possibilities of a miscarriage given our difficulties to get to this point, but judging by the reaction of others when told of Lisa's condition I think not. Everyone has been very concerned that Lisa is bleeding. However, several people have later told us that others they have talked to about us either themselves experienced bleeding during their pregnancies or knew someone who had.

As the picture to the left suggests, we conceived through invitro fertilization with ICSI (intracytoplasmic sperm injection), where the embryologist physically injects my sperm into her eggs and allows the pre-embryo's to grow for a few days before implanting them back into Lisa's uterus. The picture shows just the medicines injected during our last, successful cycle. We underwent one and half cycles last year with not quite so many needles. The half cycle was when we started the medications but never extracted any eggs. In addition to the invitro procedures, both Lisa and I underwent a surgical procedure to correct problems related to our infertility. It's been quite an experience so far, but the results are definitely worth the efforts put forth.

October 13, 2001. We learned definitively this week that we'll be having two little girls. The doctor performed an extensive 20-minute sonogram two weeks ago and told us that everything looked "absolutely wonderful". During the sonogram he was confident that we had two girls, and we've told everyone the same since then. This week the results of the amniocentesis performed just after the sonograms confirmed the doctor's findings, including their great health - more wonderful news! Their names will be Emily Ann Werst and Amanda Renee Werst.

October 20, 2001. Emily Ann Werst was born at 7:50 this evening. Her sister, Amanda Renee Werst, followed soon after at 8:14. Since they had only 21 weeks to develop, both were ill prepared for surviving in our world. Emily weighed just 13.6 ounces, and Amanda was slightly smaller at 12.6 ounces. Both measured 11 inches.

The series of events that led to these unfortunate births began Thursday night as Lisa and I prepared for our last weekend vacation before becoming parents next year. Lisa was ironing a shirt and I was determining what items to take on the trip when she felt a rush of fluid. Frightened, we called her doctor and were told to go to the hospital immediately. Once again, we were both fearing the worst during our short drive, but this time the news would not be good - we later learned that Emily's amniotic sack had burst.

Though Amanda's sack remained intact, the doctors feared that the first sack had been damaged by infection and predicted that we would have to make difficult decisions during the next few hours and days, since the infection could spread to Amanda and even to Lisa. Our first decision was whether or not to stop the contractions and prevent Lisa from going into labor. The doctors recommended that we let Lisa's body tell us what needed to be done. If no infection were present, the contractions would more than likely stop. If, however, bacteria was spreading, it would be best for both Amanda and Lisa if Emily's infected body were delivered. They felt that we would know within 48 hours of her water breaking whether or not labor would begin.

Friday involved many tests and consultations with numerous doctors specializing in both pre and post delivery care. Lisa felt well the entire day, and though she still had contractions, she didn't really feel them. Saturday morning was different. Early in the morning, Lisa started to feel a tightening in her lower abdomen. As the day progressed, the tightening turned into discomfort and later pain. She also started to have a fever that would reach as high as 102. Everyone was confident that she had an infection and believed that she would go into labor. The pain became so intense by the afternoon that Lisa finally received a welcomed epidural.

After the epidural Lisa was able to sleep - the stress and pain of the early afternoon had taken a toll on her. By Saturday evening her cervix had become fully dilated, and her fever was still high. The doctor was concerned about both Amanda's and Lisa's health if Amanda wasn't delivered, but in the end nature took care of the decisions for us. Both Emily and Amanda were born with a lot of help from their mom. Though both had had strong heart beats up until their birth, neither survived the traumatizing ordeal of being removed from their motherly home so soon.

We cannot begin to express our grief and sorrow over the loss of our daughters whom we knew only through a few sonograms and "fluttering" movements within the last few weeks. In fact, I was fortunate enough to feel their movements for the first time the night before we went to the hospital. A short, anonymous passage in a pamphlet provided by the hospital perhaps best summarizes our emotions:

When your parent dies,
you've lost your past,
but when your child dies
you've lost your future.

We can only hope to be able to read these words one day without crying.

October 26, 2001. Lisa and I scattered the ashes of our daughters today. It was a wonderful fall day, one that we will never forget. We decided to scatter the ashes at a beautiful state park in east Texas. There's a lake there surrounded by many tall trees. We had first come to know this place two months after we started dating, while we were falling in love. We have returned there many times since then, and we both believed we would one day take our children there, though not in this manner.

Like always, we had a small picnic upon our arrival. This time, though, a tree had fallen across our usual picnic area and provided a good seat, as if we were expected. After the meal, we took several pictures of the beauty of the lake to share with others and as a reminder to ourselves. We then said many words about the loss of our daughters and our love for them. We imagined them playing in the forest now, unencumbered by the cautions of worrying parents and the possibility of disturbing others in the park. After our words and tears, we proceeded to sprinkle their ashes on the forest floor, Lisa spreading Emily's remains and I Amanda's.

The ashes lying among the pine needles seemed to be missing something, so I placed two pine cones on end among them. As we had walked to this spot I noticed all the pine cones lying on the ground, and strangely they reminded me of children scattered in a park playing with each other. Perhaps this image was formed because the cones represented the continuing of life for the many trees around us. The cones were, in a sense, the children of the forest. The site still wasn't quite right, though, so I picked up two twigs and formed a cross next to the pine cones. Both Lisa and I finally felt that we had marked their ashes appropriately, and we decided we should take a picture to help us remember this final image.

At last, we felt that we had fulfilled the responsibility of taking care of Emily and Amanda's physical remains. Neither of us wanted a permanent marker on a grave site, but the temporary symbols upon the pine needles were a perfect way to honor our daughters. The pine cones and cross, like our daughters' ashes, are probably no longer as we left them, but this is what we wanted. They're existence is permanent only in the hearts and minds of those who loved them, especially their parents.

As we left we looked back on the site and noticed that the area, initially shaded by the trees, was immersed in the sunlight passing through a gap in the branches. Their resting place seemed to glow among the surrounding shadows. It was an inspirational moment. Both Lisa and I felt a sense of peace that neither of us believed we would have had if the girls had been buried in a cemetery. As sad and as difficult as the day was, it was a perfect way to mark the end of their lives; lives that never began.