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Staff Sgt. Susan Edwards-Aagaard always thought it would be entertaining if she had twins, particularly because her father was a fraternal twin and it often runs in families.
She discovered she was pregnant and went to several ultrasounds that displayed only one heartbeat and one baby. At 13 weeks, Edwards-Aagaard, an intelligence analyst with the 21st Operations Support Squadron, watched her husband’s face when he saw more than one heartbeat on the screen. She was shocked and reflexively laughed for at least 30 minutes, after which she was both scared and excited to know she was having identical twins.
When the excitement of the news sank in, the reality of very real health issues set in, which forced Edwards-Aagaard to slow down. With her fierce independence, she said she never would have asked for help, but her squadron reached out before she could say one way or the other.
“I was immediately flagged high-risk in my pregnancy because I had high-blood pressure, stress-related high blood pressure,” she said.
Edwards-Aagaard began bi-weekly prenatal appointments to monitor the twins’ progress. In the same time period, she tested for staff sergeant and began Airman Leadership School. She continued to push through anything thrown her way, including academics. One particular block of instruction at ALS conflicted with a prenatal appointment and she was just going to cancel the appointment so she didn’t miss anything important.
“I had two female instructors in ALS, one of whom was very pregnant,” Edwards-Aagaard said. “When it came to baby stuff, (Tech. Sgt. Lauren Degennaro) said, ‘Don’t you ever cancel.’”
Had she not heeded her instructor’s advice, she would not have gone to another prenatal appointment for two weeks. Degennaro told Edwards-Aagaard she had faith in her and would work through any missed material. Although hesitant, Edwards-Aagaard agreed to go.
“All of a sudden bunches of people were in the room and I was wondering what was going on,” she said. “They told me, ‘You have Twin-to-Twin Transfusion Syndrome. You’re within days of losing your babies.’ Days.”
“My babies wouldn’t be here if it weren’t for (Degennaro),” Edwards-Aagaard added. “She’s a hero.”
Thanks to the push from her mentor, the babies were saved from a much worse fate, however they were in for a battle. The diagnosis only affects identical twins and results in one baby “donating” most the blood and nutrients from the shared placenta to the other baby. According to the American Pregnancy Association, TTTS occurs among about 15 percent of identical twins and cannot be prevented because it is not hereditary. Until recently, there was no treatment and usually resulted in the death of both babies.
“My little Jack didn’t have enough fluid around him and he was shrink-wrapped in his little sac,” Edwards-Aagaard said. “Drew … was about to die because his heart was overloaded with too much blood and he was in severe cardiac distress.”
Fortunately for them, advances in modern medical technology dramatically increased the odds of survival for the twins with a quick, yet complicated laser surgery. Only a small percentage of maternal fetal medical doctors are trained in this procedure, she said, and they were lucky enough to get one of the best in Denver. All the open blood vessels were fused and an extra liter of fluid was removed from Drew’s amniotic sac.
Edwards-Aagaard said the next morning both she and her husband were relieved to see two healthy heartbeats. With the good news came less exciting news. The mom-to-be was put on bedrest at only 18 weeks into her pregnancy.
“I work out twice a day. I love to work out and went on full bedrest,” she said. “I asked if I could lift weights in bed, but they said I couldn’t do anything that would get my heart rate up or put pressure on my core.”
Three and a half months went by, all of it spent on bedrest, and Edwards-Aagaard was hospitalized. One of the amniotic sacs ruptured, which opened her and the babies up to more infections and possible complications. Even though a full-term pregnancy is 38 weeks for twins,
Drew and Jack came into the world at 31 weeks and six days.
“We almost made it 32 weeks,” she said. “My kids were really sick and, yes, within their first days of being born, there was definitely the chance of death.”
“I felt really guilty and really terrible that I couldn’t keep them any longer,” she added.
The boys were put in incubators at the neonatal intensive care unit and when Edwards-Aagaard finally got to see her newborns, they were covered in tubes. She said one was intubated and weighed only two pounds, while the other was hooked up to a massive breathing machine and had an IV coming out of his head.
“I left the NICU and I just wept,” she said. “I kept thinking I shouldn’t have gotten up that many times to get water when I was on bedrest or I shouldn’t have gotten up and taken that many steps. I felt so guilty.”
As time went on, Edwards-Aagaard reflected on the positive things. Her whole office helped the new family-of-four cook meals every week and even assisted moving into a new house. In addition, she said her leadership was incredibly supportive and worked with her schedule because at the time, maternity leave was only six weeks and her kids were still in the NICU receiving much-needed care.
“Along with preemies, comes a whole plethora of other interesting things,” she said. “Because we have TriCare, we haven’t had to worry about anything. I can give my kids all the developmental therapy they need.”
In addition to the support of her Air Force family, the value of TriCare gave Edwards-Aagaard a sense of relief. She said she couldn’t imagine the stress other parents go through when they have to weigh the cost of treatment for their children.
“I call them my million-dollar miracle babies,” she said. “I don’t have to worry about the cost. I can focus on other stuff, like my kids’ health issues.”
Since their early entry into the world, the boys struggled with weak immune systems, lung troubles, feeding, heart and gastrointestinal complications, and more. They tackle one health issue after another, but Edwards-Aagaard said they never lose their excitement to be with the other.
The interaction between the now eighteen-month-old twin boys is fun to watch, she said. Even with their health issues, they squeal with anticipation when they see each other again after a day apart at day care, chase each other around the house when they get home, use each other as step stools to get into mischief and wake each other up in the middle of the night just to be together.
“Most of the things you notice about premature babies, they will grow out of by the time they are two,” she said. “We have this whole team of people taking care of them. Pediatrics here is great and I don’t know why you would take your child anywhere else.”
The more the pair of preemies overcomes, the more active they become and mischief they can get into as they enter their “terrible twos,” just like every other toddler.