Emilie Vogas holds her 6-month-old twins in her arms as she rocks them to sleep. Ezra, the larger of the twins, is more mellow and falls sleep easily. “This is the chillest baby known to mankind,” she said.
Wally, though, does not want to sleep. “He just wants to take in the world. … I feel like he knows how lucky he is to be here,” Vogas said. She calls him her “miracle baby.”
A year ago, when she and her husband Joseph were talking about giving now 4-year-old Jamie a younger sibling, they could not imagine the year that would follow.
Wally was given a 3% chance to survive the pregnancy, but his brother, Ezra, might have actually saved him in the womb.
Knowing something is wrong
At 13 weeks pregnant, Vogas felt a “pop.” She ran to the bathroom and realized her water had broken. An ultrasound showed that Wally’s amniotic sac had ruptured, and he had very little amniotic fluid.
At that point, the family was told that within two or three days the fetus would die because of the lack of amniotic fluid, Vogas recalled. Because the boys are fraternal twins with separate amniotic sacs, Ezra was expected to survive.
Amniotic fluid helps cushion the baby and is something the baby actually continually replenishes in a process that is similar to urination, explains Dr. Grace Johnson, a maternal fetal medicine doctor at Texas Children’s Hospital in Austin.
“Amniotic fluid is important in fetal development,” Johnson said. Fetuses practice breathing movements using the fluid. “It’s a really big driver of fetal lung development,” she said.
With a ruptured sac, “one of the major concerns, even if the baby survives, it won’t have development of the lungs,” she said.
Both the mom and baby also have an increased risk of infection with a hole in the placenta, which could lead to sepsis and death.
After that news, the family went home to grieve. “We spent the week basically crying on the couch,” Vogas said.
Cautiously optimistic
A week later, they returned for another ultrasound to confirm the baby had died and the other twin was still progressing.
But when the ultrasound tech moved the wand over Vogas’ belly, she told the couple, “‘Well, those are two beautiful heartbeats,’ and we were like, ‘what?’ And she was like, ‘Yeah, no, they’re both doing really well,'” Vogas recalled.
Not only were both babies doing well, but Vogas wasn’t showing any signs of infection. Now the odds of Wally surviving went up to 25%, but there wasn’t a guarantee that he would have developed lungs even if he did survive. “We were distraught,” Vogas said. “We had been told the quality of life was going to be pretty impaired.”
Each week, Vogas continued to be monitored – and each week, Wally showed positive signs. His kidneys were working. His chest wasn’t concaved. His amniotic fluid was actually increasing. Doctors began to think that Ezra had moved in such a way to act as a plug to the hole in Wally’s amniotic sac.
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In Texas, because of the interpretation of abortion laws, the family wasn’t sure if Emilie would be able to get care if she experienced sepsis or began to miscarry one or both of the boys.
“The plan would have been to save Mommy,” Joseph Vogas said. While they didn’t want to think about it, they knew they could fly to New York or Colorado for care.
“We would have had to make some horrible choices,” she said. “We never had to, and we are very grateful. These babies were very, very wanted.”
For nine weeks, they focused on keeping Emilie healthy and continuing to grow both babies. By 23 weeks, she moved into a hospital room at Texas Children’s Hospital in Austin to be monitored.
Then on June 23, Emilie began to spike a fever and experienced extreme chills. “I was the sickest I’ve ever been in my entire life.”
Many tests ruled out everything but an infection.
Her heart rate began to climb and soon Ezra’s followed. “They had always said that the twins would let us know when it was time to go,” she said. Ezra’s heart rate told them that at 26 weeks gestation, it was time to go. Maybe it was another sign Ezra was protecting Wally from the infection, she said.
A constant surprise
On June 24, Vogas was taken into the operating room for a C-section. Three teams of doctors and nurses had prepared for this: one for Emilie, one for Ezra and one for Wally.
“Even though it was an emergency, nobody acted like it was an emergency,” the mother recalled. “Nobody was frantic. Everybody was really calm. Everything felt super in control.”
At 9:33 p.m. and 9:35 p.m., the boys were delivered.
“This guy shocked us,” Vogas said, pointing to Wally. She was preparing for bad news, but the nurse practitioner working on Wally told her, “‘He’s breathing on his own.’ And I said, ‘You mean Ezra?’ And she goes, ‘No, I mean, Wally. … I promise you I mean Wally. Wally is breathing on his own.'”
“I just burst into tears again,” Vogas said.
The team was prepared to use different types of ventilators on Wally, but “he didn’t need any of it,” said Dr. Mark Thompson, a neonatologist at Texas Children’s. He just needed some oxygen and medications to develop his lungs.
Wally has been about two weeks behind Ezra in development, consistently. Ezra left the hospital on Sept. 26, around his due date, and Wally two weeks later on Oct. 10. Wally did go home on some oxygen, but recently, they were able to take him off it.
The doctors will continue to monitor the twins for the next three to four years, but Thompson expects Wally to catch up to Ezra.
Compared to what the family was told when Wally’s amniotic sac ruptured, “he’s basically a normal baby,” Emilie said. “It’s kind of a miracle that he’s here at all.”
This article originally appeared on Austin American-Statesman: Texas baby beats the odds after scary pregnancy
