Tara Shaklee thinks she and her husband, Cody, probably had the same reaction any parent does when they found out they were having twins.
The Longmont residents already had a two-year-old son, so she said it took a minute to wrap their heads around the fact that they’d be having three kids instead of two. By the time of their 20 week appointment, the couple was just excited.
Tara Shaklee recalls that at that milestone appointment, her daughters were looking “perfect.”
“We walked away from that appointment feeling really, really good,” Tara said.
At 22 weeks, however, the outlook changed. Tara’s doctor said the twins were showing signs of Twin-to-Twin Transfusion Syndrome, or TTTS, a serious and rare condition only seen in identical twins who share a placenta where one fetus “donates” their circulation of fluid and blood to the other fetus.
Tara Shaklee was referred to Children’s Hospital Colorado the next day, where they met with Dr. Henry Galan, a fetal surgeon and maternal fetal medicine specialist at the Colorado Fetal Care Center. He was one of only a few doctors in the country who could perform the in-utero surgery needed to save the babies.
“He told us how scary this whole thing could truly be,” Tara Shaklee said.
Despite only occurring in roughly one of every 4,000 to 5,000 pregnancies, Galan and his team at the Colorado Fetal Care Center regularly treat TTTS as a referral center for a large swath of the country.
In TTTS, the blood flow between the twins becomes unbalanced, one twin is receiving too little fluid while the other is receiving too much and can threaten both. Without treatment, TTTS can lead to severe complications for twins with mortality rates for one or both at 70-100%.
“If this happens at 32 weeks, you can just deliver the babies. But when it happens this early, you really need to try to buy more time,” Galan said.
Tara Shaklee was in an advanced stage of TTTS, requiring her to undergo a laser surgery just two days later. The surgery, called selective fetoscopic laser photocoagulation, uses a small laser device to block the abnormal vessel connections and stop the harmful blood flow between the babies.
A typical surgery severs about 24 vessels — but Galan’s team cut 71, a hospital record. The team also reduced the fluid in the amniotic sac of the twin receiving excess fluid by two and a half liters.
“We’re very proud of being record holders,” Tara Shaklee joked.
Galan said Tara Shaklee looked great immediately following the procedure, but two weeks later during a routine ultrasound one baby was again surrounded by an excess of fluid.
“The Twin Twin Transfusion Syndrome came roaring back,” Galan said.
He explained that Tara Shaklee had an abnormal placenta that was extra large, encompassing the front and back of the uterus, so not all of the vessels were visualized during the initial surgery.
As their options were laid out for Tara and Cody, with the twins’ lives on the line, they had to consider things no parent ever wants to consider.
“That was a hard conversation for us to figure out whether or not we’re having two babies, one baby, no baby, and just mentally preparing for all of the above,” Cody Shaklee said.
At 24 weeks, Tara Shaklee underwent a second surgery with doctors lasering another 23 vessels. This time, it seemed to do the trick.
Following the second surgery, Tara Shaklee went in for ultrasounds twice a week to make sure everything was okay. The hope was to give the twins as much time in the womb as possible, but the experience felt like “groundhog day,” as Cody put it.
“Tara actually packed a bag every single time we went there expecting that she was going to be admitted for the rest of the time,” Cody Shaklee said. “So the plan we had for our son, our dog, our house, our life was day-by-day twice a week for 10 weeks.”
At 34 weeks, the doctors decided it was time to schedule a C-section. As the couple made their way through the hospital to get Tara’s COVID test before the surgery, the team of people who had helped them through the last 10 weeks cheered for them in the hallway.
“I’ve never been through a medical experience or know very many people who have been through something at a hospital or anything like that where they’ve gotten to be so close with their doctors and their sonographers,” Tara Shaklee said. “We just felt so taken care of. They made a really, really terrifying experience feel not as daunting as it could have.”
On June 8, Tara Shaklee delivered Indie Lou and Scottie Rae at the Colorado Fetal Care Center. They were transferred to the Children’s Colorado newborn intensive care unit, which was expected, and spent three weeks there.
“I think it was like two days after they delivered the twins, Dr. Galan came into my recovery room to check in on me and see how I was doing, and I looked at him and I was like, ‘Can I give you a hug? You saved my babies,’” Tara Shaklee recalled.
To Galan, seeing the twins go home happy and healthy was the best reward.
“This is always our biggest thank you,” he said. “That’s what we appreciate the most and enjoy the most, is being able to see the twins healthy and vigorous afterwards.”
Tara and Cody said they are so grateful for the relationships they built with the team at the Colorado Fetal Care Center, who have a reunion with the families they’ve helped every September. Tara Shaklee said their family is looking forward to that and having these people in their lives for a long time.
Now taking care of a toddler and two newborns, the couple doesn’t have much free time to reflect on their whole experience. When they do, they mostly feel gratitude for both the care they received and the support of their friends and family.
“We’re taking care of two babies,” Tara Shaklee said. “They’re healthy and we’re so grateful. You just do it because you have to do it, you know what I mean? When we get the opportunity to get back and reflect on things, it’s like holy cow, yeah, we went through some stuff. But the support we had around us — I just keep saying how fortunate we are.”
