Chapter 122

Two weeks later on a late Thursday afternoon Ty parked the Jag in an almost empty lot and ran around to get the door for Amy. Inside they left their coats on the rack and split up. Ty sat down in one of the chairs of the almost empty waiting room while Amy went up and sat with Anne, the nurse practitioner, checked in, answered a few questions about how she was feeling and once again confirming that none of her medical coverage had changed. Her next step was heading off to the bathroom to fill her cup with urine and empty her bladder which she did dutifully. Coming out Anne handed her two bottles of water to drink while she waited for the ultrasound technician to call for her.

Miriam stopped out for a minute and seeing them came over to ask how they were doing and satisfied that all was well took another waiting patient in with her.

"Nervous ?" Ty asked as Amy finished her second bottle.

Amy took his hand and leaned over to lay her head on his shoulder.

"I think I'm more excited than nervous but it's hard to tell, I'm good."

After about 5 minutes Anne came over to check her drinking progress and seeing that she was done told them that she'd let Frances, their ultrasound technician, know that she was ready. It wasn't long before the technician was out and seeing a cue from Anne, came over to the couple, introduced herself and led them back to the ultrasound room.

"Mind if I call you Amy and Ty ?"

"We'd prefer it actually." Amy said stepping up onto the end of the exam table and sitting.

"Excellent, how are you feeling Amy ?"

"Anxious I guess."

"Well, no reason for that, let me just check your heart rate and BP and we'll get on with the show." Moments later with the Velcro rip to remove the BP cuff Frances declared all normal and asked Amy to lay back and expose her belly.

They were both a bit surprised with the knock at the door and Miriam poking her head in. She smiled at them both "ready ?"

"And waiting." Ty answered.

Miriam smiled back "good" and then she turned the screen away surprising them both and Frances the tech. "I'm not big on torturing the tech, you both have vast experience with ultrasounds, no peeking and we'll all sit and go over the imaging together."

Amy frowned and Miriam smiled "sorry Amy, it'll be much easier this way."

"I get it, let's go."

"See you both in about an hour I guess." She said and walked out.

"I'm sorry are you physicians ?" Frances asked as the warmed ultrasound gel was spread across Amy's belly and Frances took the wand up in her right hand and set the keyboard close by.

"I'm an orthopedic vet and Amy is an equine generalist and rehab specialist, we teach at the vet school."

Frances nodded as she watched the screen and the sound came on. The first reaction was smiles from both the mom and dad as the steady and loud heartbeat of their baby came through the speaker.

Frances immediately lowered the volume and went to work. She had Amy switch positions a few times which came with some frowns when she noticed a concerned Ty who watched her which she explained was her positioning rather than anything reflecting the baby's health to satisfy the anxious dad.

40 minutes later after moving the wand around and hitting the keyboard time after time to record Frances stopped for a second. "Nothing seems out of place but I'm just going to run a few more measurements and two tests just to be on the safe side and then you can pee Amy. We'll print pictures from the recording and just so you know I wasn't able to determine sex, if it's important we can do another in a few weeks."

"I don't think we want to know." Ty said which elicited a nod and a smile from the tech who reached over and made a note in the file.

Once she was cleaned up, Ty helped her off the table and she headed off to the bathroom while Frances cleaned up and got ready for the next day. Amy was her last patient. Miriam came in as Amy returned from the bathroom.

"All good ?" She asked Amy who nodded and smiled.

"Excellent" Miriam said taking the printouts from the tech and then leading Ty and Amy to her office where a picture was already on the screen showing Amy's name, the date and time and Frances' name.

"Let me just take a quick look" Miriam said looking at the printouts for a few minutes.

"Ok, let's get to it. Your urine tests were perfect so no concern there, so, let's go to the video tape" she said taping a key on her keyboard which lit up the screen showing what was clearly a child laying on it's side half covered up by something that neither Ty nor Amy could make out.

"Confused ?"

"What is that ? Is something wrong ?"

"Not a thing." Miriam answered smiling, "guess you don't see this much in horses, that's an arm, that's an arm, that's a leg, that's a leg and that's a leg wrapped around a hip and leg blocking the sex of this baby."

"That's three legs Miriam." Ty said looking at Amy and then the obstetrician.

"What you're looking at are two babies sharing a placenta, monochorionic twins, identical, no doubt by the way."

"What ?"

"You of all people should get that Amy, you are carrying identical twins, either male or female. Need a second to recoup ?" She asked smiling.

"She checked, I mean is there a test ?" Ty asked.

"There is no doubt Ty, they share a single amniotic sac and there is a chorionicity

Test that Frances performed."

"How ? I mean I understand how but ?"

Miriam smiled "first, while there is a proven genetic predisposition to fraternal twins there has never been a proven predisposition to identical twins, it's pretty much considered a genetic fluke, 4 or less in a 1000 births, most obstetricians will never see or deliver identical twins in their lives."

"So this will be your first ?"

"Delivery yes but I saw an identical twin birth at Upstate during my internship about 15 years ago, a young couple from Cortland."

"My girls ?"

"Your girls."

"That's amazing, you never mentioned it, anyway, I don't think I've ever heard of twins in my family at all." Amy said

"Well, as I said there is no genetic predisposition, and this is happening so no matter what you find out, you two are having identical twins."

"Uhm, Ok, how does this change things ?" Amy asked.

"For one, you'll see me more often and there will be more ultrasounds. You told Anne you were thinking of a home birth, we're going to talk about that first. I don't have a problem with us arranging for you to have a private birthing room and for you trying for a natural multiple birth with a certified mid wife, but home, I don't know Amy, I'd prefer you at the hospital where I or Daniel can be there if we need to be with neonatologists for the babies if we need them."

Amy and Ty looked at each other and nodded. "Ok, what else ?"

"They'll be a couple more tests we'll run just to check for any abnormalities but there's no indication that anything's wrong, it's just that with mo-mo twins, which is what we'll call them for ease, we need to know."

"Like ?" Ty asked.

"Straight up there are three things we'll check for specific to mo-mo twins, twin to twin transfusion syndrome, twin anemia polycythemia sequence and selective intrauterine growth restriction. They are all extraordinarily rare. The tests are non invasive and we'll do them if we need to over the next few visits. As of now everything looks completely normal for a mom carrying twins so there is nothing to worry about."

"And ?"

"You're officially not riding anymore Amy, I'm sorry but with two, your size, it's just not safe."

Amy nodded "it won't be a problem I promised to stop when it became necessary, how about teaching and work ?"

"Care and diligence but do what you do, they're still well protected but jostling twins while riding is not a good idea."

"Twins." Amy whispered.

Ty smiled "identical twins" he murmured as well.

"Ok, let's get finished, other stuff. The fundal height or length of the baby we could get to is pretty spot on for early to mid October and with twins we're going to subtract about two weeks from that and depending on circumstances may decide to induce labor which would definitely happen at Cornell and please Amy, no magic potions. You can certainly still plan on a natural birth with a certified mid wife and one of us close by, but the odds are you'll need an episiotomy which one of us will perform, again, very normal under the circumstances and not definite, we'll see when the time comes."

"What else ?"

"Classes for one, Anne will give you a list and if I were you I would choose one run by the mid-wife you'll be using so that you build a rapport."

"Come on Miriam." Amy said.

"Elizabeth Nolan, she'll be on the list and she's a horse person. We keep ours at the same stables as hers, I've worked with her, she's extremely capable, she's good people and an excellent advocate. I trust her and she's successfully delivered several sets of twins. The classes will start in the summer but she's busy and in demand so make arrangements now and I'll send her a note to expect your call."

"I'll call her this evening."

Miriam nodded "I'd say that's it for now, I'll see you in four weeks, don't worry, you checked out perfectly and just think most people get this news and the first thing that pops up is stressing about finances."

"I guess we're fortunate in that." Amy said "uh, pictures."

"I have two nice clean shots printed." Miriam said reaching over to the printer. "I'll send the whole edited shebang in an email when we're done. I'd like to see you in say two and a half to three weeks depending on scheduling, moving on that should be fine for another month or two but eventually you'll be here ever two weeks and then once a week at the end of August and most of the time there'll be an ultrasound, so expect a hour. No fighting Amy."

Amy nodded "I'll be here Miriam."

They both looked at the pictures, again, close up, one head, one torso, two arms and undeniably, three legs, one wrapped around two others, clearly covering the sex of the one.

"Call with any questions, either of you and congratulations again."

They both thanked her and after getting handed some paperwork and an appointment card from Anne, headed out to the parking lot and their Jag.

Ty opened the door for Amy and walked around to get in on the driver's side. Amy was staring at the pictures laying on her lap side by side.

"You need to buckle up sweetheart." Ty whispered as the car came to life and he flipped on the heater.

Amy just sat staring "Ty ?"

"Hmmm ?"

"How, uhm, you're Ok with this right ?"

"It's what we got Ames, I'm fine, how about you ?"

"Well, yeah, I mean, it didn't even occur to me so…, I mean we already have twins."

Ty laughed "you didn't have them Amy, you chose them. This is different."

Amy laughed too "I guess, oh I have to text Betty that everything's fine."

"Amy, seat belt ?"

"Right." She said snapping in and putting the pictures in the folder with the rest of the papers she had. She thought for a second and just sent "all good be home soon."

Since they both had afternoon classes and the appointment would take 90 minutes they were last and so were getting home just in time for dinner.

Once he drove out of Ithaca proper Ty glanced over "How do you want to tell them ?"

Amy shrugged "telling them would be too easy, let's just hand them the pictures and let them figure it out, it'll be fun to watch."

Ty smiled "fun it is."

They were both surprised when they came into the house and found the kitchen table unset but quickly realized that there was a larger crowd than expected and they were using the dining room. Betty was sitting in the kitchen with Erma, Georgie and Wyatt. Kimmie was on Betty's lap.

"August is in town with the Ag Committee so I invited her to stay with April and Kimmie. Georgie and Wyatt came in with the twins. We're in the dining room."

"It's fine" Amy answered, "Gather the kids and we'll get washed up."

When they sat a few minutes later Amy placed the two pictures next to her place setting.

"Is that the picture, can we see the baby ?" April asked.

Amy smiled and lifted one "come on."

While April ran over and then back to Jackson Amy handed the other to Erma who was next to her. She was fussing with Kimmie who was right behind her in a high chair, glanced at it and then passed it to Charlotte who looked at it with Maddie with Betty looking past her to glance at it.

"That's a head." Jackson said pointing "it looks weird."

"That's a hand." April said, "it's so small."

Charlotte turned her head at an angle "what is that ?"

"Pappa what is that ?" Maddie asked showing Ty the picture.

"That's a leg Maddie."

"Then what are these ?"

"Those are legs Charlie."

"How can that be, babies' don't have three legs."

"Let me see Charlie." Erma said reaching for the picture just as Georgie reached out for the picture April was holding.

Amy was smiling when Erma turned to her "twins ?"

"Well it's not a three legged kid Erma" Georgie said laughing.

"Twins ?" Charlotte repeated.

"Oh yeah." Maddie said lifting her hand and getting a high 5 from her sister and then "mo-mo's" ?

Amy nodded "and confirmed, one sac, identical twins."

"Identical twins." Betty repeated "what are the odds."

"4 in 1000 Betty." Ty said "I assume there are no odds for adopting a set and later having one naturally or so low they're zero."

"Twins, we're gonna need more horses." Jackson muttered.

"We're gonna need more of everything." Betty added laughing "and some help Amy."

"We have time Gran, you Ok with the news ?"

"Well they can't possibly be as weird as the twins we have."

As if on cue the girls simultaneously objected "We're not weird."