Defying Expectations: How CMU track twins beat rare condition
As members of the Central Michigan cross country and track teams, Lauren and Megan Lasceski’s bond has grown closer through athletics.
But there was a time in their lives when running, let alone walking, seemed to be out of the question.
Just eight weeks into her first pregnancy, Erin Lasceski found out she was having twins. Once she reached the 18-week mark, Erin and her husband Mark visited a doctor, excited to determine the gender of their children.
"(The nurse) told us they were girls, but then she got really...," Erin said, trailing off.
"Quiet," Mark said, finishing her sentence.
"She called in the doctor and they were scanning," Erin said. "They finally said, 'We think you have Twin to Twin Transfusion Syndrome.'"
What is TTTS?
Twin to Twin Transfusion Syndrome is a rare disease that can occur when a mother is pregnant with identical twins. It leads to uneven blood flow causing one twin to receive too much blood and the other to receive to little, according to NORD's Rare Disease Database. TTTS occurs in 5-15% of identical twin pregnancies.
If the egg separates within three days of fertilization, the children will develop individual placentas, called monozygotic twins. However, if the egg separates between four and eight days after fertilization, the children share one placenta. As a result, they will have blood vessels running between them and a thin membrane as a separation, or monochorionic twins.
TTTS can develop at any time in monochorionic twin pregnancies as it depends on how well the fetuses regulate the flow of blood and nutrients between each other. If it becomes uneven, one child (the recipient) receives the majority of nutrients while the other child (the donor) struggles to develop.
At Erin's eight-week checkup, her doctor suspected an issue and recommended her to a high-risk pregnancy doctor.
Erin, about to embark on a trip to Spain, pleaded with her doctor to book an appointment prior to her flight.
"I begged and cried until they got me in on a Wednesday," she said. "I was leaving for Spain on Thursday... They found the separating membrane between them, but Megan was stuck way up under my ribcage.”
After returning from Spain, Erin thought she was progressing normally until her next check-up.
“Finally the doctor kind of sat me up and he explained to my husband, my mom and myself, ‘I think you have Twin to Twin Transfusion Syndrome,” Erin said. “We had no clue, he didn't explain a lot to us. He just said (Lauren) had a lot of fluid around her and (Megan) didn’t. They wanted to poke some holes into the separating membrane to equal out the fluid. And so we're sitting there, we have no clue, we say yes.”
The doctor removed a liter and a half of fluid from Lauren’s side of the placenta and sent the Lasceski's home.
'You've gone from bad to worse'
With a prospective diagnosis in hand and their next appointment two days away, Erin’s mother began searching the internet for TTTS. But in 2000, the returns didn’t match today’s expectations.
"When we found out that we had it, My mom went on the internet that very next morning, and there was one website at the time when you typed in TTTS," Erin said. "So I always tell my students when we talk about it, like, think about anything you type in now and all the different sites that come up, there was one.
“My mom came up and I could just tell, I said, ‘you know, what do you think,’ and she's like, ‘it's not good Erin.’ There were two doctors at the time in the United States that performed surgeries on this condition. One of them had his phone number on the website.”
They immediately called the listed number, but the doctor was on sabbatical, and they only got through to an answering machine.
In limbo, Erin reached out to Lisa Arthur, whom she found through her mother’s search. Arthur had experience with one of the doctors listed on the TTTS website. After some discussion, Erin and her husband went to bed prepared for their appointment on Monday.
"We went to our doctor's appointment and he scanned us and all he said was, 'You've gone from bad to worse.'" Erin said. "We had brought everything we could from that one website to him, and, I'm like, 'Well, what about this life-saving surgery?' He said, ‘I really recommend abortion,’ which we were not expecting to hear. During this pregnancy, he gave us a 6% chance, and he said, 'If they survive, they will never walk, talk, eat on their own, they will never function as a healthy human being. You know he painted the direst future for us, and we just sat there."
After listening to Erin about the experimental surgery, her doctor left the room for 30 minutes. However, upon returning to the room, the doctor tried to talk Erin out of going to see Dr. Ruben Quintero.
Feeling that taking a risk to save her children was better than aborting them, Erin once again pleaded with her doctor. He gave in and immediately sent Erin’s information to Quintero’s office.
'A hard decision to make'
The Lasceskis left their appointment and drove from Lansing to St. Johns. When they returned home, the phone was ringing. It was Quintero. After hearing the situation, the doctor offered his input.
"Well, I am currently formulating a staging process for this rare disease and you're in stage three," Quintero told Erin. "Stage four is death."
Receiving their number from Arthur, Quintero asked the Lasceskis if they could get to Florida by the next day. However, due to the cost of the procedure, Quintero recommended bringing “every credit card they owned.”
“We called all our family members, all our parents, my dad, his parents, everybody was sending us their credit card numbers,” Erin said. “When we were backing out, our neighbor was outside and we kind of filled her in real quick. Well, she worked for (Michigan Education Special Services Association), which is our insurance, and (said), ‘Let me see what I can do.’”
In a rush, they picked up Erin’s mom in Novi before driving to the airport. They walked up to the counter and purchased tickets to Tampa, Florida.
They arrived and checked in at the hotel Quintero had set up. At 5 a.m, they received a call from Quintero informing them they forgot to tell him they were coming.
Nonetheless, Quintero left a computer training he was at and met with the Lasceski's. Although Quintero wasn’t happy that they allowed their doctor to poke holes in the membrane, he decided they were small enough to continue.
“But before we did any of that because it was a Catholic hospital, we had to agree that if he got in there and couldn't save both girls that he would basically, he called it, ‘Tying off’ one of the girls and he would tie off the weaker twin to save the healthier twin,” Erin said. “And that was a really, really hard decision to make.”
As Erin began to succumb to anesthesia, a woman entered the room with a stack of receipts from a credit card imprinter and ripped them up. Erin later found out MESSA was covering the procedure.
“They go in and search the entire placenta for the arteries and veins together, and where they aren't, he occludes them, which means he burns them,” Erin said. “When I came out of surgery, he told us that there were five going out of Megan into Lauren that didn't have the reciprocal. So enough was going back and forth, but there are five separate ones where Megan was just sending her nutrients to Lauren.”
The day after the surgery, Quintero brought Erin in for another scan to see if the procedure was successful.
“(Quintero) said, 'They're gonna take you down, and they're gonna do a scan,' and said, 'be prepared, one or both of the babies could have died,'” Erin said. "Because they don't know how much of the placenta that babies had at that point. They start doing ultrasound and at first, nobody is moving, and then I could see them start to wake up.”
With both girls still alive, the Lasceskis waited a few days in Tampa before returning to Michigan.
Attending weekly ultrasounds, Erin continued to progress through her pregnancy. Then while preparing to coach a volleyball team camp in July of 2000, her doctor got abnormal readings during a check-up.
After a trip to the hospital, the twin’s readings leveled out, and she returned home. On July 26, more abnormal readings forced Erin’s doctor to request an emergency C-Section, three months ahead of her original due date.
“When they delivered them, Lauren came out first, and then I heard them say Baby B has an amniotic band,” Erin said. “But I didn't process it.”
Due to the holes poked into the membrane, when Lauren and Megan grew in the placenta, it created fibrous strands. One of which had wrapped around Megan’s right wrist and was cutting off circulation.
“Had they gone full term, she would not have had a hand,” Erin said.
Weighing 3.1 pounds and 2.5 pounds, Lauren and Megan spent five weeks in the Newborn Intensive Care Unit at Sparrow Hospital in Lansing before leaving the hospital with their parents for the first time.
“They told us they would be in the hospital until their due date, which was like mid-October,” Erin said. “So we went back to teaching in the fall. We'd go to the hospital after work, and then we call in the morning before we started teaching. I called again just to check on them, and the nurse was like oh, ‘we're just gonna call you, we're gonna send the babies home this weekend.'
“The hospital gave us anything and everything they could, but the girls went to their baby showers because they were there. After that, it was relatively smooth.”
Because they were premature, Lauren and Megan couldn’t go to regular daycare. As they continued to grow, so did Megan’s amniotic band, and no lasting effects of TTTS remained.
'Grateful and thankful'
The girls went about their lives involved in multiple sports and eventually found running in the seventh grade, albeit in different ways.
“We went to a Catholic elementary school, so we didn't start middle school until seventh grade,” Lauren said. “We both played volleyball and our mom was coaching us. I did not like it. So I wanted to quit, but my mom was like, ‘Well, you're not going home after school you have to find something to do.’ And the only two options were either cross country or fall ball softball. I almost played softball until I met someone with a black eye from softball, and at that moment, I decided I wanted to run.”
Megan started her running career on the track, competing in the 800-meters but after some convincing, she gave cross country a try.
“The summer after my sophomore year, I decided I wanted to run because all of our, Lauren and my mutual friends were running cross country,” Megan said.
After prestigious careers at St. John’s High School, the twins started to hear from college running coaches.
However, as they were making their mark on St. John's, Megan suffered a torn ACL during a basketball game as a junior, requiring three surgeries in a year.
Nonetheless, Lauren and Megan’s college decisions came down to attending Ferris State or CMU. Although they made the decision independently of each other, the twins chose to come to Mount Pleasant.
“(Swieton) gave us a lot of confidence going into a division one program,” Megan said. “She knew the potential that we had, and she believed in us more than we believed in ourselves. (Swieton) was a big reason why we felt so comfortable and confident coming in.”
Lauren immediately began running for the Chippewas in cross country, indoor and outdoor track. While Megan continued to face setbacks in her recovery.
“When I was here at (CMU,) I found out that I had a torn labrum with a bone spur, so they had to do surgery on it,” Megan said.
As a result, Megan wasn’t in the race as Lauren recorded a personal best 5k time of 19:19.7 at the Chippewa Invitational en route to being named Mid-American Conference Runner of the Week on Oct. 27, 2021.
“It was super muddy, and we were running through where we could see her,” Megan said. “When I saw her coming down the straightaway to the finish line, I was like oh my gosh, like I want both my teammates to do so well, but the twin side of me, I was so excited to see her because I know how hard she's worked.”
Megan overcame her injuries and returned to track for the 2021 Indoor season. Once again, minor setbacks shut her season down early. However, she made her return to the outdoor track in the 1500-meter at the MSU Open on April 2.
Although they ran in different heats, it was the first time Lauren and Megan ran in the same outdoor meet in five years.
Regardless of where life takes them, Lauren and Megan have remained thankful for the life they almost didn’t get to have.
“I'm grateful and thankful for the life that we have,” Lauren said. “We are so incredibly lucky to be here.”
One of the symbols that provided Erin and Mark hope when their children were in the NICU was a corkboard laden with pictures, notes, and cards from families who spent time in the same wing of the hospital at some point and were living to tell the tale.
Because of Lauren’s memories of her mother talking about staring at that board for hours and finding hope as Doctors conducted their rounds, she has made it her mission to be that light for others.
“We write a letter every year, and we attach pictures from when we were babies and then what we're doing now, basically to give those families some hope because my parents understand firsthand how difficult it was,” Lauren said. “My parents were like, 'You had a 6% chance of living, 1% chance of being able-bodied'. It started to resonate with me in my senior year of high school. I had this moment where I was like, I'm lucky to be alive, let alone being able to do all these things.”