Our twins are a joyous handful

They clamber over the seats and run after one another around the living room, screaming and laughing in delight.

Their parents, Gladys Nyambura and Danson Ndegwa, look on with indulgent smiles.

The ruckus their twin sons are making does not seem to bother them, and they make no move to quieten them down or admonish them to slow down.

You see, they consider their sons, Lucas Wanjohi and Ethan Wang’ombe, a miracle, so any chaos or noise they make is like music to their ears.

When the couple got married in September 2011, Gladys expected to conceive almost immediately, but that was not to be.

After about four months of trying, she decided to see a gynecologist, who diagnosed her with uterine fibroids.

“He told me that they were too big, therefore my chances of conceiving were slim,” say Gladys.

Gladys and her husband were crushed, but they decided to seek a second opinion, only to be given the same response.

To the outside world, Gladys and Danson were a jolly couple who were enjoying their young marriage, but inside, they nursed a pain that gave them sleepless nights.

This pain was more pronounced in Gladys, and unlike her husband who chose to “leave” it in God’s hands, the probability of never getting a child was too painful to contemplate.

It was made worse by the fact that even though their marriage was still young, there was pressure from those who knew them to have a child.

“As is the norm in our society, news of a pregnancy is expected immediately after the wedding. Friends from church, some relatives and even colleagues at work would jokingly ask when the baby was due, something that would make me even more anxious,” she says.

 “I was happy in my marriage, but I was lonely,” Gladys says.

By then, she had consulted six doctors, and each had informed her that her chances of conceiving were dim.

“One put me on medication to help shrink the fibroids, but it did not work,” she says. 

Several times, during the one-year she stayed without conceiving, Gladys experienced several pseudo-pregnancies, where she would have pregnancy-like symptoms, such as morning sickness and nausea. Excited, she would have a pregnancy test, only for it to turn negative, making Gladys more distressed.

With time, intercourse became mechanical, more of a disatisfying job, rather than a source of pleasure for the couple.

Patience pays

“We badly wanted a child, and with each day that passed with nothing to show for our effort, the sadder I became,” Gladys says.

Danson, seeing how distressed his wife had become, did everything he could to support and encourage her.

“We knew a couple who had waited eight years to get a child, and whenever she was feeling low, I would remind her their story.”

He also encouraged her to keep seeking medical help, and assured her of his unfailing love, whether they got a child or not.

Sometime in November 2012, Gladys, experiencing the familiar pregnancy symptoms that had turned out to be false six times, half-heartedly decided to buy a pregnancy kit.

“I had been disappointed too many times, therefore I could hardly believe it when two red lines appeared on the strip, signifying that I was pregnant.”

Afraid that she was imagining it, she slipped out of the house without informing her husband and went to a nearby clinic.

The doctor she found looked at the kit and told her there was no need to carry out a repeat test. Heart thumping with excitement, Gladys hurried back home, dying to share the good news with her husband.

“He was watching news, but when I told him that I was pregnant, he immediately jumped up, switched off the television, and asked me if it was indeed true.”

When she said yes, Danson went on his knees and said a prayer of thanksgiving.

Says Gladys,

“He was sobbing – that is when I realised just how badly he had wanted a child. He had been the calm one, and had seemed unbothered by my inability to conceive.”

Danson says that even though he desired a child and had been disappointed when doctors informed them that his wife’s chances of conceiving were slim, he knew that he had to be strong for her.

“It would have been unbearable, having two desperate and anxious adults in the house – I could not afford to show her how eager I was to have a child of my own.”

Behold, the twins

In late December 2012, when Gladys was two months pregnant, she started experiencing excruciating pain in her abdomen.

In a panic, she went to hospital, where she was informed that her pregnancy looked abnormally big.

The doctor suggested an abdominal scan, and while she lay there, the doctor casually asked whether there was a history of twins in her family.

“My heart skipped a beat and I said yes – my brother and aunt have twins.”

The doctor then announced, “You have now joined them, you have twins.”

Gladys was so happy, she wept, and could not hold her tears back as she broke the news to her husband, who was in the waiting room. At last, they could now visualise themselves as parents.

The joy was short-lived however, because a few days later, Gladys woke up at night only to notice that she was bleeding.

Fearing that it could be miscarriage, they rushed to Kenyatta National Hospital where she was admitted immediately.

The doctors explained that she was experiencing a threatened abortion - she was admitted for three weeks. She was also put on medication and advised to take it slow until she gave birth.

“It was quite a scare, and I am thankful that I was diagnosed in time and treated,” she says.

On July 14, 2013, Lucas and Ethan were born, and changed their parents’ lives for good.

It is expensive taking care of twins, since they have to buy everything in pairs and give them equal attention, but this couple is not complaining.

“The expense is worth it,” says Danson.

Gladys points out that the boys are quite competitive, and fight each other if one of them has something the other wants. To prevent this, they buy everything in twos, especially toys and clothes, which have to be of the same colour.

Yes, looking at the energetic boys, they are quite a handful, but their besotted parents are enjoying every moment of it.

About Fibroids

 Fibroids are non-cancerous growths that occur on the muscle of the uterus. They typically occur during a woman’s reproductive years.

According to Dr Timona Obura, a gynaecologist at Aga Khan University Hospital, they are especially common in the thirties.

“Most fibroids lie quiet with no symptoms at all, and might never require treatment,” he points out.

He also dispels the myth that having children cures fibroids, explaining that he has seen cases where fibroids enlarge during pregnancy.

Though some women with fibroids manage to conceive, fibroids that invade the cavity of the uterus can reduce chances of conception by 70 per cent.

“They affect fertility mainly because they interfere with implantation of fertilised eggs or more rarely, obstruct the fallopian tubes, making it  difficult to conceive,” explains the doctor.

Should a woman with fibroids conceive, depending on the position of the growths,  they can distort the cavity of the uterus, causing the placenta to detach, a factor that could cause threatened miscarriage. 

Symptoms of fibroids

A feeling of constant fullness or the need to empty the bladder frequently. This tends to happen when the fibroids are very enlarged.

Abnormal and prolonged heavy menstrual bleeding. This is likely to happen if the fibroids are located close to the lining of the uterus. It can cause anaemia.

Difficulty in conceiving

Causes

The exact cause of fibroids is unknown. However Dr Obura gives a list of predisposing factors:

Genetic predisposition - Women whose close female relatives have fibroids are more likely to suffer from it

If you are black

If you are of reproductive age and have never had a child or had a child many years ago

Diagnosis

Uterine fibroids are mainly discovered during pelvic examination. Ultrasound scan too tells where the fibroids are located and can tell their size. Sometimes, they are detected after looking into the abdomen with a small telescope (laparoscopy) or by looking into the uterus cavity with a fine telescope (hysteroscopy). Hysteroscopy is particularly useful in assessing how much of the uterine cavity has been affected. Magnetic Resonance Imaging (MRI) scans can also be used to assess their size.

Treatment options

There are various treatment options depending on the size, the location and the nature of symptoms. They include:

Oral and injectable medication

Various medications can be administered to reduce the flow of heavy menses. Medication can also be used to manage older patients awaiting the onset of menopause.

Once monthly periods cease, fibroids shrink naturally and most symptoms disappear.

Surgical treatment

If you do not desire more children, and are still experiencing prolonged menstrual bleeding, there are various surgical treatment options to consider.

 Abdominal hysterectomy: The entire uterus is removed. This is recommended where a patient does not want more children, and has large fibroids.

Vaginal hysterectomy: The uterus is accessed through the vagina to remove the fibroids. It is mostly used in medium-size uteruses.

Open myomectomy: The uterus is cut open to remove the fibroids. It is a suitable option for large symptomatic fibroids in a patient who desires children.

Laparoscopic myomectomy: This is a key-hole surgery technique that uses small incisions on the abdomen to access fibroid(s) mainly located on the outside part the uterus.

Abdominal and vaginal hysterectomy, and open myomectomy are available in most hospitals. However, laparoscopic myomectomy is done in a few hospitals.

Uterine fibroid embolization is a non-surgical option for patients who want to avoid open surgery or have conditions that make surgery risky.

For instance, if one has got a history of blood clots, this may complicate anaesthesia. The treatment involves cutting off blood supply to the fibroids through the arteries.

This option uses advanced catheter lab technology. Patients are admitted before the procedure and need to be admitted for a night.

Its success rate is 95 per cent. Immediately after the procedure, the fibroids shrink and dry up, reducing in size by up to a half.