The Diagnosis
Tiffany Marrara was 10 weeks pregnant with twins when she received a call from her doctor asking if her husband, Nicholas, had ever had a blood screening for Kell antigens. While some blood antigens will only deplete blood cell counts, Kell antigens travel into bone marrow and impact blood cell production at its source. The doctor told Tiffany that Kell antigens were found in her bloodwork and if they were also present in Nicholas’ screening, their babies would be at risk for developing anemia and possible heart failure.
A few weeks later, the twins were showing symptoms of anemia. Tiffany’s pregnancy suddenly became very complex. She was carrying two babies who had a rare blood condition, and one of them was positioned in such a way that intervention would be very difficult. Tiffany’s doctors were very concerned about the babies’ situation as they would need to undergo transfusions while in utero.
Tiffany and the twins underwent their first transfusion at 22 weeks with great success. Doctors planned to transfuse every two to three weeks until the babies were strong enough to be delivered.
At 27 weeks, one of the twins, Luke, began to develop complications that made transfusions difficult. At 28 weeks, Tiffany and Nicholas were told that they would need to make a choice if their next transfusion failed – if they did not deliver the babies prematurely via an emergency c-section, Luke would likely pass away due to fetal heart failure from anemia.
To Tiffany and Nicholas, there was no question as to what to do. Luke and his sister, Maddie, were born at only 28 weeks gestation. Luke soon underwent an external blood transfer, where all of the blood in his body was replaced with twice as much new blood in order to clear out the antigens. After 48 hours, Luke and Maddie were doing well and impressing their care teams.
The Dilemma
With the twins delivered and expected to be in the hospital for some months to come, the Marraras needed to figure out their next steps. Their commute to the hospital was over an hour in each direction. They also had three older children to care for and a feeling of familiarity and comfort at home. They were unsure about what to do.
“After the first week of commuting, we realized we needed at least one of us to be closer,” Tiffany said.
The Answer
“At first, I was hesitant, not wanting to leave the older kids and my husband for days at a time and losing the comforts of home after such a traumatic few days. It was difficult to think about being in a different place over an hour from my home in a city where I didn’t know anyone.
We needed to be close by, especially once the twins were bigger and needed us more and more. We decided to try the Ronald McDonald House. I didn’t know what to expect but once I saw my room, personal bathroom, the kitchen and dining areas, I felt completely at ease. “This place is beautiful”, I thought to myself! It was quiet and calm, exactly what I needed to rest and re-energize before crossing the street each day to spend time with and support the twins in their journey.
“The Ronald McDonald House made it so I didn’t have to spend more time traveling than with the twins. The House allowed me to have all the essentials I needed - food, snacks, water, a bed to sleep in! The House gave me friendly faces who cared about what I was going through and offered an ear to listen, a smile of comfort, and a place to rest. We are so thankful for the reduction of stress, peace of mind, and assistance that the Ronald McDonald House has given us. The Ronald McDonald House you read about on the restaurant donation box means so much more than it did before! We are so thankful for the House and what it did to help our family heal!“
“Thank you Ronald McDonald House for helping this Mama and her family in the greatest challenge of her life!” -Tiffany Marrara