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Mary Slaman-Forsythe

By Shannon McKelden

Each month, iParenting.com spotlights a mother who inspires and moves us, who embodies the qualities that we all admire in a person, a woman and a mother. Above all, the Mom of the Month is dedicated to her children. Rich or poor, famous or not, she shines as an example of what mothering is all about.

Mary Slaman-Forsythe-Mary Slaman-Forsythe describes the day she found out she and her husband, Steve, were expecting twins as the happiest day of her life. After meeting her husband when she was only 14, they dated for six years before marrying. Slaman-Forsythe finished college, then worked full-time, but she most looked forward to having a family.

"I was only 24 when I got pregnant on our first try," says Slaman-Forsythe. "My husband gave me a homemade card that night with two daisies on it. On the inside of the card it read, 'Let's make a baby.'"

With that romantic beginning, it was impossible to imagine the tragedy to follow. After an ultrasound confirming twins at 17 weeks, "We bought our first house later that day in my hometown of Bay Village, Ohio," says Slaman-Forsythe. "For the first time in my life, I felt complete. It didn't take long to learn that even good people can have bad things happen to them."

Twin-to-Twin Transfusion Syndrome
About a week after discovering she was pregnant with twins, Slaman-Forsythe was diagnosed with twin-to-twin transfusion syndrome (TTTS). The condition, occurring in approximately one in 1,000 babies, is a disease of the placenta affecting only identical twins with monochorionic-diamniotic (one placenta with each baby in its own sac) or monochorionic-monoamniotic (one placenta and both babies in one sac).

During a pregnancy complicated with TTTS, blood passes disproportionately from one baby to the other through connecting blood vessels within their shared placenta. "One baby, the recipient twin, gets too much blood, overloading his or her cardiovascular system, and may pass away from heart failure," Slaman-Forsythe says. "The other baby, the donor twin, does not get enough blood and may pass away from severe anemia. The babies are normal. The abnormalities are in the placenta."

The boys were named Matthew Steven and Steven James. Eighteen weeks into the pregnancy, Steven, as the donor baby, was 30 percent smaller than his brother, and lacking in amniotic fluid. Despite his mother's fierce struggles to get her doctors to help him, Steven lost his battle at 26 weeks. Ten weeks later, the boys were delivered, though only one would go home.

"I made a promise to Matthew and Steven as I held them on December 7, 1989, the day of their birth, that they would be known and remembered and that I would find the answers," says Slaman-Forsythe, who later discovered her doctors deliberately withheld treatment information that may have saved her son. "I never wanted another mother to hear the words, 'There is nothing that can be done' as I heard."

From Promise to Foundation
Her response to that promise was to create the Twin to Twin Transfusion Syndrome Foundation (www.tttsfoundation.org). The TTTS Foundation is the first and only international, 501c3 nonprofit organization solely dedicated to fighting TTTS and providing emotional, financial and educational support since 1989.

Though Slaman-Forsythe knew nothing about nonprofit organizations, she didn't let that stop her. "I did everything backwards in starting the TTTS Foundation," she says. "I had no idea what I was doing other then being powered by a mother's love and a promise from one mommy to two babies. I created the organization and then, after several years, went and got a Masters Degree in Nonprofit Management at Case Western in Cleveland, Ohio, to learn how to do what I was already doing! I added my Master's degree to my degree in Marketing."

Slaman-Forsythe's most important finding was that of Dr. Julian De Lia, medical director of the International Institute for the Treatment of TTTS (www.tttsmd.org), who pioneered the laser surgery that can save babies affected by TTTS by severing the connecting vessels of their shared placenta. "His first surgery, the first in the world, was in the fall of 1988," she says. "I was pregnant in 1989. My doctors knew of Dr. De Lia but never told me about him."

Slaman-Forsythe took on the huge project of creating this foundation in the days before the Internet. "When the Internet was created in 1995, The Twin to Twin Transfusion Syndrome Foundation had a Web site that literally changed the world," she says. "When you Googled TTTS, we were the only site listed!"

Today, Slaman-Forsythe personally coordinates help for newly diagnosed parents of TTTS babies, speaking to them on the phone, helping them over the shock of the diagnosis and telling them that, no matter what their doctors say, there is hope.

"I never thought that I would be helpful to others," Slaman-Forsythe says. "I just never thought about things like that. I was just on a mission, and still am, to fulfill my promise to my sons. I had to get the truth out into the world, into the hands of mothers who I knew were being led astray."

Mary Slaman-Forsythe-Family Support
Slaman-Forsythe feels blessed to have family support surrounding her. "My family was very supportive in the early days of the foundation and still is today," says the mother of five sons, Steven and Teddy (he passed away four years ago), and living sons Matthew, 19, Dillon, 11, and Logan, 3. "My uncle helped to get the foundation incorporated and to achieve 501c3 status. Every Thanksgiving we are all gathered together at my parent's house stuffing letters to go out to over 7000 in our mailing list to help us raise funds to continue our mission."

The foundation's board of directors is comprised of family members, and volunteers are all parents that have gone through TTTS.

Her son Matthew, now a 19-year-old college student living at home, is intimately involved in the foundation also, serving on the board of directors. "Ever since Matthew and Steven were born, Matthew has been at my side through every step the TTTS Foundation has made," she says. "I never put him down for the first two years."

The foundation's annual campaign letter last year was written by Matthew in honor of his and Steven's 18th birthday. "This was his present to his brother on their birthday," says the proud mother. "He spoke of how TTTS would never take his brother away, that they were completely bonded ... He asked that everyone help the foundation keep fighting the disease that took Steven and to help us fight the medical community to make TTTS a priority."

Growing Awareness
In an effort to increase awareness for TTTS as the No. 1 problem facing multiples, and to raise money for their ongoing efforts, the foundation declared December 7 to be World TTTS Awareness Day. This annual event included a worldwide candle service for babies who had gone through TTTS, along with a "Matthew and Steven TTTS Walk for the Babies" online at worldtttsawarenessday.org. The first walk was hugely successful, raising over $10,000.

"I will do everything that I have to and give it all that I am to make everyone in the world know what twin-to-twin transfusion syndrome is so we can fight it, win, and never talk about it again," says Slaman-Forsythe.

The TTTS Foundation's 15 Most Important Questions

Confirm at first ultrasound (hopefully by 12 weeks):

1. Is the placenta monochorionic?
2. Are the babies the same sex?
3. Can you see the dividing membrane?
4. Is the placenta anterior or posterior?
5. Do the cords have three vessels or two?
6. Are the cords fully attached to the placenta?

Ask at weekly ultrasounds (starting at week 16 to delivery):

7. What is the largest vertical pocket of fluid for each baby?
8. Can you see the bladder of the donor baby?
9. What are the weights of the babies in grams? (Ask every two to three weeks.)
10. Are the Dopplers normal for both babies?
11. Is the heart of the recipient baby enlarged or thickened?
12. Does the recipient baby have hydrops?
13. What is the measurement of your cervix? Is it long and closed or thinning or dilated?
14. Is the smaller baby growing at the same rate?
15. What is the fundal height?

Further explanation of these questions and their importance can be found at www.tttsfoundation.org/questions_explained.php.



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