MOUNT AIRY – Arthur is the explorer who likes to find himself in the middle of trouble. Brannon is the future football player. And Charles, whom they call Charlie, is “the lover,” said their mother Lori Titus.
Her three boys — identical triplets who turned 1 on Aug. 3 — are bouncing, lively, squirming bundles of baby joy. And the atmosphere in the Titus household in rural Mount Airy seems a world away from the harrowing, uncertain journey that was the triplets’ path to birth just over a year ago.
The Titus parents are members of a very small group — parents of naturally conceived, identical multiples. But they’re also part of an even smaller group, as their triplets survived a fetal blood disorder called twin-to-twin transfusion syndrome that is often deadly.
Twin-to-twin transfusion syndrome develops in the womb and causes one baby to receive too much blood, and the other not enough. In the Titus’ case, babies Arthur and Charles had the syndrome, while Brannon was not affected.
Their options were slim. They could let the pregnancy progress naturally, a choice that would have almost certainly resulted in the babies’ deaths. They could have amniotic fluid removed periodically, but that would have merely eased the symptoms. Or mom could undergo a surgery that would correct the problem, but also came with an only 50 percent chance that each baby would survive the procedure, said Lori Titus, 39.
They chose the surgery, and it worked.
The boys were born at the University of Maryland Medical Center at 29 weeks gestation, still a little early even for triplets. Things weren’t perfect — Charlie, the baby being starved of blood by the syndrome, needed to be resuscitated and required a blood transfusion.
But the babies came home in mid-September 2008, a little earlier than expected, and were “remarkably healthy for what they went through,” Lori Titus said.
Since then, Lori and Dave Titus — who also have a nearly 4-year-old daughter Rowan — have focused on adjusting to life with three infants and a preschooler in the house.
From September until December, it was just the two parents caring for the children, quite an undertaking considering dad is disabled following a stroke four years ago, and still struggles with speech. The family is supported primarily through a home-based beekeeping business.
During those first few months, the couple didn’t see each other much, just a “couple of hours at the changing of the guard,” said Dave Titus, 45.
In January, some relief came when an employee of their business started helping out as their nanny. Lori Titus’ parents, who moved in with them following Dave Titus’ stroke, live in their attic and help care for Rowan.
On a sunny mid-week fall afternoon, the babies are dressed in matching yellow striped onesies, which mom said she only does for “staged shots.” Most of the time in her hectic life, Lori Titus said, she dresses the babies in “whatever’s next out of the closet.”
She buys diapers from Amazon.com, two to three cases at a time, and estimates that the family will go through upwards of 10,000 diapers as the twins progress through infancy.
The boys look exactly alike, and their parents have occasional trouble telling them apart. They rely on birthmarks — Brannon has one on his leg, and Charlie has one on his forehead — for now.
Describing her babies’ emerging personalities, mom picked up one boy, believing he was Charlie, and then realized she was wrong.
“You’re actually Arthur, aren’t you,” she cooed, lovingly.
The babies are immensely inquisitive, quintessential 1-year-olds. They’re crawling everywhere, getting into everything and poised to take their first steps. Their current favorite toy is one that shoots plastic balls out of a tube and comes with the prerequisite obnoxious noise.
They seem to be communicating with each other in their own way when they play, mom said, and are generally happy, congenial babies who only get upset when they’re hungry or tired. They are on the small side, mom said.
But their development is “pretty age-appropriate for what they’ve been through,” said Dr. Ted Wells-Green, the triplets’ pediatrician.
Having survived twin-to-twin transfusion syndrome, it’s possible the babies could have other health problems later on, but right now, “they’re doing quite well,” said Wells-Green.
An accomplished woman — she has a master’s degree in forensic science from George Washington University and later earned an online MBA from the University of Baltimore to help her run her business — Lori Titus is the picture of calm amid the storm.
“Mr. and Mrs. Titus have done admirably well,” said Wells-Green, adding that Lori Titus is exceptionally calm, moreso than some parents he’s seen with just one child.