Kindgo
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Doctor: One twin bossier than other
August 7, 2002 Posted: 7:33 AM EDT (1133 GMT)
LOS ANGELES, California (CNN) -- The conjoined twins separated in a dramatic 22-hour surgery are resting apart for the first time in their lives Wednesday morning, sleeping in the intensive care unit of the Mattel Children's Hospital.
Maria Teresa and Maria de Jesus Quiej-Alvarez, joined at the head for the first 377 days of their lives, were in critical but stable condition, doctors said, their heads wrapped in gauze so thick it resembled helmets.
"They are doing clinically well. Their vital signs are stable and they are essentially sedated to have better control of their breathing," said Dr. Jorge Lazareff, director of pediatrics at UCLA.
"[We'll] start seeing on Thursday or Friday how they will tolerate the slow process of waking up.
"When they smile back at us, then we'll know they are back to where they were before the surgery," he said.
Hospital footage showed the girls' father in a T-shirt that read, "God has been so good 2 me!"
Just hours after they were separated, Maria Teresa was rushed back into the operating room for another almost five-hour operation because she developed a buildup of blood beneath the membrane that surrounds the brain, said Dr. Michael Karpf, vice provost of the UCLA Medical Systems.
Lazareff said the problem was noticed very quickly and surgeons found the bleeding came from veins in the scalp and from the bone and was not directly related to Monday's surgery.
He also said he hopes for a "good, if not excellent" prognosis for both girls.
Doctors called the 15-hour operation to separate the sisters "very successful."
UCLA medical student Houman Hemmati, who was present during the operation, said the mood in the operating room became tense as doctors neared the most critical part of the separation.
When the infants were finally pulled apart for the first time in their short lives, people in the room were "crying, cheering, screaming, you name it, and when that was done, we paused, looked at twins, and really appreciated what we'd just done," Hemmati said. "It was miraculous."
But the lead surgeons said they were concentrating so hard on the work that still had to be done that there was no thought of celebrating at that point.
The team was composed of neurosurgeons, plastic and reconstructive surgeons, anesthesiologists and nursing support staff. (More about the operation)
Personalities and hairdos
When asked if people would be able to tell years down the road that the girls had ever been conjoined, one doctor said some work still needed to be done to improve the girls' hair.
"Because we didn't have enough scalp and had to do some expanding and use skin grafts, right now their hairdo isn't much better than some of the undergrad students at UCLA," Dr. Henry Kawamoto, director of plastic surgery at UCLA, said with a smile.
"In the future we will be able to shift or stretch the skin that we transplanted to give them a more normal appearance to their scalp," he said. "And also bone-graft the areas of deficiency."
Lazareff, a native of Argentina, said the twins have very different personalities.
"Maria Teresa is slightly more bossy of both of them. She is the one who wakes up the other one and pulls her around. And she is one who constantly seeks your smile and your approval," he said. "Where as the other one is slightly more withdrawn, but still very sociable."
The girls were born July 25, 2001, after their mother underwent an eight-day labor near their home in rural Guatemala. They weighed 4.4 pounds together. Their mother is a homemaker, their father a farm worker.
A Spokane, Washington-based nonprofit organization called Healing the Children arranged for the girls and their parents to be flown to Los Angeles.
Doctors think conjoined twins are caused when the single egg that would normally divide into two in the case of identical twins does not wholly separate. As a result, some of the body parts are fused, according to experts.
In 40 percent of cases, conjoined twins are stillborn. Another 35 percent of them survive until their first birthday. In only about 2 percent of cases are the twins joined at the head.
Because such cases are so few, statistics about success rates of surgery to divide them do not exist.
Although the operating room personnel were donating their services, the procedure still cost about $1.5 million, the hospital said -- beyond the resources of the girls' parents. The hospital has established a fund to recover expenses.
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God bless,
Kindgo
Inside the will of God there is no failure. Outside the will of God there is no success.
Posts: 4320 | From: Sunny Florida | Registered: Jun 2002
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