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California and the West

Conjoined Twins Born Healthy

Medicine: Girls, who doctors had feared might not survive birth, may eventually be separated despite rare way they are connected.

February 11, 1998|TOM GORMAN | TIMES STAFF WRITER

LOMA LINDA — Relieved doctors and a joyful father announced the birth Tuesday of twin girls joined from the waist down, saying they appeared healthier than expected.

Gabrielle and Micheala Garcia, topped with wispy, curly brown hair, issued lusty cries after birth by caesarean section Tuesday morning at the Loma Linda University Children's Hospital. Soon thereafter, their proud parents were stroking the infants' heads, cooing their names and beaming proudly.

By afternoon, doctors were talking optimistically of the possibility of eventually separating the girls, a medical challenge never before accomplished with twins conjoined in such a rare fashion.

The babies, collectively weighing 8 pounds 11 ounces and joined side by side, face the same direction and share just two legs and a single bladder, intestinal tract, liver and kidney. Their separate spinal cords merge at the tailbone within a single pelvis.

Conjoined twins occur in about 1 of 200,000 live births, and being joined in this particular Y-shaped fashion occurs in fewer than 5% of those cases.

The twins' father, Angel Garcia, 26, had braced himself for the possibility that the girls would not survive birth, and Tuesday afternoon he was grinning broadly before a media horde in a hospital conference room.

Asked how he felt, Garcia stammered in trying to frame his response. "I don't have the words to explain how I feel," he said. "I was just so happy, so joyful, to see them both come out OK. I didn't think it was going to turn out so good, so far."

He said he and the girls' mother, Karen Crowe, 21, were not concerned about what the future would hold for the twins, paraphrasing Jesus' advice in the Sermon on the Mount, "Don't worry about tomorrow . . . let tomorrow take care of itself."

Saying he was concerned now only for their immediate health, Garcia added: "I'm not worried about the separation. If they can be separated, praise God. If they stay together, hey, that's cool to me and that's cool to Karen."

Doctors caring for the newborns sounded decidedly more upbeat Tuesday than they had the previous day, when they warned that they might not be able to separate the twins if they survived birth, because of anticipated circulation problems.

In fact, the girls appeared about as healthy as any other newborns, doctors reported. The only immediate complication--which physicians anticipated based on prenatal testing--appeared to be a blockage in the girls' shared gastrointestinal system. Surgery to correct the problem is anticipated.

Also as expected, Gabrielle, the left-side baby, had weaker blood circulation than her sister, but both were in "reasonably stable" condition, doctors said.

Crowe was conscious for the hourlong caesarean procedure and Garcia was at her side.

"It was music to our ears to hear both babies begin vigorously crying right from birth," said Dr. Gerald Nystrom, director of the hospital's neonatal intensive care unit and the physician who is overseeing the babies' care.

"They pinked up quickly," he said. "Neither required more than stimulation, suction and some oxygen."

"All things considered, they're in good shape right now, and are comfortable," Nystrom said, adding, "They have a long road ahead of them."

What will happen next depends on what doctors can now learn about the girls' shared anatomy, they said. Various tests were begun immediately.

"We're hopeful for their survival," Nystrom said. "Some surgery will be needed, but the specifics we're not able to discuss."

On Tuesday doctors, more openly than Monday, discussed the possibility of trying to separate the infants.

"They would seem separable," said Dr. H. Gibbs Andrews, a pediatric surgeon who, in 1996, led a Loma Linda team in successfully separating another pair of conjoined twins. In that case, the girls were connected at the abdomen and only shared part of one organ--the liver, which was divided between them.

"I think we can do it successfully, yes," Andrews said bluntly. "But there are still a good many issues we need to discuss and plan for . . . involving all the specialties of pediatric surgery."

The twins are expected to remain hospitalized at least one or two months, and the decision on whether to attempt separation would not be made for at least three to six months, doctors said.

Crowe and Garcia, who live in Barstow, also are parents of a 14-month-old daughter. Garcia described himself as an "unemployed jack-at-all-trades."

Conjoined twins are sometimes referred to as Siamese twins, for Chang and Eng Bunker, who were born in Siam in 1811 and later exhibited by the Barnum & Bailey circus.

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