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Doctors pleased that conjoined twins remain “in perfect neurological condition”
Carl and Clarence Experience Their First Snowfall
NEW YORK CITY, NY (December 8, 2003) -- Surgeons at The Children’s Hospital At Montefiore (CHAM) as a precaution today removed the tissue expander from under 19-month-old Carl Aguirre’s scalp because of a minor infection. The tissue expander had been inserted November 24th during the second in a series of surgeries planned ultimately to separate conjoined Filipino twins Carl and Clarence Aguirre. This marks the second time tissue expanders have been removed because of a resulting infection.
On Friday, Carl and Clarence left the Westchester rehabilitation hospital at which they are staying between surgeries and arrived at CHAM during the height of the recent blizzard.
"Carl and Clarence came out of today’s surgery just fine, and they remain in perfect neurological condition," said David Staffenberg, MD, chief of Pediatric Plastic Surgery, CHAM.
"They did beautifully during their second major surgery on November 24th when we gently pushed apart their brains and tied off three major shared veins," said James T. Goodrich, MD, chief of Pediatric Neurosurgery, CHAM.
"They remain in great shape, neurologically-speaking, which is our number one goal," said Dr. Goodrich.
"During the past few days we determined that the area surrounding the tissue expander was becoming infected," said Dr. Staffenberg, "and by removing the expander we will prevent a minor infection from becoming something more serious."
"As we’ve said all along, Carl and Clarence themselves, and how well they react to the various procedures, will determine how and when we take the next steps," said Dr. Staffenberg.
"These minor infections are telling us that, because of the complexity of these separation surgeries, Carl and Clarence cannot physically tolerate the insertion of tissue expanders at the same time as their craniotomies," said Dr. Staffenberg.
"As we move ahead with the separation surgeries, we now know will have to wait for more healing to take place before tissue expanders are inserted," Dr. Staffenberg said.
"This is a normal part of the surgical process, and we’re accustomed to adjusting to developments along the way," Dr. Staffenberg said. "We designed this separation process in stages specifically so we could reconsider and re-choreograph our procedures as we move toward the ultimate separation surgery for Carl and Clarence."
"Our end goal -- separation of the boys so they have a better chance to live healthy, normal lives -- has not changed," said Dr. Staffenberg.
The boys’ mother, Arlene Aguirre, is a nurse in her home country of the Philippines, and says she is "confident with the doctors’ course of action."
"Infections cannot always be prevented. I have great confidence in the way the medical team is proceeding and in the care the twins are receiving at CHAM," said Ms. Aguirre. "What is important to me is that there has been no negative change in the boys," she said. "Clarence, who’s suffered from hypertension, has already had his blood pressure go down as a result of the surgeries. My boys are very happy and very energetic."
Arlene and her sons saw their first snowfall this past weekend. "There is no snow in the Philippines, and as Carl and Clarence were being put into the ambulance for the trip to CHAM they wondered what was falling on their heads!" said Ms. Aguirre. "They kept raising their hands to catch it."
"It was also my first time seeing snow," said Ms. Aguirre. "I was just happy to actually see it. It felt like cold bubbles."
This morning, Carl and Clarence enjoyed some play therapy with CHAM Child Life Specialist Kimberly Serraro, who had them taking turns knocking down a pile of foam rubber bricks and clapping their hands and wiggling their feet to tunes from a music box.
Carl and Clarence will spend the next few days at CHAM, and then return to the rehabilitation hospital for continuing physical and nutrition therapy until they are ready for the next surgery.
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Director, Division of Pediatric Neurosurgery,
CHAM
We're known around the world for successfully separating Carl and Clarence Aguirre, born joined at the tops of their heads. Our specialists care daily for children with brain tumors, spinal cord injuries and craniofacial deformities.
