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One Year After Arriving in the US for Surgery, Two Separate Boys are Making Medical History
New York City, NY (September 13, 2004) --Clarence and Carl Aguirre returned to The Children's Hospital at Montefiore September 9 for routine CT scans that continue to chart their remarkable progress just five weeks after the delicate surgery that separated them. For the first time ever in medical history, neither twin has shown any sign of neurological compromise following separation.
"We do these routine surveillance scans to see how well Carl and Clarence are handling their cerebrospinal fluid (CSF)," said David Staffenberg, MD, co-leader of the boys' surgical team. "Normally, CSF is produced at a constant rate and reabsorbed as well, allowing for constant circulation."
"Because of the way the twins were separated, Dr. Goodrich and I anticipated that Carl would be most at risk to develop hydrocephalus, or a buildup of fluid on the brain," Dr. Staffenberg said. "The fact that he has not has been a happy mystery to us."
"That neither Carl nor Clarence has needed a shunt to help handle their CSF, again, makes this separation uniquely wonderful even only five weeks after the event," said Dr. Staffenberg.
Accompanied as always by their mother Arlene Aguirre, the boys spent time before their tests playing with CHAM Child Life Specialists Kim Serraro and Moniqua Jackson and showing off a few new skills. Carl has begun to crawl and Clarence has shown real marksman's skill when throwing toys in Carl's direction.
The Aguirres arrived in New York one year ago, on September 10, 2003, traveling from their home in the Philippines to CHAM for the series of surgeries that ultimately would separate them. "What a difference a year makes," said Robert Marion, MD, the boys' pediatrician at CHAM.
"They continue to do exceedingly well, better than any of us expected at this stage," said Dr. Marion. "They are both eating with gusto, enjoying food by mouth for the first time in their lives."
"Carl and Clarence are both already noticeably larger than they were before the last surgery, and continue to grow by leaps and bounds," Dr. Marion said. "It is really something to see!"
Doctors, nurses and other specialists on "Team Aguirre" at CHAM report the boys' vital signs continue to be normal and neither has any infection or fever. "Even Clarence's blood pressure is normal now, and he's off all medications," said Dr. Marion.
"The boys have begun vigorous physical, occupational and speech therapy programs, and their muscle strength is improving every day," said Dr. Marion. "They are clearly interested in walking and are starting to bear weight on their legs in therapy."
Doctors said Carl and Clarence continue to be somewhat limited in terms of what they can do by the relative weakness of their neck and trunk muscles, the result of having had to lie on their backs and sides for the past two-and-a-half years.
"They are getting stronger every day, and our original prediction of their walking in three to four months seems attainable," said Dr. Marion. "In fact, I promised Arlene they would be walking by Christmas, but they may do it even sooner."
"I am so happy with how my boys are doing," said Arlene Aguirre. "Except for their bandages, now they are looking and acting like any other boys anywhere in the world."
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