Montefiore in the News
Carl and Clarence Now Riding Tricycles and Standing
New York City, NY (March 11, 2005) - Formerly conjoined twins Carl and Clarence Aguirre continue to do well on all fronts six months after making medical history at The Children’s Hospital at Montefiore (CHAM) as the first craniopagus twins to be surgically separated in stages, without any apparent neurological damage or deficit. The brothers, who will be three-years-old in April, have spent the winter relatively illness-free. Their doctors say this is probably a side-effect from having had their tonsils and adenoids removed at CHAM a few months ago to help treat acid reflux issues.
"They are eating well and growing nicely, and both of them are now officially on the normal growth curves for height and weight," said Robert Marion, MD, the CHAM pediatrician who has been caring for the brothers since their arrival in the US in September 2003. "Clarence's hypertension, which was a major concern before their separation surgery, has completely resolved," said Dr. Marion. "He is not on any antihypertensive medications."
"Their personalities continue to be different from each other, with Clarence very friendly and outgoing, always smiling and Carl more serious," said Dr. Marion. Carl has had a life-long problem with gastroesophageal (acid) reflux, a consequence of having to live lying on his back until the separation surgery. "Although he still has occasional episodes, these have gotten a lot better than they were last fall," said Dr. Marion. "The removal of his tonsils and adenoids definitely has helped."
Carl and Clarence are now each riding tricycles. Their therapists at Blythedale Children’s Hospital, where they receive physical and speech therapy, use Velcro to secure their shoes to the pedals and they can both sit on their tricycles’ seats and steer and pedal independently.
Earlier this week, when the temperature reached 60 degrees in New York, the boys were taken outside to ride their tricycles on a secluded walkway. With a gentle breeze blowing in their faces (something they'd never experienced before), they looked like they were having a great time.
"They almost ran me over with those tricycles in the hall the other day," said James T. Goodrich, chief pediatric neurosurgeon, who led the boys' surgical team at CHAM. "We've discovered that riding tricycles makes use of the same muscle gruops that Carl and Clarence already had pretty well developed."
"They are both pulling themselves up, standing holding on and cruising, which every parent knows means they are taking steps while holding on to a table or other stationary object," said Dr. Marion. "Last week they graduated from the infant classroom to the pre-school classroom, a major advance on their road to recovery."
Specialists say both boys continue to add new spoken words very slowly. "They each say a few words, but are clearly behind where they should be, verbally, for kids of their age," said Dr. Marion. "I can't explain this, but, with the motor advances they're making, I'm not all that worried about it."
"When you think that it's only been six months since their separation surgery and that their motor skills have advanced by more than 10 months from where they were, it's a really heartening sign about their future," said Dr. Marion.
Dr. Marion added that Clarence and Carl look like any other twins at this point, even though both boys are still wearing dressings to cover their heads. "They look like any other growing boys, and wouldn’t even stand out in a crowd," said Dr. Marion. "It continues to be extremely gratifying having the opportunity to take care of two little miracles," said Dr. Marion. "This is a unique experience for me. In the 20 years that I’ve been at Montefiore, I've never had the change to care for any other patients who had absolutely no chance of survival when I first met them, and then, following a surgical procedure, could actually look forward to a future of limitless potential," he said.
"Thanks to a lot of talented and caring practitioners on their medical teams, that's basically what Carl and Clarence are looking at now," he said. "Limitless potential for a very good life."