Four months after their history making separation, Carl and Clarence Aguirre recently returned to New York's Children's Hospital at Montefiore for the first in a series of low risk surgeries to reconstruct their skulls and scalps. No big deal, at least in comparison to the four high stakes, life and death brain surgeries the Filipino twins have already undergone in the last year. Their mother Arlene is not even worried. Instead, she's happily complaining about how hard it is to take care of two newly separated sons, as demandingas any two-and-a-half year old boys.
Once, her boys' future seemed very bleak, joined at the head, forced to spend their days on their backs. But now thanks to their separation and with still no evidence of any brain damage, Carl and Clarence each continue to gain ground.
Julie Knitter, occupational therapist: “Carl's really exploring his body and space, using his hands to move, all the things he never had an opportunity to do in his first year of life.”
Since returning to Blythedale Children's Hospital in Valhalla, N.Y., where the boys are staying between surgeries, they've not missed a day of physical and occupational therapy. And because of this, the twins have both gained strength in their necks muscles, allowing them to sit up on their own. Their plastic surgeon David Staffenberg sees this as a breakthrough.
Dr. Staffenberg: “Seeing them sit up was phenomenal for me. That's the position that I like to see babies in. If I could have brought fireworks into the hospital, I would have.”
The boys are even working toward standing, expecting that one day, not so far off, they'll both be walking. One of the other goals is to wean Carl and Clarence from their feeding tubes. Now that they're both nearly reached normal weights and sitting up, doctors want the boys to learn to eat normally fulltime.
The twins seem engaged and happy. While they only say a few words and are behind cognitively, doctors have every hope they will catch up.
Rita Erlbaum-Kotarac, speech therapist: “Carl's been saying a lot more words since the separation, both in imitation as well as on his own. Clarence now is spurting a little bit and is starting to do that, too.”
Clarence seems to want to play with Carl more than Carl wants to play with him, but both are most interested in getting the attention of their mother.
The remarkable success of the Aguirre's surgeries recently prompted New York City's mayor to single out the Children's Hospital at Montefiore's separation team for a science and technology award.
The Aguirre boys have also caught the attention and the hearts of the kiddie sensation, the Wiggles, Australia's answer to Barney. The silly foursome stole away from their world tour to come to Montefiore to perform for Carl and Clarence along with the other patients there.
But all the hoopla notwithstanding, Carl and Clarence, their mother, their doctors and their therapists are all working hard in the trenches for the day the boys can go home. Plastic surgeon David Staffenberg checks on the boys every afternoon, changing their bandages.
Dr. Staffenberg: "So you see the bald spot is just in the hair line? His hair line over here is normal. And it's normal all the way around but what we've got to do is eventually bring the scalp up over the top.”
Spending so much time with them, this doctor is unashamed to say his love for Carl and Clarence has deepened.
Dr. Staffenberg: “To some extent, they're my little boys, and you know when they do these things, when they sit up and when they, when they play, they're making me proud, and you know the idea of separating myself as a physician is an impossibility.”
Dr. Staffenberg has a surprise of his own. This spring he himself will become a first-time father.
Dr. Staffenberg: “I couldn't be happier. I think if I've gone through this, I hope I'm ready to be a dad. I think I am.”
Last Wednesday, Dr. Staffenberg seemed just that. With the tenderness of a parent and the skill of a surgeon, he and the rest of the Montefiore team took a first step in the process of reconstructing Carl and Clarence's skulls and hairlines. They successfully performed a skin graft procedure to cover the bald areas on the boys' scalps. Doctors report that the boys are doing fine and already ready to get back to playing, on the road to a future their mother could only dream of.