The road to recovery
operation, but in this case we had to carry out the procedure as an emergency because there was an obstruction,” he says. “The intestine was joined and we didn’t know why it wasn’t working.”
In the hours before the operation, Agostino visualised how it would go. “I think preparing yourself is the most important thing – preparing yourself not just physically but mentally,” he says. “I usually relax and make a mental plan. I think things through. I think about possible complications and how I could correct them. This is the most important thing when separating conjoined twins – the mental plan.” On average, he operates on one set of conjoined twins a year.
The day after their birth, the babies were laid side-on and Agostino cut across their abdomens at the point where they were joined. “When you separate conjoined twins there is always an uncertainty about what you’re going to find and in this case, not everything was shown in the scan. The anatomy was very disorganised.”
Once he’d looked inside he found that the babies were sharing the lower intestine. Ruby had her upper intestine only, whereas Rosie had both the upper and lower intestine. They were also linked by the bowel and a little bit of the bladder.
He made a judgement over who would get what, then he started cutting and dividing tissue until they were separated. Afterwards one baby stayed put and the other was taken to another theatre. Then the babies were stitched up. The operation, which took about five hours and involved a medical team of 15, went smoothly.
The Formosas were hugely relieved to be reunited with the girls. “They were in an incubator so we couldn’t touch them or pick them up,” says Daniel. “It was nice to see that the operation was a success and they were separated, but it wasn’t nice to see all the tubes coming out of them.” After the operation the babies were put on a morphine drip and on a respirator. A catheter was inserted into their bladders and an intravenous line gave them fluids. They spent five days in the intensive-care unit and then were moved to a ward where they remained for just over two weeks.
Angela recalls her trepidation in those first few days. “They were tiny, little babies, they didn’t cry much at all. I was too scared to touch them.”
But the girls recovered well and, three weeks after the operation, they were ready to go home. Daniel was frantically working on their new house and getting the twins’ bedroom ready. He arrived at the hospital in his taxi with Lily in tow. “I was frightened to go over a bump because I had these fragile goods on board,” he says.
It was daunting for Angela to be away from the secure bubble of the hospital, and she could see that their new house still needed a lot of work. “I was really happy to have them home, but I was a bit scared too,” she says. “The state of the house was quite depressing.”
One year on, the girls are thriving and their different personalities are shining through. In a few months they will need to undergo more surgery, but the Formosas aren’t worrying about that for now, they’re just focusing on how much joy the girls have brought them.
“I still can’t quite believe how far they’ve come,” says Angela. “I didn’t think I’d ever get them. I never thought I’d hold them in my arms.”