TWINS IN A CLASS OF THEIR OWN
Rosie and Ruby Formosa were born conjoined but four years after undergoing separation surgery the sisters are preparing for their first day at school
IDENTICAL twins Rosie and Ruby Formosa can barely contain their excitement about starting school for the first time. Watching them skip hand-in-hand in their smart new uniforms it is hard to believe that their mother Angela feared she would never get to enjoy this very special occasion.
In the womb her daughters were given just a 25 per cent chance of survival after a scan revealed they were conjoined. It is a rare condition that affects only 1 in 200,000 live births.
“It was the worst case scenario,” recalls Angela, 35, from Bexleyheath in south-east London. “I was scared and upset. We were told there was a high chance the girls would not survive the pregnancy. At that stage the doctors could not tell what was connecting them. I didn’t prepare to bring them home. It was heartbreaking.”
However the person who calculated those bleak odds did not reckon on the incredible fighting spirit of Rosie and Ruby, or the skill of surgeons at London’s Great Ormond Street Hospital (GOSH).
Up to 60 per cent of conjoined twins are stillborn yet this pair not only survived but thrived in the womb for 34 weeks until their planned early arrival.
Rosie and Ruby weighed more than 5lbs each at birth and their mother still treasures the moment she heard two little cries, although the girls were joined at the abdomen and shared part of an intestine.
Soon afterwards the babies were whisked away for separation surgery by a team led by paediatric surgeon Professor Agostino Pierro.
Conjoined twins are genetically identical and are therefore always the same sex. They develop from the same fertilised egg and for reasons that are not clear conjoined girls are much more common.
Over the past 30 years GOSH has treated 27 pairs of conjoined twins. The first surgery to separate twins was performed there in 1985 and techniques are advancing all the time.
Without the operation Rosie and Ruby would have died because their shared intestine was blocked. Fortunately they were not linked at the head and did not share a vital organ. A shared heart makes it near impossible to separate and save both.
SEPARATION is always the preferred option but there have been cases where it has been too risky. Ronnie and Donnie Galyon from Ohio in the US, who were born in 1951, are the oldest surviving twins who remain conjoined.
Surgeons were optimistic that both Rosie and Ruby would pull through but there was always the chance that one girl would live while the other died during the five-hour operation. In previous instances surgery meant the certain death of the weaker twin but in this case the girls were equally strong.
Angela says: “When I held them before the surgery I thought, ‘Is this the last time I will cuddle my daughters?’ And then they were anaesthetised and I thought, ‘Will they ever wake up?’ They were so tiny. It was the most difficult 24 hours of our lives.”
The operation was a success and Angela, who was 16 weeks pregnant when she discovered the twins were conjoined, adds: “Seeing their two little bodies in separate cots for the first time I just burst into tears with happiness.” Their father Daniel, 40, a taxi driver, celebrated by painting their bedroom.
Angela says those anxious times in hospital now feel like “a million years ago” but still treats every landmark, such as a birthday, as a cause for extra celebration.
Rosie and Ruby face more surgery but in the meantime they are happy, healthy and can’t wait to start the same school as their nine-year-old sister Lily in a few days. “They have met their teacher and won’t stop talking about her,” says their proud mum. “They are looking forward to painting – anything messy – and they love reading.
“It is a big milestone. There were times when I thought I would never see them start school so for it to be almost here is so overwhelming.
“They are very similar. They are bubbly, very headstrong and very determined.”
Rosie and Ruby have a close bond. At nursery each girl would constantly seek out her twin and they insist on wearing matching outfits. Rosie has always been slightly ahead of her sister when it comes to matters such as learning to crawl or speaking but Ruby is a great copycat and catches up quickly.
The four-year-olds’ parents are supporting the Back To School campaign which is celebrating the achievements of all children who are well enough to begin classes in the weeks ahead thanks to treatment at GOSH.
Angela adds: “They understand that they were once joined together but I don’t think they realise yet how special that is.”