Health & Medicine

Conjoined twins undergo marathon separation surgery as tense hours tick by

As a team of doctors waited Tuesday morning at Lucile Packard Children’s Hospital, the Sandoval family formed a circle of prayer around 2-year-olds Eva and Erika and planted a final round of tear-soaked kisses on their tiny foreheads.

The girls, wrapped in purple hospital robes and resting on a cot, looked up at their parents and siblings with loopy affection, seemingly unaware that they were about to undergo a risky operation to separate their fragile, conjoined bodies. Eva reached for the dangling cord of her sister Esmeralda’s sweatshirt, as if to pull her even closer, while Erika reached blindly at the nose and chin of her oldest sister, Aniza. Brother Emilio stood with his hands crossed and leaned into the circle with an ear-to-ear smile.

“Mama,” Eva slurred. “Papa.”

Parents Aida and Arturo gazed down for a long look at their girls. The university chaplain linked the family’s hands together in prayer while taking Erika’s into her own. As tears streamed, the family held each other tighter.

Their prayers said, nurses wheeled Eva and Erika through double doors toward the operating room where the marathon surgery would take place. A nervous wait of as long as 24 hours had begun for the family.

Fused from the chest down, the twins from Antelope have managed to grow into talkative, playful toddlers while sharing a liver, bladder and some digestive tract as well as a third leg. Their parents and Stanford doctors, however, decided to go ahead with the dangerous surgery because of growing health risks if the twins stayed conjoined.

Only a few hundred surgeries have ever been performed successfully to separate conjoined twins, and doctors calculated a 30 percent chance that one or both twins wouldn’t make it through Tuesday’s operation. Their procedure involves 50 members of the hospital staff specializing in plastics, orthopedics, urology and other fields.

In the waiting area, the three older siblings gathered in a tight huddle out of sight, their faces buried in one another’s shoulders as they released their sobs.

“It’s so hard to think about it – they’re just so helpless right now,” said Esmeralda, 25. “I just can’t believe this is the last time I’ll see them before they’re going to be separated. I know everything is going to be OK. There are so many positive vibes from everybody.”

The Sandovals’ long day started at a quarter past 5 a.m. in the Palo Alto apartment they had rented. About 30 relatives who had come in from all over the country rushed to roll up their air mattresses and fold blankets strewn on every armchair and couch.

Arturo belly-flopped on a mattress and nuzzled his pajama-clad girls as the rest of the clan dressed and packed. Aniza ran her long, manicured fingers through Eva’s tangled brown hair and attempted to wrangle it into a ponytail as Aida packed up crocheted blankets and head scarves to shield the girls from the brisk morning air.

With Aida following close behind, Arturo lifted his daughters’ combined 42-pound bodies in his arms and hefted them into the elevator.

Minutes later, the Sandoval clan marched into the hospital in an oblong pack and spread out with snacks and magazines in a waiting room set aside just for them. As the hours wore on, more cousins, aunts, uncles and other extended family trickled in, until hospital staff moved them to a bigger space. The hospital finally settled the family in its auditorium.

Many wore “Sandoval Twins – Born as One Soon to Be Two” sweatshirts that were ordered when the girls were born in August 2014. Aida and Arturo showed off newly printed T-shirts with a family photo of themselves, the twins and their three older children. Arturo’s sported the social-media-inspired slogan “#winning.”

Aida said having the family nearby helped take her mind off the stress of the surgery.

“They’re distracting me,” she said. “I definitely feel the love from everybody. In moments like this, with everybody being here together, it definitely makes us stronger.”

Iris Petrosky, Aida’s younger sister, said she didn’t think twice about jumping on a plane from Texas.

“My sister said she really needed me here,” Petrosky said. “I will be here until they kick me out. I’m not leaving her side.”

Throughout the day, the family caught up in English and Spanish with relatives they had not seen for months or years. They also passed around Nayeli, Esmeralda’s 11-month-old daughter. Young cousins braided each other’s hair and played games on their phones. A donated buffet of sandwiches and carnitas with rice and beans arrived for the excited family around noon.

Aniza said the family’s gatherings were always festive, even though this one was underscored by the most urgent of concerns.

“Knowing we’re going to be there for over 12 hours, that’s a long time to be sitting,” Aniza said. “It’s not like we’re having a party, but our energy and our jokes will keep us distracted through the long day. I realize this trip isn’t a vacation. It’s for my little sisters.”

Aida’s parents, who were both born in Mexico and traveled to Palo Alto from Redding despite health concerns, were welcomed with warm embraces in the afternoon. The entire family joined in a recitation of the Lord’s Prayer led by the Rev. Tom Martin of St. Pius Church in Redwood City, who also praised Aida and Arturo in a passionate speech for their dedication to the twins.

Isabel Pineda, Aida’s 69-year-old mother, said she was proud of her daughter’s strength and wanted to lend the family her own support.

“I’m so worried,” she said. “I need to be here to support my child. I don’t want her to see me cry.”

She never thought she’d have new grandchildren at such a late age, she said, but she was elated as soon as she saw Eva and Erika. She recalled the way they would paw at her bracelets and earrings as babies and smile at her constantly.

“My kids, they are too old, so this was a surprise – a real surprise,” she said. “I’m so happy. I’m too old, but I hope I can have enough life to be there for them. I hope everything will be OK and I can see them grow up. That is my hope and that is my faith, that they are going to be OK.”

Anne Shachal, an infant development specialist in Lucile Packard’s neonatal intensive care unit, helped take care of Eva and Erika during the seven months after their birth. She and staff there had never treated conjoined twins before, she said, but together with Aida they figured out the best ways to hold them, sit them up and engage them with toys.

On Tuesday, she took the day off work to be with the Sandoval family. Aida’s face lit up when Shachal joined the weary crowd.

“I’ve watched them develop from fragile little babies to robust babies who are bursting with personality,” Shachal said. “(Surgery) was always something everybody wanted for them, but there was always a delay. It’s a bit surreal to know it’s actually happening today.”

Sammy Caiola: 916-321-1636, @SammyCaiola

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