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Conjoined Twins News Conference

Aired August 6, 2002 - 13:00   ET


KYRA PHILLIPS, CNN ANCHOR: Now to Southern California, live from UCLA Medical Center, with more now on the condition of those twins separated.


UNIDENTIFIED FEMALE: UCLA hospital systems, and director of UCLA Medical Center, who will make a brief statement about the twins' current continue. Naomi Bronstein is a volunteer with Healing the Children, and Chris Embleton is the director of Healing the Children, the nonprofit organization that helped to bring the children to the United States and to UCLA.

DR. MICHAEL KARPE, DIR., UCLA MEDICAL CENTER: Good afternoon. At 9:17, Maria Teresa taken back to the operating room to deal with a subdural hematoma. A subdural hemotoma is a collection of blood underneath the scalp, and that needs to be dealt with to make sure that the pressure doesn't buildup in the scalp. This is not necessarily an unexpected complication. Dr. Jorge Lazareth (ph) has said that he thinks that this will be manageable, and that he still feels surgery can be quite successful for Maria Teresa.

As I said earlier before, we will be on a minute-to-minute basis, hour-to-hour basis and a day-to-day basis. We are through a critical phase. The surgery was the first major step that was really quite successful. We need to get through the next couple of days, and we will certainly keep you informed of any significant changes.

Dr. Lazareth (ph) will be available for comments when he's done surgery, but his attention is strictly focused on the children at this point in time.

I am going to introduce Chris...

QUESTION: Is this life threatening for Teresa?

KARPE: This is very complicated surgery, and until we get past several days, it will be life threatening for both of them. We're minute to minute, hour to hour, day by day. We just can't get ahead of ourselves.

All I can say is that the children are receiving incredible attention, and we certainly will do everything that we possibly can to make sure that surgery works out as well as we hope it will work out. Healing the Children has been very important in making this possible. So I'm going to turn over to Chris, and she will be available to you.

QUESTION: Are you staying too, sir?


QUESTION: Can we ask you questions before you leave?

KARPE: A couple of questions.

We tried to get that information to you as quickly as it was confirmed. You received a press release. We will try to get you information as quickly as we ourselves get it. We want to make sure that the information we give you is correct, accurate, we understand the implications of it, and at this point in time, the surgeons have to do their work, and no one is going to interfere with them getting what done what needs to be done. The focus is on the children. As soon as we have information for you, we'll get it to you.

The other baby is in the intensive care unit doing well, as we speak.

QUESTION: Can you talk about the work that your team did last night?

KARPE: It is not my team. I happen to be the person administratively responsible for the hospital. The team headed by Drs. Lazareth (ph) and Kamoto (ph). They will be available to you when they get out of the OR and they think it's appropriate.

QUESTION: As an institution, this is an incredible thing for UCLA.

KARPE: This is an incredible thing for the children. This is about the children. And it's an incredible thing about the children.

What UCLA did it did because we have the specialist, and the facilities and the expertise in neurosurgery and plastic surgery, neuroradiology, brain mapping and brain function, and its' because of that expertise that we took on the project. But this is about the children. They're the heroines in this stories. The surgeons and the anesthesiologists are the other heroes and heroines in this story.

QUESTION: Doctor, one more question. Maria De Jesus, the girl who is in intensive care, is she awake yet?

KARPE: I can't answer the question. I don't know exactly what mental status is at this point in time.

QUESTION: Can you assess how the doctors are feeling after 22 hours?

KARPE: The doctors, they're pretty tired. But they will do what they need to do to get through this thing, and give these young ladies every possible chance that they can. So doctor -- both of them have gotten some rest, and Dr. Lazareth (ph) is on immediate call to deal with issues. There are a team of pediatricians taking care of these babies in an intensive care unit. They're extraordinarily experienced, and so these young ladies will get the best of care possible any place in the world.

UNIDENTIFIED FEMALE: Chris Embleton now will speak to you.

CHRIS EMBLETON, DIR., HEALING THE CHILDREN: As someone who dearly, dearly loves these little girls, and of course is very, very concerned about the development this morning, I truly believe that we are still going to have our miracle, and the only thing I would really ask the world to do is to pray for these little girls, that they would heal.

I -- in other cases that I've dealt with through the years, these things happen, and we want you to know that the best care possible is being given to these girls. I want to read a letter quickly from the consulate of Guatemala. I received a fax from him today, and I think it's a very special fax, so I would like to read it quickly.

"I have been in contact with the minister of foreign affairs, who is following this with great anticipation. Our ambassador in Washington and Guatemala, people in Guatemala, and all over the world, via the Internet, and they have all been awaiting the wonderful news that we have received. On behalf of the people of Guatemala, the government and I wish to express our most profound and sincere appreciation to all involved with this marvelous gesture of goodwill. From the bottom of our hearts, we thank you." And that's Mr. John Allman (ph) working with the consulate here in Los Angeles.

I'm willing to take a few questions.

QUESTION: Have you spoken to the parents this morning?

EMBLETON: No, I just actually just arrived at the hospital.

They were notified throughout the...

You know, they preferred being with their family at home, because of -- they just wanted to be alone.

QUESTION: Are they arrived at the hospital?

EMBLETON: I just arrived here, so I don't know. I think they are here.

QUESTION: They are here now?

EMBLETON: I don't know. I honestly do not know, because I just arrived here.

QUESTION: Can you talk about the need to collection more donations to cover these expenses?

EMBLETON: Yes, this the one of the most expensive surgeries that you can possibly have, and it is true that UCLA has been willing to underwrite much of it. But the truth of the matter is, donations really are needed. And therefore, a fund has been established, both at Healing the Children and at UCLA, and if people wish to partake of this miracle, they can do so by making donations, as well as offering their prayers.

Yes, I have received calls from Guatemala. I have to tell you that the whole nation of Guatemala has been waiting this news. It's really true. And in particular, waiting the news have been the nurses and doctors who were carrying for these girls for 10 months.

The pediatrics foundation is the agency that referred the girls to us, and they've been calling every two hours to get an update.

NAOMI BRONSTEIN, HEALING THE CHILDREN: I speak very badly, so you have to speak to me very slowly.

Pure joy. Pure joy. The people of Guatemala have been having masses and prayers for these children for a long time, and these little "maritas (ph)," these little children are the children of Guatemala, and the whole country has come together for these kids, so there was nothing but peer joy and celebration.

QUESTION: And I'm wondering specifically about the -- what the parents said or what their reaction were?

EMBLETON: You can well imagine how you would fell as a parent. It doesn't take great imagination to figure out how the parents feel. I think the -- they felt very much like what we did last night. And that is pure joy, pure joy, and the fact that this moment had finally come.

QUESTION: Did they say anything about the doctors or the team at UCLA?

EMBLETON: I believe the father issued a statement. I wasn't here at the time, because we finally went home last night. Of course, profound appreciation for the doctors.


PHILLIPS: Right now, you're listening to one of the representatives from Guatemala, where those two -- the twins are from, talking about pretty much how rare it is to find a doctor that can perform such a surgery. That's why the girls are in the United States.


PHILLIPS: And going true this. Now the biggest piece of news, I guess, to come aside from that is Dr. Michael Karpe talking about the one twin. It was Maria Teresa that was whisked back into the hospital room with blood building under her scalp. No was this expected, unexpected? Was it normal?

GUPTA: I think it had to called unexpected still. Certainly no one wants it. What we're talking about, they call it a subdural hematoma. That means blood that has accumulated on top of the brain, between the outer lawyer of brain and the brain itself.

Kyra, especially after an operation like this, it's not uncommon to have these sort of bleeds. Certainly, no neurosurgeon expects or wants it to happen, but it does happen sometimes. Certainly being under anesthesia for 24 hours, it does make the blood a litter thinner, so you're more likely to bleed. As we've talked about so many times, they are operating on some large blood vessels and the chance that one of these blood vessels could start to bleed ever one of those blood vessels could start to bleed even after the operation, certainly a concern.

That's precisely why they call these few hours, these few days, the most critical part of this operation. I know you've called it that, and it's a good point, because this is the sort of thing you've got to worry about. In her case, they probably saw that she wasn't waking up as well as the other twin, decided to get CAT scan. That would have shown the blood on top of brain, and then made the decision to go ahead and take back to operating room. The sooner the better with something like that.

PHILLIPS: How do you drain the blood? How do you relieve that pressure. Let's start with that.

GUPTA: I don't know exactly where this particular blood collection is, but let me just show you on the model here, basically, again, it's going to be blood that's probably in the area where they operate, somewhere in the back of the brain. Here actually pushing on the brain. When that happens, you actually have to remove some of the bone around there. Maybe some of the new bone that they just put down, even, and go ahead and open the outer layer of the brain. That's going to be right on top here.

Almost immediately you are going to see the blood, and you go ahead and just literally remove the blood, find out what's bleeding, stop that, and close again, like they did a few hours before. That is the most classic sort of way they probably approach something like this. It sounds like they're doing that right now.

PHILLIPS: So the blood is building up and causing pressure on the brain. Is that what triggers a stroke?

GUPTA: It can trigger stroke-like symptoms. One of the things that you might see in someone like her, is that she just might not be moving one side of her body as well. And if she's not moving a side of her body as well, they'll say, gosh, is this a stroke, or this is something that's actually pushing on the brain that we can operate on and actually remove. In some ways, thankfully, it's the latter. because it's something you can actually do something about. Removing the blood should hopefully make her more normal again in terms of her movements.

PHILLIPS: Now the other twin, Maria De Jesus, saying that she has not -- she's still asleep. Is that OK? GUPTA: It was an over 20-hour operation, and certainly operations that long, you want to let the kid sort of wake up slowly. There's no reason, really, to try and wake these children up more quickly. You want to keep your pain management under good control. Sometimes you give them enough pain management where they're not really breathing well on their own yet. You keep on the ventilator. All those things expected. I wouldn't be surprised if it would be end of the day today, or even tomorrow, before they come off the ventilator.

PHILLIPS: Sorry to ask you these kind of random questions. Let's talk about the covering of their head. First of all, the process of covering the skin. How do they cover the top of the head? And then of course, I want to know, how does the hair grow back?

GUPTA: Well, I'll tell you, this is pretty neat stuff. And I think it's equally fascinating as the actual neurosurgical procedure. They actually put these little balloons underneath the scalp about a month ago, and what that did it actually Expanded all the skin and the reason for that was that you are going to need to get the extra skin to cover the hole, literally the whole, that's left by this operation.

Now all of that is the same skin from the top of the head. They didn't have to take the skin from other parts of the head. So it should grow hair normally. These girls, they have a lot of hair already, as you can see. But that hair should grow back well, which is different than you take skin graft from somewhere else on the body, which you've see maybe in burn victims and stuff like that, they actually have to cover it with skin grafts. That won't grow hair as well. But for these girls little cosmetically, they should look pretty good.

Their ears were not completely aligned. These were all things the plastic surgeons are thinking about as well. These are very important issues for these girls, especially as they grow up. But it looks like everything should grow normally.

PHILLIPS: All right, Dr. Sanjay Gupta, ask you to kind of stay with us here and standby. We are going to go back to Gary Tuchman, the other big player in the story. He is live there at the medical center. A little bit of news. He want to weigh in on what's been happening -- Gary.

GARY TUCHMAN, CNN CORRESPONDENT: Well, Kyra, we've been talking about all day, how one of these little girls bigger than the other one. When they were connected, she kind of dominating the twisting and turning these children would do, and it was always Maria Teresa who would be able to turn over her sister. Maria Teresa is in the operating room right now. I think it's very important, and Dr. Gupta pointed this out, that this is not necessarily unexpected. That was the quote from Dr. Karpe, and that it's manageable. Doctor Karpe had come out and talked to us earlier. He said, please, let's not jump the gun, we're very happy, but don't get exhilarated yet, because the hours, and days and the weeks ahead are very crucial. He told us that. He stressed that. And now they do have this complication. But once again, it's very important to point out that Dr. Karpe has told us just now that it's manageable.

Back to you, Kyra.

PHILLIPS: And that is good news. All right, Gary Tuchman, thank you.




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