Clarence and Carl Aguirre
Born (2002-04-21) April 21, 2002
Manila, Philippines

Clarence and Carl Aguirre (born April 21, 2002) are former conjoined twins born in Manila.[1] They were conjoined at the top of the head and shared 8 centimetres (3.1 in) of brain.[2] More than 1–2 centimetres (0.4–0.8 in) will affect brain functionality in one or both of twins.[1] Without separation, they were expected to live around 6–8 months.[3]

Biography

Arlene Aguirre, a Silaynon nurse working in Manila, discovered at her four-month ultrasound that her sons were conjoined twins.[4] As a Catholic, she refused to have an abortion, and gave birth to Carl and Clarence on April 21, 2002, ten days before her due date, via C-section.[5][4] The boys were craniopagus and were joined at the top of their heads, meaning they were unable to sit up or see each other.[2][6] The doctors recommended the typical solution of sacrificing one child to save the other, but Arlene refused to choose which boy to save.[1] She returned to her parents' home in Hacienda Paz, Silay, where her mother Evelina could help raise the boys.[5][4] The boys' father was married and had four other children to support and was only able to provide small sums of money once a month.[4]

By February 2003, the boys had difficulty eating and were often ill.[4][5] The Philippine Airlines Foundation and the American nonprofit Children's Chance helped Arlene connect with New York neurosurgeon James T. Goodrich.[4] Goodrich's team spent six months researching, preparing, and communicating with the Aguirres' doctors in the Philippines before they accepted the case.[5] Arlene, Carl, and Clarence flew to the United States in September 2003 to have the boys separated.[6][4][7]

In September 2003, tissue expanders (pouches filled with saline) were implanted under the boys' scalps to create more skin to cover the twins' wounds after separation.[8] The surgeries began in October[8] at the Children's Hospital at Montefiore in The Bronx, New York.[6] The hospital covered their multi-million dollar medical expenses and continued to support them after their surgery.[9][10]

On August 4, 2004, the final surgery was completed and, at two years old, Clarence and Carl became the first craniopagus twins to be separated using a staged method.[3][6][1][11] Goodrich, plastic surgeon David A. Staffenberg, and their team performed four surgeries over ten months.[1] During the surgery, Goodrich discovered two inches of shared brain were not detected in MRIs or during the first three surgeries. They were continuous rather than fused, making it more complicated to operate on, as severing a shared brain incorrectly would cause medical distress.[2][10][12] He was able to find a narrow strip and the boys were successfully separated.[13][14]

Most of the post-operative rehabilitation took place at Blythedale Children's Hospital in Valhalla, New York.[15][16] Both wore helmets to protect their brains; when they are fully grown, their skulls will be patched,[1] though no approximate date has been made publicly available.

Within just over a year, Clarence was able to walk short distances and Carl could walk using a walker; both boys were also learning to speak.[17] By September 2014, the twins were still attending physical therapy at Blythedale. In the month following the surgery, Carl developed a seizure disorder, but by 2014, they were down to two a day rather than a dozen.[9] However, he has had some degeneration in his right parietal lobe, has limited use of his left side,[1] and uses either a wheelchair or leg braces to move around.[3]

As of October 2021,[18] Arlene and her sons live in Scarsdale, New York in a home that has been funded by a variety of charities, as Arlene has been unable to work on a medical visa.[3][6][1][9]

References

  1. 1 2 3 4 5 6 7 8 "Once-Conjoined Twins Have Come A Long Way 10 Years After Separation". CBS New York. 2014-08-04. Retrieved 2021-10-30.
  2. 1 2 3 Tomasi, S. Ottavio; Winkler, Peter A. (2020). "Letter: "The Most Interesting Man in the World" – A Tribute to Dr James Tait Goodrich". Neurosurgery. 87 (2): E241–E242. doi:10.1093/neuros/nyaa195. Retrieved 2021-10-30.
  3. 1 2 3 4 Harkins, Joe (n.d.). "Ten Years After: Medical Tourism Surgery is Cause for Celebration". Medical Tourism. Retrieved 2021-10-30.
  4. 1 2 3 4 5 6 7 Sarmiento, Maria Carmen (n.d.). "The Aguirre Twins - A Back Story Paid Forward". Positively Filipino. Retrieved 2021-10-30.
  5. 1 2 3 4 Abraham, Laurie (2005-08-12). "Separation anxiety". NY Mag. Retrieved 2021-10-30.
  6. 1 2 3 4 5 "Ten years later, once-conjoined twins are living separate lives". Denver Post. 2014-08-03. Retrieved 2021-10-30.
  7. ↑ Curry, Ann (26 September 2005). "Next steps for former conjoined twins". msnbc.com.
  8. 1 2 "Conjoined twins: A look back at the historical surgery". LoHud. 2014-08-02. Retrieved 2021-10-30.
  9. 1 2 3 Lerner, Jane (2014-08-04). "Formerly conjoined twins mark decade since surgery". USA Today. Retrieved 2021-10-30.
  10. 1 2 Fitzgerald, Jim (2004-08-16). "Conjoined twins' surgery a success story". Park City Daily News. Retrieved 2021-10-30.
  11. ↑ "Famed neurosurgeon to speak at UC Irvine on Friday". LA Times. 2007-05-09. Retrieved 2021-10-30.
  12. ↑ "Slow Separation for Twin Boys". CBS News. 2004-08-02. Retrieved 2021-10-30.
  13. ↑ Spicuzza, Mary (2004-08-04). "Doctors separate twin boys despite finding brains were fused". The New York Times. Retrieved 2021-10-30.
  14. ↑ "Twins stable after separation surgery". Fox News. 2004-08-05. Retrieved 2021-10-30.
  15. ↑ "Carl and Clarence Celebrate Second Post-Surgery Anniversary". Montefiore. 2006-08-04. Retrieved 2021-10-30.
  16. ↑ Abraham, Laurie (August 12, 2005). "What Happened After Dr. James Goodrich Separated the Head-Joined Aguirre Twins - Nymag". New York Magazine.
  17. ↑ "Aguirre Twins Take First Solo Steps". Montefiore. 2005-09-26. Retrieved 2021-10-30.
  18. ↑ Gold, Michael; Slotnik, Daniel E. "Dr. James T. Goodrich, who operated on conjoined Filipino twins, dies at 73". ABS CBN News. Retrieved 2021-10-30.
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