Monday, May 27

One twin finally out of intensive care unit


Maria de Jesus and Maria Teresa Quiej Alvarez, twins formerly
conjoined at the head, continue to improve and could return to
their home country of Guatemala some time in October, doctors
said.

Maria de Jesus was upgraded to good condition and was moved from
the pediatric intensive care unit at the UCLA Mattel
Children’s Hospital into a regular patient room Thursday.

“She’s going along very well, smiling and giggling,
all the things she’s supposed to do,” said Dr. Henry
Kawamoto, the chief plastic surgeon on the twins’ case.

Maria Teresa has been upgraded to fair condition and remains in
the PICU.

In the weeks following the 23-hour separation surgery on August
6, Maria Teresa underwent several follow-up surgical procedures,
causing her recovery to lag behind her sister’s.

Maria de Jesus was able to leave the PICU because she no longer
needs a drain to remove extra fluid from her brain.

Unlike her sister, Maria de Jesus is also eating by mouth. Maria
Teresa continues to be fed by a tube to her stomach, according to
PICU staff nurse Trish Bohuslav.

The nurses continue to provide the twins with “basic
care,” giving them feedings, checking their vital signs,
changing diapers, and giving them medication. Occupational
therapists are working to get Maria Teresa to eat again, and
physical therapists exercise her arms and legs.

“We would like it better if both were doing equally well.
It’s hard to see one of them lagging behind the other,”
Bohuslav said.

“(Maria Teresa) will get there; she’s just going at
a slower pace,” Bohuslav added.

The girls’ parents, Wenceslao, Quiej, 21, and Alba Leticia
Alvarez, 23, who have been unavailable for interviews, are reported
to be very happy with their daughters’ progress.

In preparation for the return home, they have been undergoing
training on how to care for their daughters.

“(The twins) will need the parents to participate with
them in their recovery,” said Cris Embleton, executive
director of the California chapter of Healing the Children, the
nonprofit group responsible for bringing the 14-month old girls to
UCLA in June.

Embleton, who is in charge of seeing the twins home, plans on
having a group that would include a doctor, a nurse, a social
worker, and physical and occupational therapists accompany the
twins on the plane. They would spend around three days working
“with their counterparts in Guatemala and then turn it over
to them,” Embleton said.

Before the girls leave, Maria de Jesus will undergo a minor skin
graft procedure.

“It will complete the healing of Maria de Jesus
totally,” Kawamoto said.

The procedure involves taking pieces of skin approximately the
size of a postal stamp and putting them over the areas where the
skin has not completely regenerated.

Within the next few days, the PICU staff expects Maria Teresa to
no longer need the drain and join her sister in the regular
pediatric ward.

“Everyday, (Maria Teresa) is a little bit more active, a
little bit more improved compared to the day before,” said
Dr. Andy Madikians, one of the PICU physicians.

At this point, Madikians said, it is difficult to predict the
long-term recovery of the girls.

“You will never know exactly until years have gone
by,” Madikians said.

“The major issues have been dealt with, and everything
seems to be healing well,” he added.

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