Formerly conjoined twins Maria de Jesus and Maria Teresa Quiej Alvarez are not yet ready to return to Guatemala, doctors at UCLA’s Mattel Children’s Hospital announced Nov. 27. Maria de Jesus’ scalp has not fully healed from the last surgical procedure to graft skin to the back of her head, so the twins will spend Thanksgiving at UCLA’s Mattel Children’s Hospital.
“The graft itself has healed perfectly,� said Dr. Henry Kawamoto Jr., lead plastic surgeon for the twins’ medical team. “However, a small section of skin surrounding the graft on the back of Maria de Jesus’ head has not healed as swiftly as we would like.�
While both girls are healthy enough to return home, Kawamoto wants Maria de Jesus to more fully heal before she leaves the hospital. Regardless of size, every scalp wound must be taken seriously because the brain lies beneath it, Kawamoto said.
“We realized that the weight of Maria de Jesus’ head on the bed had diminished blood flow to the area and prevented healing,� Kawamoto said. “We’ve requested special bed cushions from the physical therapist and asked the nurses to periodically reposition Maria de Jesus. The wound has improved tremendously since we’ve taken these extra measures.�
Kawamoto’s team is applying a topical growth factor gel donated by Ortho-McNeil Pharmaceutical to Maria de Jesus’ wound to accelerate wound healing. Called Regranex, the gel contains a factor normally found in the body (referred to as a platelet-derived growth factor) that is part of the body’s natural healing process.
UCLA doctors face a different challenge with Maria Teresa. A recent series of tests shows that she is hearing-impaired in one ear.
“Maria Teresa has a decreased auditory perception in one ear -- probably as a consequence of the surgery,� said Dr. Jorge Lazareff, chief neurosurgeon for the twins’ medical team.
Still, both doctors emphasize that both sisters are thriving and improving each week. In particular, Maria Teresa, whose recovery has lagged behind her sister’s since the surgery, is looking around her and making eye contact with visitors, responding to “coos� from family and staff members, and displaying jealousy when her twin steals the attention. Both girls also continue daily sessions of physical and occupational therapy to help strengthen their mobility.
“We expect them to spend Christmas in their home country,� Lazareff said.
“They should reach Guatemala in plenty of time to hear their relatives sing ‘Feliz Navidad’ to them,� agreed Kawamoto.
While all UCLA physicians on the twins’ cases are donating their services, Mattel Children’s Hospital is absorbing the $1.5 million and rising cost for the twins’ medical care. As a research hospital, UCLA decided to accept the case for humanitarian reasons, and to learn from the rare surgery how to teach other physicians to care for future cases like the twins’. The girls’ parents are under no obligation to reimburse the hospital for the twins’ six-month stay.
To recover some of its expenses, the hospital established a fund called Twins Care at UCLA. To date, donations have fallen short in helping to pay for the twins’ hospitalization. Checks payable to UCLA Foundation may be mailed to UCLA Medical Sciences Development, 10945 Le Conte Ave., Ste. 3132, Los Angeles, CA 90095.
Healing the Children has also raised private donations on behalf of the twins’ care. Contributions may be mailed to Box 221478, Newhall, CA 91322.