Former conjoined twins Emily and Caitlin Copeland celebrated their 18th birthday this week, having beaten the odds for survival after being separated 17 years ago. The girls were born fused at the chest, bile ducts, and liver. Dr. Kevin Lally performed the surgery to separate them when they were 10 months old. They will graduate from a Houston high school this month as co-valedictorians. Caitlin said, “I think for anyone it’s exciting to get to 18, but in particular for us, I think, it’s just a really big blessing that we got to 18, considering what could have happened.”
Lally said he was not certain the April 1998 separation surgery would be successful. According to the Mayo Clinic, conjoined twins typically are stillborn or die shortly after birth. The success of the surgery to separate them depends on where they are joined and how many organs they share. For Emily and Caitlin, the important factor was that their hearts were not shared, according to Lally.
When Crystal Copeland learned she was pregnant with twins she and husband John Copeland were thrilled, until the doctors told them the babies were conjoined. Crystal said knowing that frequently one baby survives and the other dies was the worst. Before the birth of the conjoined twins 18 years ago, the amount of available information was nothing to celebrate, scanty and inaccurate. Crystal said when she Googled conjoined twins all she got was babies that died and circus acts. The couple visited Lally, who was surgeon in chief at Hermann Memorial Children’s Hospital in Houston, while Crystal was still pregnant. His opinion was that there were good opportunities to separate them and allow them to live normal lives.
There were other complications after the girls were born. One had a blocked intestine and had to have surgery when they were only 2 days old. Lally had wanted to separate them during that surgery, but once the procedure began it was discovered that in addition to being conjoined, the organs were only discharging through one twin. Doctors decided to wait until the babies were older and larger before attempting the separation.
The conjoined twins’ mom watched them grow, but Caitlin was bigger than Emily, trying to roll over on her sister, and attempting to crawl, but Emily was too heavy to be dragged. When Caitlin would try to roll over, Emily would flail her arms and scream.
Conjoined twins begin as a single fertilized egg, which typically develops into a single baby. Sometimes it will divide in half one or two weeks after fertilization, resulting in twins. It is not known exactly what causes conjoined twins. One theory is that the egg divides late and incompletely. Another theory is that the egg divides completely but for some reason fuses back together. There are a variety of connections that the babies may experience, from a simple skin bridge with both children having independent organs, or sharing vital organs such as the heart, or digestive systems. Sometimes a large segment of the body is shared.
With Caitlin heading to Concordia University Text in Austin to major in education, and Emily going to the University of Houston to study hotel management, the formerly conjoined twins will be truly separated for the first time since their birth 18 years ago. As Caitlin says, they are freaking out a bit. Emily says it is a little scary.
By Beth A. Balen