IVORY COAST –– Ten-month-old separated from parasitic twin

YAMOUSSOUKRO – It was late January when Nancy Swabb found herself wanting to help a family across the Atlantic Ocean, in Cote d’Ivoire — all because of a photo.

A friend had shared a post on Facebook about the need for a host family for a nine-month-old girl for two months while she received medical care in Park Ridge, Illinois. The post came from Children’s Medical Mission West, a nonprofit that helps transport children around the world to receive free medical care for rare conditions and issues.

Swabb saw a photo of baby Dominique on her mother’s lap. “That photo really captured my heart,” Swabb said. “She looked so sweet.”

Pediatric plastic/reconstructive surgeon Dr. Frank Vicari shows the operating room team the model of Dominque’s spine created for this complicated procedure.

The nonprofit has asked CNN not to include Dominique’s last name for privacy reasons.

Dominique had a twin, but she never fully developed, instead fusing with her in the womb. She was born with what is known as a parasitic twin, where the underdeveloped twin formed incompletely and was entirely dependent on Dominique’s body.

She was born with her parasitic twin’s waist, legs and feet growing out of her back. Dominique was also born with two spines that were closely connected. Cases of parasitic twins are so rare that most of them are known by the names of the patients.

Without surgery to remove the parasitic twin, Dominique’s life would not be a very long one. Her tiny heart and lungs were working to support the equivalent of two bodies. The mass of kicking legs attached to her neck and back would continue to grow, causing deformity, abnormal forces on the spine and a life of pain, doctors said.

But the complicated surgery would have to be done at a hospital equipped to handle the risks, and Dominique would need a foster family to help her get through it.

Even before her surgery on March 8, baby Dominique spent hours in the hospital, undergoing tests and preparation. Doctors at Advocate Children’s Hospital ordered an MRI, an MRA, a CAT scan, X-rays and a CT myelogram to analyze the anatomy of the the parasitic twin and how it connected.

They used the scans and imaging to create a 3-D model of Dominique’s two spines. They also discovered a second bladder behind the extra limbs that would need to be removed.

Dr. John Ruge, a pediatric neurosurgeon at Advocate, had worked with Children’s Medical Missions West before. He constructed a team of five surgeons and more than 50 physicians spanning specialties across the hospital to remove the excess limbs.

“It allowed us to come up with a plan of attack how we could safely and effectively remove this very complex part attached to this little baby’s spine and end up with a healthy and happy child at the end of the day,” said Dr. Frank Vicari, a pediatric plastic and reconstructive surgeon at Adovcate who has operated with Ruge for years.

The team staged a mock operation to figure out who would be doing what at specific parts of the procedure.

On March 8, the team worked for six hours to remove the entirety of the parasitic twin. They had to be careful to disconnect any nerves and blood vessels so that Dominique wouldn’t sustain damage, numbness or paralysis.

Through extensive planning, they were even able to remove it all in one piece. She is now 2 pounds lighter.

All that remains is part of an abnormal bone that stabilizes Dominique’s spinal column. They used soft tissue from the twin’s thigh to cover the area.

Baby Dominique exceeded their expectations at every turn. She recovered so well that she was sitting up the next day and sticking her tongue out. She went home in five days, and the doctors do not foresee any complications or need for followup surgery.

Dominique still has two spines. They are hers alone. They are so intertwined that the doctors aren’t entirely sure which spine her structural support and bodily functions rely on. To look at an X-ray, Dominique has one brain connected to one spinal cord that diverges into two, each going into a spinal column.

Swabb’s family will continue to foster Dominique until mid-April, when she can be medically cleared to reunite with her birth family in Cote d’Ivoire. Swabb hopes the two families can meet one day.

Source: (CNN)

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