San José, Costa Rica, since 1956

After Surgery & Disneyland, Twins Back Home

Yurelia and Fiorella Rocha were walking, talking and playfully biting at one another at the Marriott Hotel near Costa Rica’s Juan Santamaría International Airport on Monday, their first day back on home turf as separate children.
Groggy at first, encircled by photographers and TV cameras after a flight from California, the formerly conjoined twins were handed toys and lip-gloss to play with and soon warmed up to the reporters.
The Rocha twins were born 29 months ago, attached at the chest and abdomen, heart and liver.
With the help of a U.S. foundation, Mending Kids International, the twins, accompanied by their mother, María Elizabeth Rocha, and teenage sister, Cinthia López, went to Stanford University in California to undergo the high-risk operation in November.
They faced a 50% chance of survival, according to Dr. Carlos Esquivel, one of five surgeons, two anesthesiologists and several nurses in the operating room.
“There were two hearts attached and two livers were joined,” said Esquivel in a phone interview from Stanford. “I had to divide the livers, and that was the first stage of the operation.
After that we separated the hearts, and then we closed the abdomen and the chest of each twin.”
But before these operations could be done, a plastic surgeon implanted “tissue expanders” – like balloons under the skin – three months prior to the surgery, Esquivel said.
He explained that it is a similar process to the procedure used to stretch the skin for breast implants. “You inject saline fluid every week to stretch the skin. At the time of the surgery, we deflated them (the tissue expanders) and removed them, and when we separated the twins, the skin had been stretched enough to cover the defects.”
For Cinthia, 14, the experience was quite unnerving.
“It was tense for me,” she said. “I didn’t know how it was going to end up. People were saying they could die.” Then, gazing fondly at her baby sisters, she added, “But look at them now.”
Esquivel said the twins are not likely to face complications after the surgery. “They are doing very well. If I didn’t know they were conjoined twins, I wouldn’t be able to tell the difference. They look like normal kids,” said the doctor, chief of transplantation at Stanford.
Accompanying the family back from the United States was Cris Embleton, founder of Mending Kids, which financed the Rochas’ stay in California and raised donations for the operation at the Lucile Packard Children’s Hospital. It was the hospital’s first case of conjoined twins, and Mending Kids’ third.
“These girls have actually been the ones that have come out the best,” Embleton said, handing the girls lip-gloss from her purse to keep them occupied. Seemingly aware of their TV appearance, the twins smeared it all over their mouths.
“At some later date they may (want to) do some plastic surgery on the chest area,” Embleton said. “But they’re normal, in every respect of the word.”
Although they’re identical, the celebrity twins are becoming famous for their distinctive character. “They have amazing personalities. Fiorella is very fearless and adventuresome. Yurelia is very shy and quiet,” Embleton said, echoing the mother’s words at a conference last month in California, the twins’ first public appearance since the operation (TT, Jan. 25).
In Cinthia’s eyes, both twins have brightened up since the separation. “I see them really different – happier, more affectionate,” she said.
María Elizabeth Rocha, 40, thanked God, U.S. and Costa Rican doctors, the foundation, the people of Costa Rica and her native Nicaragua for showing concern about Yurelia and Fiorella, her 10th and 11th children.
Since the operation, it hasn’t all been doctor visits and media events. Embleton said there were fun times too.
“Two days before we came down here we did what every child who comes to America wants to do, and that is we took them to Disneyland.”
“Our time’s up,” said Embleton answering a reporter’s question about the possibility of a follow-up by the foundation.
“I’ve worked in countries all over the world, and one thing Costa Ricans can be very proud of is that you guys don’t need us. It really says something about your country that you have a very good medical system,” she said. “This is just a unique case. In other countries, we have to take all kinds of kids because they have very little medical care.”
Initially planning to settle in Tuesday at their home in Alajuelita,María Elizabeth and her daughters have moved to a San José hotel because one of the other 11 children has the chickenpox, San José media reported.

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