The parents of ten-month-old conjoined twins who were born sharing a skull and a brain are opening up about how they are adjusting after the girls were separated during a ‘one-in-a-million’ surgery last month.
Abigail and Micaela Bachinskiy of Sacramento, California, were born on December 30, 2019 as craniopagus twins, meaning they were joined at the head and shared a skull, a brain, and soft tissues — until doctors managed to successfully separate them during a 24-hour surgery that took place at UC Davis Children’s Hospital on October 23 and 24.
Now the girls’ parents, Liliya Mirochnik and Anatoliy Bachinskiy, tell People that they’re still getting used to their daughters having two separate bodies, and it’s been quite an emotional journey.
Unique: Abigail and Micaela Bachinskiy of Sacramento, California were born in December 2019 as craniopagus twins, which are conjoined at the head
Not your everyday twins! They shared a skull, a brain and soft tissues, which occurs in just 10 to 20 babies in every one million births in the US
Surprised: Liliya Mirochnik and Anatoliy Bachinskiy were shocked when they initially learned their twins were conjoined, believing at first that it must be a misunderstanding
New normal: Now they are getting used two having two separate babies
The babies made headlines after their birth due to their extremely rare condition. Conjoined twins only occur in approximately one in 200,000 births, while the odds of being joined at the head are just 10 to 20 in every one million births in the US.
But doctors immediately began preparing to separate the twins, and ten months after their birth, they performed the successful operation, leaving the parents with two separate little girls.
‘The doctors were always saying one in a million,’ Liliya said. ‘But I had a feeling because I saw God[‘s] hand through the pregnancy, so many miracles, like big miracles, you know? And I just knew that God’s taking care of this.’
‘It took me a minute to hold them because they were so unique,’ Anatoliy added. ‘You got used to them being together, and now you’re seeing two different girls, two different bodies and … it’s just amazing.’
‘It was very special,’ Liliya said. ‘I was crying when I held them, tears were filling my eyes. When you hold them, if you have some worries [internally]… they just run away. I wasn’t heavy inside, I was so relieved.’
‘From day number one, you could tell their personality [and] who is the boss,’ she added. ‘Abi, she’s bigger and she’s more bossy. But Mika, she is more gentle… I think they will get along very well because they’re different and will complete each other.
‘They love each other and you can tell, even when being separated right now. The first couple of days, Mika would reach her hand to find Abi and Abi was looking for Mika. That was so cute.’
‘It was very special,’ Liliya said. ‘I was crying when I held them, tears were filling my eyes’
Special: Abigail and Micaela immediately began beating the odds: Of twins conjoined at the head, approximately 40 per cent are stillborn and about 33 per cent die after birth, normally due to organ failure or abnormalities
Ahead of the game: Many conjoined twins never even make it to delivery, let alone an operation
The couple, who also have three sons, were shocked when they initially learned their twins were conjoined, believing at first that it must be a misunderstanding.
‘But later on, God just gave me peace inside, and I just stuck with that. And my husband was supporting and encouraging me,’ Liliya said.
Abigail and Micaela immediately began beating the odds: Of twins conjoined at the head, approximately 40 per cent are stillborn and about 33 per cent die after birth, normally due to organ failure or abnormalities.
But 25 percent have been known to survive and even have the option to be separated, depending on where they are attached at the skull.
Dr. Granger Wong, UC Davis Children’s chief of plastic surgery, highlighted the rarity of the girls’ situation to DailyMail.com.
‘Conjoined twins in and of themselves are rare and to have them joined at the head is even more rare, and to even have the favorable anatomy to be divided because sometimes shared too many structures is even rarer,’ he said.
Many conjoined twins never even make it to delivery, let alone an operation, Wong added.
Separation: On October 23 and 24, doctors operated for 24 hours to separate them
‘There was planning for every step of the way that we could think of,’ UC Davis pediatric neurosurgeon Dr. Michael Edwards told DailyMail.com
Urgent: When the girls turned nine months old, doctors said they could not wait any longer to separate them
But Abigail and Micaela did extremely well, spending seven weeks in the NICU before going home.
‘We have felt so much support from staff,’ Liliya said. ‘We have received so much help, so much advice. It has made us feel at home here.’
For 10 months, doctors practiced simulations on 3D models to prepare for numerous scenarios that could occur during surgery, including compromised airways or collapsed lungs.
They also used augmented reality to study the blood vessels that would need to be detangled and separated — and practiced doing so.
In June, a plastic surgery team placed custom-designed tissue expanders underneath the scalp and stretches the skin so each girl’s head has enough skin to cover their skulls after the operation.
‘There was planning for every step of the way that we could think of,’ UC Davis pediatric neurosurgeon Dr. Michael Edwards told DailyMail.com.
‘Everything’s gotta happen on time, the right way, everybody ready and no question about what we’re asking them to do.’
When the girls turned nine months old, doctors said they could not wait any longer to separate them.
Success! The surgery involved more than 30 people, including neurosurgeons, nurses, anesthesiologists, pediatric surgeons, and plastic surgeons
‘The doctors were always saying one in a million,’ Liliya said. ‘But I had a feeling because I saw God hand through the pregnancy, so many miracles, like big miracles, you know? And I just knew that God’s taking care of this’
‘It took me a minute to hold them because they were so unique,’ Anatoliy said
Two teams: They were split into two medical team divided by color with Team Purple taking care of Micaela and Team Orange taking care of Abigail
Micaela (left) and Abigail’s (right) attachment is extremely rare, occurring in just 2% to 6% of all twins. The babies are recovering well in the PICU, doctors say
‘There have only been mid-20s in terms of conjoined separations in world history. They haven’t been done younger than six months of age,’ Wong said.
‘Doing it too much later, there are certain developmental milestones you want them to have and the biggest one is mobility, and eventually crawling, standing and walking and obviously, if they’re conjoined, they’ll be delayed.
‘We want them old enough to handle such an operation but young enough not to miss developmental milestones.’
The day of the surgery, which started on October 23 and went into the morning hours of October 24, involved more than 30 people, including neurosurgeons, nurses, anesthesiologists, pediatric surgeons, and plastic surgeons.
They were split into two medical team divided by color with Team Purple taking care of Micaela and Team Orange taking care of Abigail.
‘One team manages one baby and one team manages the other and there’s no crossover for assistance,’ Dr. Rajvinder Dhamrait, director of pediatric anesthesiology at UC Davis Children’s told DailyMail.com.
Extra care: The babies initially spent seven weeks in the NICU after they were born
Grateful: The parents have expressed gratitude for hospital staff
‘From day number one, you could tell their personality [and] who is the boss,’ mom said
‘So if one baby deteriorates, the other team does not help. Then there’s a coordinator, or an overseer, who manages both. That was me; I did both,’ he added.
‘The operation has to be done as accurately and expediently as possible because the longer it is, the greater the risk of blood loss, of exposure to anesthetics,’ said Wong.
‘It was like a choreographed ballet because we had to choreograph all the movements so it could be done as quickly as possible.’
At 3.28am on October 24, Edwards announced, ‘Cranial separation!’ when the babies were officially separated to the cheers of the team.
‘Everything went well. It felt almost impossible to separate them, but God and the doctors and nurses at UC Davis made it possible. We are so thankful,’ Liliya said.
Edwards, the neurosurgeon, says he cannot wait to see the girls interact when they see each other for the first time.
‘I like to go up there every morning because the world around us is full of bad things and terror, and you go up there and see these two little girls, and it’s a good start to the day,’ he said.