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Conjoined twins delivered at Children’s Memorial Hermann Hospital share story 18 years later

HOUSTON (September17, 2014)

Conjoined twins Caitlin and Emily Copeland appeared on Good Morning America, Inside Edition and in People magazine after sharing their story of defying all odds 18 years after birth. To see the story on Good Morning America, click here.

Caitlin and Emily Copeland may seem like your average identical twin sisters. Besides their looks, they have many other things in common: they share the same friends, the same smile and laugh, the same summer job working at a local uniform store, the same extracurricular interests – both were cheerleaders, played sports, and served on student council. They share the same thoughts and finish each other’s sentences. They even share the same academic achievements, both just graduating as co-valedictorians of their high school senior class.

But at one time in their lives, the twins shared something much more significant and they have the visible scars to prove it: Emily and Caitlin were born conjoined. Conjoined twins are an extreme rarity, only occurring once in every 200,000 live births. Approximately 40 to 60 percent of conjoined twins arrive stillborn and about 35 percent survive only one day, making the overall survival rate of these twins somewhere between five and 25 percent.

“We don’t feel like we are different in any way,” said Caitlin. “Sometimes people ask us if, because of our medical history, we have a tighter attachment than other, normal twins. There’s no question my sister and I are extremely close, but it’s difficult to say if we are closer than ‘usual’ when our special bond is all we've ever known.”

Their parents, Crystal and John, were high school sweethearts who got married shortly after both graduated from Texas A&M University in 1992. A few years later, the young couple decided they were ready to start trying for a family and, in the fall of 1995, Crystal found out she was pregnant. She went in for her first ultrasound, nervous at what the results might show since she knew twins ran in her family, but her longtime physician, Dr. Paul I. Cook with The OB/GYN Center of Houston affiliated with Children’s Memorial Hermann Hospital, said nope – it wasn’t twins.

10 weeks later, the Copelands went in for a more detailed ultrasound. “I’ll never forget that morning,” Crystal recalled. “The tech looked at us and said, ‘Oh, there’s two! Your chart didn’t say anything about twins!’” Although excited about the news, Crystal could sense something was wrong. The tech stared at the image just a little too long and the look on her face was just a little too serious. Crystal’s suspicions were confirmed when they were asked to come back in a couple days for yet another, even more detailed ultrasound. This time, the image clearly revealed what the initial ultrasound tech had feared. Their babies were conjoined.

“I held it together the whole time they were delivering the news,” said Crystal. “Once the consultation was over, they asked us if we’d like to exit a more private way. We followed an office assistant to a back stairwell and as soon as she closed the door behind us, I lost it.”

Once they got home, the Copelands started evaluating what their options might be. “At the time, if you searched ‘conjoined twins’ on the internet, all you got was circus acts and babies that died.” Dr. Cook called them later that evening to check on them and reassure them that no decisions needed to be made until they could confirm where specifically the babies were joined. He would be speaking with Dr. Kevin Lally, who is now professor and chair of the department of Pediatric Surgery at UTHealth Medical School and surgeon-in-chief at Children’s Memorial Hermann Hospital, and one of them would be in touch very soon. “That was the longest, hardest weekend of my life,” said Crystal, who at this point, could already feel her babies kicking inside her.

Thankfully, a much needed ray of light came for the Copelands early Monday when Dr. Cook called with the most hopeful news they’d heard yet. The twins were not joined at the heart, which could have been fatal, but instead were joined at the chest and liver and, because of this, Dr. Lally thought the twins had a good chance for a successful separation. The Copelands decided to take their chances. “We were scared, of course, but trusted that God had a plan for our babies and that we were in good hands with the clinical team taking care of us,” said Crystal.

Dr. Cook gave Crystal explicit instructions for the remainder of her high-risk pregnancy, instructions she followed with an almost scientific precision, including being told she needed to try her very best to carry to at least 38 weeks. On June 10, 1996, 38 weeks to the day, Dr. Cook delivered the girls via cesarean section. Not knowing how long the procedure might take, he had booked the operating room for several hours. It took the team just 30 minutes. “It ended up being a straightforward caesarean with no complications," said Dr. Cook. “Their delivery was a miracle that we were both excited about and prepared for. It was a day I will never forget.”

Immediately following delivery, the girls were taken to the Neonatal Intensive Care Unit (NICU), where a team of expert neonatologists would be able to deliver the highly specialized care the girls required. Joined from breastbone to belly button, the twins shared a single crib and were put in the unit’s only isolation room, where staff had placed paper over the windows to protect the girls from prying eyes.

After spending their first few months living at the hospital in the NICU, in and out of surgeries, Caitlin and Emily were finally able to go home. Dr. Lally, who also happens to be an identical twin himself, had already decided he and his team needed to give the girls time to get a little bigger before attempting the separation surgery, so for the next several months, Crystal and John lived somewhat in isolation. “It wasn’t that we were ashamed of the girls, we just didn’t want them to ever be thought of as anything other than two little girls,” said Crystal. 

The Copelands had previously been told they might have to wait until the girls were two years old for the surgery, but at just ten months, the doctors decided they were big enough and they were ready.

Dr. Lally and his carefully selected team of 18 nurses, physicians and technicians met in the operating room three days beforehand to do a trial run-through using two dolls taped together at the abdomen. When asked how he felt prior to the surgery Dr. Lally shared, “We all understood how complex it was, but I was confident we had the right team in place to meet the medical challenge.”

He was right. The separation surgery, which took more than six hours, was a success. “I really expected it to be a momentous occasion to see the girls in separate beds, but it really didn’t hit me then,” said Crystal, after seeing her babies apart for the very first time. In the months following, Caitlin would go on to have one additional surgery while Emily needed two, and both required many months of wound care. But in almost no time at all, before they even turned 18 months old, the girls were leading perfectly healthy lives — and have maintained it ever since. “They never even get colds,” Crystal said. “Cumulatively, they might have missed three days of school. Maybe.”

Fast forward nearly 17 years later and the girls have not only beaten the odds, they are smashing them. Both went on to excel in athletics and academics. Emily is an accomplished clarinet player. Caitlin was second team all-district for softball. Both were cheerleaders. Both were National Honor Society. Both were valedictorian of their high school senior class. And now, on the 18th anniversary of the girls’ miraculous birth, both decided it was time to share their deeply personal story with the world for the first time.

"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," Caitlin said. Emily added, “If our story of hope can help just one family out there, then we’re excited to share it.”

Emily is attending the University of Houston to study hotel and restaurant management to become a wedding planner. Caitlin moved to Austin where she is attending Concordia University Texas and is majoring in secondary education to become an English teacher. This fall is the first time the girls have ever been truly separated in 18 years. “I’ve already cried a bunch about it, but I think if there’s ever a time to do it, it’s now,” Caitlin said. “We’ve bought iPads and plan to FaceTime each other every night.”

As for Dr. Lally, he couldn’t be more proud of how the girls have turned out. "Many of the doctors and nurses on our team that day are still here, still providing that same great care to our pediatric patients. We celebrated the successful separation surgery together then, just as we are celebrating this important milestone together now. You don't always see the long-term results of what we do, and it's nice when you get to see a good one.”