Sharing an Uncertain Future

Woodbridge Parents Prepare for Separation of Conjoined Twins

Swaddled in their mother's arms, the babies gaze with newborn wonder into identical faces that offer no hint that they are rare survivors, one of medicine's most compelling mysteries. Beneath their pink rosebud pajamas, Jade and Erin Buckles are fused as one.

Delivered by Caesarean section Feb. 26 at the National Naval Medical Center in Bethesda, the girls are conjoined at the abdomen and chest. Each has her own limbs and, doctors are fairly certain, separate organs and vascular systems, except for the liver, making the girls good candidates for separation.

Just making it into the world alive defied steep odds; statistics on conjoined twins vary, and are sketchy, but experts believe they occur only once in every 70,000 to 100,000 live births. Of those, a mere fraction survive.

In the sunny living room of their Woodbridge townhouse, Erin opens her mouth to suck on sleepy Jade's tiny fingers. Taking the cue, mom Melissa Buckles, 30, produces a doll-size bottle of milk, first carefully supporting the twins before swooping her own arm into the swan-dive it takes to feed them. Their father, Marine Gunnery Sgt. Kevin Buckles, 34, stands watch, ready for action should Jade demand lunch at the same time -- a trick that requires a double-parent crisscross move.

Since bringing their delicate daughters home from the Neonatal Intensive Care Unit a month ago, Melissa and Kevin Buckles have struggled with emotional and physical challenges that become even harder as the babies grow and the date of their separation surgery nears. If all goes as planned, surgeons at Children's Hospital in the District will separate the babies in June, when they are 3 months old.

For now, though, the couple has to rely on improvisation and ingenuity to get through each day, whether it's working with bioengineers to build a car seat or lining up all the snaps to make two sets of footie pajamas into one.

"Changing diapers is fun because you have four legs kicking at you," notes Kevin Buckles, on temporary leave from his post as assistant drum major in the U.S. Marine Drum and Bugle Corps. To make matters worse, the diapers have to be put on sideways, since the babies face one another.

"We had to learn how to think outside the box," says Kevin. Just transporting the babies to frequent medical appointments is a major undertaking. Melissa, a high school English teacher, scrunches sideways in the back seat to monitor the twins in the temporary car seat designed for them by the National Institutes of Health.

"Sometimes when they're sleeping, their faces fall forward, and I worry about one blocking the other's airways," she says.

Learning to care for their newborns was mostly a matter of practice, the parents say, but resuscitation remains a big fear.

"Because of where they're joined, you can't do chest compression," Kevin says. Doctors taught the couple how to perform CPR backward -- coming in from behind with their thumbs.

But Erin and Jade, delivered at 34 weeks, proved so robust from the beginning that they didn't even need intubations while in the Neonatal Intensive Care Unit; they were released from the hospital after just one week. Returning last week for shots and a checkup, the babies weighed in at a combined 13.1 pounds.

"How's the feeding been going?" Lt. Christopher Watson, the babies' doctor, asks the couple in an exam room with cartoon Dalmatians painted on the walls.

"Good," Melissa replies. "Jade still doesn't eat as much as Erin."