When Emily and Francesca Selvaggio were four days old they became the youngest Siamese twins ever successfully separated. Today, after surviving eight months of intensive care at Johns Hopkins Hospital here, Emily went home, ready to take her place in the family with her sister.
Weighing a scant 10 pounds, Emily peered with luminous brown eyes at reporters, photographers and hospital staff assembled for her farewell at Hopkins Children's Center.
Her surgical separation from her sister, Francesca, who was released from the hospital five weeks after the operation, marks the first successful Siamese twin separation at Hopkins and only the 24th in recorded medical history.
Cradled by her father, Charles Selvaggio of Dagsboro, Del., and surrounded by her mother, Carol, two grandparents, her twin sister, an older sister, Sarah, and a platoon of doctors and nurses, Emily had no comment, not even an official whimper.
Doctors pronounced her fit to go home, though they cautioned that she is not completely out of the woods. She has a muscular imbalance that causes a "postural problem" and she also may have a mild form of cerebral palsy, said Children's Center pediatric surgeon-in-chief Alex Haller Jr.
The posture problem -- a tendency to lean back too far -- is being corrected with therapy, he said, and a positive diagnosis of the mild cerebral palsy must await extensive test results.
Referring to the twins as "Miss Emily" and "Miss Francesca," Haller said, "We expect them to be normal young ladies when they grow up."
The twins were born March 2, joined at the abdomen, with a combined weight of 15 pounds. They were transferred to Johns Hopkins from Peninsula General Hospital in Salisbury, and four days later, a special 22-member medical team performed a 10-hour operation to separate them.
Fortunately, said Haller, the only "shared organ" that the twins had was the liver, making the surgery simpler and less risky than in many Siamese twin cases.
The liver was almost as large as two normal livers, he said, and was equally divided between the girls.
Francesca, who now weighs 16 pounds, had few post-surgical problems, but Emily developed a severe intestinal obstruction that prevented her from digesting food properly.
"Emily had feeding problems which only time could resolve," said Haller. She was kept in the hospital's neonatal intensive care unit for seven months where she was fed largely by tube to her stomach.
The "turning point" came last month, said Haller, when her stomach showed signs of emptying normally.
A tube is still placed in her stomach, but she now is able to take about 75 percent of her formula food by mouth, he said.
Emily's hospitalization cost an estimated $175,000, Haller said, with only a fraction of it covered by the Selvaggio's insurance. The rest was paid from special funds from several organizations established for just this kind of contingency, including the Eudowood Fund and the Garrett Fund for the Surgical Care of Children.
Charles Selvaggio, 27, a piano instructor, offered his "deepest heartfelt gratitude" to the hospital staff, saying they were "tremendous in their loving care" for Emily during her months of hospitalization.