Separating conjoined twins born in Vancouver could prove to be not only one of the most challenging operations surgeons will face, but also one of the most expensive.
Based on the money required for previous separation procedures, the cost of the surgery in terms of hospital stay and post-operative rehabilitation could soar into the millions, those who have performed the surgeries said.
Felicia Simms, 21, delivered the girls named Krista and Tatiana at 12:05 p.m. PT on Wednesday.
(CBC)
Five years ago, twins Ahmed and Mohamed Ibrahim were born by caesarean section in a remote village in Egypt. The boys were joined at the head.
The boys spent the first year of their lives in a Cairo hospital. The next year was spent in the Dallas Children's Medical Center in Texas, while doctors meticulously planned the surgery.
In October 2003, doctors separated the twins during a 34-hour surgery.
The operation on the Egyptian boys was hazardous. Their brains were connected through an intricate network of blood vessels. Untangling the web of veins was the most difficult and dangerous part.
In the case of Ahmed and Mohamed, doctors and nurses donated their time.
But if money had been charged for the separation and the one-month post-operative stay, the total cost for the procedure alone would have been $2 million, said Sue Blackwood, director of the Dallas-based World Craniofacial Foundation, a non-profit group that helps children with deformities of the head and face.
Total tab: $4.5 million US
Then there was the additional cost of a lengthy rehabilitation.
"They could crawl together, but they had never walked, so we had to start from the beginning," Blackwood told the CBC. "We had to teach them how to eat. We had to teach them how to walk and we had to build up muscles they had never used before."
"Ahmed and Mohamed's care for 3½ years had a $4.5-million price tag on it."
The U.S. bills were covered by donations and charity.
Province pays for all necessary procedures
Even in cases when positive outcomes are expected for both children, the prohibitive costs cannot be borne by parents, said Dr. Deborah Money of B.C. Women's Hospital.
"The costs of ongoing living with the twins may be an issue, but they have not borne any financial cost specifically related to health care," Money told the CBC.
If and when it's determined Krista and Tatiana can be or should be separated, the province's medical services plan will cover all necessary medical procedures.
Conjoined twins can be separated at several hospitals across Canada and the United States.
While the medical services plan will cover the cost of treatment for the girls, it's not clear who will cover the cost of transportation and accommodation if they have to get those treatments outside of B.C.
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