Maliyah Herrin received dialysis for the first time Wednesday afternoon, a day after doctors completed surgery to separate her from her twin, Kendra. Before the surgery, she could use her sister Kendra's kidney.
The Herrin twins are in critical but stable condition at Primary Children's Medical Center. Born conjoined, the 4-year-old girls were separated Monday during a surgery that took 26 hours.
Their mother, Erin Herrin, said the first sight of them was a little surprising. Conjoined, Kendra was on the left. In their room in the pediatric intensive care at PCMC, Maliyah is on the left. "That was a little shocking," the mother said during a press conference at the hospital Wednesday afternoon.
Their dad, Jake Herrin, said all his emotions came to the surface when he saw them. "It was like seeing them born again. They were in brand new bodies. It was really an amazing experience."
He said they "look just like normal little girls, just with one leg."
It was a strange experience to see them lying on their backs, something neither could do before without having her sister on top of her, Erin Herrin said.
They also looked much better than their parents expected following such a dramatic surgery. Doctors divided the girls' shared liver and intestines, reconstructed their bladders and built a new pelvic ring for each of them during the painstaking and complex operation, which involved eight surgeons.
The twins had shared Kendra's kidney, with Maliyah's blood crossing to it through the liver. Since the liver was divided Monday, Maliyah now has no kidney and will need dialysis until she gets a transplant. Doctors expect she'll be healed enough to receive one of her mother's kidneys in several months.
Maliyah and Kendra are swollen and are heavily sedated to control their pain, but Maliyah squeezed her hand and Kendra opened her eyes briefly as if to say, "Mommy, I'm here, we did it. We were brave," their mother said.
Their beaming big sister, Courtney, 6, said she can't wait to have them home so she can play with them. "They are good girls, and I love them so much."
Erin Herrin became emotional when she talked about the medical team that performed the surgery. They are her "angels," she said. and without them this would not have been possible.
As it was when they were joined, the girls' vital signs are almost identical. And when one was getting an x-ray, the other's blood pressure went up, Erin said. "Their bond is so strong."
That connection is "one of those great mysteries of life" that no one understands but which makes "life wonderful," said Dr. Rebecka Meyers, chief of pediatric surgery, who was coordinating surgeon during the separation.
She said doctors would follow the girls' cues in terms of reducing pain medication. As they heal, the twins will have lower blood pressure and need less pain medicine, which will in turn bolster their breathing and allow doctors to remove the ventilator, "the next big step." One of the best signals they are healing will come when they urinate. That will also help reduce the swelling.
As for the future, the girls will need more reconstruction, particularly to allow each to be fitted with a prosthetic leg.
"These girls will never be girls who did not undergo a major separation and have special battles and special needs," Meyers said. But they will live rich, fulfilling lives, she predicted.
Overnight, the nurses in the intensive-care unit arranged the twins' hair in elaborate French braids to surprise the Herrins. And they remembered to celebrate a difference. Maliyah's bow is yellow, Kendra's purple, just like their favorite colors.
"They looked so pretty this morning," said Meyers.Jake Herrin said he suspects the girls are sleeping better than mom and dad. Erin Herrin woke up in the night convinced something was wrong. A call to the hospital reassured them the girls are doing well.