A few days ago, baby Ella was enjoying some tummy time. For parents Sandy and Jesse Fuller, this felt wonderful. That’s because Ella was born conjoined by the abdomen to her twin, Eliza.
When the couple learned Sandy Fuller was pregnant with twins, they felt stunned. Then another surprise followed.
“Four weeks after we found out there were twins, we … confirmed that they were conjoined,” Sandy Fuller told TODAY for a segment aired July 10. “We were shocked.”
Surprise after surprise
The Fullers learned the babies were conjoined when Sandy Fuller was 12 weeks pregnant, and soon after, they met with a team at Texas Children’s Hospital to prepare for the babies’ arrival.
“That’s kind of what helped the process because we’ve had time to (have) people be involved in the planning,” Jesse Fuller told TODAY. “It was kind of a blessing and a curse finding out that early because we’ve had so much time to think about it.”
They soon discovered the babies were connected at the abdomen, and their livers were joined. But that’s all doctors could tell from early imaging. Time would reveal how much the two babies shared.
“(The doctor) said, ‘You don’t really find out what more (is connected) until they’re older, a little bigger,” Sandy Fuller said. “They were so tiny at 12 weeks (gestation).”
Later, the babies underwent a 3D scan, and the family learned more about their twins.
“They each had their own (liver), and then it just fused together at where they met,” Jesse Fuller said. “So that was a blessing as well.” While doctors could tell the girls didn’t share other crucial organs, such as a heart — which was welcome news — they remained unsure if the babies would share connections in other places. Luckily, the images of the girls stayed stable.
“Things never changed. It stayed the same,” Sandy Fuller said. “As they grew, (the liver) was all that they were sharing.”
The Fullers live three hours from Texas Children’s Hospital in Houston, so when Sandy Fuller was 32 weeks pregnant, she went there to stay. Doctors wanted her close in case anything happened. They hoped to deliver the babies at 35 weeks. On March 1, 2023, Ella and Eliza arrived right on time. Seeing her daughters for the first time felt incredibly joyful for Sandy Fuller.
“It was a beautiful experience because I just knew, ‘Oh my gosh, my babies that I’ve been carrying in here are now outside the womb,’” she said. “They’re good — and they immediately started to cry.”
Jesse Fuller had felt nervous about his wife undergoing a C-section. But he was comforted by how the staff navigated delivery.
“It all was amazing,” he said. “The team was so prepared because they knew from so early on what they needed to do. So everything went so smooth.”
Preparing a team for the delivery and separation
Twins joined at the stomach are called omphalopagus conjoined twins, Dr. Jonathan Davies, co-leader of the conjoined twin clinical program at Texas Children’s Hospital, told TODAY. Conjoined twins occur once in every 50,000 to 60,000 births, and many are stillborn.
But discovering that the babies were conjoined early meant Davies and his team could prepare for the birth and eventual separation.
“I’ve been part of the team that (cared for them) starting before they were born up until going home,” Davies said. “We heard about the girls about four months before they were born, and we got our team together and started planning for every part of their hospitalization.”
Dozens of doctors, nurses, therapists and support staff from various departments were involved. “Conjoined twins offer new challenges, and each one is different," Davies said.
“We have to sort of specialize just for them — from the simplest things of how we position them in the bed and move the around to when we give medications, how we’re giving them medications and what dosage that we use,” he continued. “That’s a lot easier when you have one baby in one bed … (than) when you have two babies side by side. That becomes much trickier, and there’s a lot of potential for risks.”
Even feeding them felt challenging, as Ella and Eliza faced each other. Medical staff also needed to consider how the babies would rest. Staff flipped them from side to side so they could rest comfortably. Doctors also need to consider their growth, both physical and cognitive. For four months, neonatal intensive care staff navigated the challenges of caring for the conjoined twins to make sure they were healthy for their separation surgery in June.
Dr. Alice King, pediatric surgeon at Texas Children's Hospital, led 17 surgical staff in separating the babies.
“They’re so rare that there’s no playbook,” King told TODAY. “In the back of my mind, I always have my plan A, B and then all the way down to like L, M, N.”
After a six-hour surgery, Ella and Eliza were successfully separated and started their new, separate lives.
“The future has no limits for them,” King said.
When the Fullers held their babies separately for the first time. they experienced “an overwhelming feeling (of) excitement," Sandy Fuller said.
“I was just so grateful that I could finally hold my baby on her back,” she told TODAY’s Savannah Guthrie and Hoda Kotb.
Jesse Fuller added: “I was super excited to see them separate and doing good. It’s definitely getting easier as the days go on. They’re getting better, stronger.”
Ella is “sassy” while Eliza is “chill," their mom said. Since being separated, they still love being side-by-side. Big sister Emi can’t wait to meet them.
“She’s really excited,” Sandy Fuller said of her other daughter. “She carries these two little twin baby dolls around and she says, ‘My babies.’”
The Fullers hope to be home July 11 and look forward to being reunited.
“It’s going to be amazing. It’s going to be a very emotional day,” Sandy Fuller said. “There were many times when I felt like, ‘How can I get through this?’ There are moments where you feel like you can’t go anymore. But then you just pray and gain that strength right back and you just do it.”