Contributions to Tapia twins’ care crosses disciplines and campuses

Audrey Kane, an occupational therapist with the Children’s Hospital of Richmond at VCU, is a certified passenger safety seat technician who is trained to provide solutions for children in need of car seats with special accommodations. Kane has been an occupational therapist for 20 years, but she has never seen conjoined twins before. Still, when she was approached to help devise a car seat that could hold Maria and Teresa Tapia, the set of conjoined twins surgically separated here this week, Kane did not hesitate or decline the new challenge. She got to work.

She was not alone.

Morgan Yacoe, a senior sculpture and pre-med major, worked with her friend, Kristi South, a recent VCU sculpture graduate, to craft a cast model of the twins that a plastic surgeon could study to ensure that the appropriate size skin expanders were used to achieve closure for the girls after separation.

Kristin Caskey, an associate professor of fashion design, worked with a collection of her students to design dresses and a Halloween costume to the twins’ unique measurements – clothes that they could wear during the weeks they were in Richmond awaiting surgery.

Each was tapped to grapple with a task that would help make life easier for Maria and Teresa, and each found a way to contribute to the girls’ care and livelihood.

“It’s good knowing that my service is needed and that it can be used to help people,” said Clara Hill, a junior fashion design major.

David Lanning, M.D., Ph.D., associate professor in the VCU Department of Surgery and surgeon-in-chief, Children’s Hospital of Richmond at VCU, said the widespread contributions played an important role in the twins’ experience.

“It has been fantastic to see so many people from different specialties outside of medicine rise to the occasion and offer things that have a very positive impact on the girls,” Lanning said.

Improvisation was a common theme for those involved in each of these projects. They took the skills and experience that they had, and they applied it to a scenario that they’d never considered in all of the years of training that had prepared them for the job.

Kane, for instance, used a car seat typically used for children in a spica cast, which is a large body cast, because it provides extra width and no sides, allowing the children to fit in it together. She also adjusted the straps and belt so they would not put any pressure where the girls were having tissue expansion.

The result was that the twins no longer were limited to being transported by ambulance and could enjoy increased flexibility in their travels, riding to appointments, play dates and a visit to a garden.

Yacoe faced a number of new conundrums on her project – a process that started with her and South in scrubs taking plaster molds of the twins and resulted in a silicone model that Jennifer Rhodes, M.D., assistant professor in the Department of Surgery and director of the VCU Center for Craniofacial Care, could utilize to ensure that there was enough skin for each girl following the separation.

“It’s very, very satisfying to be able to directly combine my interests in sculpture and medicine in this way that’s hopefully going to help the surgeon,” Yacoe said.

Anna Johnson, a junior fashion design major, said the project was so challenging and unique that she felt as though she had to try it. Much of the emphasis of the fashion project was on the functionality of the dresses, focusing on warmth, comfort and hygiene.

However, Johnson said that the students also wanted to design dresses that would be fun for the girls, their mother and their visitors, so they made clothes with aesthetic flourishes, such as a dress with a flared silhouette – no easy element to feature for a dress accommodating conjoined twins.

“We did not want these little girls to have to sacrifice looking cute,” Johnson said.

The clients never drifted far from anyone’s mind. Yacoe, who had met the girls, said she wanted to do the best job possible for the twins. Hill said the story of Maria and Teresa moved her and her fellow students.

“I felt like I was actually building a connection with the girls without meeting them,” Hill said.

Kane spent time with the girls on multiple occasions, ensuring that the car seat was a good fit. Kane called the girls “delightful.”

“They’re very affectionate and playful little girls,” Kane said. “They’re fun to be around.”