Conjoined Bhutanese twins Nima and Dawa have first examinations

CONJOINED Bhutanese twins Nima and Dawa Pelden have had a series of scans and tests that will dictate their path to separation at the Royal Children’s Hospital.

CONJOINED sisters Nima and Dawa Pelden are this morning undergoing the series of scans and tests that will dictate their path to separation at the Royal Children’s Hospital.

Having first met and examine the Bhutanese sisters yesterday, RCH anaesthesia pain management director Dr Ian McKenzie said the girls were being anaesthetised for “quite a lot of tests”, imaging scans and blood tests to determine their nutrition and general health to undergo gruelling surgery.

TWINS NIMA AND DAWA ARRIVE IN MELBOURNE

CONJOINED TWINS’ MERCY DASH FROM BHUTAN TO MELBOURNE FOR RADICAL SURGERY

HOW NIMA AND DAWA WILL BE SEPARATED IN MELBOURNE

“We finally got to meet Dawa and Nima yesterday, everything is very positive,” he said.

“We have quite a lot of extra work, explorative things by way of tests, to double check everything. That process is starting today.

“Once we get the results of all of that we will be very keen to make a date and plan some surgery in the future. But, so far so good.”

Doctors had intended to conduct their first assessment of Nima and Dawa by videolink to the Children First Foundation’s Miracle Smiles retreat at Kilmore, where they are staying with their mum Bhumchu Zangmo, to recover after the journey from Bhutan.

But when one of the sisters woke with a slight cough and another of the children from the retreat was travelling to the RCH for an appointment, the opportunity was used to visit the hospital for a more thorough physical examination.

Travelling nurse Tshewang Choden pushes mum Bhumchu Zangmo in a wheelchair as she holds Nima and Dawa arriving into Melbourne. Picture: Alex Coppel

While the exact details of the 14-month-old twins’ remain a mystery until the scans are completed, Dr McKenzie said the specialists have been pleased to see how healthy Nima and Dawa are and the wonderful care they have been provided.

However, he said there are many bridges to cross before plans for their separation can be completed, with it being difficult to even work out how much weight each had lost when they cannot be weighed independently.

Anaesthetising the sisters is also complicated due to the unknown extent of shared blood flow and difficulty in positioning them, though Dr McKenzie is confident his experienced team can manage the situation.

“They are pretty skinny and haven’t been able to practise crawling the way normal kids would, so maybe their muscles haven’t been able to develop the way normal kids would, so we want to double check if everything is alright generally,” Dr McKenzie said.

“They are pretty small, they are a bit fragile and we will be taking the best care we can. We expect it will go very well.

Conjoined twins Nima and Dawa arrive in Australia to have life saving surgery with mum Bhumchu Zangmo. Picture: Alex Coppel

“The shared circulation stuff can be very simple or it can be very complicated because they can actually be affecting each others’ circulation in a way that can be very negative to the other one — so far we don’t have any evidence that is going on with them but that is the sort of thing we might find out some more information out on as time goes by.”

RCH Head of paediatric surgery Mr Joe Crameri said he was thrilled with how well the girls had presented since arriving in Australia, following a marathon journey from the eastern Himalayas this week.

“The twins were as advertised. We didn’t see the connection was broader and bigger than we have been led to believe.

“I was reassured that the twins were active and were interacting with one another, and I was pleased to see that mum was feeding girls quite well.

“They looked like happy, healthy girls who are reacting quite well with one another.”

Based on scans undertaken in Bhutan it is believed the girls have a connected liver and possibly bowel, but the extent of the connections or whether other organs are compromised is not yet known.

HOW YOU CAN DONATE

With the surgery and 24/7 care Nima and Dawa will require in Australia the separation process could cost up to $300,000.

CFF chief executive officer Elizabeth Lodge now hopes the Australian public’s generosity during a fundraising campaign can match the RCH’s skill.

“These little girls are extra special because if we didn’t do this surgery … we are just concerned whether they would live,” she said.

“We are just thrilled the Royal Children’s are working with us.

“They have separated conjoined twins before, Trishna and Krishna who were brought to Australia by Children First Foundation, so that expertise and knowledge will be harnessed once again.

“We will have some of the same surgeons, the anaesthetists, the theatre staff, we will have an ICU team back with us again, so we are very confident these little girls will be separated successfully and soon be able to crawl, roll, jump and run as two little independents.”

Here’s how you can help Nima and Dawa:

1: Donate by phone on our toll-free number 1800 99 22 99

2: Text TWINs to 0437 371 371 to make an online donation

3: Visit childrenfirstfoundation.org.au/donate and select Twins18 as the campaign name

4: Donate by electronic transfer via your online banking system to the account details below.

Bank: Bendigo Bank

Name: Children First Foundation (CFF Gift Account)

BSB: 633-000

Account number: 163045552

Reference: Enter your full name and “twins”

To receive a tax receipt for donations made by electronic transfer please email [e-mail] with the transaction details.

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