Twins Nima and Dawa amaze surgeons with their recovery following separation

Just weeks after their separation, formerly conjoined Bhutanese twins Nima and Dawa Pelden have stunned surgeons as they stand, crawl and giggle their way around the world in a faster than expected recovery.

Nima and Dawa Pelden have stunned their surgeons by ­recovering faster and better than expected following their separation surgery.

The formerly conjoined Bhutanese sisters have not only adapted to life on their own, but barely sit still after developing a taste of independence during rehabilitation at Children First Foundation’s Kilmore retreat.

The 17-month-olds’ dramatic improvement has promoted discussion about their return home, which could take place within weeks, depending on further medical checks in mid to late January.

TWINS’ MERCY DASH FOR RADICAL SURGERY

TWINS NIMA AND DAWA LEAVE HOSPITAL

HOW RCH SURGEONS SEPARATED NIMA AND DAWA

Nima, who has always been the more dominant of the twins, has learned to crawl and pull herself up on furniture so she can stand and begin to move around on her strengthening legs.

Dawa, who faced a tougher rehabilitation after spending much of her life trapped under her sister, is also moving around ‘commando’ crawling and rolling, though in the past few days has also begun getting into position to crawl.

Bhutanese twins Nima (left) and Dawa (right) are recovering fast after leaving hospital two weeks ago. Picture: Alex Coppel

The Bhutanese twins Dawa (left) and Nima (right) are making huge progress after leaving hospital. Picture: Alex Coppel

On Wednesday the twins returned to the Royal Children’s Hospital for their first medical examination since being discharged and head of paediatric surgery Dr Joe Crameri said they had far exceeded his expectations.

“I was amazed to be honest,” Dr Crameri said.

“I just couldn't believe how mobile and how strong they looked. They are much more just like normal toddlers — it’s great.

“I thought the journey to get them moving would be a long one. I thought their posturing and all the rest of it would be quite a bit of work.

“They are getting physio and a lot of help from mum, but a lot of it is just that they want to get on and explore the world and they are doing it themselves.

“It reassures me how resilient children are. With all they have been through and the restrictions they have been through, this gives them a sense of normality and they are just running with it.”

Joined as a mirror image of one another from their chests to their abdomens, Nima and Dawa were separated by a huge team of RCH surgeons on November 9, following a mercy flight from Bhutan by Children First Foundation.

For the first fortnight following surgery the girls could not bare to be apart from each other, but have grown to enjoy their new-found freedom since moving to Kilmore and undergoing regular physiotherapy to straighten their bodies and improve their movement.

Nima (left) and Dawa (right) with mum Bhumchu Zangmo at Children First Foundation’s Kilmore retreat. Picture: Alex Coppel

The girls sit with other kids at the retreat Jack Kalangis (left), Dawa, Nima and Annfredda Larry. Picture: Alex Coppel

The twins Dawa (left), and Nima (right) are learning to feed themselves and increasingly tolerate food by having lunch with the other kids at the retreat. Picture: Alex Coppel

Their mother Bhumchu Zangmo is further reinforcing the physiotherapy movements while playing with the sisters, who constantly laugh as they move around the Kilmore retreat with volunteers and other children undergoing their own treatments.

CFF chief executive officer Elizabeth Lodge said the charity’s physiotherapist was helping the girls reach the milestones needed to overcome their joined start to life and prepare for life back in Bhutan.

“In one of the first conversations I had with Bhumchu she told me she had two little independent girls that just couldn’t be independent and, to now see them flourishing as independent sisters is just beautiful,” she said.

“Their little personalities shine and the two of them have just taken flight.”

Having permanently arched their backs to gain room for each other for their first 16 months, both Nima and Dawa have now learned to sit up straight in a major breakthrough that is now allowing them to begin crawling and standing.

Crucially, the sisters are also learning to feed themselves.

“Surgically they look great but, more importantly, they are getting independent, they are moving,” Dr Crameri said.

“Dawa, whose head movement was pretty marginally when they left (hospital), even she is starting to try to crawl now so that is very impressive.

“Dawa has completely changed. She was getting on her knees, getting up and had good head control.

“She is not as good as Nima, but she is starting to move around crawling. She is really advancing really quickly, which is fantastic.”

The girls Nima (left) and Dawa (right). having lunch with the other kids in the retreat. Picture: Alex Coppel

Nima is now crawling and pulling herself up to stand. Picture: Alex Coppel

Nima learning to stand. Picture: Alex Coppel

Bhumchu Zangmo carries Nima (left) and Dawa (right) in the traditional Bhutanese way. Picture: Alex Coppel

Dawa (left) and Nima (right). Picture: Alex Coppel

The twins continue to receive nutritional supplements from nasal gastric tubes to build strength, but are expected to be free of the interventions by Christmas, overcoming one of the final hurdles needed to return to the Himalayas.

Wednesday’s examination also revealed Nima had a minor issue at the top section of the wound where she was separated from Dawa, which Dr Crameri believes will have healed by the time he re-examines the sisters in mid January, possibly for the final time.

Both girls also have sections of the chest and lower ribs protruding as a lasting sign of where they were joined, which Dr Crameri believes will reduce in time but could be “remodelled” when the girls reach their teens if required.

The impact of having to lay on their side has also left the sisters’s heads slightly asymmetrical, but their appearance is improving now that they are free from the pressure of their forced positioning.

“I will probably see them in mid January and then, hopefully, surgical we can give them the A-OK that everything is healed and then we can formulate a time to go home,” Dr Crameri said.