What life is like now for formerly conjoined twin sisters after separation surgery

ABC News(NEW YORK) -- Like many toddlers, Eva and Erika Sandoval spent their third birthday party playing with friends and family, laughing and eating cake -- a Princess Sofia cake from the Disney TV series, “Sophia the First,” for Eva and a Woody from “Toy Story” cake for Erika.

The twin girls each had their own party outfits -- Eva was dressed as Princess Sophia, Erika was dressed as Woody.

But for their parents, Aida and Art Sandoval, this was more than just their daughters’ birthday. It was a miracle.

This was the first birthday the twins, who were born conjoined and who had spent most of their young lives in a hospital, had celebrated as separate individuals. Doctors weren’t certain they would make it this far.

When then-44-year-old Aida Sandoval found out she was pregnant three years ago with twins, she and her husband were surprised but “so excited.” But as they started to plan to add two more to their family of five, the couple received devastating news. Her doctor referred her to a specialist who told her that the twins were conjoined and may not survive.

“[The doctor] asked me to call Art,” Aida said. “And I couldn’t. Like, how do I tell him? … So the doctor had to call him.”

Conjoined twins are a rare phenomenon, and their chances of survival are even rarer. About half are stillborn and only 35 percent survive beyond their first day, according to the University of Maryland Medical Center.

The Sandovals, who live outside of Sacramento, reached out to Dr. Gary Hartman at Lucile Packard Stanford Children’s Hospital in Palo Alto, California, an expert in the world of conjoined twins and who had six successful separation surgeries under his belt. When Dr. Hartman reviewed the Sandovals’ case, he said he was honest with the couple about the twins’ chances of survival.

“What we told them was [what] we thought [which was] we didn’t know that they could be separated,” he said. “We said, ‘You would need to assume … that they would never walk’ … We weren’t real optimistic about quality of life.”

Doctors gave the Sandovals the option of terminating the pregnancy.

"We talked about it, we talked about it," Art said. "It was like - let’s give them a chance....You know? It’s- if it was meant to be, it's meant to be."

At 33 weeks, Aida gave birth to Erika Rose and Eva Victoria. The girls were joined from the sternum all the way down to the pelvis and they shared a third leg.

The first time seeing them was “very emotional,” Aida Sandoval said.

“They have tubes, they had the little covers over their eyes,” she said. “You can’t carry them, they’re very fragile … you feel helpless because you question yourself, ‘Are we doing the right thing?’ But then you talk to them, you say, ‘You are strong, and you’re going to get through this.’”

The twins spent the first few months of their lives in the neonatal intensive care unit. They weren’t deemed strong enough to go home until they were 7 months old.

When the Sandovals were allowed to finally take them home, Aida said she dressed them in little gowns. Over time, they reached milestones together -- their first words, learning to stand and developing their own personalities, with Eva as the talkative one and Erika as the observer.

But by the time they reached 2 years old, Eva had grown stronger than her sister, and then their health started to decline, so the decision was made to attempt to separate them.

In trying to explain the surgery to the girls, Aida said, “I would always role play, and [say], ‘Some magic is going to happen, and Dr. Hartman is going to be your magician.’”

The surgery was very risky. The American Pediatric Surgical Association said that at that point, only 250 separation surgeries have been successfully performed in the world, and doctors told the Sandovals that there was a 30 percent chance one of the twins would die.

Art Sandoval said they weighed the odds, but in the end they knew their girls were fighters, and he said they believed, “They will pull through this.”

On the morning of the surgery, Dec. 7, 2016, the medical team, led by Hartman, started with a prayer asking for unity, strength and guidance. Hartman’s plan was to separate the organs in the girls’ chests first and then move down the abdomen and finish with the pelvis.

After five-and-a-half hours, the girls were separated successfully, but the surgery was far from over. The medical team realized they didn’t have enough skin to close the girls’ incisions so they had to turn to their once shared third leg.

“They had told us earlier that they may have been able to use that third leg and keep it and give it to Erika, but when it came down to it, there wasn’t enough tissue to cover up Erika. So they had to use the tissue of the leg,” Art said.

“That was really hard,” Aida added. “It’s just like a punch in the gut.”

After 13 hours of surgery, Eva was wheeled into recovery. Her sister Erika followed two hours later. Their parents were on pins and needles until they saw the girls.

“I was excited just to know that they were alive still,” Aida said. “Just to know -- see them breathing.”

In the weeks that followed, Erika, the once smaller twin, thrived, making tremendous progress in physical therapy, but recovery was a bigger challenge for Eva.

Through all of this, Aida was mostly parenting solo as Art, who had to keep working full-time to cover the medical bills, drove the three hours from their home in Sacramento to the hospital in Palo Alto every weekend to visit her and the twins.

Finally, three months after their separation surgery, the twins were allowed to go home. Under the care of their local hospital, Eva and Erika continued to go to physical therapy and were fitted for wheelchairs. At home, the family settled into a new routine, with Aida being able to walk outside with a stroller built for two for the first time.

The best part of this whole journey, Aida said, was “finally bringing them home and being a family.”

“We’ll still say, ‘Dr. Hartman and his team performed magic,’” she continued. “Eva will see her scar and she goes, ‘My sister was right here.’ And I said, ‘Yes, your sister was right there.’”

The girls made amazing progress, surpassing all expectations, but they still have more challenges ahead. They have been on feeding tubes since birth and are just now getting used to eating solid foods.

But they are embracing their independence as typical toddlers, full of curiosity and mischief.

“The worst part is over,” Aida said. “We’re here. We’re done … when you think about it or when you talk about it, those emotions do come back. But right now, it’s just looking forward, looking to the future … and they are vivacious, they are just -- they’re spunky little girls.”

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Fla. doctor apologizes after video shows him yelling, cursing at patient, Fla.) -- A Florida doctor, who was seen yelling and cursing at a patient in a now-viral video, said he did so because the woman was "abusive to the office staff," according to a statement he released on Wednesday.

Peter Gallogly, a physician at the Gainesville After Hours Clinic in northern Florida, said the video was the last minute of an "hour-long episode" with Jessica Stipe, who he says became irate and refused to leave the office. Gallogly also apologized, however, saying he "overreacted."

Stipe, who shared a video of the incident on her Facebook page Monday, said she was "in severe pain and throwing up in the trash can" when she complained about the long wait time and asked for her co-pay back, according to her Facebook post.

She said she called the police after the doctor allegedly snatched her 16-year-old daughter’s phone and shoved her when she attempted to retrieve it, according to the post.

"I asked for my co pay back so I could leave and go back home to bed and try to be seen elsewhere tomorrow because I'm just that miserable," Stripe wrote. "The Dr was mad I wanted my co pay back and was unhappy with having to wait so long and proceeded to cuss me out."

Stipe’s video had more than 310,000 views and over 2,200 shares on Facebook as of Thursday morning.

Gallogly apologized in a statement on Wednesday and said he was defending his staff when he overreacted. He also sent ABC’s Gainesville affiliate WCJB testimonies from witnesses who described Stripe as "irate" and alleged that she threatened them.

"Ms. Stipe had been increasingly belligerent and abusive to the office staff, cursing and threatening them with violence, because she was unwell and had been waiting to seen by me for more than an hour," Gallogly wrote in a statement obtained by WCJB.

He said the situation escalated after Stripe received her refund, but refused to leave.

"I went to the front desk only because after Ms. Stipe received her refund, she refused to leave the office, and continued her abusive behavior towards staff,” Gallogly said.

"Despite repeated requests from the office staff, she repeatedly demanded to see me instead of leaving," he added.

The Gainesville Police Department has opened a criminal investigation into the incident, according to the Gainesville Sun.
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Community pulls together to help make an ill boy's wish of becoming a ninja come true

iStock/Thinkstock(NEW YORK) -- The community of Sacramento, California, pulled together to help a boy with a congenital heart condition fulfill his dream of becoming a real-life ninja.

Bryant Mordinoia, 5, was diagnosed with his condition the day he was born, his father Justin Mordinoia told ABC News today.

When asked what he wished for by the Make-A-Wish Foundation of Northeastern California and Northern Nevada, Bryant immediately said he wanted to become a real-life ninja because "ninja's fight bad guys."

"He’s the sweetest kid, he doesn’t have a mean bone in his body," Mordinoia said of his son. "He is a very loving kid, a little bit shy. He's opening up today ... he's having a blast."

"He had his first open heart surgery at two months old," Mordinoia added. Bryant was scheduled to have another open heart surgery this year, but his father said doctors pushed it back in hopes that he could grow a little stronger first.

Mordinoia added that Bryant has been obsessed with the Lego Ninjago movie.

"If we’re at home, and Netflix is on, if its not Lego Ninjago there's a problem," Mordinoia added. "He walks around the house kicking and punching."

The Make-A-Wish Foundation set up ninja training for Bryant and then called on community members to come cheer him on as he saved Sacramento from an evil villain.

Bryant will be "called upon to save Sacramento and chase the villain around town with action-packed altercations," the invitation from the Make-A-Wish Foundation stated.

Throughout the day, Bryant helped catch a villain who tried to steal an elderly woman's purse outside of the Bank of the West, and then helped free a police officer who was held hostage by the villain in a series of elaborately orchestrated showdowns by the Make-A-Wish foundation and with the support of the community.

"He won't stop talking and is loving every minute of it," Mordinoia said of the festivities for Bryant held today.

Mordinoia added that the support his family has received from the community went "over and above" what he expected, saying that hundreds of people came to cheer Bryant on as he fought off bad guys.

"I didn't expect it to be half of what it is now, there's hundreds of people here," the father said.

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Boy with terminal cancer wishes for Halloween cards from around the world

Britney Horton(BIDDEFORD, Maine) -- The family of a terminally ill boy is asking strangers to lift his spirits by sending him greeting cards for his favorite holiday of Halloween.

Now, Brock Chadwick has received nearly 1,000 cards from places as far away as Singapore.

"It's definitely very exciting and he's happy," mom Brittney Horton told ABC News. "You can tell he hasn't been the greatest but it's lifted him for sure."

Horton of Biddeford, Maine, said her son, Brock, 7, was diagnosed in February with glioblastoma, a high-grade cancer in his brain and spine.

"A recent MRI scan showed that he has more tumors both throughout his brain and spine and basically those tumors are starting to cause his body problems," Horton said. "He just recently had a seizure so it's getting scary."

A nurse at Maine Children's Cancer Program at Barbara Bush Children's Hospital said Brock is one of their patients, but could not comment further due to privacy laws.

"To cheer him up, Horton said that Brock's great-aunt began a movement called "Brocktoberfest," requesting Halloween cards from people through the her "Team Brock" Facebook page since he loves the holiday so much.

Soon cards, candy, books and pictures came pouring in from all over the world including France, the United Kingdom and Scotland.

"I didn't think it was going to be this many," Horton said. "I was expected maybe a couple hundred, definitely not this."

With help from his sister, Aubri-Ella, 3, Brock has begun opening almost 1,000 cards. On Tuesday alone, he counted 75 packages, Horton said.

Each card is filled with well-wishes and Halloween jokes

"It's made him smile a whole lot more," Horton said.

Brock hopes to be either the Hulk or Captain America for Halloween

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Puerto Ricans face growing threat from disease after Maria, experts fear

iStock/Thinkstock(SAN JUAN, P.R. ) -- Three weeks after Hurricane Maria devastated Puerto Rico, the 3.4 million U.S. citizens living on the island are now facing a growing public health threat – disease brought about by the conditions after the storm ravaged the island. And experts fear that this situation could get worse before it gets better.

The storm, which officials already blame for 44 deaths, has left nearly 90 percent of the island still without power, and a third of potential water sources undrinkable. While 97 percent (65 of 67) of hospitals are now open, only 43 of these hospitals have electricity, and even those with electricity may be running at limited capacity.

“The hurricane has left us in a critical situation with regards to medical infrastructure needed to save lives,” said Dr. Rajeev Fernando, chief of infectious diseases at Stony Brook Southampton Hospital in New York, in an email to ABC News. Fernando is joining a team of doctors in Puerto Rico in order to help treat patients and protect them from disease-related threats to their health. And he says that he expects that the number of sick Puerto Ricans could climb, since many infections take two to three weeks to manifest.

“Acute diarrheal diseases are a big concern and are commonly seen after flooding,” he said, adding that mosquito-borne diseases may also pose a threat due to the abundance of standing water from floods.

But he also noted that another threat – a life-threatening infection known as leptospirosis – could also put the lives of many at risk.

In fact, Puerto Rico Governor Ricardo A. Rossello said on Wednesday that health officials at the CDC have already begun investigating four recent deaths to determine whether the disease, which is rare in the United States, might be behind them.

Leptospirosis is a bacterial disease that can be transmitted from animals to humans. And while people can get it from livestock and domestic pets, rats and other rodents can also spread it.

Direct contact with these animals or contact with their urine – through contaminated food or water, or through cuts and scrapes – can lead to infection. And because those affected by floods are also more likely to cut or injure themselves and potentially come into contact with contaminated water and surfaces, they face a much higher risk of getting this disease if this bacteria is present in the environment.

The disease can be deadly. According to a 2010 review from the Collaborating Centre for Reference and Research on Leptospirosis, fatality rates can be as high as 30 percent. Symptoms run the gamut from fever, to kidney failure, liver failure, pulmonary hemorrhage and a dangerous inflammation of the tissues around the brain and spinal cord known as meningoencephalitis.

The treatment for the disease is a course of antibiotics such as penicillin and doxycycline that costs less than $1 per day. But because of the difficulties in mobilizing medical supplies within Puerto Rico after the storm, patients with severe infections may not have access to these life-saving antibiotics.

Various medical groups are calling for additional funding to support efforts to provide Puerto Rico with the tools needed to prevent the spread of disease. The Infectious Diseases Society of America (IDSA) and HIV Medicine Association (HIVMA) released a statement Wednesday urging congress to approve disaster relief funds providing “essential medicines, healthcare supplies, clean water, safe food, and health infrastructure restorations for victims,” all of which are vital for infection control.

But whether these efforts will manifest in time to prevent a wave of flood-related diseases has yet to be seen.

“If we don't act swiftly, I anticipate things are going to get a lot worse before they get better,” Fernando said.

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Childhood and teenage obesity is on the rise worldwide

Getty Images (NEW YORK) -- The number of obese children and teenagers worldwide is ten times higher than it was four decades ago, according to research from the World Health Organization and Imperial College London published in The Lancet. In addition, 213 million boys and girls were overweight but not obese last year according to the study, which looked at data from 200 countries.

In real numbers, 124 million young people ages 5 to 19 were obese in 2016 compared to 11 million in 1975, the study showed. Researchers analyzed data from 2,416 population-based studies that measured the height and weight of 31.5 million people between the ages of 5 and 19.

“These data highlight, remind and reinforce that overweight and obesity is a global health crisis today, and threatens to worsen in coming years unless we start taking drastic action,” Fiona Bull, program coordinator for surveillance and population-based prevention of noncommunicable diseases at WHO, said in a statement.

In the U.S., 7.5 million boys and 6.1 million girls were obese in 2016, the study found. In comparison, 1.6 million girls and 1.7 million boys were obese in the U.S. in 1975.

In recent years, obesity rates have become more stable in high-income countries, including the U.S., but they continue to rise in low- and middle-income countries, Majid Ezzati, lead author of the study and professor at Imperial College’s School of Public Health, said in a statement.

“These worrying trends reflect the impact of food marketing and policies across the globe, with healthy, nutritious foods too expensive for poor families and communities,” Ezzati said in a statement.

In many middle-income countries in Latin America, East Asia and the Caribbean, children and teenagers have quickly gone from being mostly underweight to mostly overweight. The trend puts these children at a greater risk of disease, said Ezzati.

“The trend predicts a generation of children and adolescents growing up obese and at greater risk of diseases, like diabetes,” he said. “We need ways to make healthy, nutritious food more available at home and school, especially in poor families and communities, and regulations and taxes to protect children from unhealthy foods.”

More children and teenagers worldwide are moderately or severely underweight than obese, but that will change by 2022 if the obesity rates continue to grow as fast as they did in the last 40 years, according to the study.

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What to eat, and what not to eat, for a good night's sleep

iStock/Thinkstock(NEW YORK) -- How well you sleep can have a significant impact on your overall health, and not getting enough sleep has even been linked to overeating, according to ABC News' senior medical contributor, Dr. Jennifer Ashton.

Ashton appeared on Good Morning America to share why it is so important for adults to get seven to nine hours of sleep a night, saying that insufficient sleep impacts your hunger and fullness hormones.

When you're not getting enough sleep, the levels of certain hormones that indicate fullness plummet, which signals to your brain to eat more food. As a result, sleep deprivation can lead to overeating and gaining extra pounds, according to Ashton.

If you find yourself especially hungry late at night, Ashton shared her top picks for foods that can help promote good sleep, as well as what to avoid eating before going to bed.

Foods that help a good sleep:

Dairy products contain tryptophan, a sleep-promoting substance, which is why they make the perfect late night snack, according to Ashton.

Other foods that contain tryptophan include nuts and seeds, bananas, honey and eggs.

If you are especially hungry at night, Ashton recommends going for some carbohydrate-rich foods, which may help boost tryptophan in your blood. She recommends eating a bowl of cereal and milk, nuts and crackers, or bread and cheese.

Foods that hurt a good sleep:

Spicy foods, such as jalapeños, can hurt your sleep, Ashton said.

Chocolate contains "hidden caffeine," and should be avoided before bedtime, according to Ashton.

Alcohol can also hurt the quality of your sleep.

Foods high in protein can hurt your sleep because they are harder to digest and contain the amino acid tyrosine, which promotes brain activity. Ashton recommends skipping out on high-protein snacks before bedtime.

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Author John Green wrote new novel to share his personal struggle with OCD

ABC News(NEW YORK) -- Best-selling author John Green said his new novel, Turtles All the Way Down, was a way for him to connect with children who suffer from obsessive compulsive disorder (OCD) and an opportunity to share his personal struggle with the disease.

"One of the reasons I wanted to write this book was because I did feel very alone in that for a long time," Green told ABC News Chief Anchor George Stephanopoulos. "I think that psychic pain can be tremendously isolating, and that only compounds the hurt of it."

The book focuses on a 16-year-old girl named Aza who suffers from OCD. "She feels like she has thoughts that she can't get rid of, that kind of feel like they're coming from the outside of her. And then she uses compulsive behaviors to try to manage these thoughts that she can't stop having," Green said.

"I hope people understand, maybe get a glimpse of what it's like to live with this kind of mental illness. Writing about the relationship between parents and children in this book was really important to me."

Green has a strong relationship with his fans known as "Nerdfighters" and said his interactions with the online community helped frame the way he approached writing this book.

"The great thing about my job is that I get to hear from teenagers and young people every single day. But also I was writing for you guys when no one else was reading it, in these, like, coded blogs that only a few people could read," he said. "That was super helpful to me because I was able to write for a really small audience that was also really generous."

Turtles All the Way Down is Green's first novel since his 2012 hit The Fault in Our Stars.

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11-year-old's touching reaction to adoption news captured on school's camera

Jackie Alexander(SALT LAKE CITY) -- A Utah school's camera captured the emotional moment when an 11-year-old student learned that she was going to be adopted by her foster family.

Tannah Butterfield leaped into the arms of her school's office manager, Jackie Alexander, after hearing the news.

"All that excitement, joy and happiness that you see in Tannah went right through to me," Alexander, 45, told ABC News on Tuesday. "We could not quit embracing. She just held me tight. It was pure joy at its finest."

Alexander, an employee at American Heritage of South Jordan in Utah, said she's known Tannah, a sixth-grade student, for nearly two years.

"She's just one that I've made a little bond with and it's lasted," Alexander said.

On Oct. 2, Alexander received a phone call from Jen Fisher, Tannah's foster mom, and asked her to share the good news with Tannah that she and her husband, Jeff, would be officially adopting her.

The Fishers had been Tannah's foster parents for two years.

"[Jen Fisher] had called to tell me that everything had went well in court that day, that Jeff and her were going to adopt her and the rights were [removed] from the biological parents," Alexander said. "She was just so worried and didn't want her to wait any longer, so that's where I got to play a small part."

Jen Fisher of West Jordan, Utah, told ABC News that seeing Tannah's reaction on video was priceless.

"We were just shocked," Jen Fisher said. "I did not expect that from Tannah. It was amazing."

In addition to adopting Tannah, the Fishers will also be adopting her siblings, Teagun, 6 and Tallie, 2, as well.

The children will join the Fishers' biological son and daughter Aiden, 13 and Macy, 10.

"We just loved them so much," Fisher said. "My husband and I had a lot of infertility problems and we had wanted more."

"This kind of fell on our lap," she added.

The couple said they hope the adoption will be finalized next month.

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California wildfires: How to help those impacted

CHP - Golden Gate Division (SANTA ANA, Calif.) -- Wildfires have swept through California, killing at least 15 people and injuring over 100.

With thousands of acres burned and the fires still raging, here's how you can help those affected by the blazes.

Facebook has created exclusive Crisis Response Centers for three of the fires -- the Sulphur Fire, the Tubbs Fire and the Atlas Fire.

If you want to volunteer to help, you can let the community of the Crisis Response Center know that you're looking to participate in volunteer efforts.

The Crisis Response Centers also allow people to start a fundraiser or donate to ongoing fundraisers. They also serve as a resource to view information about the wildfires, including local news reports and updates, as well as photos that other Facebook users in the area are posting of the devastation.

The online centers also allow you to check in, letting your Facebook friends know you're safe if you're living in the affected areas, or allow you to make sure that your friends in those areas are safe.

You can also help by making donations.

The Center for International Disaster Information, which is part of USAID and focuses on informing people about the most effective ways to support international disaster relief and recovery, recommends monetary contributions because they let relief organizations urgently purchase the supplies they need.

"Cash donations allow relief supplies to be purchased near the disaster site, avoiding delays, and steep transportation and logistical costs that can encumber material donations," CIDI's website notes.

Additionally, the organization recommends making sure that the money donated is going to vetted relief agencies.

To ensure that you're contributing to established agencies, you can visit an organization like Charity Navigator or GiveWell, which monitor charities, making it easier to determine where to send your money securely.

The American Red Cross is among established relief organizations that are highly rated by Charity Navigator. The Red Cross is working to provide shelter, food and comfort to those that had to flee their neighborhoods in the affected wildfire areas.

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