LOMA LINDA VALLEY CHAPTER

The Loma Linda Kiwanis Club was pleased to present Dr. Renatta J. Osterdock, Chief, Section of Pediatric Neurosurgery at the Loma Linda University Medical Center and Children's Hospital in Loma Linda, California. Dr. Osterdock presented her experience as head of the surgical team involved in the separation of conjoined twins (joined at the skull). The successful surgery was chronicled by the Los Angeles, California NBC news affiliate and presented as a special series the week of 28 March 2005. Only five such surgeries have been performed in the last ten years.

Dr. Osterdock, who is a member of the Loma Linda Kiwanis Club, graduated from Northwestern University Medical School, and completed a neurosurgery residency at Tulane University. She then completed the neurosurgery fellowship at Le Bonheur Children's Hospital and St. Jude Children's Research Hospital in Memphis, Tennessee. She has shared her wonderful gift of medical talent throughout the world, most recently doing medical missionary work in Thailand. she also included a brief video of the story of the twins.

In March 2004, Blanca Cabrera was told that a sonogram of her pregnancy revealed that the twins she was expecting had a problem. they appeared to be joined at the head. She was referred to the Loma Linda University Medical Center where high risk prenatal care could be provided. It was at this time that Blanca first met Dr. Renatta Osterdock. It would be Dr. Osterdock who would head the team that was later assembled to take on the delicate task of separating the twins. Conjoined twins occur every 2.5 million births. Half of them die after attempted surgery separation. This is primarily due to the fact that many of them have shared vital organs which cause the death of one or both after separation. The twin girls in this case were fortunate in that they had completely separate brains, and the major risk involved possible shared blood vessels and brain coverings.

On July 16, Blanca gave birth to the identical twin girls, Cristal and Cristina, who were tightly bound by the bony skull in a "V" formation. Almost at once, plans were made to perform the first such craniopagus (joined at the head) surgery at Loma Linda Children's Hospital. When word spread that the hospital was going to attempt such a humanitarian effort of this magnitude, funding and equipment was provided from medical instrument makers, medical imaging and model makers, and donations.

A surgical team was assembled and included four neurosurgeons, two plastic surgeons, and 4 anesthesiologists. Dr. Osterdock likes to point out that among the key team members, over 90% were women. Eventually the staff involved in the surgery and care of the infants reached 120. Next, detailed imaging and scans were used to guide the surgery and to help fabricate models of the skull, brain, and blood vessels of each infant. Two special beds were manufactured just for this surgery. Using the new equipment and models, the entire team practiced over and over each step of the surgery plan. Then, on March 3, 2005 the ten hour surgery was performed. The previous night the parents and relatives and the operating team gathered in the lobby of the hospital to support each other in the operation planned for the following day and to pray for a successful outcome. Their prayers were answered, after two hours of careful work by Dr. Osterdock and staff, the twins were separated and the remainder of the operation turned over to Dr. Andrea Ray, a specialist in craniofacial surgery and others to close the wound. Nineteen days after the surgery, the twins were ready to go home.

Throughout the ordeal, the hospital staff and the public became fir supporter of the twins and their family. donations of food, clothing, and money poured in. Since the parents live 150 miles away and did not have adequate transportation to get to and from the hospital, a charity group in a neighboring city obtained the funding to present the parents with a new minivan to accommodate the needs of the twins and their other two children. The twins still face additional plastic surgery, but for now are described as growing and developing independently, and taking on their own personalities.

Dr. Osterdock, a Kiwanian, and her staff truly embody the spirit of Kiwanis: serving the children of the world.

Resin model of the skulls of the twins used to plan the operation

Model of the brains and major blood vessels of the twins used to plan the operation.

Dr. Osterdock (left) speaks to the club members

Standing room only as club members and guests are intensely focused on the details of the presentation

Before: Cristina on left and Cristal on right

The sugery

After: Dr. Osterdock (left) and Dr. Ray with the twins after the operation.

Going home!

Welcome to the Loma Linda Valley Chapter of Kiwanis International. The driving force of Kiwanis is people meeting together with the purpose of serving the community, especially the children. The future of our communities, and even the world depends upon the way in which we nurture our leaders of tomorrow.

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