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Massage Today
December, 2003, Vol. 03, Issue 12

Formerly Conjoined Twins Successfully Separated, Doctors Remain Hopeful

By Rebecca J. Razo

Last fall, Massage Today reported that conjoined Egyptian twins, Ahmed and Mohamed Ibrahim, were being evaluated by the Children's Medical Center in Dallas to ascertain whether they were candidates for separation surgery.

During the process, Dr. Kenneth Sayler, one of the twins' surgeons and founder of the World Craniofacial Foundation, referred the boys to John Upledger, DO, OMM, and a team of therapists from the Upledger Institute for several rounds of CranioSacral Therapy (CST) to help their brains begin to function independently (

"We got a lot of independent functioning between the two children [following CST treatment], all the way from brain function to bowel movements," said Dr. Upledger. "When they first came here, it seemed that one twin was performing much of the physiological functioning for both of them. And I thought [that] if these kids were separated, the child whose systems aren't working as strongly may well die. So, we worked on bringing about as much independent functioning of their body systems as possible, and encouraged their bodies to begin a subtle separation where the brain vessels were shared."1

On Oct. 12, 2003, a team of 10 surgeons, nine anesthesiologists, and dozens of nurses, medical technicians and other support staff participated in the 34-hour surgery at Dallas Children's Medical Center, which resulted in the successful separation of the boys. Immediately following surgery, the boys were placed in medically induced comas to minimize the risk of brain swelling. Several days later, the comas were lifted, and on Oct. 24, the boys visited each other for the first time.2,3,4

"They play a lot with a tambourine and their stuffed toys, and there's a lot of giggling and laughing going on," said Dr. James Thomas, chief of critical care services at Children's. "The medical team continues to be pleased with their progress."4

Each day, the boys receive several therapy sessions, including physical therapy, speech therapy, and play and music therapy. They usually nap between sessions and are also sleeping through the night. Doctors continue to monitor the boys' brains for increased fluid pressure, but so far, none has shown any danger signs.4,5

Mohamed, Ahmed, Ibrahim Mohamed, mother Sabah Abou Al Wafa. - Copyright – Stock Photo / Register Mark Formerly conjoined twins Mohamed (l) and Ahmed share a moment with their father Ibrahim Mohamed, mother Sabah Abou Al Wafa and older brother Mahmoud. Photo courtesy of Skeeter Hagler and Children's Medical Center, Dallas. Although the twins are making daily progress, they are still listed as "guarded" by doctors,* and there has been no speculation of when they might be able to return to Egypt; however, once the boys do return home, they are likely to travel to the States for additional therapy and reconstructive surgeries that could take several years to complete.2

"Once they're out of the woods, they'll probably come back for more CranioSacral Therapy," said Dr. Upledger. "I think we can help clear up a lot of residual tissue trauma to give them a reasonably good chance of [living] normal [lives]. I feel very good about it."1

For daily updates on the twins' progress, visit the Children's Medical Center Dallas Web site at or

Editor's note: As of November 14, the twins conditions were listed as "good." They have been transferred from Children's Medical Center to Medical City Dallas where they will continue their rehabilitatation and undergo craniofacial reconstruction.


  1. Statement from Dr. John Upledger, Oct. 30, 2003.
  2. Conjoined twins successfully separated. Press release, Children's Medical Center Dallas, Oct. 12, 2003.
  3. Children's Medical Center Dallas, Twins Web site, Frequently Asked Questions.
  4. Twins off IV medications, enjoy interacting with others. Press release, Children's Medical Center Dallas, Oct. 27, 2003.
  5. Progress, visits continue for Ibrahim twins. Press release, Children's Medical Center Dallas, Oct. 29, 2003.


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