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Operation saved baby with eight limbs
Published Nov 24 2010
The boy with eight limbs.
Playing happily with his two older brothers, little Rishabh Ghimire seems just like any other contented one-year-old. But a closer look at the scars on his abdomen will give a hint to the Nepalese youngster's shocking start in life. Rishabh was born with a massive growth attached to his stomach. It was a half-formed parasitic twin, with two arms and two legs but no head, which was feeding off his blood supply and slowly draining life from the stricken child.
Mercifully Rishabh's life was saved thanks to a ground-breaking operation earlier this year, which removed the deadly growth. The story of the eight-limbed youngster - dubbed Octoboy - gripped Rishabh's native Nepal and India, where some even believed he was a Hindu god. Born to dad Rishi and mum Januka in January last year, Rishabh is one of 200,000 children afflicted with the rare condition annually.
It occurs when twins fail to separate in the womb and the less developed body remains attached to its host sibling, leeching energy to remain alive. Time was running out for Rishabh, who would certainly have died without the operation. In a new TV documentary that tells the fascinating story, Januka is shown struggling as she picks up her screaming son and his parasitic growth before the surgery has taken place.
She says: "He is my little king, but he can't eat and he cries all the time.
"He is so thin and he gets sick day and night. When I first saw Rishabh I didn't know what to think. "We were confused as we had never heard or seen anything like it before. "Some villagers believed Rishabh is the divine reincarnation of a many-limbed Hindu god, but superstitious locals call me a witch and mother to a living ghost.
"When people say nasty things it feels horrible. As a mother I cry on the inside. I put on a brave face, but it troubles me." Without surgery Rishabh risked death because the killer twin was placing a severe strain on his heart. Luckily, through children's charity Mending Kids International, leading US paediatric surgeon Dr James Stein agreed to conduct the life-saving operation at Los Angeles Children's Hospital.
The documentary - My Shocking Story: Octoboy, will be shown on Discovery UK on Nov 24 - sees Dr Stein visiting the Ghimire family in Nepal last year. The procedure was scheduled in the US for early 2010. Prior to surgery, Dr Stein said: "It's a big decision to undertake such a separation.
Rishabh Ghimire after the operation.
"But to be able to do this type of complex surgery is kind of a dream come true. Still, there are lots of things that could go wrong. "Rishabh is seriously beginning to fail to thrive.
He's not growing like he should and these are the first signs he's beginning to deteriorate and desperately needs this operation." His mum and dad's nerves show as they prepare for the 8,000-mile journey from Nepal to California. They are a poor family who farm crops and livestock and are daunted by the prospect of travelling to the United States.
Dad Rishi says: "We cannot speak their language. They don't eat with their fingers. We have no idea how we should act. "I know this is a major operation. My fear is what happens if the operation fails. "How would we return home? What would I tell my parents? How would I take it? It scares me. "My prayer for Rishabh is that he becomes well and his life is a success."
Early the morning after arriving in California, Rishi, Januka and Rishabh meet Dr Stein to discuss the operation. In Nepal, a CAT scan confirmed the parasitic twin had no brain, heart or internal organs of its own, besides a liver that is fused with Rishabh's. Hospital staff delicately ask how the parents feel towards the lifeless body soon to be removed from their son. It would have been his brother, but its excess skin may be useful to cover wounds.
Rishi says: "You can use whatever Rishabh needs. The rest isn't much use." Januka feels the same. She says: "I want him to be normal and someone that others will look up to in the village." The next day is full of emotion as staff take Rishabh away for his operation. He has never left his mother's side and she collapses in floods of tears.
At 5am, Dr Stein and a medical team of 10 set to work. The intensive procedure will take five hours. It begins by cutting open the parasitic twin's back to see into Rishabh's stomach cavity. Dr Stein says: "I think we have a basic understanding of the anatomy from the CAT scan but there is always a surprise. "There is always going to be something in there that is a little different.
"Babies aren't born with a conjoined twin with a completely standard anatomy. "That's going to be the interesting part - figuring out what to do with the little surprises." The intestinal tracts are found to be separate, but with fused livers Dr Stein decides to leave both inside Rishabh. With the tot sound asleep, the doctor uses a black marker to draw a cutting line on the body parts he is about to remove.
He says: "You do a final check with everybody that they have everything they need. Then it's the moment of truth. The trunk of the parasitic twin was really just a skin flap we could use to close up later. "The upper extremities - the shoulders and arms - were then separated from the lower along with the lower extremities - the abdomen complete with large intestine and legs."
An exhausting five hours later, Dr Stein rests the two large body parts on a surgical table. He says: "In this line of work it's pretty unusual to be handing a whole part over to a scrub nurse. "In this case it was a good feeling. We knew we were removing something that shouldn't have been there." Afterwards the two pieces are taken for examination, while little Rishabh is rushed to intensive care.
Ten days later, Januka and Rishi choke back tears at a final meeting with Dr Stein, when it is confirmed Rishabh can go home. Free from his twin, the tot has even started to crawl for the first time. Januka says: "He seems so happy now. He won't stop playing and moving around. Before he couldn't even get to his knees. Now he can wear ordinary clothes and there's no stopping him."
Tears well up in Rishi's eyes as he thanks the doctor for helping his son. He says: "Thank you so much for everything. "You have given my child new life. I'll never forget my time in America. This has changed our lives and Rishabh has completely transformed. "He has a new happiness in his life. It's so beautiful. "The only other person that could do this is God himself."
