From the archives: This story was last updated in May 2019.
With triple the love and joy sometimes comes triple the threat. In what is being touted as a “first,” triplets Jackson, Hunter, and Kaden Howard had undergone an operation a few months after their birth to treat a rare skull condition.Born to Amy and Michael Howard in October 2016, this adorable set of triplets were born with craniosynostosis, a rare deformity in which the skulls are merged in the womb, leading to misshapen heads upon delivery.
Since this condition can lead to complications unless it is nipped in the bud, with conditions like headaches, vision problems, and even brain underdevelopment, it was necessary to operate at the earliest.
Thankfully, the boys were diagnosed within a week under the scrutiny of the NICU.
This is how in just nine weeks after their birth, these babies found themselves at the Stony Brook Children’s Hospital in New York, and became the first set of triplets to undergo simultaneous skull surgery.
“I was nervous before the surgery for sure,” Amy, then 38, told the newspaper. “But now they’re doing great. It’s amazing.”
While admitting that they’re certainly a “handful,” Michael, then 41, happily confesses, “But I wouldn’t change it for the world!”
With this being their first pregnancy, they opted for a spontaneous, natural process. In fact, they didn’t find out they were expecting three until the second obstetrician visit.
Amy admits that when she first saw the boys, she did not realize that there was anything to worry about, even with the protruding foreheads and elongated heads. So, when she finally held them after their birth on Oct. 22, at 9:37 a.m., a skull deformity was far from her mind.
Michael states, “I wasn’t sure; I could kind of tell there was something up with Jackson and Kaden. Hunter I couldn’t really tell. But we both just thought it was a normal kind of thing.”
The boys’ surgeon Dr. David A. Chesler says he could immediately see there was a problem—but he was stumped.
Identical siblings Jackson and Hunter had sagittal synostosis, while their fraternal third brother, Kaden, had metopic synostosis. Here, the conditions remain the same, but it meant that the bones to be removed during surgery were different.
But the reasons for his genuine surprise were the sheer odds of this happening. One only has to take a look at these mind-blowing estimates to understand the fascination with this case.
“The chance of having triplets is 1 in 1,000. The chance of sagittal synostosis is 1 in 4,000. The chance of metopic synostosis is 1 in 10,000.”
“If you crunch all the numbers, the chance of having triplets with these conditions is one in 500 trillion,” claims Dr. Chesler.
He goes out on a limb to claim that the chances of such a thing happening is very rare—it has never been documented in medical literature and no one he’s spoken to has ever seen it before.
Considering each boy had significant deformities, Dr. Chesler decided to do one CT scan for each to understand the needs of the surgery better.
While he usually makes a diagnosis based on the shape of the head, this was the best move considering the circumstances, and since one CT scan wouldn’t hurt a baby, he allowed it.
The surgery took place in the first week of January 2017 where each boy was individually operated upon over the course of two days. It involved removing a bone from the skull, releasing the prematurely closed suture through two small incisions.
An operation of this magnitude takes between 90 and 180 minutes and only accounts for an average of one hospital night stay. Fortunately, unlike open-skull surgeries, there is rarely any need for blood transfusion in endoscopic surgery as the chances of blood loss and other risks are significantly lowered.
Amy feels like it didn’t quite sink in until a few weeks after they found out that they needed surgery.
“I started to worry about brain damage—if their brains couldn’t grow, what does that mean exactly? There isn’t clear data on links between craniosynostosis and brain development.”
But she was assured by Dr. Chesler that it would be fine.
As a part of the post-operative care, the three boys had to wear custom-sized helmets, 23 hours a day, 7 days a week, in order to shape and mold their skulls as they grew up.
They were required to wear protective headgear for six months.
As for precautionary measures, the triplets will also need to go for two checkups every year until they are 6 years old.
And while this may be an extremely rare condition, and a first for triplets, there is a reassuring number at the end of it: 95 percent of the cases see normal head development in the subjects after the surgery and recovery.
In October 2018, the precious triplets turned 2. They are now thriving in life.
One hopes for the best for this lovely family and wishes the first-time parents Amy and Michael all the best with these sweet little bundles of joy.
