Abygail Fitterer decided her sister's pacifier had to go. Within arm's reach of Madysen, she reached up and pulled. Victory. She let it drop to the carpet in the Fitterers' living room in south Bismarck.
Not to be outdone, Madysen grabbed an identical-looking pacifier out of Abygail's mouth.
The girls stood in pink camouflage dresses, propped by their parents' hands. Stacy Fitterer, the twins' father, held Madysen while Suzy Fitterer, the twins' mother, held Abygail. The girls squirmed to get the pacifiers off the floor and occasionally swatted their hands at each other.
This sibling rivalry started almost from the beginning, when the girls couldn't get more than an arm's length from each other. The Fitterer twins were born a year ago Aug. 8, two independent girls connected at the chest.
"At this stage, we see pictures, and look back and it feels like it wasn't us," Suzy said.
The Fitterer family reached this point after the first five months of the girls' lives were spent preparing for, and culminating in, separation surgery.
Separation surgery was at Eugenio Litta Children's Hospital at the Mayo Clinic in Rochester, Minn. The girls were born in Minneapolis at the University of Minnesota Fairview.
"The first time they were on separate stretchers, you assume they will be little, but they looked so big," Suzy said. "It was different thinking of them separate because everything they did was together."
The girls will need another surgery on their chest when they are 3 years old, followed by therapy.
After the initial surgery, the family waited for the girls to be stronger and reach a point that they could come home.
"They've developed their own attitudes," Suzy Fitterer said. "It's what got us home."
The girls are inquisitive, taking in their surroundings. Grandma has taught them to make some faces, Suzy said. The grandparents help with watching the girls.
"They are big into studying faces," Suzy Fitterer said. "If you pick one up, the other gives you puppy-dog eyes."
At first, the Fitterers thought they would be in Rochester until May. But first Abygail and then Madysen coughed out their ventilators.
When Madysen went off the ventilator, her parents had three options - reinserting it, a tracheotomy or leaving it out.
"They were ready to reintubate … we were watching the monitor and she was okay," Suzy said.
A few days earlier, the doctors talked to the Fitterers about bringing home infants with tracheotomy holes.
"They had never sent (a child) home with a hole in the throat," she said. "One is hard, but two was never done." The girls' perseverance made it irrelevant.
May would have been preferable to February, the height of the cold and flu season, to come home. Visitors were limited, but it still couldn't keep the girls from getting a respiratory virus. Madysen was admitted for a half-day to the hospital because of the virus.
"It was a tough time to come home, even though they say the hospital is the worst place to be (during flu season). I don't even know if it was scary,"she said. She just wanted the girls safe, and at home.
Since the bout with RSV, the girls have stayed healthy. Physical therapy and occupational therapy once a week and a visit from specialist with Bismarck Early Childhood Education Program helps them catch up.
"They are still behind for 11-month-olds because for six months they were not able to work on it," Suzy said
The therapy helps them build up chest muscle that they couldn't work on when they were conjoined. Each day, the girls become more mobile.
"They drop to one side, Abby to the right and Maddy to the left. Everything was that way when they were conjoined," Stacy said. "They tuck an arm under and push off."
The girls' development is behind because of the time they were conjoined. Their weight is also delayed. When they were born, they weighed about 6 pounds each. Now they weigh 13 pounds each. A normally developing 1-year-old weighs between 20 and 25 pounds.
Their birthday will be a small event because they need to continue to keep the girls in good health. Then in January, the family will celebrate another special day. Other families of conjoined twins make this day a special day of celebration, she said.
The family found their story told around the world in newspapers and on television.
"I think the uniqueness of the situation brought more attention than we expected," Suzy said.
The family shared most of its thoughts through a Web site on Caring Bridge.
Family, friends and strangers write to the Fitterer twins. The family's updates on the girls have been posted almost since the day the girls were born.
Sometimes an unknown person calls them with something homemade for the girls. These gifts show the Fitterer family how the girls' lives have touched other people's lives.
The Fitterer family attends benefit meals for other families as a way to give back to the people who have donated to them.
"I don't know if it's that you don't notice until it happens to your own family, but if we see one, that's where we eat, so we give back," Stacy said.
With the notoriety also come insensitive or strange comments. People have asked if the girls are the "Siamese twins," or if one is a boy and one is a girl. Conjoined twins can only be one gender and other names for this unique type of birth are derogatory.
"It's okay to say 'Hi,' but don't ask to hold them," Suzy said.
The family hopes for the girls to have a normal childhood.
"I hear people talk and say it's such a miracle and they are thriving now," she said. "I'm starting to believe it. A lot of why we are here today is because a lot of people were praying for us."
At church, she's waiting for the day her girls are talking in church.
"Father Schumacher will say, 'It's those Fitterer twins again,'" Suzy said.
(Reach reporter Sara Kincaid at 250-8251 or sara.kincaid@;bismarcktribune.com.)