On Wednesday, Jan 30th, we will be taking the girls in for their second surgery. This surgery is going to reconstruct their lip. The doctor said that each girl will be under for about 3 hours. Yes, that means we have a kid in surgery for over 6 hours. It is a long day. We will be leaving our house around 4:30 in the morning so that Jenna can check in at 6:15. Her surgery will probably start around 7:30/8:00. I know lots of parents say it is hard to watch your kid go limp in your arms and then wait the few hours while the doctor does his magic. Well, Ted and I have found the perfect solution for that horrible wait…. entertain a second tired, hungry 2 year old the whole time. While Jenna is having surgery, we will be trying our hardest to keep Quinn happy until it is her time to check in. By the time we hand off Quinn, it is time to get Jenna who is just waking up. And if it goes anything like last time, she’ll be screaming at the top of her lungs, ripping at cords and thrashing around uncontrollably. By the time we get Jenna under control, we can move her to the recovery room in Ted’s arms. Then it is a mad dash to get all of our stuff out of the car, set up our things before I quickly head back to surgery to wait for Quinn. Yeah…it’s going to be another long day.
So what are they all going to do? Well, Jenna and Quinn basically have an M for an upper lip right now because of the lip adhesion they did back in October. Before that they had 3 loose flaps.
The doctor is going to take the middle part of the M and slice it open making two very thin flaps. He will then go to the outer legs of the M and make a slit there. He will dig around until he can find the muscle band ends on the right side and on the left side of Quinn and Jenna’s lip. In a normal lip, this muscle band runs the whole length of lip and it allows you to control your upper lip. He will stretch these muscles until he can connect them together to form one continuous muscle. I am not sure if he is grabbing nerve tissue and blood vessels to go along with the muscle too. Anyways, the thin flaps of skin from the middle v section will then get wrapped around the front and back of the muscle. The skin will get sown together and then tucked into the mouth.
I originally thought the middle section of skin would be part of the lip but apparently it is not lip tissue, it is inner mouth tissue. The long legs of the M will then get stretched and pulled so that they touch each other and close off the actual lip. In the end they will have a complete lip and a Y shaped scar. Confused yet? The doctor told us that the girls’ faces will look a little weird for a good 6 months until all of the stretched tissue starts to relax.
I am nervous about this surgery. The results of this surgery determine when the next batch of surgeries take place. When we adopted the girls, the doctors told us that a normal cleft lip and palate baby will have an average of 10 surgeries clustered into 3 groups. There will be several surgeries right now, another several when they are around 7 or 8 (when permanent teeth start arriving) and the last set when they are full grown (around 15-17). We are starting to enter it “if this happens we have surgery” phase of the first set of surgeries (if that makes sense).
During this surgery, the doctor will be stretching the girls’ lips a lot. The hope is that this stretching encourages the lip tissue to grow accordingly. However, if the lip and face tissue doesn’t grow enough, then we may have to do another surgery to encourage more stretching. If the face tissue overcompensates and produces too much skin, the doctor may have to go back in to remove some skin. I am hoping the skin reacts perfectly and we are spared either of these too surgeries. In addition to these problems, there is also the nose problem. Quinn and Jenna’s noses are a bit small even for a normal Asian baby. If their face pulls too much and their nostrils become too small, we will have to insert more cartilage into the middle part of the nose to make the nostrils big enough for breathing. Here ends the first set of surgeries. So we could be done after 2 or we could have a total of 4 for this section of their medical treatment. I’m praying for 2!!
The next set of surgeries won’t begin until the girls are around 7. They will need a bone graft taken from their hip and inserted into the dental ridge and hard palate. This set of surgeries sounds even more invasive than the ones we are doing now. Thankfully, I won’t have to worry about these for another 5 years or so.