For those who don't yet know, our daughter is going in for her first cleft surgery early on Tuesday morning.
I am definitely starting to get nervous. Looking at her huge smile, how happy and comfortable and thoroughly at ease she is these days, how vigorous and thriving, it hurts me to think of cutting her up, weakening her, causing her pain...even if it is only temporary. She is so perfect as she is, so utterly beautiful, I can't imagine anything making her more perfect. She will come out of surgery looking like a different person, and that makes me sad.
But this is something she needs, something for which we have been preparing since first getting her referral.
Just to give you an idea of what will be happening to her on Tuesday, she will be having her initial palate closure as well as her initial lip adhesion. I lip adhesion is the first stage of a two-stage cleft lip surgery. It's a newer technique, and the one that our surgeon deemed best for Flynn's wide cleft. Because she is a year old, the muscles of her upper lip have grown accustomed to being in the position they are in now. When they're drawn together, the upper lip will be very stiff. It will be difficult for her to move and stretch her mouth. There will also be a higher chance of her splitting the lip while it's healing. For this reason, the surgeon will be doing a rough, rudimentary lip closure during the first surgery, allowing the lip time to loosen up and become accustomed to its new position before going in for the second, cosmetic surgery. The second surgery will take place about six months from now, and the surgeon will then go in and do a refined cosmetic job, removing the scarring of the first surgery and perfecting the "cupid's bow" of the lip. She tells us that the first surgery will look "like a bad cleft lip surgery". I've seen many examples of her work, and she really does an amazing cosmetic job, so I have no doubt that the ultimate result will be lovely.
As for the palate, that's the really rough part. Flynn has a very wide internal cleft, running all the way through from the gumline to the back of the palate. It will take some doing to close it, and she runs a good chance of having "fistulas" open in the roof of the mouth after the surgery. During the second surgery in six months, the surgeon will go in again and close up any fistulas that have re-opened since the first surgery.
During this initial surgery, she will have ear tubes put in to allow her ears to drain and open, which will give her better hearing (she is on the low end of normal, and so far has been lucky enough not to have the ear infections that are so common in children with clefts).
She will be in surgery for about three hours, and in the hospital for at least two days. She will be able to come home with us when she is willing to drink liquids on her own. Until then, we will be staying in the hospital with her. Total recovery time from the surgery is about three weeks, but she will be feeling better after the first few days.