report on bone graft appointment

Let us begin with winsome.

In reference to Emma Kate, of course.

This girl leaves rooms full of smiling people in her wake.

So sweet her countenance.  So dear her person.

Our appointment?  Dr. Sampson is a lovely man.  We so enjoyed meeting with him, and he was kind, gentle and patient with Emma.  She was nervous about the xrays and he was wonderful and even stayed in the room with us talking to her as the machine beeped.  Emma Kate was fine as long as she stared deeply into my eyes while I held on to her dear little leg as if I was holding her hand.

There is good news!

How intricately the Lord crafted His Emma Kate.  While her lip was a bilateral cleft as was the cleft of her palate, it is not so with her gum line.  Emma Kate has a unilateral cleft through her gum line!

What does this mean?  Simply that only one side of her gum line is clefted and thus we only need to graft bone onto one portion of her mouth, not across both sides!  This is wonderful news indeeed!

It also lends credence to the question of the clefting being a result of amniotic band syndrome, not two separate "things".  When a cleft occurs it usually is symmetrical in terms of being unilateral or bilateral from the front to the back.  With amniotic band syndrome, the clefting becomes haphazard.  I'm going to check back in with our geneticist to see what she thinks now that we have new information showing the cleft to be irregular in nature.

It doesn't really matter, it is more for my own curiosity.  Either way, our Emma Kate is simply perfect to us.  Truly and wonderfully made. Fashioned in love and grown in the grace and goodness of the Lord.  Purposed for now and created with good works planned for her in advance!  She is His beloved, made to delight in Him and bring Him great glory.

Dr. Sampson is going to join Dr. Sidman in our July 25th surgery to extract a tooth that needs to come out to allow a better outcome on the bone graft surgery.  Great to fit things in together.  He will just pop in, pull it out, and then hand-deliver it to us in the waiting area to do the "tooth fairy money deal" for her.  How cute is that?!

And surgery?  December or early January.  Jim and I can pick the date, and then schedule.

So, little Emma Kate has a lovely fall to enjoy NO SURGERIES!  I'm so glad for her.  We so longed for her to be able to simply enjoy setting sail to school.  She has craved school since coming home.  A gracious gift to have a long stretch for her of simply living life, no medical procedures involved!

And that's the news from Lake Woebegone.  Where the children are above average and the weather willy-nilly.  :)

Love,
Sara

restoration {alveolar bone graft}

What is an alveolar bone?

Some children who are born with both a cleft lip and a cleft palate also have a problem with the alveolar (al-vee-OLE-ar) bone, which makes up the gum ridge or front portion of the roof of the mouth. The alveolar bone is a thin layer of bone that forms the sockets around the roots of the upper teeth under the gum tissue.

When there is a cleft in the alveolar bone, it means there is a fistula (FIST-yoo-la) or hole from the mouth to the nose. This cleft in the bone and gums prevents teeth from growing properly and the floor of the nose from developing normally. 

What is an alveolar bone graft?

The alveolar bone graft repairs the hole in the gum ridge and stabilizes the bone arch, providing better support for the base of the nose and new bone for the roots of the developing teeth to grow into.

How is the graft done in surgery?

To do the bone graft, a piece of bone usually will be taken from your child’s iliac (ILL-ee-ack) crest, the upper ridge of the hip bone. The doctor will make a 1- to 3-inch incision (in-SIZZ-yun) or cut in the skin just over the hip bone and in the bone itself to remove the inner portion of the bone. This part of the bone, called cancellous (CAN-sell-us) bone, is soft and pasty and can be shaped to form the patch that will close the hole in the alveolar bone. Gum tissue inside your child’s mouth then will be closed around the bone and sutures (SOO-chers) or stitches will hold the tissue in place as it heals. 

This is the general lowdown on the surgery that Emma Kate will experience sometime this fall.  Today we drive an hour away to consult on that surgery with our oral-maxiofacial surgeon, Dr. Sampson.

I would be Dr. Sampson's favorite patient if I were 12.  Yes, it is true.  I was a complete nerd and hugely loved my headgear.  

I know.  Gasp with me.

And yes, I did share that lovely little tidbit at the cleft team meeting.  I'm sure the geneticist was feverishly jotting down notes about me.  Dr. Sidman laughed aloud and said Dr. Sampson loves the headgear.  Apparently those of us that do are few and far between.

Enough said.

Or, make a comment.  Come on!  You know you want to!  

If you could have seen me then...

Back to our regularly scheduled programming: Emma Kate.

We go today of all days because the timing of this surgery is crucial.  We need to fit it in after her sphincter pharyngoplasty {say that twelve times fast}, which is on July 25.  And it needs to occur before her permanent front teeth emerge.  Since she has started to lost bottom teeth, we are in the time range for doing it promptly.

How to be so glad your daughter can have all these surgeries to restore her mouth, and also so sad for her to have to endure so many surgeries?

She is grace personified.

After our neurological visit yesterday, I had the starch knocked out of me for the end part of the day.  I felt this tired feeling of relief.  I'm wishing we didn't have to go today, because I'd like instead to sit around and eat grilled cheese and tomato soup on the screen porch while the rain falls outside.  I'd like to cuddle up with the kiddos and ignore the rest of life's duties.  An ostrich day?  Head in the sand and all.

Nope.  We're off here shortly.  And I know when we are home, it will be good.  Worthwhile and important.  

Jeb only threw up twice this morning getting the molds of his teeth for his braces.  Wonder how Emma Kate will do having her very first panoramic x-rays.

I think I'm getting a latte.  Seriously.  :)

We'll update the sidebar on our "upcoming surgeries" when we know more!  

Thursday love from rainy 63 degree Minnesota!,

Sara