Update on Nani

Today Nani and I went to Primary Childrens in SLC for more doctors appointments. We were both a little anxious about them because of this marks the beginning of her journey with orthodontics and more surgery. Will gave both of us a blessing this morning, which helped tremendously.

Our first visit was with the orthodontist. A nice assistant made an impression of Nani's teeth with some goopy purple stuff. We did this about 10 months ago, and it was a not so nice experience. The tray that was put in her mouth was triggering her gag reflex, and the whole procedure seemed painful, accompanied with lots of tears. Today was nothing like that. The assistant did a great job and the impression came out beautifully! Then she took two tiny rubber bands and stretched them out so that they would slide in between Nani's molars on the top. They will be there for a few weeks to help move the teeth just enough so that the expander will fit nicely. Just imagine a chunk of meat stuck between your teeth and you should get the picture.

Then we met the doctor and he looked at her mouth, and asked us to pick a color for her new expander. She picked red. We will be getting it on the 18th of this month. I asked if he had any models that he could show us, and he brought out a slightly bigger one, but it helped us get and idea of what to expect. The two wings slide over the molars, and then meet in the middle where there is a little cranking device that is covered in some kind of plastic as to not scratch the palate. He said it is kind of like having a wad of gum on the roof of your mouth. So basically, she will get the expander in two weeks and have it in for around 6 months until her gum line in in the right position.

After meeting with Dr. Yam, we went to lunch at Nani's favorite place, Taco Bell. She enjoyed her bean burrito and a few cinnamon twist with little problems with the rubber bands. Then we drove back to the hospital for our next appointment. Once a year we go to a craniofacial clinic where we see a team of doctors that specalize in caring for kids who have clefts. It is great, but does take a while.

First we met with her ENT (ear, nose, throat) doctor. He checked her ears, and there is quite a lot of fluid behind her left eardrum. Not a good sign. Both of her tubes are out and we have been waiting to see if her ears would behave, but it looks like we will be getting her 4th set of tubes some time in the next few months.

Next we saw her plastic surgeon. He gave me a better understanding about the bone graft that is coming up. After her expander does its job and gets her palate to the right width, she will be scheduled for the bone graft. Basically they will cut the skin on the edges of the gumline where the cleft is and bring them together where they form a nice line, and where the space is that was skin and air, they will pack with bone marrow, then stitch up the skin around it. The bone marrow will promote bone growth and the space that was there will be filled. How do they get the bone marrow? Well technology has advanced from what the plastic surgeon tells me and the procedure is much less invasive than it used to be. Before, they used to chisel a piece of bone off of the hip, and then scrape marrow out. Painful! But now, they have a cork-screw like device that they use to go into the hip bone and bring out the spongy bone marrow, that only requires a tiny inscision. So after the bone graft, she will be on a liquid diet for 5 days, and then a soft food diet for 5-6 weeks. This will all take place this summer ('10).

After talking about the bone graft, we talked about the advancement procedure that will bring her upper jaw forward to where it needs to be. The surgeon will cut the palate and then move it forward, and then Nani will have to wear a halo thingy that will hold it in place while it heals. That will be next summer ('11). Whew! Our summers are booked!

Our next visit was with the speech pathologist. She did a little test to see how nasal Nani was, and how her articulation has improved and her numbers were outsanding! She has made so much progress this past year with her speech therapist. I am so impressed with all of the treatment she has recieved, and am now a strong believer in speech therapy. It works!

Our final visit was with the coordinator who suggested I talk with another mom who happened to be there at the clinic whose daughter recently had the bone graft surgery. It was an answer to my prayers to speak with this woman. Her daugther is 5 and will turn 6 this month. She told me about her experience and gave me much needed assurance. Amazingly her biggest challenge has been the soft food diet. She said the expander and the surgery were bearable, but the diet is rough. Her first thought was scrambled eggs, but the doctors ruled that out because they are too chewy. So basically anything that you can slup, you can eat. Her daughter is constantly hungry, and has lost weight. It is good to know this before hand, so that I can be prepared when the time comes.

So all in all, today was a wonderful day. Much better than I had anticipated. I have been anxious for months about this new journey, and I finally felt that peaceful feeling that everything is going to be OK, and that we are doing the right thing. Once again I have felt the power of the Atonement in my life.