A friend asked me that question when I told her we were at Riley.
"Well, they often start out that way!" was my reply.
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| All buckled up and ready to go, bright and early. Riley the dog is buckled up too. |
Monday was Owen's yearly Craniofacial Clinic day. A day full of appointments when we get to see all the doctors that he sees in regard to his cleft lip and palate.
We saw the Plastic Surgeon, Oral Surgeon, Speech, and Audiology. This year I had 2 specific requests—that we see Dentistry and ENT.
Dentist Issues
Because of Owen's SPD (Sensory Processing Disorder), going to the dentist has become increasingly awful. I was frustrated with the Pediatric Dentist we see up here in Fort Wayne when they seemed to understand what I was saying about his special needs but chose to ignore it completely during the exam.
Our family dentist is very open to me trying to bring Owen to the office where the rest of us get our care. It meant so much to me that they were understanding and willing to do what they could to help Owen survive a dental visit.
You see, sensory-wise, going to the dentist is the absolute worst. Bright lights, weird noises & smells, tools and pastes and all kinds of textures IN YOUR MOUTH!
I believe with a careful approach Owen could have little successes at tolerating a teeth cleaning. I asked his Pediatric Dentist to approach him as if he were a brand new 2 or 3 year old patient. Introducing each step and each instrument. Allowing him to investigate it and get comfortable with it. But, no. There was none of that. Only pushing through the appointment which resulted in Owen kicking, screaming, flailing and biting the dentist. And ended in us having to hold him down to just get it over with it. NOT OKAY. Not on a kid with medical trauma. Not on a kid with sensory issues. Not on a kid who has oral defensiveness tendencies due to his cleft lip and palate. Not on a kid who really needs to not hate the dentist because he has YEARS of dental work ahead of him.
So done with that.
I was open to trying our luck with our family dentist, but the Developmental Doc at Riley that we saw in July suggested I consider getting his dental care at Riley because they are used to kids with sensory issues and have other options, like sedation, when necessary.
Hence my request to see a Dentist this year at Clinic. And I will say that to her credit she took the time to hear me out, validate my concerns, and explain her experience and plan for this type of issue.
I suppose it is yet to be seen how this will go, but I think this is the route we are going to take. She suggested that each time we are at Riley for any reason that we should come up to the Dental Clinic for a "Happy Visit", just to familiarize Owen with the space and the sounds etc.
They also have lots of options available, like doing a dental cleaning while he's under in the OR for some other unrelated procedure. We are totally taking her up on that one! Genius!
ENT
The ENT (Ear Nose and Throat Doctor) that Owen had at birth retired shortly after Owen turned 2. The next ENT we had down there moved to a different hospital at some point. I honestly can't remember when. It was probably in the middle of a lot of Tethered Cord and Bowel and Bladder concerns and fell off my radar.
Owen had ear tubes placed at 10 months old, which promptly fell out. The doc put in "permanent" T-tubes when Owen was 14 months old. These have been in ever since.
I remember our doctor telling me they would need to be surgically removed someday, but I do not recall WHEN he said that should happen.
In the grand scheme of things I deal with with Owen's medical care, ear tubes were the least of my worries. I didn't give it much thought. I get his ear drops for infections from his local pediatrician and we carry on as normal.
Recently I've realized that the only ear infections he gets are due to water getting into his ear via the tubes—like in the bath or pool. Even with ear plugs this seems to happen more often than I'd like.
So I requested to see an ENT.
And this is what he said: "T-tubes should stay in no longer than 2 years. 4 at the most."
"Oh, great! So you mean 7 1/2 years might be a problem?!"
He wants to remove them ASAP. He tried in office, but they were stuck. This means day-surgery. I asked if we could hold off until another surgery and piggy-back it. I mean if you've waited 7 1/2 years what's a few more months?
He was not comfortable with that.
"Convince me. I get that every doctor thinks their thing is important, but I have to look at the whole picture here. This would be surgery #30."
He explained that the danger of having tubes in that long is something called "cholesteatoma". (Yes, I learned yet another new word.) It is basically a skin cyst that grows in the middle ear. It is not cancerous, but can errode the bone and delicate tissues of the ear causing hearing loss. He won't know if this has occurred for sure in Owen yet until he gets in there.
"Grrrrr-eat,."
Convinced.
Scheduled day surgery for November 17.
BUT it could get postponed...
IF surgery #31 is scheduled after his Orthodontist appointment November 9.
Orthodontics & Oral Surgery
The Oral Surgeon Owen had since birth, Dr. Heidelmann retired and his "understudy" took over. She is really nice. And young. Which is weird.
She is concerned about Owen's bone graft on the Right Graft of his Gum Cleft. Has not remained as stable as the Left Graft. Possibly due to how his teeth have come in and many other factors.
It's a mess in there. What can I say.
Soooo... she wants to do a Secondary Bone Graft.
Sooner rather than later.
Good times.
The deciding factor on timing will be an x-ray (CBT) he'll have November 9th at his preliminary Orthodontic appointment.
I look for this too be happening soon.
Orthodontics
And so it begins.
I had a similar discussion with this new doctor as I had with the Dentist about his sensory issues. She understandably wants to "see how he does" with his first appointment rather than just jumping to anesthesia exposure. I'm good with that, but let's just say... i don't have high hopes for this going well.
Jaw Surgery
Oh, I almost forgot... The Oral Surgeon and Orthodontist both explained that Owen will likely need jaw surgery to retract (is that the right word?) his upper jaw (bring it forward and widen it).
Oh boy, that will not be fun.
This surgery will happen before his teens, but not anytime soon I hope. I think they need to do a little orthodontic work and get some teeth moved around a little before they do it.
The Rest of Clinic
The rest of Clinic was pretty uneventful.
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| One of our favorite nurses. Owen has seen Luann in two clinics since birth. Love her. |
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| Our new Plastic Surgeon. He's French. |
Plastics - doesn't need to see him for 2 years. Our new doc was very impressed with Dr. Havlik's work on Owen's palate and lip. Truly amazing that he hasn't had a fistula (opening) occur. [Oh, except that with all this orthodontic and jaw work one might develop. Aweseome]
Audiology - hearing checked out great
Speech - still great on the word level, but when he gets talking too fast (especially to an "unfamiliar listener") he is difficult to understand. Still working on slowing down and enunciating. Some of this will resolve with time as he learns the situations where he needs to focus more on how he's speaking.
In Other News
Therapy - I am still trying to get to the bottom of the behavioral issues Owen is experiencing. We have an Eval scheduled for October 21 in Kokomo through Owen's therapy place, HopeBridge. Hoping this gives us some insight and a direction to go.
Urology - The day after Owen's tentative ear tube removal (Nov 17) we have another appointment at Riley with Nephrology and Urology. We've never seen Nephrology before. Looking forward to learning more new words. Not. This appointment will hopefully shed some light on the reasons why Owen is developing so many bladder stones.
We did a 24 hour urine collection a few weeks ago and sent it off to Chicago for testing. He'll have a RUS (renal ultrasound) and KUB (x-ray) that day as well.
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| Playing Minecraft in Kid Zone after a morning full of appointments made his day. |
Please Pray
Thanks as always for caring about our little guy.
Please continue to pray for wisdom as we deal with his complex medical needs. As difficult as those early years full of surgeries and therapies and appointments were, these recent years of unknowns and new unexpected challenges are really wearing on us, if I'm honest. Our whole family feels it. Please pray that God continues to give us grace when we fall short as parents. And grace for our other kids. That they will continue to live with their brother in an understanding way and not let their hearts get hardened by bitterness. Pray for Owen too. I think he is really struggling with understanding what's happening to him and why things are so hard for him at every turn. He doesn't have the expressive language yet to help him process it.
Some days are better than others. I soak up the good days when they come and God sustains us again and again through the hard days.
"Surely God is my help; the Lord is the one who sustains me." Psalm 54:4