Today was Garretts assessment by the Childrens Hospital Cleft Palate Team. It took all day but was a great experience. Here is a recap:
1. Ear-Nose-Throat doctor. Nose is fine (other than the perpetual scratch he has had on it for over a week!). Throat is fine. Ears both have fluid behind them which is normal for children with CP. So during his surgery he will also have tubes put in both ears. This is a routine procedure.
2. Audiologist. His hearing is not up to par although they are rather sure that it is due to the fluid behind his ears. They will retest him after the tubes are put in.
3. Psychologist. We discussed Garretts comfort with communication. And the fact that he rarely verbally communicated in the orphanage. About a week ago he "found" his voice and has been very anxious to mimic our words, sing, and copy our lip formation. This is all great news. He will actually have less "compensation" behaviours to retrain (often children with CP will try to compensate for the nasal effect and have to undo these behaviours once the palate is fixed)
4. Internation Adoption Psychologist. He appears to be adjusting just fine. We discussed the only real issue we are having which is a slight hoarding tendency. Initially it was mostly with food. But he has really gotten over that and is confident that the food will keep on coming. Now it appears to only be toys in places that are not home. He is smart enough to not put them in his pocket but instead slides them in my purse! So I have to make a quick check at every checkout line to make sure I am not walking out with an uninitentional freebee!
5. Speech Therapist. She covered his initial approach, how she will work with his speech therapist at his school and her participation in future evaluations. Garrett will need lots and lots of speech therapy over several years.
6. Nurse Coordinator - she will be coordinating with all four surgeons:
Plastic Surgeon -- palate repair
ENT -- ear tubes
General Surgeon -- hernia repair
Urologist -- circumcision
We do not currently have a date for his surgery.
7. Plastic Surgeon. He provided the official diagnosis of "Incomplete Soft Palate" caused by Pierre Robin Syndrome. He indicated that Garrett will need to stay in the hospital for atleast one night, possibly two. The recovery time is about 3 days before he will be able to eat something besides soft food. The gist of his surgery will be to loosen up the soft palate on the sides and stretch it to the middle and stich it closed. The sides will then fix themselves. There is a change (1:4) that the stitching and/or sides will not close or remain closed properly. In which case he may be up for another surgery later on. He did check his jaw development and bite and decide that breaking/extending the jaw was not necessary. The ped dentist will confirm this although we had already taken him to our personal ped dentist who has agreed that it is not necessary.
8. Pediatric Dentist. He was not here today.
