Thursday, December 29, 2011

I do declare, "A Lip Repair!"

Well, I pushed this post off until the very last minute didn't I?

On Dec. 6th., Hunter went to the hospital for his lip repair surgery! As the days were closing in on the repair my stomach just kept churning and I would just stare at him and soak him in!


A smile to remember


I was so scared about losing the smile I had come to know and love. I was very nervous that he would go in for surgery and when he came out I wouldn't feel the same about him as I did in that moment. Needless to say, the second the nurses brought him back to me safe all of that melted away and I was still as in love, if not more, with him as I had always been. I only lost my composure for a moment of two. The minute that the nurse picked him up to take him away my heart sank into my stomach and the second that she walked out the door with my son there was nothing I could do to hold the tears in. It seemed as though he had just left when the ENT came in and told us that his tubes were in and her job was done. Then it was only like an hour or so before the plastic surgeon came to tell us that he was done. The time that took the longest was waiting for Hunter to come back to me. I paced the room, in and out of the hallway, just waiting to see him. Then there he was, and oh boy did he look just miserable.

Back in my arms

 The next day we learned to feed him with a syringe. My sister had actually been there with him and was the first to try this new technique, and if I do say so myself she did fantastic. I was the last one to catch on to feeding him this way. He could only have pedialyte until we left the hospital later that afternoon.


pedialyte via syringe


We also had to clean his lip and nose a little bit at a time with some sterile water and a cotton swab. He had to wear arm restraints (which though torturous for him, were super cute!). [Just a hint for other mama's of cleft babies: arm restraints fall off pretty easily - to keep them on we had Hunter in long sleeved feety outfits and cuffed the end on the sleeve over the bottom of the arm restraint, warning: it doesn't take them long to figure out how to just take their arm out of the whole sleeve, but at least at this point it's stuck in their clothes and away from their face!] Hunter pulled through like a champ. Once we got him home, he no longer seemed so helpless and miserable, he did so great with everything.

The day after surgery and smiling already!

 This month has been filled with doctors appointments, which has almost become routine at this point. We had pre-op, immunizations, surgery, follow-ups with plastics and ENT. Our Holidays were wonderful. The kids had a great time.

A Video for Hunter




A Happy New Smile for Hunter and
A Happy New Year to You!

Friday, November 18, 2011

Doin' The NAM Thing

The NAM
Okay, so, I admit I am WAY late on this post. Tough cookies - read on! On Aug. 31st Hunter got his NAM (Nasoalveolar Molding Device). We have been diligently taping this thing into his mouth day in and day out. Every week it gets adjusted at the oral facial prosthedontists office. This device brought the parts of Hunter's palate closer together. It also reshaped his face. A couple weeks ago the Nasal Stent was added to his NAM. This part with help shape his nose to hopefully give it a more semetrical look after surgery.


NAM taped in!
There's not too much to SAY about the NAM - other than the fact that it truly is AMAZING. . . I'll just let you see for yourself in the following pictures.


You can see how the shape of his entire face/nose has been transformed

After 2 months on the NAM - AMAZING!


Monday, September 5, 2011

The Details of Hunter's Cleft



Hunter has a bilateral cleft lip and palate. The cleft that he has on his right is a "complete cleft lip and palate". The lip is affected all the way up into his nose and the palate is affected through his gums all the way back into his mouth. His uvula (dangly ball, punching bag, or whatever else you want to call it) is divided in two.The cleft he has on his left side is an "incomplete cleft of the lip and an incomplete cleft of the palate". This cleft does not go all the way up into his nose nor does the palatal cleft go through the gumline. It does, however begin behind the gums and continue all the way back into his mouth.

Hunter will wear a NAM (Nasoalveolar Molding) device as sort of a retainer to get the two pieces of his palate closer together before his lip surgery. He will hopefully have lip repair surgery when he is 3 months old. Since his palate will be closer together this will cause less stress on the lip repair as the pieces of his lip will not have to be stretched as far. This will promote better healing for his lip (especially on his right side). At this same surgery Hiunter's nose will be worked on but not perfected. The main goal of this surgery is to get the lip and its muscles back to where they should be. Also, at this surgery, ear tubes will be placed if they are not placed in Hunter's ears before 3 months. Since he already has a nasty ear infection, an early surgery for ear tubes is a possibility.

Hunter's palate will be repaired sometime around the age of 12-14 months. At this surgery the pieces of Hunter's palate will be pieced togeher where they should be and his Uvulas will be brought together.

Many surgeries may follow this one. The plastic surgeon says Hunter will definetly need at LEAST 4 surgeries total (lip repair, palate repair, lip/nose revision before Hunter starts school, and bone graft when Hunter reaches dental maturity to put a bone in the empty gap of his gums.)

In addition to these, Hunter will need extensive orthodontic work. Braces, probable palate expansion (a procedure that requires head gear), and more.




WARNING: the included pictures are graphic real life depictions of Hunter's actual cleft lip, cleft palate, and divided uvula. If the paragraph above is enough to satisfy your curiosity and you do not wish to see the pictures, this would be a good place to stop.

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NOTE: I did not MAKE Hunter cry to get these pictures, I just caught him when he was already upset (hungry) and we were waiting for Daddy to come back with a bottle.





Complete cleft on his right affects the structure of his nose.


Hard to tell, but this is Hunter's palate.
Point of reference: the pink in the upper right of the mouth are
his gums where his two front teeth will come in.
The pink in the bottom of his mouth is his tongue. 


This picture shows Hunter's uvula is split in half.
(the two dangly balls in the back of his throat)



Monday, August 22, 2011

Hunter is Here!

Going to have a baby!
Arrived at the hospital to be induced at 7:00 am Wednesday morning (8/17/11). Started Pitocin, broke my water, and waited. Things were moving VERY slowly (if at all at times). When I finally hit 4cm and was able to have an Epidural, I decided to wait a bit. I just didn't feel like my contractions were strong enough for an Epidural. After awhile of more nothing happening and being stuck at 4cm we decided to get the Epidural and see if things would start to happen when I wasn't so focused on every little contraction. Well I have to say that I had the most brutal Epidural ever administered on any human being ever. The anesthesiologist tried 8 times to get the Epidural in. He kept on hitting my vertebrae. HURT LIKE HELL - and of course I couldn't move because well, the man had a needle in my SPINE! Well he finally got the damn thing in and it didn't take too long for me to start to feel better.. By this point I was off the external monitors and all of the monitors for the contractions and Hunters heart rate were coming right from the source.

Hurry up and wait!
I was so glad that all of my family was there. My mom, Dad, Sister, Husband (Josh), and for a good portion of time, my son, Avery.

Daddy and Big Brother!
Soon after my little one went to stay with my sister in law, the rest of my family got silly. It made for a good time even though we were all exhausted and my moms car had been involved in a minor fender bender in the parking lot because some teenaged twit was talking on her cell phone and not paying attention to anything else around her. Then some lady came in with my nurse demanding I flip over and get on my hands and knees to try to get things moving to "avoid surgery". I FREAKED out. She just walked in, started flipping me this way and that way. I couldn't feel my legs, let alone did I trust they could hold me up. On top of it all she said the "S" word (surgery). Well my SuperMom basically told her to shove off and I never saw her again. After that I kept having to roll from side to side to try to get things moving as far as getting Hunter to push on my cervix.

Side to Side, trying to get things going.
 Well by the end of the night I had not dialated past 5cm. My family all went home to get some well deserved rest (with the exception of my husband). This was sometime around 11:45pm. About 15 minutes later my OB came in to check on things and. . . no change. Hunter's head was beginning to swell and with nothing progressing she called for a C-section. SCARIEST WORDS EVER. Well the only anestesiologist that was there was busy with an emergency apendectimy, but as soon as he was done, we were going to go have a baby. Josh called my parents back to the hospital and filled them in on what was going on. I had decided that I wanted to be completley put under for the C-Section because Josh would not be able to keep me calm if I had to be awake while I was being cut open. It was very important to me that he cut the umbilical cord. Well, they got us all dressed up for going to the OR.

All dressed up. . . don't wanna go!
When it was time for the anestesiologist to come in and talk to me he had said that he did not want to put me under because it was more dangerous for me and baby to be completley under. Well instant change of plans because I just wanted to do whatever it took to bring Hunter into this world in the safest way possible for HIM. I agreed to be awake. I really wanted my mom to be there with me because I had to be awake, but Josh was already dressed for the job and I still really wanted him to cut the umbilical cord. So we went back to the OR and I managed to fit myself on the narrow table and I got all strapped down, legs together and one arm out to each side (imagine, if you will, a lethal injection execution). The anestesiologist (who was amazingly wonderful) began to administer the anestesia. . . 1st try - no luck - 2nd try - no luck - 3rd try - no luck. . . well. . . remember that brutal Epidural from earlier? It wasn't in the correct position to numb my body where my body needed to be numbed for the C-Section. So I ended up having to be put completley under anyway. I hate to disappoint you, but this is where we skip ahead (as I have no recollection of what came next lol). When I came to there were nurses rudely poking and proding my belly where I had just been cut open. I put an end to that immediatley. Things were kind of a bit of a blur and I couldn't see very well.

Hunter is Here!



Finally got to hold my Hunter! (look like hell but.. . who cares?!)


Josh had brought Hunter over to me so I could see him. To be honest, I could barely make him out because my eyes just could not focus. When I finally got to the post natal room I finally got to hold my baby. Hunter John. He was born at 1:30AM on Thursday 08/18/2011. 8lbs 15oz 20 1/2" long. Hunter was born with a complete cleft of the lip and palate on the right side and an incomplete cleft lip and incomplete cleft palate on the left side.


Papa holding Hunter
 My dad had held Hunter while I was waiting to be coherent enough to hold him. I just want to share this and why it means so much to me. My dad had never held a baby this small before. He married my mom when my sister and I were older. When my older son was born it took him at least 6 months to trust himself enough to hold him, and by 6 months my older son was a good size. My dad held my tiny baby when I couldn't. He let Hunter know that everything was going to be okay. He wanted my son to know that he was loved and safe. He wanted him to know so much so that he didn't let his fear of holding such a small baby stand in his way. When Hunter was born my dad's love for him grew so big that nothing was going to stop him from letting his grandson know from the first moment that he was going to be there for him now and for every time he is going through a tough time. This meant the world to me (when I heard about it after I came to, of course).

Mommy, Daddy, and Hunter

During my pregnancy my main concern was whether or not I was going to be able to feed Hunter. Feeding is often difficult for a baby born with a cleft. Hunter fed like a champ right away. They had been feeding him with a Mead Johnson Nurser. I had packed 6 different nipple/bottle combinations to take to the hospital - I was determined to find the best way to feed my baby. A nurse from the NICU asked if I had brought with me a Haberman. I had. She came up and we figured out the Haberman together and Hunter was feeding better than ever. I had yet to be successful at feeding him myself. For Hunters next feeding I asked to be alone with Hunter. I felt that without the pressure of someone looking over my shoulder, expecting me to be able to feed my baby, I'd be more successful. I was right. With just me and Hunter alone together feeding took less than 15 minutes. He is a feeding champ!

Daddy feeds Hunter with the Haberman

Another concern we had was whether or not Big Brother Avery was going to warm up to Hunter. During our stay in the Hospital Avery was not too keen on the idea of Hunter. He did hold him a couple of times in the hospital. When he wanted him he wanted him but when he was done he was done. When we got home Avery was wonderful! he just wants to help out. He tells us when Hunter wants a "baba" and gets Hunter blankets and covers Hunter with a blanket and gets under the other side of the blanket and lays with him. He loves to give Hunter kisses. They are both so wonderful :)

Brothers
2 tired boys
Welcome Home Hunter




Thursday, June 16, 2011

June

Well, we sure have been staying busy. Big Brother Avery is turning 3 on the 18th, Mommy and Daddy turn 25 this month AND celebrate a wedding anniversary! On top of that Avery is starting speech therapy, we've seen everyone from the eye doctor to the ENT to make sure everything else is functioning ok for him. He doesn't use his upper lip to articulate words, and he has a slight tongue tie (very little).  We met with Hunter's plastic surgeon and were very impressed and pleased with him! He pretty much came into the room, shook our hands and said, "Don't worry, I Got This!" He's a very pleasant guy. He also has ALOT of experience under his belt. It was very comforting to meet with him before Hunter is born. Other than that there's not very much to share this month. Everything is moving along. I feel as though I will be pregnant forever. I barely get ANY sleep at night and things can NEVER be "Just Right".

Friday, May 6, 2011

HAPPY MOTHER'S DAY TO ME!!!!

Hunter John 22wks 2D
So, we were told that the Amnio results would take 10-14 days to come back. Well today was day 14 and I was tired of waiting. So, at 11:00am I called the Perinatal Center and left a message with a nurse that I would like my results. I was very polite even though I WANTED to say "listen lady, its been 14 days give me the results. . . and next time just tell people it's going to be 14 days, and if they come in earlier they will be suprised instead of worrying." But, I'm not a very confrontational person (to strangers anyway, lol). So I minded my P's and Q's. 20 minutes later a different nurse called me back to tell me the results. I held my breath until she said "[the doctor] looked at the results of your amnio, and everything looks normal" I "whewed" aloud, and then I cried. I couldn't stop saying "thank you SO much!" She also assured me that Hunter was INDEED a boy - Y chromosome and all! So this is probably the BEST mother's day present EVER!!! (Not that we weren't expecting the results to come back normal, but you never REALLY know until you KNOW).

Tuesday, April 26, 2011

Bringing Everyone Up-to-Date

This blog is for our friends and family. It is intended to help them follow our journey as we become acquainted with our newest addition: Hunter John. We will not only become a mother, a father, and a brother, a grandma, a grandpa, and an aunt, of a baby born with cleft lip and cleft palate, but we will become stronger, closer, and complete as a family.

Our journey begins with finding out the big news: We were pregnant!. . . . again. After suffering a miscarriage on March 24th, 2010, naturally we were excited, frightened, anxious, worried, nervous. . . everything. We quickly shared the news with our friends and family. We saw our OB and received the expected due date of August 24th, 2011.


First Picture of Baby at 12 weeks


Things were going along as well as could be expected. We just wanted to get to that "magic date" where we would enter our second trimester and take a deep breath. We made it. Aside from morning sickness and any other symptom of pregnancy you could imagine, everything was looking good.

At our 20 week appointment we had a scheduled ultrasound before seeing our OB. We were holding our breaths. The question on our mind: "Is it a boy or a girl???" and there we had it! It's A Boy! The ultrasound technician went about taking all the proper measurements and looking at every part and piece of our little boy. Then it was over. We had some pictures and a DVD our our precious little boy. Then Josh asked the question, "So, everything looks good then?" and the answer. . . "I'm not allowed to say." We both knew at that point it wasn't good.

We went to our scheduled OB appointment. That's when we were told by our doctor that our baby boy showed signs of cleft lip and cleft palate. I remember saying "Of all the tings our baby could have, at least this is something that can be fixed." Questions were asked. "How soon can they fix this?", "Will he have mental disabilities?" and many more. We were assured that cleft lip and cleft palate were not associated with mental development. We were referred to a perinatalogist to confirm the cleft lip and palate. Our appointment was set. Two weeks away.

We named him Hunter John

Hunter's profile 20 wk ultrasound



                                          Hunter John 20 week ultrasound video

After two weeks of questioning:
"Could they be mistaken?"
"If there was no mistake, how bad is it?"
"Maybe it's just his lip, and not his palate?"
Many, many questions, many tears, lots of worry. By the time it was time for our appointment with the perinatalogist we'd accepted that our baby had in fact had a cleft. We'd equipped ourselves with educational tools. We'd read stories and reviewed photos of other cleft affected families. We just needed to know. . . "how bad is it?" Nothing could have prepared us for what was coming next.

A student came in and began the ultrasound. She examined all of Hunter's parts and pieces. She examined his heart, kidneys, head, legs, toes, everything. . . except his face. We'd caught glimpses of what we thought were the cleft when his face quickly flashed on the screen, but then it was gone again. Then the "real" ultrasound technician came in and began examining Hunter. Apparently he was in the perfect position for her to examine his face. She began taking "sweeps" and producing 3D images of Hunter's face. There it was, a unilateral complete cleft lip on his right side. The perinatalogist came in and began examining Hunter. She confirmed that his palate was severely affected as well. She could not say one way or the other whether or not his soft palate was affected, this is something we will not know until he is born.

Hunter at 22 wk ultrasound 3D

Hunter John 22wk ultrasound 3D
                                            

Since Hunter wasn't opening his hands, the doctor suspected that Hunter had Trisomy 13 or Trisomy 18. Both are chromosomal disorders that severely mentally debilitate and may even cause death before or very shortly after birth. We had an amniocentesis done right away to test for the chromosomal disorders.

The doctor suspected these chromosomal disorders with her only evidence being that Hunter would not open his hands. We were overwhelmed. The thought that it went from "something we can fix" to something potentially fatal for our baby broke our hearts. Then on top of it all they stuck the biggest needle we'd ever seen right through my belly. It was almost too much to bear. Many tears were shed, and then. . . a realization. Hunter's hands were open in our 20 week ultrasound. Hunters hands were open in the beginning of the latest ultrasound. Something they probably didn't see because these images were presented when the student was performing the ultrasound. We later learned that the chromosomal disorders present with clenched fists where the fingers over-lap each other. A picture given to us by the perinatologist clearly shows Hunter's fingers are aligned perfectly side by side. We have also ruled out Van der Woude syndrome, which is the most common syndrome associated with cleft lip and palate.
These are Hunters Fingers


We are also confident in ruling out Apert Syndrome, Aarskog Syndrome, Crouzon Syndrome, Goldenhar Syndrome, Hemifacial microsomia, Popliteal Pterygium Syndrome, Shprintzen Syndrome, Stickler Syndrome, and Treacher Collins Syndrome at this time. However, there are hundreds of syndromes that may present with cleft lip and palate, these are just among the more commonly known ones. We have no reason to believe that Hunter is mentally affected at this time.

(You can see Hunter waving his little fingers up next to his head about eight seconds into the video from the 20 week ultrasound)