Kate's Bone Graft, Part 1

Kate's bone graft really wasn't on our radar last year. It was something that the doctors said she would need when she was about eight, so although we knew it was out there in the future, we didn't spend too much time pondering it.  However, that changed when we saw Dr. N. at the Commission back in November. He wanted to go ahead and get X-rays of her mouth, so that he could track the growth of her mouth and determine when the surgery would be.  Dr. N. is an oral surgeon who has worked with Kate's (now retired) plastic surgeon for 30 years.  I asked him once what the likelihood of a bone graft failure was, and he told me that he had one fail once.  Once.  OK, you get the job. 

Kate is missing her left lateral incisor - aka, the tooth that doctors sometimes use to decide when to do this surgery. Because of this, there was a wider window of time to get it done.  Dr. N. said that either the summer of 2013 or 2014 would be fine, or even later if we needed to wait for whatever reason.  We went home that day thinking 2014 sounded fine with us. Or later.

Then in the spring a couple different things happened that caused us to start reconsidering.  First, the central incisor started coming in at a weird angle.  And when I say weird, I mean it was pointing straight out and the bottom edge was vertical and pressing on her lip.  Thankfully it has now started to rotate itself down into a better position, but it still has a way to go, and it irritates her upper lip.

Second, the other three lateral incisors started to erupt, meaning that her jaw was close to the right stage of growth for the bone graft to happen now.  This was surprising since Will still has one of his baby lateral incisors, and at the time this happened, he had two or three.

Third, one day at a visit to Jack's plastic surgeon, Dr. L. was making small talk with Kate and got this look on his face that meant he noticed something.  He asked her to start making faces (lip puckers, etc.), and according to him, all of Kate's upper lip muscles aren't properly connected.  That was news to us, since her (now retired) surgeon never mentioned it.  So I started making appointments and asking questions.  Within a very short amount of time we saw the other members of Kate's plastic surgery team (who thought there was no muscle issue but wanted to do some work to minimize the scar - I said no; they also said that they would work with either Dr. N for the bone graft, or their ENT for an ear drum repair, but not our ENT), an orthodontist (who said he would normally do a palate expansion on a child getting ready for a bone graft, but wasn't going to touch that front tooth with a ten foot pole because it could fall out if we start shifting things around), her ENT (yes, we can do her ear drum repair when we do a lip revision; no, we can't do an ear drum repair when we do a bone graft), and three different speech therapists (who all agreed with Dr. L., something was amiss with that front lip).

By this time it was May of 2013, and honestly it was too late for a summer 2013 bone graft, what with vacations and all (ours and Dr. N's).  Plus, was had to make decisions about which surgeries to do and which ones could/should be combined.  I consulted with Dr. L through all of this too, even though he has never seen Kate as a patient.  I decided to wait until summer 2014 so that she would have time to heal, and I would have time to mull over the choices.  There was no reason to rush.

As we considered, the decision was made to have Dr. N. do the bone graft, and then later, after she was healed we would have Dr. L do a major lip revision while Dr. M (ENT) do a ear drum repair at the same time.  Three birds with two stones.  

As summer rolled by, I became more and more thankful that I hadn't scheduled a bone graft.  Talk about busy!  We didn't slow down at all, and as per usual, we barely saw Tim except on vacation.  Also as the summer rolled by, I realized that there was no way I could schedule a bone graft for next summer either.  It wasn't going to be any better!  I knew he was suggesting summer because it is when lots of people's lives slow down, but let's face it, we aren't "lots of people."

I called Dr. N's surgical coordinator in August to discuss the possibility of doing it over fall break instead.  She suggested the Thursday before break, and then Kate would have eleven days to recover before school resumed.  Mimi could come up and care for the boys, then they could be farmed out when we got home from the hospital on Friday.

And that is what we did. 

(Stay tuned for Part 2.)