Humpty Dumpty: Hudson's version

A post by popular demand!

With Hudson's palate repair scheduled for this Friday I've had many, many, people ask me how it will be repaired. Not just recently but over the past year as well. My answer to them: Do I look like a surgeon to you? Just kidding... But really. I don't blame you all. How does a doctor make something from nothing? Right? Well it's all quite interesting. I've have the procedure explained to me a few times as well as doing my own research. But it's one thing to hear it and another thing to have to explain it to people! I've done my best though... I think.

I feel pretty darn educated on the matter of clefts. I've tried my best to relay that information to others through my blog. It's something near and dear to me and I want you all to know just that much more about the world of clefts. This is a post I've been thinking about doing for a while (regardless of the nagging...)  and with Hudson's palate repair just 2 days away I finally decided to hack away at it.

So here it goes...

Try and keep up as I explain the repair procedure to you. Thanks to my mad artist skills I've even provided you with pictures! I've found some pretty good pictures online but Hudson's is so unique to all of those I wanted to draw it out myself for you. My photos of his palate are always just bits and pieces. He's a wiggly little boy OK? His palate is so fascinating to me so I hope the picture I drew really helps you see what it looks like as a whole!

Hudson cleft palate

After repair.

Hudson's palate would be classified as an incomplete bilateral cleft palate. There are incomplete and complete, and bilateral and unilateral. His is incomplete because the cleft stops at his alveolar ridge. Remember his NAM? Nasoalveolar Molding. If his cleft were complete there would be a separation of the alveolar ridge too and when surgeons use the NAM it helps bring the gap closer together. Hudson's NAM was mainly to open his flat nostril which he had. He does have an upside down "V" looking notch in his alveolar ridge. Almost like an indent. He'll most likely need bone grafting a few years down the road in that spot so his teeth will have bone to grow in. If he has any teeth in that spot...

His cleft is a bilateral cleft because the gap takes up both sides of his hard and soft palate. Left and right. This is most likely why he has 2 uvulas! Split right down the middle! I love those uvulas...

OK, are you caught up on the background info? Good.

His surgery should take about 2 hours, so I've been told. But you never know... I'll try not to be too worried when the second hand passes his two hour mark and I've still not heard anything about my baby. I hate picturing him on the OR table, knocked out, and being worked on... MOVING ON!

OK so the procedure...

With his cleft/gap down the middle of his palate he does still have the sides of his palate intact. Dr. Beals (his wonderful surgeon) will take tissue and muscle from the sides of his intact palate and bring them over to the middle to cover his cleft and rebuild his palate. Dr. Beals will sew it all together closing the cleft and bringing his 2 uvulas into one. Hudson will be left with raw tissue exposed from the sides of his palate to heal up on their own. No, he will never have bone where his hard palate is and where bone should be. The new muscle and tissue will be enough for him to speak, make new silly noises, and suck through a straw.

And that's a palate repair in a nutshell. Give or take. That's from my own understanding and some online reading. Not too complicated, right?

Hudson will have a 10 day recovery period where he's only allowed his bottle and liquids. He'll also have his lovely arm restraints again. And to top it all off, no paci... Boo. His palate will be ever so delicate the first couple of weeks and we don't want to go poking holes through it now do we? Sometimes the holes do happen and that would be called a fistula. But that's for another day. And we do NOT want a fistula. It could lead to another surgery. Poor buddy. I have really high hopes for him though. For a smooth recovery. I just hope my hopes aren't too high... I expect it to be a little more rough than his lip repair. We are staying a night in the hospital after all.

   

He's one amazing kiddo! I've never even had surgery before! Or stitches! He's got that on me! And he's not even 18 months old. That's a lot for one little boy to handle. But he's not just any little boy...

Wish us luck!

"Out of suffering have emerge the strongest souls; the most massive characters are seared with scars."
-Khalil Gibran