Monday, January 11, 2016

Orthodontist Visit

Today was a big day for our little guy! It was his first appointment at the orthodontist! If you remember from the previous post, the orthodontist is basically the key decision maker for the first step of David's care plan. We were waiting to see him to find out if we could use braces to close David's palate before surgery or if we would need to have an appliance put in like we did with Lily.

So today I had to be in Tampa by 10:25 after dropping the other three kids off at school. I managed to get Matthew to the bus on time and Caroline to her class a little early so that I could drop Lily off in the office by 9:15 and get on the road. Of course when I took her into the office there were other people waiting and the secretary was nowhere to be found. By the time someone came up to help us it was already 9:15. She called Lily's classroom and Ms. Cindy came up to get Lily. David and I were on the road by 9:20. According to my GPS arrival time I had only 2 minutes to spare. I made great time on the highway and was set to arrive 10 minutes early! Then I made the mistake of getting off on Fletcher. The traffic was awful and I watched the minutes tick away. We slid into the parking lot at 10:24 and made it just in time!

David was all smiles until we got out of the car. Then he got his nervous look and started shaking his head no. Sorry buddy, there's no turning back now! He was fine when we went in and played in the waiting room while I filled out paperwork. Then they brought us back to the new patient office to fill out paperwork. David was very clingy and wanted to be held so I could tell he was nervous. After the paperwork was completed we needed to take some pictures.

We went into another room and I tried to put David on a stool so they could get a regular old normal picture of him smiling. He lost his mind. As soon as I put him down he started crying and tried to catapult himself off of the stool. I scooped him up and tried to calm him down by taking a picture of him on my lap. It didn't work. He is totally crying in his picture. Then we had to go sit in a dentist chair for more invasive pictures. Seeing as how just sitting and smiling caused so much trauma, I was dreading the rest of this task. But thank goodness for Wendy. She was the wonderful woman taking the pictures. She handed David latex gloves and helped him put them on, then gave him one of those plastic things they use to hold the lips back. He was completely distracted and warmed right up to her. Next thing I know he's holding the plastic thing to keep his mouth open and biting down like a champ while Wendy took pictures. No tears!

We headed back to the office while the pictures were uploaded and printed and shown to Dr. F. for his opinion. David was happy as could be. I kept him busy with the Chinese/English app on my phone. Then Dr. F. came in, and of course he started crying again (he's really got the stranger danger thing down). To calm him down Dr. F gave him a musical toothbrush which he then proceeded to hold up to his ear and play repeatedly. Eventually he stopped crying and I could actually have a conversation! I was so excited to hear that Dr. F didn't have any hesitations about doing braces! He asked me if I wanted to come back or go ahead and do them today, and I decided it was better to just rip off the band-aid and get this party started.

At this point it was 11:20, and in order to get Caroline on time I would have to leave at noon. I had no idea how long everything would take so I called my mom for backup. Dr. F wanted to have the same tech that put Lily's brackets on do David's so we had to wait a bit for her to finish with her current patient before she could work on David. Finally it was our turn! David followed Carmen over to her chair, but as soon as it was time to sit in the chair he started freaking out again! I think that the fear and nervousness about not understanding what is happening is actually what makes him cry. Once he realizes what is going on he calms down and is pretty compliant. Carmen quickly realized that getting David to lay in the chair wasn't an option, so instead I crouched down on the floor and held him half standing in front of her. She showed David how she was going to blow air on his teeth and clean them with cotton and all of a sudden he was totally fine with it! I think he just wants to know that he can escape at any time ;o) From that point on David did awesome! He stood right there in front of her and let her do the whole cycle - dry, clean, place bracket, heat light - for every tooth! A few times he got tired and signed all done, but he hung in there. My legs lost all feeling sitting on the floor with him and Carmen's back almost died from leaning over, but at least he didn't cry! Once all the brackets were on she placed the elastic chain and we were done! David was all smiles and was so proud of himself for being brave. Now we go back next Wednesday for tightening - yikes!

Thank you all for praying for us through this journey. We are ecstatic that the first step of this journey has gone smoothly, and now we pray that the braces do their job and pull David's palate together. We probably need to visit Dr. R again and schedule surgery sometime soon as well. But today, we celebrate success!

Friday, January 1, 2016

David's 1st Cleft Appointment

Blog blackout is over! At least for today ;o) I know that many of you want updates on how David is doing, but to be honest writing about the past month seems kind of overwhelming. So I'm starting with a baby step and just updating about his first cleft appointment.

We went to see the cleft team on December 18th, except on the way up there we discovered that there was a mixup and we weren't actually on the schedule for the day! Thankfully the team coordinator is awesome and told me to come anyway and we would work something out. It actually ending up working out better! Instead of paying to see a speech pathologist (no speech, so not much to evaluate!), social worker, pediatrician (he had already seen ours), ENT (no fluid when the pediatrician saw him), audiologist (hearing tests are tricky when you don't speak English!), and dentist, we just saw our surgeon. It was just like having an office visit, just not in his office!

Dr. R checked out his cleft (non-evasively thank goodness!) and commented on both how wide it was and how old he is, compared to most cleft patients. David just sat on my lap and nervously eyed the doctor, but he didn't cry at all. Unfortunately the team orthodontist wasn't there, and he's a big part of the surgical plan. Dr. R. took some pictures of David to send to him, but nothing will be decided until we have an appointment with the orthodontist.

So, here are the options. We are hoping that we can use braces to bring David's cleft closer together. This will enable Dr. R. to close everything - lip, gumline, and palate - in one surgery. This would obviously be amazing, so we are praying that the braces are an option and that they are effective! Since David is 4, his bones are not as flexible as Lily's were when she had braces. If the orthodontist doesn't think they will work, then we go to Plan B. In Plan B David will have an appliance attached to the roof of his mouth that will help to close his palate. Unfortunately the only way to place is the appliance is with a surgery. Once the appliance is in place for about a month, David will have another surgery. In this surgery Dr. R. will close his lip and gumline and remove the appliance. The palate tissue will need time to heal from the appliance, so we will have to wait about 3 months for the lip to heal before David has a third surgery to close his palate.

We are obviously on Team Braces and are praying for one surgery! Our appointment with the orthodontist is on January 11th so we will know more then. If he thinks braces will work, they will go ahead and put them on that day so we don't have to drive back to Tampa (again!). I will update again when I know more!