Again...WHY is Esther Marie Having Surgery?

I have realized in the last few days that many people don't really understand why Esther Marie is having surgery and what it is all about. I have been sharing that she is having surgery on Wednesday and asking people to pray and they ask...What is the surgery for? She looks fine.

She does look good, but that's because she had surgery in China to repair her complete, bi-lateral (double) cleft lip. I am guessing that Cleft Lip Patient 7 (click on the link) is what Esther Marie looked like when she was born.

A Cleft Lip may be unilateral or bilateral, complete or incomplete. The goals of cleft lip repair include re-establishment of muscle continuity and re-creation of the normal landmarks of a lip. The skin, muscles and mucous membranes are surgically moved from their abnormal positions and joined back together again.

This surgery tomorrow is to repair the INSIDE of her mouth...her cleft palate....which means the open roof of her mouth. She has two openings (holes) in there that are open from her uvula to her gum line. There is a ridge down the middle between the two openings (bi-lateral, complete) If you click on the "cleft palate" link, you will see patient 1 showing a single opening in the palate. Esther Marie has two openings.

A Cleft Palate may be unilateral or bilateral, involve the soft palate only, soft and hard palate, and extend thru the gum where teeth will eventually erupt. The goals of cleft palate repair include re-establishment of muscle continuity in the soft palate, and re-approximation of the palate lining across the cleft. The palate lining is shifted from the sides to the center and stitched together. The bare areas left on the sides heal in spontaneously.

How does having this open palate affect Esther Marie and why does it need to be repaired? Well, she can't speak clearly because of it. Her speech is nasal sounding because of air that moves through the openings, and food and liquids get in there and can come out her nose. So she definitely has to have this repaired. Both her soft and hard palate are affected..and this is a major surgery. Her mouth will be held open with some type of clamps for about three hours during the surgery; therefore, her little face will be quite swollen when they are done with the repair. There will be bleeding and oozing and it is quite painful. Her recovery is 4 to 6 weeks and she has to eat very soft foods for 4 weeks. She also will be wearing arm restraints for two weeks so she doesn't put anything into her mouth (i.e., straws, forks, toys, etc.) that could damage the repair that has been done. A puncture would be devastating!

Click here to view some before and after photos of cleft lip and palate patients...and to read more about this birth defect. This site explains things much better than I am able to. Esther Marie will end up having more surgeries for various issues, including a bone graft later, braces and maybe jaw repair. Cleft issues are on-ongoing and the child requires periodic evaluations to determine what other treatments/surgeries that they need.

Esther Marie will also have the ENT doctor clean the ear wax out that is impacted close to her ear drums. She has tested for some hearing loss in the low tone range and hopefully, this ear wax is the cause. She may end up with tubes in her ears if the ENT doctor determines she has too much fluid build-up, which is a common problem in cleft children.

One of Emmie's fingers is curling because of some scarring that she has, so Dr. G will do some repair work on that finger so the curling doesn't get worse as she grows. He is the same doctor who is doing the palate repair.

The surgeries will take 3 to 4 hours and we would really appreciate your prayers during this time and during her recovery, especially the first two weeks. We are waiting on a phone call from the surgeon's nurse who will let us know the time of surgery. I'll post that as soon as I know.