Day 1 Post Op

Overnight in the hospital went well...She was able to get a bit of sleep in between the nurse coming in every hour. Her nose bled quite a bit in the night as well.  She was given Tylenol every 4 hours in the night, some antibiotics and didn't need any morphine until mid-morning when we tried unsuccessfully to get her up to use the washroom. Her face is getting more puffy by the hour even with all the ice we have been using.  We were able to get her up on her feet once and she shuffled/hopped to the washroom.  When she stands it is a classic stork stand, with the left leg bent...

The surgeon came by and liked what he saw.  He was actually surprised that her face wasn't more swollen.  He discharged her and will see her again only if we feel she needs to be seen or if we have any concerns. He was great. He said we could call him anytime.  All her follow up will be done here with our orthodontist.  Basically he said the biggest concern is infection.  We need to be super diligent to keep her mouth clean, hence the rinsing guidelines and brushing instructions.  He said to watch that we don't see any white on the gum line as that would be bone and that the stitching could tear easy if the gum gets infected...he said not to worry so much about the graft itself not taking, but to be concerned of the affects of infection. She will have an x-ray done in 6 months and that will tell us if the whole graft was successful.

We drove home right away after being discharged...they gave her some Tylenol with codeine and she was a trooper for the four hour drive. We stopped once for a potty break and to get her a popsicle.

Once home she has some soup broth and we set her up on the couch to watch some TV...she didn't last long and fell asleep on the couch. 

Surgery Day

This morning Miah had a bone graft at BC Children's Hospital.  She was scheduled at 10:30 and they even got her in a little early.  The oral surgeon had three surgeries booked for today...all three were young girls having their bone graft surgeries.  This was one of  the reasons we chose this particular surgeon...he apparently does these procedures all the time. On the way to the hospital Miah kept telling us her new stuffed Squirrel was scared.  We kept reassuring the squirrel that God would be with him the whole time and Miah did her best to reassure him that he would be ok. Miah never admitted to being scared though...

Our pre op procedures were a little different than we were used to.  There was no meeting with the anesthetist prior to surgery day and she was allowed to drink clear fluids up to 3 hours before her surgery time. Having a drink when she woke up made the morning a little more bearable.  We only had to check in one hour before surgery time and they had a great play area set up in the surgical waiting room.  We were allowed to all come into this area as a family and wait with her.  Parents are allowed into the OR with their children if they choose...I didn't have to even ask. I was able to gown up (Miah said I looked even more funny than last time in my fancy blue hat), and walk her into the OR. I lifted her onto the table and within 2-3 minutes they had her IV in and she was asleep. They didn't even make her wear that hat she hates so much!

Her surgery took 2.5 hours and I was able to wait in the parents waiting area right outside the OR while Drew and Mackenzie toured the aquarium for a change of scenery. When the surgery was finished, the Dr. came to speak to me in the waiting area and sat down with me, going over all the post op instructions...a very long list of do's and don'ts....some of which include:

• Clear fluids for the first few days, then we can move to pureed food once she is able to brush her teeth well. He said this transition could be as soon as Miah can tolerate a good brushing after every meal. Soft mushy foods for at least three weeks and then on week four we can try some softer pieces that she can chew with her back teeth. He said it would be at least five weeks before she can bite into something like a sandwich with her front teeth and even longer for foods such as a raw carrot stick.
• No bathing for 1 week, then on week 2 she can start having showers...then on week 3 she can have a bath.
• Rinsing her mouth with salt water...up to 20 times a day. Brushing as soon as possible three times a day.
• She is on antibiotics for 10 days and medication for pain.
• Icing her face a few times per day to help with the swelling

I was able to sit with her in recovery. She never did wake up until we got transferred to her room.  Her pain was pretty well managed the first day with Tylenol and Morphine. She never complained about any face pain, only pain in her hip.

Grandma and Grandpa came by later in the afternoon as well as the Epps. Miah loved having some familiar faces come to visit. She was a little drowsy, but enjoyed the gifts she received.

Her face started to swell about 8 hours post op. The surgeon said that this would continue and that Monday (Third day after surgery) we would see the worst of it...after that, it should start to get better. She says that her "Cleft feels funny."  I am assuming that it is the swelling that feels different...or perhaps the stitches are bugging her.

Surgery # 7-Pre Op Photos

Tomorrow we head to Vancouver. Miah will be having surgery on Friday at BC Children's Hospital.  I'm pretty sure this is surgery # 7, although Miah says it is 10.  Maybe it feels like 10...poor sweet thing.  She has been VERY anxious this time. She talks about the upcoming surgery constantly and breaks out into spontaneous tears when least expected.  I think that last experience in the ER when she broke her arm is still fresh in her mind...the ER experience where they tried unsuccessfully to start an IV.

I'm planning on blogging our experience with Miah's bone graft in hopes that it can help someone else prepare their child for this same surgery, as well as document this process for Miah to better understand one day.

Miah's Upcoming Surgery

Miah is scheduled for her bone graft surgery on July 5th at BC Children's Hospital. Many of you have asked what this surgery entails so I figured I would post a bit of a description.

Alveolar Cleft
The cleft lip and palate are repaired as babies, but the alveolar cleft when wide should be repaired at a later time to avoid growth disturbance. Usually this is done when the permanent teeth are coming in. The cleft surgeons work closely with orthodontists in preparing for the procedure so that the teeth and gums are optimally positioned for surgery.



The procedure requires taking bone graft (usually some bone marrow from the hip bone) to fill the gap in the alveolus or gums. After the procedure, the patient needs to be on a soft diet for ten days and be careful in brushing the teeth not to damage the healing incisions in the mucosa of the gums. It takes about 3 months for bone formation to show on an X-ray and confirm that the bone graft has taken. Once this is confirmed, then the orthodontist can resume work on aligning the teeth.

We were told that if the graft is 80% successful that they will be thrilled, if 50-70% of the graft takes, there is a chance that it will have to be redone, and anything less will require a second go at it.  It will be a long three months of waiting to see. Please pray that it will take the first time as this is not a very fun surgery to go through.

"A child born to another woman calls me Mom. The depth of the tragedy and magnitude of the privilege are not lost on me" -Jody Landers

I read this quote on a friend's facebook status yesterday in honor of Mother's Day.....what a profound and accurate statement.  I often find myself at a loss for words and inability to express how I feel about the honor I feel that I get to parent this sweet gift from above, and at the same time still can't wrap my head around the loss that has happened in order for us to be where we are.  The word tragedy is the only one I can think of...what kind of a world do we live in where a mother cannot keep their child? I don't know the reason for Miah's abandonment, but I'm sure if falls somewhere in between the family not being able to care for her; either financially or not being able to legally call her their own due to government restrictions.

This past Tuesday Miah fell off the monkey bars at school and broke her arm. As she lay sedated in her hospital bed, I was overwhelmed with emotions and the thought that her biological mother should be here...that her biological mother would want to be here. It saddens me as a mother that another mother does not get the opportunity to comfort their child in a time of need.

 

The result- a broken arm and 4-6 weeks in a cast.  I have one very disappointed little girl who can't go to gymnastics and swimming lessons for a few weeks.  We also found out this week that her bone grafting surgery is scheduled for July 5th. She might be taking two months off from all those extra activities....we might have to find her a new hobby...

 

Disneyland

This past week we took our annual family vacation to Disneyland. We just don't seem to tire of this place!  Each time is a little different as the girls get older.  The first time we went we spent most of our time visiting Princesses and characters.  Now, we are often found in lines for the more thrilling rides and the animation academy.  I don't think we even saw a princess once this trip.

 

 

One of the highlights of our trip was that the girls got to meet their cousin Alyssa for the first time.  How fun it was for them to have an older and cool girl to play with.  It was much more fun to ride with Alyssa than just Mom or Dad. Alyssa is living in California working with YWAM. What a great opportunity for our girls to hear about what she is doing with her life.

 

 

The other highlight of our time away was the day we spent in LEGOLAND with Tian.  Tian and Miah were friends from China.  We were told by the nannies at the girl's orphanage that they were buddies.  It is always a joy to see these two girls interact with each other.  I hope that they will continue to cherish this special friendship forever!

 

 

 

 

 

 

 

Chinese New Years 2013 in Photos