Craniofacial Appointment - 2010

This afternoon was Rachel's yearly Craniofacial Team appointment. It's hard to believe that we've been seeing this team of doctors on an annual basis since Rachel was just 5 weeks old.

We saw five doctors today, the med student to the Pediatrician, the Pediatrician, the Speech Therapist, the Dentist, and the Plastic Surgeon. The ENT was not there today, but it's okay, her hearing test in November was normal.

Because we see so many doctors, we go to these appointments prepared to wait for hours. Our appointment was at 2:30 and we were finally put into a room just after 3:30. We've learned through the years it's best to just come prepared, thus we had the laptop with movies, Rachel's homework, our iPhones fully charged (and charger in purse if need be!), and snacks!

How Rachel passes the time...
How her parents pass the time... First up was the medical student to the Pediatrician. Followed by the Pediatrician. They checked Rachel's overall health over. Listening to her lungs, heart, checking her ears, eyes and mouth.Feeling her glands, etc. They were interested in how she was doing overall - if she likes school, how she's doing, etc. She weighs 48.2 lbs and is 44 inches tall. Recommendations from him - get a base eye exam from a Pediatric Ophthalmology. Her eye lids are a little low and they just want to make sure there isn't an underlying condition that sometimes accompanies cleft palate babies. Next Up: The Speech Therapist. She asked questions and we explained to her that we'd been in the process of obtaining Speech Therapy for Rachel through the school district since August 4th. She talked with Rachel and asked her to repeat sentences back to her. She agrees, there is still a need for therapy. There is some nasality with certain sounds, and some improper placing of her tongue for some letter pronunciations. I asked if we were out of the woods as far as Rachel perhaps needing a surgery called a P-Flap, which is basically another surgery to lengthen her palate and help with those sounds that nasally. The Speech Therapist is pretty sure that with therapy and re-teaching on tongue placement, that that surgery would be purely optional in Rachel's case as only a few sounds she makes are nasally. She gave us a packet of papers to give to the school Speech Therapist and would like to see us back for a Speech Only Evaluation in 6 months. I'm in the process of drafting up an email to the school therapist to hopefully light a fire under her in getting this process moving.

Next Up: the dentist and her resident. Nothing big there to report. They asked a few questions and then dawned rubber gloves and went to town at looking at her teeth. Making note of which teeth are out of place, etc. They did say she had a great alveolar arch for a cleft affected child (meaning her gum bone is well formed and not caving in, it's perfect with the exception of where her cleft is. Bone graft surgery to be done once the onset of permanent teeth are noticeable. We have a wonderful pediatric dentist and we see her next week for regular check ups and cleaning. So Rachel's good to go, dental wise, for now.And last, but certainly not least, we saw the plastic surgeon. Not Dr. Martin, who did Rachel's palate repair, but the other plastic surgeon on the team. This is the second year in a row where we've seen her and I like her. We talked about the future and impending bone graft. And that more than likely a nose revision would be done at that time. She mentioned no need for a lip revision. Thank the Lord for the plastic surgeon who repaired her lip!!! He did an awesome job!

It was just before 6:00, by the time we walked out of the clinic. A long afternoon indeed. Happy to have that over and have it be uneventful. Next years appointment, depending on how Rachel's teeth are, and if she's had any fallen out by then (she'll be 6 1/2 years old) there will be potential talk of surgery. Which would be her next major one. But for now, we're enjoying the quiet journey for now!