Palate surgery recovery

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Maggie was well enough 3 weeks post-op for our annual beach trip.

Physical recovery

Maggie’s recovery went pretty well, all things considered. She did not take a drink for 3 full weeks after palate repair, save the one bottle she drank immediately after surgery. Her surgeon told us she would be fine as long as she was eating pureed foods like applesauce, yogurt, baby food purees, milky mashed potatoes, and the like. She existed on that type of food for 3 full weeks.

One day she indicated that she wanted a small sip of water from my glass. The next day she tried another tiny sip from my water, but still refused to drink anything else. It felt like a lot of pressure trying to keep her hydrated, as we had to make sure that we were making up for the amount of liquid she would have normally gotten through her food, which meant feeding her very frequently. We needn’t have worried, though–she was glad to eat all sorts of pureed foods and she did just great and never got dehydrated.

Once she started seeming a little bit willing to let liquid pass her lips I went to Dairy Queen and got her an arctic rush. She had never had one before, but she was very interested in it! I added some water to thin it a little and she drank the whole thing straight down in her Avent cup. From then on, drinking because less of a challenge. I won’t say she got right back to normal, but every day got steadily better until about week 4 post-op she was drinking normally. She never would take the bottle again, though–surgery effectively weaned her from that. I was sad to see it go, but with her 2nd birthday rapidly approaching, I guess it was time.

She had a Dr. visit three weeks post-op with her surgeon and he said her repair looked great and he did not believe she would develop a fistula. As I am catching up on posts right now, we are 3 1/2 months post-op and she is doing fantastic. She has not developed a fistula and she is finally starting to try and say some words and imitate some sounds.

For awhile after surgery some things got worse–she started drooling more than she had previously, and food came out her nose every time she ate. I found out that those things can get worse for a time after surgery as little ones get used to the new feeling of their mouth–but that they would resolve with time. Now, over 3 months post-op, she doesn’t drool at all. Occasionally she sneezes and food comes out her nose, as her gum-line is still cleft (it will not be repaired until she has her bone graft in elementary school, before her permanent teeth come in). It is not a daily occurrence, however. She is also becoming much more comfortable with letting me brush her teeth, which is great. She will open her mouth now, and she seems to like it. I am using an electric tooth brush for her these days as she prefers that by a mile over the regular kind.

Mental recovery

This part was much harder. I love the team we use at UAB in Birmingham, but I am not a fan of their anesthesia policies. They will not let parents go back during anesthesia, and they will not let parents see their child until they are done in recovery and ready to meet their parents in their hospital room. We have had other procedures done in Atlanta and they always let me be with our child while they are falling asleep and again before they wake up. I really think this experience was traumatic for Maggie, and we paid for it for about 2 months post-op.

Maggie showed so much anxiety after her surgery that we were not able to return to her regular therapies. We had planned to take about 3 weeks off and then go back to speech and physical therapy after her 3 week post-op appointment and our beach vacation. Unfortunately, she showed so much anxiety during therapy that we couldn’t accomplish anything. We contacted the International Adoption Clinic about it and they recommended that we take some time off of therapy and allow her to have more time to recover emotionally from her surgery. Her attachment to me became more ambivalent at that time, where she would seem very needy and didn’t want to let me out of her sight, but when she was with me she didn’t relax–she was clingy and fussy. She also started showing jealousy toward her siblings at this time–hitting and pushing them if they tried to sit on my lap and wanting me all to herself.

Maggie has always been a pretty easy child, but we have had some sleep issues to contend with. Whenever she is under stress it shows up during her sleep patterns. After going to bed easily and happily for months she began to show a tremendous amount of anxiety at night. This did not happen immediately after surgery–it took about two weeks. Once she started feeling better and no longer needed medicine for pain we began to see signs of night time stress. She didn’t want to be in her room or in her bed, she wanted to stay up until all hours of the night playing until she physically could not stay awake any more, and she was waking up in the middle of the night crying. This was not “normal” for her except in the first couple of months after coming home and during her post-surgery phase after her lip repair.

The adoption clinic suggested we start giving her melatonin at night to help her sleep. That was effective almost immediately and she began sleeping peacefully again, going to bed happily at her normal time and sleeping through the night.

We were able to resume her therapies after a 2 month break, starting at first with the therapists both coming to our home for awhile before transitioning Maggie to therapy outside the home. She has relaxed again in her attachment toward me, and she is now back to her normal happy self.

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