Fistula Repair and P-Flap Surgery

Matteo had his second cleft palate surgery today. It was a "twofer" surgery with fistula repair (to repair the hole in the roof of his mouth that was created when his palate repair dehissed) and a pharyngoplasty, (also called a "P-flap" surgery) which will lengthen his soft palate and, fingers crossed, improve his speech.

Matteo has heard us talk about the surgery a lot, but we'd never actually sat him down and explained what was going to happen and I realized I owed it to him, even if he's barely three and a half years old, to do that.  Given his lack of a sense of time, I chose last night, the night before surgery.  I explained that when he woke up he wouldn't be allowed to eat or drink anything and that right after getting dressed, we would be going to the hospital for a surgery to fix his mouth.  He seemed sad and when I asked him if that made him scared, he shook his head yes.   

His mood changed at the hospital and he was suddenly excited to push the buttons on the elevator and show me where to go.  He goes to the hospital for speech and other appointments, and it's clear he's become quite familiar with the place.

That his mom is late for everything actually ended up working in his favor.  Last year Matteo had an afternoon surgery, which started late, and it was tortuous trying to keep a hungry, thirsty and cranky two-year-old distracted.  He had what I thought was a 9:00 a.m. surgery, which meant we were supposed to be there at 7:30 a.m.  Well, the surgery was at 8:30 a.m., so we should have been there at 7:00 a.m., but well, I was shooting for 7:30 a.m., and of course we were late.  When we showed up at 7:45 a.m., the staff was waiting for us, checked us in quickly and whisked us back to a pre-op room.  One after another, nurses, the surgeon, the pharmacist, a nurse anesthetist and the anesthesiologist stopped by the room to check in. At exactly 8:30 a.m. a trio of nurses wheeled him back to the OR, he calmly let them put his mask on, he quickly fell asleep, I gave him one last kiss, and the surgery I'd grown so anxious about in the preceding weeks was finally underway.   

The surgery took about an hour and Matteo ended up spending longer in recovery than he did in surgery thanks to needing an extra-large dose of Morphine, which caused him to take an extra-long nap. His surgeon met with me while we waited for Matteo to wake up and he reported that both procedures had been completed without complications. Despite the uncomplicated surgery, he reiterated how painful the next 5-7 days could be for Matteo since a p-flap surgery involves taking skin from the back of the throat to use to lengthen the palate.  He also reminded me how fragile his palate is and why a strict liquid diet is going to be crucial to his recovery.  The failure rate is still relatively high, which makes me nervous.

We spent the afternoon settled in Matteo's hospital room, where he went in and out of sleep.  When he was awake, we tried to get him to drink and eat something, but that was a tough sell because swallowing clearly caused him a lot of pain.  My mother-in-law had come to keep me company, so we hung out and did our best to help Matteo stay comfortable.

I know the therapy dogs are there for the kids, but with Matteo sleeping off the anesthesia, I got to spend some time with Freddie, a six-year-old Golden Retriever. 

Chris and Celina came over after dinner with the kids, who seemed to have forgotten why Matteo was in the hospital and fixated on what they thought was a sweet set-up - all the juice, pudding, ice cream and DVD's Matteo could ever want.  Not even Matteo throwing up dried blood (and what looked like a lot of it!) scared them away.

Chris volunteered to do the night shift, which I'm so thankful for since I find sleeping overnight in hospitals so incredibly lonely.  I'll be back in the morning to relieve him.  Hopefully Matteo's stomach has settled by then and he is finally able to eat something.  He won't be discharged until he's eating and the nurses feel like his pain management is under control.