Post-Surgery Recovery

Matteo's post-surgery recovery is going a lot better than this point last year.  Of course having this extra year together has helped, both in attachment and Matteo being a year older and able to understand that much more.  But I give a lot of credit to Matteo himself.  This kid is such a trooper!

Matteo was seemingly back to his usual self when I arrived back at the hospital the morning after his surgery.  He was sitting in bed watching a movie and although Chris hadn't been able to get him to eat more than a few small bites of ice cream, he had been drinking plenty and his pain seemed under control.  Chris went to work and Matteo and I hung out the rest of the morning and into the afternoon.  We received visits from various health care providers, played a matching game, put stickers in the sticker book Grandma had brought him and then cruised through the hospital in a wagon.  It was a lazy and quiet day at the hospital for us.

The only time Matteo appeared in pain is when I cajoled him into eating a few bites of his lunch.  Granted, he was eating pureed chicken mixed with gravy, so that there might have been the root of his discomfort, but I knew the nurses weren't going to discharge him if he didn't get some "solid" food into his stomach.  I otherwise wasn't concerned by what he was or wasn't eating because he had practically chugged two bottles of PediaSure and Carnation Instant Breakfast in one sitting and was willingly drinking plenty of water. He had already defied the surgeon's prediction that he was going to barely drink anything for five days following the surgery due to his throat, so I considered Matteo to be ahead of the game.

Into his second full day of recovery, Matteo continued to only want to drink Carnation Instant Breakfast, but I made it with whole milk and added some of the protein powder Marcel had left behind in an attempt to get as many calories and as much protein into his body to fill his tummy and heal his mouth. I got him to eat a fruit puree pouch and then a bowl of chocolate ice cream for dinner, but if he otherwise just wants to drink Carnation Instant Breakfast for the next two weeks, I'm fine with that if it means we get him through the liquid diet.

Overall, I can't believe how much better this surgery has been compared with last year's surgery and compared with what I had prepared myself for.  I brought Matteo into work this afternoon to visit my co-workers, some of his biggest fans, and no one could believe what a good mood he was in.  He was hamming it up for everyone, playing peekaboo from behind the cubicle partitions and basically acting like a typical three-year-old kid who had NOT just had surgery 48 hours prior.

As thankful as I am for his easy recovery, we're definitely not out of the woods.  I'm still very nervous that his palate could suddenly fall apart.  A small opening the size of a pencil eraser or smaller wouldn't be concerning and "shouldn't" affect his speech, but anything bigger than that is something they want to keep trying to repair.  My question was how.  They could do another fistula repair, which would be possibly an out-patient procedure, but would require the same liquid diet during recovery, or they could do a procedure where they take skin from the inside of his cheek and "fill in" the hole.  I know I shouldn't be focused on the options for another repair since it hasn't come to that yet, but it does make me feel a little better knowing that there are options.

Thankfully the p-flap procedure, which extended his palate and will do the most to improve his speech, has a high success rate and the doctor isn't worried about that coming apart.  There is the possibility that the surgeon will need to "tweak" the p-flap at some point in the next year if the desired speech results aren't achieved, but that's at least an out-patient procedure and less painful of a recovery.

In addition to Matteo's physical recovery, a lot of speech therapy stands ahead of him as he learns to retrain his muscles to make all the sounds that have been impossible for him until now.  Even though Matteo had not made much progress in speech therapy prior to his most recent surgery, I took comfort in hearing his speech therapist tell me that all the hours of therapy was time well spent because he was learning proper placement of sounds, even if he couldn't actually master those sounds. He has the practice in place so that once the surgery is completed, he has the potential to make more rapid progress than if he had done no speech therapy prior to his surgery. 


While hearing all this from Matteo's speech therapist was promising, a lot of unknowns still remain about how much progress he will actually make and in what time period.  My biggest concern is that Matteo's speech may be affected by more than just his cleft palate.  My gut has been telling me lately that there's maybe more going on and Matteo's speech therapist admitted the same hunch to me.  She had never mentioned anything until now because a speech disorder is too difficult to properly diagnose in a child who doesn't have much discernible speech. It's an observation she had tucked away and will wait to look into more a few months post-surgery. 

Chris does not believe anything beyond a cleft palate is affecting Matteo's speech and predicts that by his fourth birthday we'll have trouble keeping him quiet.  Let's hope he's right about that!