Cleft Lip and Palate

Many of you have asked about the typical course of treatment for Jonathan once we have returned home from China.  I will give my best attempt at giving you an idea of what will happen and when.

After Returning Home From China:
After our initial visit to the International Adoption Clinic (usually about 1-2 weeks after returning home), we will schedule our first visit with the Cleft Clinic at Children's Hospital, where the team will discuss the best treatment plan for Jonathan. We are very fortunate to have a Cleft Clinic here at Children's Hospital were we will be able to meet with all the professionals involved in his care.  At this time, we will schedule a surgery date for his cleft lip to be repaired.

There will be three necessary surgeries for Jonathan...

Cleft Lip Repair
He will also have ear tubes placed at this time.

Cleft Palate Repair
Approximately 3 months after the lip repair, his cleft palate will be repaired.  The cleft palate surgery requires suturing of the soft tissue of the palate.  Jonathan will stay 1-2 nights in the hospital for this surgery. Depending on how well the palate closes will determine if additional surgeries for the palate will be needed. After the palate is repaired, a speech evaluation by a speech pathologist is recommended. 

Bone Graft

This surgery is typically done between 7 and 9 years of age.  Because Jonathan has a gap in the bone of the gum line, a bone graft will be needed along his alveolar ridge.  Bone from the hip is used to fill the gap in the gum line.

Additional Surgeries (If Needed)
If surgery for speech is recommended, a pharyngeal flap will be done. 

If a revision of his lip or nose is needed, the usual time is before kindergarten. 

As the child grows their face changes. A revision of the lip and/or nose may be desired around age 11-14 years

Around 12-16 years, orthodontics are usually started.

Between 15-20 years, some surgeries that may be needed include jaw surgery to bring the upper jaw forward and/or the lower jaw back, septorhinoplasty – to straighten and refine the nose, malar implants – to build up the mid-face (cheekbones), and revision of the lip and nose. 

The Lord has given us total peace and we are ready to tackle whatever is needed for our son.  Now, lets just get him home!!!

Update
We are currently waiting on our LOA (Letter of Acceptance) from China.  We have been waiting 56 days and the average wait is 60-90 days.  We are CREEPING closer and closer to the average wait.  The wait for LOA is so hard and long, but with frequent reminders, we remember that this process is all in the Lord's timing, so we try to wait patiently.  Some days are just plain difficult though.  That longing to just touch and hold our little boy sometimes gets the best of our patience.  You would think the waiting would get easier the third time around, but NOTHING is easy about knowing your son or daughter is on the other side of the world and you must wait.   

Once we receive our LOA, we should have a better understanding of when we may travel.  We are hoping and praying for the end of April/beginning of May.  The girls are genuinely excited and are ready to get on that plane to China to get their little brother (we shall see how long that excitement lasts ;)).

Jonathan should have received his care package!  A friend of ours delivered his package to the director of the orphanage who will then give it to his foster family for him to enjoy!  Our friend is currently in China meeting her precious little girl who is in the same city as Jonathan.  Thank you so much Rushton and Derek for hand delivering our little one's package!

And last but not least, we received updated pictures, a video, and answers to 10 questions!!!  This was such an amazing blessing during this time of waiting!