Craniofacial Clinic visit

Logan did amazingly well! It was a very long day, and I'm glad it's over. Ryan thoroughly enjoyed his playdate with his cousin, which is a good thing, since we would have been hard-pressed to entertain TWO little boys in that exam room all day.

Most of the visit went much as expected. Logan was more participatory with this speech/language pathologist, but her findings matched those of Miss Laura. She loved what she saw in Miss Laura's evaluation and will work with us and her to help Logan progress with his speech. The pediatric dentist was elated to learn that we have a great pediatric dentist here in town that we use; he's someone Children's is very familiar with and enjoys working with. They'll happily consult for us with Dr. Tom and Dr. Jared. That's wonderful, since Dr. Tom is pretty close to perfect in my mind! Anyone who will see all of my crew at one time has my vote--and that office will. I can take all of them in to get their teeth cleaned, and the whole crowd will be done and we'll be out of there in less than an hour. Plus, our orthodontist is willing to work with Children's for Logan's orthodontia, which means we can do all of those things right here in town. The social worker and nursing care coordinator were very helpful and will be great resources for us as we move forward. It will be nice to have such great people on our side!

Our second to last visit was with the plastic surgeon. Up to this point, we were thinking that we would not have to be back for about 9 months, which was nice. This doctor was very direct and very clear about his thoughts for Logan's care. He believes (and we agree, given his explanation and diagram) that Logan needs surgery, and sooner rather than later. It will be interesting to see how his opinions are integrated into the team approach to care. He feels very strongly that Logan has an insufficiency in his palate repair that requires an additional surgery in order for him to be able to make sounds correctly. He showed us the physical evidence in Logan's mouth while Logan made sounds that led him to that conclusion. He believes that while speech therapy will be very helpful, it will only frustrate Logan UNTIL this correction is made because he cannot yet physically make the sounds we are asking him to make. He would prefer to run a few additional tests now and schedule surgery soon if the tests agree with his opinion. I don't know whether the rest of the team will agree. I think both of us would like to have Logan do the additional testing sooner rather than later. I'm thankful we have an excellent pediatrician who can help us make this decision. If we had to make a decision right now, both of us would schedule his surgery as quickly as possible so that he isn't any more frustrated than necessary. But we'll see...

Our last visit was with the audiologist. We expected that Logan would have a BAER hearing test (where he would likely be sedated, then hooked up to an EEG type machine to determine his hearing) but that's not what happened. Like a trooper, Logan walked into the room, allowed them to hook him up with the ear pieces, and played games with the assistant. He did amazingly well, performing the tests nearly textbook perfectly! If only the results had been textbook perfect as well. One test (a tympanogram) indicated that he does, in fact, probably have fluid in his left ear. The second tests showed that he has some low frequency hearing loss in his left ear. A portion of the test indicated that it's not only his eardrum that is the problem, that there are some inner-ear issues as well. The audiologist thinks that tubes may help but that because there's something else going on too, we may not see the improvement we hope for. It will be interesting to see what happens next in this area. Because of his age and history, they would not wait to insert tubes in his ears; it's simply a matter of scheduling his visit with the ENT and moving forward. The other results complicate things a bit, and the scheduling is a significant issue as well. Right now, the ENTs are booking first appointments in SEPTEMBER. Please pray with us that God, who has opened so many doors already, would open one more so that we can move forward with Logan's hearing!

It was quite interesting overall, and not as overwhelming as it could have been. In the big picture, he'll have several surgeries before he's 13, but nothing we hadn't expected. Right now, it's these first few months we're more concerned about, making wise decisions about his palate insufficiency and his hearing.

So now we wait for the final reports and recommendations, and the opportunity to schedule a visit with the ENT. Then we get to make decisions! :)