Once More into the Breach

Now that things here are returning to normal after a second hurricane (this one called Ike) blew safely by the neighborhood, we’ve scheduled another lip surgery for Henry, this time a full reconstruction. Our surgical team thinks it would be better to skip another first stage lip adhesion surgery since that procedure has failed twice and might not hold a third time. One of Henry’s ear tubes has come undone and we’ll add this to the docket for this round as well.

A first stage adhesion is an initial procedure that fastens only skin, which is one reason why for Henry it keeps tearing open. The full reconstruction will dissect muscle around the lip and nose to also be connected under the skin. This will give the new lip and nasal area some natural functionality and allow for relatively even growth as the years go by. A full reconstruction is theoretically stronger but could still tear apart. We’ll just need to be very careful and Henry will get a brand new pair of those clunky arm mitts.

Henry’s new upper lip and its surrounding area will be stretched unusually tight, which could easily leave him with an under bite. But this round will be overseen by our team's senior member, known nationally for this kind of work. This surgery will be very broad in scope and will undo and correct much of the right-side healed remains of Henry’s first surgery in China, which we now know had been botched. We are glad there are charitable organizations like Smile Train and Operation Smile that organize medical teams to travel to undeveloped regions of the globe to perform reconstructive surgeries on children born with cleft conditions, including many children who have been orphaned or abandoned. But we’ve learned that occasionally doctors who participate in some charity teams do so with little expertise or little or no background in handling severe cleft cases, and that blanket promises to save lives with a single “45-minute operation” are, for most cases, hopeful exaggerations. It may be that for these children a dehisced or failed surgery is better than none; that it's simply worth the try. Then again there have been problems.

At any rate, this next surgery for Henry will be a complex set of procedures that should begin to determine how his face will ultimately appear to the world around him. We think we've chosen well with our doctors here, and once again must simply hope for best.

As is, Henry’s cleft face is normal to us and precious in a way, since it is so unusually expressive, especially when he smiles. But it is admittedly a very unusual face that garners stares and a variety of squeamish reactions in public settings. This was particularly so after his last surgery when his lip sutures tore open; the result for a while had the look of an open wound. Still, each weekday morning Henry goes to the large outdoor general morning meeting at our girls’ school, toddling about or fussily clinging like any other child his age. He accompanies us to stores, to restaurants, to parties. He basically goes everywhere, and everywhere his sisters are his ready defenders. Brows furrowed, they sometimes ask what’s wrong with people, especially other kids, who are afraid of Henry or uncomfortable around him. For Dorothy and Clara are certain that Henry is just right, even if they’re not quite certain that his cleft problems are just temporary.

But behind Henry’s unrepaired lip opening is today a remarkable new hard and soft palate that is healing well where there had been only a gaping hole prior to his surgery in August. The rest, his parents know, is doable. Unfortunately, each round, much like that last one, is also going to hurt, a lot.

Henry made two years old on September 10, which with friends we marked in warm celebration. He is a very special little child and we still can’t believe we were so lucky to have found him.

We’ll return to the hospital on October 13.

Home Sweet Home

All's well that ends well, we suppose. We've all returned home after the storm. Andy returned quickly to New Orleans on Wednesday as duties called, and to check on the house which came through with minor damages. Trish and the kids returned last night, having moved on to stay with yet more kind friends farther north in Tupelo, MS, since we lost power early during the storm at our first evacuation stop. While less powerful than predicted, Gustav came onshore with unusual forward speed that carried hurricane-force winds far inland into central Louisiana, trashing main transmission lines and crippling the state's power grid. Now we are wearily keeping an eye on another large storm that also appears to be heading toward the Gulf.

New Orleans is a familiar mess, with signs and power poles askew and piles of debris temporarily lining the streets. Some new traffic lights were damaged and we are again handling these intersections as in Chinese cities, which isn't really so bad since it transforms something completely impersonal like driving into a kind of folk dance. It's this sort of thing that helps to make our city worth returning to; like that clear sense that everyone standing in line with you at the supermarket has come through the same ringer. While it doesn't erase complicated differences in race or socioeconomics it genuinely reaches across them, which is unique.

But this blog isn't really about New Orleans or hurricanes, except only indirectly. It's about little Henry and, in a larger sense, abandoned children with special needs and scarce resources--hidden away in far off corners of the globe. Sufficiently reminded by this storm of how lucky we truly are to have such wonderful friends, a special home, and each other, we'll reach into our well worn pockets to send another donation to help buy new clothes and shoes for older children at Henry's orphanage in Pingliang, Gansu.

Hoping for the Best

Henry is officially a New Orleanian, since he has now evacuated for his first hurricane (this one called Gustav). Here at our destination 50 miles north of the city, in a calm break between early bands of the storm, the rest of us are considering whether there is any special advantage to having to repeat this. Maybe. Maybe not. The near misses and smaller storms of years long past were humbling but Katrina in 2005 changed us at far deeper level: it was a precious reminder of the beauty and resilience of our children and how each smile is a gift, each hug returned is a soft treasure, and each tiny hurdle overcome is a magical triumph. Everything else was just stuff. Who cared if the house got whacked? We could rebuild. We know a lot of families felt this way to varying degrees; it helped.

A second big hurricane within three years can make one remember one's stuff more wistfully. We can only hope our hard-fought home will still be intact when we return. Generally New Orleans comes through okay in storms that land west of Morgan City, LA, as it appears this one may. Large storms pushing a lot of water and spitting wind gusts in the form of tornadoes are finicky, however.

We are staying with good friends at their comfortable home in a mid-size town safely inland above the Northshore area of Lake Pontchartrain. They have a daughter who was also adopted in China, Dorothy's age. The girls are a bit apprehensive about the weather of course, but busily determined to squeeze some fun from this event. Luckily, Henry in just the last few days seems to be have been in a lot less pain from his surgery. He is a bit fussy from sudden travel but generally his happy self. His new palate is healing well; his lip area less so but our surgical team thinks it looks ready to try a third lip closure, which we were in the midst of scheduling. Both hospitals with which our surgeons are associated in New Orleans are today veritable fortresses, so for Henry the storm is likely to be just another short medical delay.

We're hoping for the best and are reasonably optimistic about our own circumstances. It's still a few hours before dawn when the worst of this hurricane should begin to reach the coast and a lot of people who left behind homes in Louisiana's rural coastal parishes below New Orleans are facing much worse odds, unprotected now by wetlands fast disappearing. You know them. They're the people who drill much of our domestic oil and gas just off shore, grow our sugar from cane, and catch our oysters, crabs, and shrimp.