This past Tuesday we returned from the hospital with Henry after he successfully underwent a surgical procedure called an alveolar bone graft. It went well. Our cranial facial surgeon, who had performed some of Henry's earliest surgeries, did the work this time and he is very well practiced. Henry is well practiced too.
At ten years old Henry knows how to prepare himself for surgery. He knows how to ask questions about things that make him feel uncertain, and that it's okay to keep asking the same question if he has any doubts. He knows how to cooperate afterward and focus on the things the doctors say he'll need to do in order to be released to go home as quickly as possible. And as he recovers this time, he knows that of course it hurts but he carries this with the kind of assurance that comes with having been through much worse.
An alveolar bone graft is a procedure that for Henry added bone to the gaps in the area where his upper teeth might have been had he not been born with a cleft lip and a cleft palate, in his case an extremely wide bilateral variety. During the surgery, bone material was taken from his hip and grafted into two gaps on either side of a center "post" of cartilage and bone matter that had been constructed several surgeries ago. In taking bone from the hip, an incision around 6-8 cm long was made in his skin, then a hole was cut through the outer surface of the bone so that some of the inner portion with its marrow could be scooped out, after which the hole was closed and stitched up. The marrow will eventually grow back and the hip will be good as new, although not without being pretty sore for about 3-6 weeks.
To replant the bone matter into Henry's upper jaw, the surgeon opened the red gum tissue near the gap to be filled and peeled it away to form a pocket into which the bone matter could be packed. The gum tissue was then closed with sutures over the bone. Often as in this case the surgeon makes some additional adjustments to finally close the "floor" of the patient's nasal passages directly above. The procedure did not leave visible sutures; they were all sewn on the inside of Henry's mouth. Afterward, there was the usual, expected swelling.
Originally, our cleft team had planned a graft for just one of Henry's two bilateral gaps , with a second procedure to be scheduled sometime around the Christmas holiday school break, or maybe during Mardi Gras in February, to complete the graft for the other side. But this week our surgeon felt confident enough during the surgery to just go ahead and complete both grafts now, which gave us yet one more thing for which to be thankful, safely home for this happy Thanksgiving.