Henry: P-Flap Failure

Monday, July 30, 2018

P-Flap Failure

The pharyngeal flap ("p-flap") surgery that Henry underwent a couple of weeks ago apparently came undone, or "dehisced." The surgery had aimed to transfer muscle tissue from the back of his throat (pharynx) to his palate in order to narrow the opening to his nasal passages. Sutures meant to hold the tissue in place unraveled, and now his speech is even more hampered than before. The prospect of still more surgery this year was a surprise and disappointment.

It was heartbreaking to watch Henry process this news, particularly with some strangers including a medical resident and a first year medical student in the examination room at the time. But he handled it well.

It doesn't appear that simply redoing the p-flap is an option. At any rate, we'll first have to let the tissue in the area heal for a minimum of about 6 weeks. This means Henry will soon start his 6th grade school year at a new school (middle school) with some serious speech issues much more pronounced than usual. Probably the quickest we could return to the hospital for a repair would be Thanksgiving break in November.

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How This All Began

It was a typically dusty afternoon on September 11, 2006 in a dry, hardscrabble, terraced plateau region of Gansu Province in northwest China. There in Jingchuan County south of the city of Pingliang, a driver named Tian Wu Ping had just dropped off a fare at a roadside hotel called the Tian Yuan Guest House when something caught his eye on the east side of the crossroad and next to a refuse bin.

It looked at first like a bundle of rags but turned out to be an infant wrapped in an old cotton quilt, a small baby boy who appeared to be newborn. Tian picked up the child and called the local police. The baby had been abandoned. He was missing part of his face below his nose. Born with a serious cleft anomaly, he had no bone structure between the upper bridge of his nose and his lower jaw, and no separation between his oral and nasal/sinus cavities.

Moreover, the child had been left by the roadside without the usual effects. No red cloth note indicating a birth date. No bottle, cup, or packet of formula. No infant clothes. The police drove him north to Pingliang and turned him over to the prefecture Civil Affairs Bureau, which placed him with the Pingliang City Social Welfare Institute. The staff at this orphanage named him Liang Xiao (Small) Wei (Big).

On admittance, a doctor noted that Xiao Wei was indeed just a day or two old and underweight at 5 lbs. Then this frail little child took his place among about 80 other children then at the orphanage. Another exam at five months showed that despite the issues that can accompany his condition, Xiao Wei was small but growing. So the orphanage staff posed him for a few photos and prepared a dossier of paperwork to send off to Beijing, to the China Center for Adoption Affairs (CCAA), for his case to be accepted into the CCAA’s waiting child program.

China's waiting child program seeks to find homes internationally for orphaned or abandoned children with special needs that might otherwise make finding a family highly unlikely. These can include treatable medical issues such as congenital heart disease, Hepatitis B, cleft issues, or spina bifuda. Some waiting children have more severe issues.

Not all abandoned children with special needs become waiting children. Not all waiting children find homes.