Dayna's Bone Graft

Yesterday, Dayna went in for her "big" surgery. This is the one that will determine a lot of her oral/dental/craniofacial future. She needed a bone graft that will eventually create a complete upper jaw for her. This allows her fistula (remaining hole behind her top teeth) to close completely and creates bone so we can do necessary dental implants and orthodontia down the road.

I write this post to be able to give information to other parents down the road. I didn't have a lot of information from other parents myself, as the procedure is somewhat new. Our doctor used a BMP procedure (bone morphogenetic protein). This takes a synthetic protein that is injected in the graft site. A traditional graft takes bone from the patient's hip, or from cadaver bone. Because we used BMP, she will have no healing required from her hip. This will mean quicker recovery and less pain. Our research has shown us that a BMP has the same chance of failing as a traditional hip graft.

It was an outpatient procedure done by an oral surgeon (as opposed to a plastic surgeon). It was supposed to be 90 minutes, but hers took about 2 hours. Because her surgery got a late start, and wasn't first thing in the morning, we didn't leave the hospital until about 9:00 last night.

While in surgery, one of her top baby teeth fell out. It had no bone to connect to and just came free. So in addition to a visit to the hospital, Dayna will also receive a visit from the tooth fairy.

Once out of surgery and in our room, Dayna took one dose of the narcotic painkiller. She was pretty much out for the next 4 hours. At that point, she took regular Tylenol and didn't complain of pain again.

She is extremely swollen, but by the time we left the hospital, her pain level was at a 2. She took the narcotic again at bedtime, mostly so she would sleep (since she took a 6 hour nap total in the afternoon).

This morning, she was asking for a smoothie. Her pain was at a 1 (and that was a headache.) She took ibuprofen and has been pretty much at a 0 all day with only one more dose of ibuprofen after a nap. She's eaten a cup-o-noodles and 2 more smoothies. Her appetite is fine.

One thing we did notice was a lot more initial oozing after this surgery than we've seen before. It was pretty messy. But by this morning, the oozing was mostly saliva with little blood.

At this point, we'll check back with the doctor next week. She's on limited activity and a soft diet for 2-3 weeks. The biggest concern is that she could take a blow to the face, causing the graft to fail.

All in all, this was the hardest surgery for her to wake up from. Her swelling is considerable, but her pain is remarkably under control (almost non-existent.) She can't smile yet, her speech is slurred, and the muscles in her face aren't quite working yet because of all the swelling. She drinks from a syringe, because a cup is a bit too hard for her to handle right now. Baby spoons are just the right size, and since they're rubber tipped, seem to be perfect for her.

Her palate with expander before surgery

Dayna's an old pro - she was telling the Child Life Specialist the ropes

With snuggle blankie - ready to go

Goofing with Mom

Loving on Dad

Showing her mad UNO skills while waiting

Showing Daddy how to crush some candy

Post-op; notice the swelling in her cheeks

Puffy cheeks and lips that celebrities would envy

24 hours later - still puffy and swollen - especially her right cheek