August photos - lets talk about cleft palate

What is a cleft?

Cleft means gap!

What is a palate?

The palate is the roof of the mouth and separates the mouth from the nose. 

What causes a cleft lip or palate?

A cleft lip and/or palate occurs when these areas of the face fail to fuse properly in the early stages of the pregnancy.  Research has not yet found out why.  It could be genetics or environment.  To be honest, it is all academic to me.  Ultan is here with us and I wouldn't change him.

If you run your tongue along the roof of your mouth you will feel a ridge. This ridge was formed when your palate fused - probably when your Mom was 4-7 weeks pregnant with you!  And you have two palates, the front part where it is hard is aptly known as the hard palate and the back part where it is soft is know as the soft palate.  Babies can be born with hard cleft palate or soft cleft palate or both.  Ultan was born with both cleft hard and soft palate so if you look at the photos below you will see his cleft going from the front behind his gum to the back.

Treatment

Ultan's plastic surgeon repaired the front part of Ultan's cleft palate during his lip repair which helped in forcing the two sides of the cleft together.  Ultan's surgeon Dr Lam Lai Kun uses the 'push back' technique when repairing.  This technique helps Dr Lam guage the correct length of Ultan's palate which (no pressure Dr Lam) is extremely important for Ultan's speech.

For parents who are diagnosed, Ultan's cleft palate would be on the severe range.  It is rather wide but as I say, all that is academic.  He will have his palate repaired tomorrow and we know he will recover from a successful surgery.

So, yes, we are here the night before Ultan's palate repair.  A little in denial, putting it to the back of our mind.  I have to say, the run up to the palate repair has been a hundred time easier than Ultan's lip repair.  I am not sure if it is because, as parents, we fall in love with our babies, we fall in love with babies cleft lips and to have to leave that go is extremely emotional.  Or is it that we completely underestimate our babies, and we discover day 5 post-op that our baby has recovered while you, the parents, are slumped on the couch feeling the grey hairs arrive watching your wee baba chase the helium balloon at the end of the string as if nothing had happened?  Or is it that we know repairing the cleft palate is medically necessary for speech, eating etc so we want what is best for our child and are willing for it to happen? 

I don't have the answers but I am far less emotional this time around but it doesn't mean that I am not thinking about the external factors that I can't control.  We will have three doctors in Ultan's theatre (as Ultan will have grommets inserted, there will be the ENT Surgeon and the anaesthetist CS Lam).  We have left Dr LK Lam choose his two partners for we didn't want any egos to bloom nor deflate.  However, we are relying on all these doctors to be on form, to deliver, to be partners.  For this time I am not going to underestimate my son, I know he will fight for the recovery that is required.  So, as I say, no pressure Dr Lam, we are relying on you to deliver!

The pictures below show some variations of cleft lips and palates.