Well we made it to California and we are excited to be here. We arrived yesterday with little trouble. Our standby flight went perfectly and we checked into our hotel room. They were very helpful and gave us everything we requested. We are in Fremont, California. It is about 15 miles from the Stanford Ambulatory Surgical Center. We have to cross the bay into Palo Alto to get to the hospital, but it should not take too much time getting over the bridge.
After our travel yesterday, we spent today mostly relaxing. The only appointment we had today was at the California Ear Institute for a pre-op meeting. Before the meeting, we spent a lot of the day around Stanford University to find out exactly where the surgery will take place. The weather has been bad all day. It has been overcast and drizzling rain. The locals said it has been very dry and warm until this week. I guess we brought the Utah weather with us.
During our appointment an audiologist gave Lauren a hearing test. We have had a few tests done before, but not here. They tested different decibel levels for both ears to graph her scores. Her non-affected ear scored very well and this is where they set the bar for her in regards to her normal hearing range. The other side, as expected was lower, but the doctor was surprised at how well she scored. In terms of numbers, she scored as low as 5-10 decibels on the normal side and 40-50 decibels on the Atresia/Microtia side. They said her scores are considerably good for a child with atresia.
After the testing, a Dr. Ort examined Lauren briefly. He may be one of the doctors assisting Dr. Roberson on Monday. He proceeded to explain the surgery and answered any questions we had. He told us of all the risks associated with the procedure. Foretunately, most of them seemed so rare it really eased a lot of our concerns. The procedure he described was exactly as Dr. Roberson explained to us at the conference in October. In all, the surgery should last about 2 1/2 hours. We were told that we must be at the hospital at 6:30 AM PST on Monday. The surgery is scheduled at 8:30 AM. She is not to eat anything after midnight the day before the surgery.
The doctor said that as soon as she regains consciousness after the surgery, she can be released from the hospital. He also said she should not feel too poorly after the surgery. She will be heavily bandaged for the first couple of days, but on Wednesday, the large bandage will be removed and we will be released to come home. They are not concerned about her flying home and they feel it is actually better for her to fly home this week than to wait. The protective packing and gel foam that they will use to plug the new ear canal will protect her during the trip. She must keep this packing in the new canal for three weeks. Some of the packing will be removed a little each week, but it won't be fully removed until after about a month. We have planned to have an E.N.T. doctor locally removing the packing. He was recommended by another family that had their daughter complete this surgery not too long ago. We will have to give her antibiotic drops into the new ear canal to prevent infection and occasionally change some outer dressing.
It is unknown how soon after the surgery we will know if it improves her hearing. It could be immediate or it could be a couple of months. After the packing has been removed and some healing has taken place, they will retest her hearing again to see what the improvement will be. However, I think we may be able to recognize that ourselves. There are two things that can't be determined until the surgery and that is the location and proximity of the facial nerve and the condition of the middle ear bones. Dr. Roberson, after reviewing the CT scan, doesn't feel like the nerve will be difficult to work around. However, if he does get in there and finds it will be a problem, he will stop immediately and will not continue if there is a danger of damage. The other is the condition of the middle ear. The doctor today said that in all Atresia cases, the middle ear bones are not fully formed. This is one of the main reasons she would never have 100% hearing in that ear. During the surgery they isolate the middle ear and check to see it's condition. If it is in a good working order, they will leave it to work as it should. If it is poor condition they could remove it and replace it with a titanium implant.
The new canal will be formed behind her Microtia ear. They will take a graph from some muscle tissue near this same location to use as the new ear drum. The top layer of skin from the back of the scalp will be used to graph in place for the new canal. It will be about a 3 inch by 3 inch area. The doctor said she won't have to lose too much hair and the rest of her hair should cover the graph area. Since this graph is the top layer of skin, it will not contain hair cells so they can use it for the ear canal. The rest of the pre-op visit we signed forms, completed paperwork, and worked out the financials.
Overall, Lauren is in great spirits. I think she will do fine. We are optimistic that the news will be positive after the surgery. The goal is to improve her hearing under the 30 decibel range. If this is possible, she will not need any hearing device in the future. It will never be as good as the non-affected side, but it would allow her to hear and develop normally. The rest of the weekend we are going to try and do some sightseeing if the weather permits.
We really miss the rest of the family and hope the other kids are doing well. Lauren really misses them. They are not here to play with her so we find we have to fill in and we don't have the same energy that Cameron or Kara have. I plan to try and put updates on here daily. Especially right after the surgery. We thank all of you for your thoughts and prayers.