Decisions...Decisions...
It's hard to believe, but the time has finally come to address the one issue we were aware of when we first met our little man...the ear...or "nub" as we affectionately call it.
We had our initial appointment with his new ear surgeon last Friday. (Remember his old guy ABANDONED us last year. To move to Utah. To start a private practice. Whatever, man. We don't hang out with quitters.) Where was I...oh right...new guy.
Dr. Owen walked me through the various options as I tried to keep Zane from swinging from the rafters. I usually have my trusty Dr wife (don't laugh...we've had something interesting conversations!) or my actual hubby to help interpret/remember all the details AND corral Zane. This time, I found myself alone for the most intricate discussion since we adopted the 2 kiddos. Me. Details. And all of this was while Zane was literally hanging from the light and checking my vitals and the whole nine. **sigh**
I'll do my best to give you all the run-down, realizing that Chris and I haven't had even a second to have the conversation it will take to make this decision! One thing to note with all of the options below, except #1, is that the nub will likely be removed completely. This is actually different than previously discussed but understandable. Just something else to process for Zane.
Option 1: DO NOTHING. We were actually tossing this option around 2-3 years ago. Zane was completely oblivious to the nub and didn't seem bothered by it in the least. Fast-forward. Zane is now very self-aware and is constantly asking when he can get his ear "fixed." He doesn't like to have people ask about it at all. Even though he understands that kids are curious, he takes it as "mean" when they whisper about his nub to their parents or each other. (He's not imagining that either, as I recognize it happening often...but I've rarely seen it happen with malicious intent.) In spite of our reassurances, he's even to the point now where he doesn't like to go new places where people will see him for the first time. So...option 1 is off the table.
Option 2: PROSTHETIC EAR. This was never mentioned before, but I'm not sure this would be a good fit for Z. No pun intended. They could attach the ear with internal magnets or posts, much like a hearing aid.
Pros: Not surgical. Don't have to worry about blood vessels, ear canal, rejection, recovery time, etc. It would also be the most realistic-looking, as they're able to match his skin tone exactly...as well as the shape, texture, and thickness of his left ear.
Cons: It's removable. It's fragile to the degree that China could chew it, Zane could take it off at-will and do no-telling-what with it. Could traumatize entire soccer teams when it falls off during a game. You get the idea. The surgeon said we could get an extra...we'd need 20.
Option 3: RIB GRAFT surgery, combined with existing tissue from the nub, to reconstruct a new ear.
Pros: Established method that has been around "forever." Uses all of Zane's own bone/skin/tissue so there's very little possibility of rejection. There are 3 variations of this surgery so we're able to choose the one that would work best for Zane's case.
Cons: Regardless of which of the methods is chosen, the rib graft plan would actually be 4 different surgeries, separated by about 6 months each. That means the whole process would take almost 2 years. :/ He would also have a pretty significant scar on his rib as well as the recovery-time doubling. The rib-graft ear is a good bit thicker than his natural ear because it's not possible for them to match the thin, yet flexible composition of the natural ear. It could also discolor a bit over time. We have to be concerned with blood vessels, misplaced ear canal, etc.
Option 4: MED PRO ear. This is basically a plastic ear that is created to mimic the existing ear, covered in skin grafts from Zane. These would be taken from under his arm, behind his ear, his hip, etc. This is very polarized option...doctors are either for or against it...no middle ground.
Pros: It's a one-time surgery. The plastic is more sturdy and is easier to shape into the more realistic imitation of the other ear. No rib extraction necessary.
Cons: It's the "new kid" on the block since it's only been around 20 years. I can only assume that the skin grafts would require some healing time. There is a potential for extrusion...the plastic could pop THROUGH the skin at some point. Very rare, but still a possibility.
So...yea...there they are. 3 completely different options to choose from...piece of cake.
He literally said Chris and I needed to google all the options...for real, GOOGLE...and decide what we think we want to do.
In addition, there's the timeline. I asked Dr. Owens how far out we'd be looking at, once we decide what to do. He said he thinks it should be done as soon as possible, given his age and growth. When I asked if that could be as soon as next summer, he said he would say it could be late spring, at the latest. :0 So basically...Zane gets the titanium plate out of his jaw in April, it heals, and then we do the ear. Again... :0!
In the meantime, the doctor will be discussing Zane's inner ear with Dr. K. He's not sure why that hasn't been part of the conversation yet...as that will determine how they proceed with whatever decision is made. If there's a potential that Zane could hear one day, then we need to salvage the existing ear canal, navigating around it and avoiding it at all costs. If that's not a possibility, regardless of what we do, then they will just "obliterate" the canal and save a lot of time. Pretty big part of the decision-making process.
So basically...no big deal.
Lots and lots...oh, and lots...of decisions to be made and prayed over! We appreciate all of you that choose to join us in that!
We had our initial appointment with his new ear surgeon last Friday. (Remember his old guy ABANDONED us last year. To move to Utah. To start a private practice. Whatever, man. We don't hang out with quitters.) Where was I...oh right...new guy.
Dr. Owen walked me through the various options as I tried to keep Zane from swinging from the rafters. I usually have my trusty Dr wife (don't laugh...we've had something interesting conversations!) or my actual hubby to help interpret/remember all the details AND corral Zane. This time, I found myself alone for the most intricate discussion since we adopted the 2 kiddos. Me. Details. And all of this was while Zane was literally hanging from the light and checking my vitals and the whole nine. **sigh**
I'll do my best to give you all the run-down, realizing that Chris and I haven't had even a second to have the conversation it will take to make this decision! One thing to note with all of the options below, except #1, is that the nub will likely be removed completely. This is actually different than previously discussed but understandable. Just something else to process for Zane.
Option 1: DO NOTHING. We were actually tossing this option around 2-3 years ago. Zane was completely oblivious to the nub and didn't seem bothered by it in the least. Fast-forward. Zane is now very self-aware and is constantly asking when he can get his ear "fixed." He doesn't like to have people ask about it at all. Even though he understands that kids are curious, he takes it as "mean" when they whisper about his nub to their parents or each other. (He's not imagining that either, as I recognize it happening often...but I've rarely seen it happen with malicious intent.) In spite of our reassurances, he's even to the point now where he doesn't like to go new places where people will see him for the first time. So...option 1 is off the table.
Option 2: PROSTHETIC EAR. This was never mentioned before, but I'm not sure this would be a good fit for Z. No pun intended. They could attach the ear with internal magnets or posts, much like a hearing aid.
Pros: Not surgical. Don't have to worry about blood vessels, ear canal, rejection, recovery time, etc. It would also be the most realistic-looking, as they're able to match his skin tone exactly...as well as the shape, texture, and thickness of his left ear.
Cons: It's removable. It's fragile to the degree that China could chew it, Zane could take it off at-will and do no-telling-what with it. Could traumatize entire soccer teams when it falls off during a game. You get the idea. The surgeon said we could get an extra...we'd need 20.
Option 3: RIB GRAFT surgery, combined with existing tissue from the nub, to reconstruct a new ear.
Pros: Established method that has been around "forever." Uses all of Zane's own bone/skin/tissue so there's very little possibility of rejection. There are 3 variations of this surgery so we're able to choose the one that would work best for Zane's case.
Cons: Regardless of which of the methods is chosen, the rib graft plan would actually be 4 different surgeries, separated by about 6 months each. That means the whole process would take almost 2 years. :/ He would also have a pretty significant scar on his rib as well as the recovery-time doubling. The rib-graft ear is a good bit thicker than his natural ear because it's not possible for them to match the thin, yet flexible composition of the natural ear. It could also discolor a bit over time. We have to be concerned with blood vessels, misplaced ear canal, etc.
Option 4: MED PRO ear. This is basically a plastic ear that is created to mimic the existing ear, covered in skin grafts from Zane. These would be taken from under his arm, behind his ear, his hip, etc. This is very polarized option...doctors are either for or against it...no middle ground.
Pros: It's a one-time surgery. The plastic is more sturdy and is easier to shape into the more realistic imitation of the other ear. No rib extraction necessary.
Cons: It's the "new kid" on the block since it's only been around 20 years. I can only assume that the skin grafts would require some healing time. There is a potential for extrusion...the plastic could pop THROUGH the skin at some point. Very rare, but still a possibility.
So...yea...there they are. 3 completely different options to choose from...piece of cake.
He literally said Chris and I needed to google all the options...for real, GOOGLE...and decide what we think we want to do.
In addition, there's the timeline. I asked Dr. Owens how far out we'd be looking at, once we decide what to do. He said he thinks it should be done as soon as possible, given his age and growth. When I asked if that could be as soon as next summer, he said he would say it could be late spring, at the latest. :0 So basically...Zane gets the titanium plate out of his jaw in April, it heals, and then we do the ear. Again... :0!
In the meantime, the doctor will be discussing Zane's inner ear with Dr. K. He's not sure why that hasn't been part of the conversation yet...as that will determine how they proceed with whatever decision is made. If there's a potential that Zane could hear one day, then we need to salvage the existing ear canal, navigating around it and avoiding it at all costs. If that's not a possibility, regardless of what we do, then they will just "obliterate" the canal and save a lot of time. Pretty big part of the decision-making process.
So basically...no big deal.
Lots and lots...oh, and lots...of decisions to be made and prayed over! We appreciate all of you that choose to join us in that!
