Day 3: The Before and After

When I first held Chloe in my arms on the day she was born, I immediately noticed her innate appetite, her curly brown hair, and her squishy face. It wasn't until the next day that the hospital pediatrician would identify that squishy face with the indent that made her eyebrows so expressive as a condition called Craniosynostosis.

It took me weeks to learn how to pronounce and spell that word correctly, and even longer to look up pictures of the surgical procedure.

"Her forehead looks adorable to me!" I reassured myself that her condition was mild at most.

"If it's simply cosmetic," as our first neurosurgeon from San Diego Rady's Children's Center suggested, "then why put her through major surgery to fix a fault in her forehead (which I believed to give her happy eyes and inquisitive eyebrows)?"

The neurosurgeon continued, "Almost every parents who opts out of surgery now will decide to have it done when their child is above 5 years old. By that time the bone is harder to separate, the correction does not look as clean, and the child is old enough to remember the experience. And sadly, kids can be mean and may tease her because of a disproportionate head shape."

Darn. Good point, doctor. Why couldn't I just have been right!

He was very confident when he said, "After her surgery she will be a normal, happy girl and I hope you keep me updated with ballet recitals, piano lessons, and..."

"And soccer practice!!" I interjected.

Before surgery, the metopic suture that formed prematurely on her forehead was creating quite a point.

In the image of Chloe in her 'sleepy tiger' operation outfit, you can see the triangular shape of the forehead that would continue to get worse. The two front skull plates are meant to fuse at about 6 months, yet, Chloe's was half-way fused at birth. This causes the eyes to slant upwards as they are pinched towards the nose.

Rare cases show pressure forming on the brain and sometimes can cause milestone delays in babies. A developmental psychologist tested Chloe at 6 months and found her development was closer to a 9 or 10 month old and categorized her in the 95 intelligence percentile!

The only category tested lower in was reciprocal communication, which included this test: Dr. Johns called Chloe's name- to which she smirked and didn't look at the doctor- then she called 'Mary!" to see if Chloe was paying attention to her name or simply the sound. Personally, I think she's so sophisticated, she's already developed selective hearing.

Following her surgery, a CAT scan was performed and compared to a CAT scan from 4 days old.

On the left is the 4 day scan, on the right, 2 days post surgery.

Dr. Urata, our plastic surgeon at L.A. Children's Hospital, told us in a reassuring way, "I know this surgery seems like a big deal to you, and it is, but in a different way, it's not a big deal to me. I perform 1-3 cranio surgeries every week and have completed thousands of them successfully, with no complications."

How grateful I am for doctors and surgeons who devote their life to making surgeries like this possible.

His assistant, Dr. Ibrahim Khansa, explained the scan results. In the second image, the skull had been removed down to the nose and above the eyes by neurosurgeon, Dr. McComb, and plastics took over molding the shape. Slits were made horizontally in the bone so the point could be rounded. The edges of the eye sockets were pulled out to reduce the sunken shape. Bone grafting was done between suture holes. The empty areas will fill in over the next 5 years as the bone continues to fuse. Dissolvable plates were placed vertically in the middle and sides. Mom did really well trying not to faint while all this was explained.

The drastic difference I noticed was how flat her forehead had become. In order to prevent the skull from returning back to a metopic ridge, the shape is overcorrected. In 1-2 years, the overly flat forehead will have rounded out well. Within 5 years, the plates should dissolve and the soft spots should harden.

Before surgery, Chloe's head was pointy, her personality was determined, she was crawling from cupboard to bookshelf at swift speedy speeds, her laugh was contagious, and she had all the love in the world.

The only change is now she a nice round head and a warrior's battle scar to prove her bravery.

#Craniosynostosis #CranioSurgery #CranioWarrior #LAChildrensHospital