Nathan's first surgery

Today, Nathan had his first (of three) surgeries at the University of Iowa Hospital in Iowa City. Mary and Lynn Cox drove down with Nate yesterday afternoon and spent the night in a hotel. They were able to take Nate swimming in the hotel's pool, which Mary said he enjoyed. This morning, he was taken into the O.R. to have his "crown" put on. I hope to soon have pics placed so you can see what I'm about to try to describe, but here goes:

Nathan has "hemifacial microsomia" with microtia. In layman's terms, in the womb half his face was not fully developed and his ear was not fully formed. The mandible (lower jawbone) on the right is not completely formed and does not have its growth plate. He also lacks the chewing muscles on the right side of his face. The left side is completely normal, and as he grows the left side of his face is growing normally and the right side pretty much not growing at all, so his face is gradually getting more asymmetrical. Eventually this can lead to considerable problems, such as twisting of the airway- which would not be a good thing!

Today, he had hardware placed that will "distract" his jawbone, or pull it back into a more correct alignment. The device is similar to a "halo" and is attached to his skull with pressure point screws, four on each side. Coming down from the front of the halo is a bar which is attached to Nate's chin by two pins. A plate was surgically inserted onto his chin for these 2 pins to attach to. Tomorrow, Mary will be taught how to perform the daily adjustments to this contraption that will gradually pull Nate's jaw back into alignment. In 3 weeks, we will return to Iowa City and they will take some of Nate's rib and rib cartilage out and graft it into his jaw. This graft will act as a growth plate in the future. In another 3 weeks, we will again go down and all the hardware will be removed.

During the 6 weeks that Nate is wearing the halo device, he will not be able to open his mouth more than a 1/4 inch or so. Mary has been able to spoon some orange sherbet into his mouth tonight, but it looks like feeding will be difficult for the next 6 weeks. According to the surgeon, he will not be able to chew anything harder than mac & cheese, so soft/pureed diet is what he'll be getting. Nathan is a carnivore. He loves meat- beef/chicken/pork- if you give it to him Nate will eat it!

Todays surgery went well. Nate is dealing with some discomfort, oozing of blood around the chin plate and groginess. We will keep you all informed of his progress. I'll try and post some before/after pictures too. Keep Nate in your prayers as he deals with this situation in his life.