When I miss a call from the craniofacial surgeon's schedule coordinator, I don't have to listen to the entire voicemail. As soon as she says her first name, I delete the message. I know who she is, I will not forget to call her back, I have memorized her extension. But it's not like I delete the message because I prefer to keep a tidy inbox. (I definitely do not care about that, I keep ignoring my 1,000 unread emails because it amusingly annoys my husband.) I have to remove the dang thing off my phone immediately because surgery is scary and for one moment more, I need to put it in the freezer and it needs to not be happening.

But it is happening, probably late summer 2015. Her palate still looks good, but she needs additional work on her right cleft. The bone in her orbital rim is not doing its job, so her eye still droops (ADORABLY), and there is a lot of built up tissue in her cheek that needs to be removed. Her surgeon told us all of this at her post-op checkup, and, per usual, it all made sense at the clinic and as soon as we crossed the threshold into our home it promptly made very little sense. So I'm requesting another appointment with the surgeon. Like, last time they took skull bone and put it into her orbital rim. Are they harvesting bone again? From where? And what's the deal with all that bulky tissue? Why is it there, would it just continue to get more extreme and will it cause her difficulty in some way? Because if not, do we really want to be doing surgery on it? I worry that we already might be creeping up from surgery she needs and into surgery she "needs."

The other big thing he's going to do is explore her left eye in detail while she's under the anesthesia for the main procedure. Her left eyelid doesn't close all the way, which means she can't fully blink. I used to think, big whoop, but, now she's always acting foolish inside, outside, everywhere. She's normal toddler-clumsy and she's also blind-in-one-eye clumsy. If she got a spec of dirt in her eye, she couldn't flush it out by blinking. I'm not even sure if her tear ducts work properly in that eye. Her surgeon wants to take a look during this procedure, know exactly what he's dealing with, and then attack it at a later date.

In other news, we switched to private speech therapy. She goes twice a week. Shierry still only wants to say "m"s. She can say "b" and "n" sounds, but it's difficult, and her cheek and lip muscles are apparently real lazy, because she almost always reverts to "m". So, Baba is still Mama, and no is mo. Her therapist thinks that because of the clefts and surgeries, Shierry's systems are out of whack. Her development in her gross motor was pretty separate from her fine motor, was separate from her eating, was separate from her speaking, was separate from her vision, was separate from her hearing.

These are the tedious details for those who are curious. Her gross motor was and continues to be somewhat delayed (girl is not super great at motor planning, she barely climbs anything, etc), because of her partial blindness and the fact that she was always having/recovering from surgeries at major milestone points, while her fine motor has always been quite good. She could eat reasonably well, but she learned to eat when she had a huge cleft-sized crater in her mouth. So, her facial muscles for chewing are weak or numb, largely due to the fact that they've only recently been cobbled together. Also, she has always chewed food way in the back and to the side of her mouth and she grew accustomed to that level of sensory input. So now she doesn't like to chew difficult things (meats) and she prefers to chew things that relay a lot of input to her system (cheerios). The speaking, enough has been written about that. Her vision, duh, blind in one eye. As for her hearing, the clefts have resulted in extensive fluid buildup that even when not rising to ear infection level, which it chronically does, can still negatively impact her hearing.

Which is all a rambly way to say, her therapist is working on getting her systems to work together, in addition to typical speech therapy stuff. It's a process and she made it clear that we can't predict the future or create clear rubrics for success. As long as Shierry consistently communicates more and is happier for it, I'm good for now.

We have also started to get Very. Concerned. about her teeth. The teeth have to be healthy so that they're ready for orthodontia so that her mouth is ready for future surgeries. Definitely to close up the bone gaps in her upper jaw and possibly for a bit of jaw distraction. Not, like, tomorrow, but eventually. We've always brushed her teeth, but now we have to floss them. I barely even floss my own teeth. And my teeth are sickly. Will I never learn?!?! The other thing with her teeth is that they're nuts, twisted every which way, erupting directly behind each other. They're goofs. But healthy for now which is all I care about.