Day one in Chicago.  It is amazing we travel this far and still possibly not where we need to be. 
Main concern at this time is Wes' speech, which I believe is clear to everyone that he will need another surgery.  Symposium last year, Dr. Williams said a videoflouroscopy and nasoendoscopy were needed to best navigate a plan for VPI (Velopharyngeal insufficiency). At Shands Wes had a videoflouroscopy. Here they have ordered a nasoendoscopy for Friday. We will get a report with their plan after.
It also seems to be the consensus that during this surgery, Wes collapsed nostril will be addressed. Not fully repaired, as this comes years from now.
After this surgery, the plan becomes much more complicated. As if surgery is not difficult enough. This plan will include surgery to address his flat nasal bridge, surgery and orthodontics for retruded midface and mallocculsion, possible hypertelorism (wide set eyes). This plan will become more detailed as he grows and develops and will be a process over many years.
The biggest complication seems to be that each issue and surgery is not independent. Everything is intertwined and completely involved, if that makes sense. As Dr. Vicari explained that his encephalocele sat in the area where his soft palate should hit to close off his nasal passage as he talks, I started to realize how everything fits or tangles together.
It seems that we have been able to piece together care for Wes, yet have not found the complete team. I honestly do respect when a doctor offers or suggests the opinions of others, which is where we are now. Dr. Vicari suggested and encouraged us to seek a second opinion concerning surgery for Wes’ hypertelorism with an expert team. He plans to get a list together of doctors who specialize in this specific type of surgery. Options seem to range from New York to Seattle with one possibility in Miami.
So today we walk out of an appointment, not unlike many other appointments with some questions answered, some still to be discovered, and new ones weighing heavily on our hearts and minds. For now we are heading to playroom and then the Zoo. Life was meant to be lived, those who know me and my guys know we love to have fun.