Charlotte went to Royal Oak for a check up today, and her nose is progressing nicely.  She won’t have to visit next week, and her next trip will be for the third surgery on her nose.  According to Dr. Chiayasate, this next phase of surgery is the most difficult in terms of her appearance.  In this phase, they will extend a flap of skin from her forehead to cover her nose.  The skin on her nose right now is mostly from her hip, so it doesn’t match the rest of her face.  This upcoming procedure will help her nose to blend in.

He suggested that Charlotte speak to the media prior to surgery if she is willing, but supposed that she probably will not be comfortable after the procedure is completed as her appearance may take some getting used to.

This week, Charlotte watched her niece during soccer practice and spent more time outdoors, particularly in the evening when the sun is not very intense.  Her best friend and next door neighbor, Aleanna, is moving to a new home, which has her feeling a bit blue.  She still plans to have sleepovers regularly, but will miss seeing her each day.

Tim, Charlotte’s adoptive father, returned to work this week after about six months off on short term disability after surgical correction of torn shoulder ligaments.  He was unable to return to first shift due to availability, so is now working second shift.  After 40 years of first shift, this is quite an adjustment, but Tim is hopeful that an opening on first shift will be available soon.  He does not know yet whether he will get approved time off for Charlotte’s surgery on October 4, as he exhausted his FMLA leave while recovering from his shoulder injury.  We are hopeful he will be able to work out an arrangement to be with Charlotte at her surgery, as he has never missed one.

Thank you for your continued support.  Charlotte enjoys reading comments from you and receiving letters, too.

When Charlotte was in the hospital, we were contacted by Inside Edition, who stated that they were really touched by Charlotte’s story and wanted to be the first to share it nationally.  After some deliberation, we decided to allow them to come to us and interview Charlotte and the family.  Multiple times, we specifically asked them not to bring up the past, the attack, and to focus on her healing and the way the community has been so awesome about coming together and the amazing work that the surgical team has done.

I’m sure you can imagine our family’s shock, disgust and embarrassment when we watched “When Racoon’s Attack.”

Fortunately, Charlotte did not see the segment with snarling, biting raccoons and she won’t.  EVER.

Since school has begun and Charlotte may not be ready to return until January, we have some important planning to do:

1. Secure a tutor from homebound services and/or hire a private tutor.
2. Develop a lesson plan and aggressive reading program to ensure that Charlotte does not fall behind her classmates.
3. Find a local counselor to work with Charlotte as she adjusts to her new face and start regular appointments.

Charlotte would love to receive letters from you or your children.  She may become a bit isolated while she is home schooled, and letters give her an opportunity to practice reading and writing and keep her spirits high.  She had a pretty down period before her surgery last week as she worried about the appearance of her nose, which at the time needed repair.

She had a nice surprise as she was recognized by a police officer in Howell, MI on the family’s trip back home after her surgery last Wednesday.  The family made an unscheduled stop as the rental car was smoking.  The previous users had apparently checked the oil and left the cap off.  The oil was sputtering and smoking onto the engine.  Officer Gary Mitts recognized the family and let Charlotte check out his police vehicle.

Sharon, Tim & Charlotte Ponce enjoyed their brief visit with Howell Police Officer Gary Mitts on their way home from her surgery last week.

Charlotte enjoys a tour of a real police car.

Charlotte went for a check up yesterday and her nose is recovering well from last week’s surgery.  She’s going back again next week and has her next surgery scheduled on October 4.  It will take about six hours and require a 3-5 day hospital stay.

Charlotte’s surgery yesterday went well.  Thank you to those who kept her in your prayers.  In a surgery that lasted approximately an hour, Dr. Chaiyasate successfully reinserted what will be her septum into her nose and cleaned up the infection which had developed.  Charlotte stayed overnight to ensure that the infection was cleared up and returned home this afternoon.  They placed a plastic stint into her nostrils to hold the septum in place as it heals.

Her next surgery will take place in about 4 weeks.  She will go to Royal Oak weekly to have the doctor check on the healing progress and ensure no further infections develop.  With Tim (Charlotte’s father) returning to work next week, we still haven’t determined whether he will be able to take the time off to travel with her.  He has been on short term disability for about six months recovering from corrective surgery for torn shoulder ligaments.  He has never missed a surgery thus far, and we’re hoping he can work it out to be there.

Here is an excerpt from an email by Dr. Chiayasate detailing Charlotte’s remaining procedures:

As far as her nose is concerned, she will require at least three more surgeries.  The forehead flap and the rib grafting will be performed in the next stage which is approximately 4 weeks from now.  The third stage includes thinning of the forehead flap (giving the nose definition).  The last stage will be to get rid of the attachment which will be connecting the forehead to the nose.
She definitely will require more minor surgeries as she grows and that is difficult to predict.

The lip will require a two stage operation.  The first stage will be a lip switch operation or Abbe’ flap.  Two weeks later I will bring her back and divide the attachment from the lower lip.  I plan to integrate this reconstruction between the third and fourth stage of the nasal reconstruction.

The ear reconstruction should require a 2 or 3 stage operation.  It depends on which technique I decide on.  This is a rather complex surgery requiring micro surgery.  I may use a Medpore ear implant buried under the microvascular flap.  I will bring her back to lift the ear up creating ear projection.  As your aware, plastic surgery is a science which requires imagination and creativity so this plan may vary as necessary when the time comes.

Kongkrit Chaiyasate, M.D.
Cleft and Craniofacial Surgery
Pediatric Plastic Surgery
Reconstruction Microsurgery/ Microvascular Breast Reconstruction

Assistant Professor of Plastic and Reconstructive Surgery
Oakland University William Beaumont School of Medicine
William Beaumont and Beaumont Children Hospital

Charlotte is about to leave for the trip back to Beaumont. Both family vehicles need service before they can make the trip, and, thanks in part to Charlotte’s benefit, we were able to rent a car on the holiday and have the money for hotels, if this turns into an extended trip. We are so grateful.

We won’t know until Charlotte gets there if she will need to stay in the hospital. She has been complaining of pain and discomfort with her nose, which previously didn’t seem to bother her. If she has developed an infection, it will need to be treated before she can head home.

Sharon and Tim are disappointed that they will miss Marshall’s first day of school, but his big brother Aaron will have the day off and will get Marshall off to school. Marshall (11 years old) has been a pretty awesome big brother through all of this. He showed up at the Pizza Ranch last night and helped to bus tables while his parents answered questions that guests had about Charlotte.