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                    Battlin' Brittany

How does a serious birth defect affect a newborn? A Carroll County [MD]
family recently faced this difficult question. But they are on the way
to answering it with the help of doctors at Children's Hospital. My
associate, Booth Moore, has the story:

As if it were not enough for Bill and Christine Flanagan to cope with
the birth of identical twin girls, they found out right after the May
18, 1992 delivery that one daughter would have special needs.

Caitlin Flanagan is a normal, healthy child. Her twin, Brittany,
however, was born with a facial disfigurement called a bilateral cleft
lip and palate.

"Cleft" means divided or split. Brittany was born with the condition
because parts of her face and mouth failed to come together in the early
months of fetal life.

"When Brittany was first born, it was a real bad shock," Bill said. "We
only saw her for about 15 seconds before they rushed her to the neonatal
ward because she was not breathing well."

When the Flanagans did get to see Brittany again, she was hooked up to
several tubes. Doctors said that if she did not eat, they would have to
feed her intravenously.

But Christine saw an early indication of her daughter's spirit and will
to fight. "In just a few hours, she had already sucked down eight ounces
of fluid and surprised us all," she said.

Bill, who works in Columbia as a computer systems support engineer,
admits he was apprehensive about how the rest of the family would react
to Brittany's facial disfigurement.

"Billy, our 5-year-old son, reacted better than my grandmother," he
said. "When we first brought the twins home, he just loved the little
babies. He paid no mind to the cleft lip. It was the older folk we had
trouble with.

"They were leery about her lip because they didn't know what it was.
They were even afraid to hold her."

When doctors at Silver Spring's Holy Cross Hospital told the Flanagans
that Brittany's condition would require regular visits to an eye and ear
specialist, a speech therapist, an orthodontist, a neurosurgeon, and a
plastic surgeon, the couple wanted to choose the place best equipped to
coordinate all aspects of her care.

"We are trying to decide between Children's and another hospital," Bill
said. "But when we attended a Maryland Society for Cleft Lip and Palate
Children picnic, our choice was clear. You could see the difference in
the two hospitals in the faces of the children."

Michael Boyajian, chairman of the Craniofacial Center at Children's,
successfully repaired Brittany's bilateral cleft lip and palate in two
surgeries during her first year of life.

After each surgery, Brittany had to wear arm restraints for a couple of
months so she would not put her hands in her mouth and puncture her
newly created palate.

"Her first year was pure hell," Brittany's mother said. "She was either
in the hospital or in arm restraints." Nevertheless, Brittany adapted
well, and according to her mom, "even learned to straight-arm crawl."

Because craniofacial problems can affect hearing and speech, Brittany
had to be tested in each area. "My first clue that she might have a
hearing problem came when I dropped an iron skillet on our kitchen
floor," Christine recalled. "I had to peel Caitlin off the ceiling, but
Brittany didn't even bat an eye."

Brittany temporarily had lost 40% of her hearing, doctors at Children's
discovered. They placed tubes in her ears and, according to the
Flanagans, Brittany's hearing improved.

Nevertheless, Brittany's parents say her hearing still comes and goes.
She will have a third set of tubes put in her ears next week. Her speech
is also delayed, and she is undergoing speech therapy. But physician
Michael Boyajian doesn't seem worried. "I don't see any reason why
Brittany cannot do anything she wants," he said.

Brittany will spend the next 16 years growing up with the doctor. She
will need to have other surgeries to reconstruct her nose and correct a
possible underbite.

"The way we see it," Christine said, "there could have been a lot worse
things to happen to our little girl." But as she motioned toward the
doctor, she added: "I honestly believe, if it weren't for this man's
hands, Brittany would not look this good today."

[Children's Eases Brittany's Path, Bob Levy, Washington Post, December
12, 1994]

CURE Comment: Keep battling, Brittany. We're in your corner.

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