The Commission for Children with Special Healthcare Needs clinic

How does cleft care work in Kentucky?

So how does cleft care work in Kentucky? Right now, cleft care is located in two different geographical places: Louisville and Lexington. But because Cincinnati is on the border, many Kentuckians get cleft there as well.

Advantages to staying in Kentucky

However, there is an advantage for families that stay in Kentucky for cleft care. The Commission for Children with Special Health Care Needs is funded by the state and addresses the needs of all children with health care needs; not just cleft lip and palate. There are a lot of benefits with the clinic, but there are two major advantages:

  1. It’s a multidisciplinary clinic. Experts from many specialties work as a team at the clinic, all seeing patients on the same day. Team members involved in cleft care include speech therapists, audiologists (hearing), nutritionists, oral surgeons, pediatric dentists, orthodontists, plastic surgeons and social workers.Although seeing all of these experts can make for a long day for patients, the one-stop shop allows team members to hold a multidisciplinary meeting after seeing the patient. Experts talk about the patient and discuss the plan of care.When the care gets complicated, this meeting becomes more important because it allows for coordination of care and clear discussion between health care providers. Nurse coordinators play a vital role in making these multidisciplinary meetings possible – they make appointments and keep everyone organized!
  2. Cleft care can be a large financial investment. The clinic helps families with fewer resources get the help they need and deserve. I completely believe in this philosophy, and it makes me proud to be part of The Commission for Children with Special Health Care Needs.

Learn more about the The Commission for Children with Special Health Care Needs »

Clinic waiting area

Clinic waiting area

Specialists from UK HealthCare

The bulk of the specialists who make up the cleft portion of the clinic also work at UK HealthCare. This offers the best of both worlds, as it joins state resources with UK HealthCare specialists. Also, all procedures are done at UK HealthCare, which allows patients to take advantage of pediatric anesthesia and all the pediatric specialists and resources at Kentucky Children’s Hospital. The staff at Kentucky Children’s Hospital makes sure everything is the safest and most comfortable for you and your child during surgery.

Cleft care can be complicated, and without someone to help guide you through it, it can be quite overwhelming. With all these specialists seeing your child, it is quite confusing to know what step comes next. That is why you need someone who is specifically trained in craniofacial surgery to make sure all the steps and procedures are done appropriately and at the right time. I like to think I am your “easy button.” I am the person who takes care of all the coordination and answers your questions.

My goal is to make sure the cleft care at UK HealthCare is the best in Kentucky, as well as the surrounding states. There is the benefit of having several centers, but I will go out on a limb to say there is no one else out there who is more dedicated to making sure everything goes well throughout a child’s journey through his or her cleft treatment. As a parent, I cannot think of anything more anxiety-provoking and stressful than your child undergoing surgical treatment. All my cleft families get my email and contact numbers, and I take pride in being available for my patients. I take pride and joy in making sure care is personalized for you and your family.

Children of the Americas clinic "waiting room"

Medical mission trips

When we see cleft in popular media and hear about it in daily conversation, it is usually focused on developing nations and how we can help provide care to those who have none. Along those lines, I’d like to provide a little information about the mission trips both Henry Vasconez, MD, and I do since we both feel cleft care should be something all children and parents should have access to, no matter where in the world they are.

Dr. Vasconez has a mission trip to Ambato, Ecuador, with the Medical Mission Ecuador (MME). There, he corrects cleft lips and palates, but he also repairs many other congenital anomalies including microtia (small or misshapen ear). Other surgical services go as well, including OB/GYN, pediatric orthopaedics and neurosurgery.

I have been to several other countries besides Ecuador. These include the West Bank, Palestine; and Zacapa and Retalhuleu, Guatemala.

Children of the Americas (COTA)

The trips to Guatemala are with a group from Lexington called the Children of the Americas (COTA), which is based out of Lexington. The focus of this trip goes beyond cleft care and includes OB/GYN, orthopaedics, pediatric general surgery, pediatric cardiology, general pediatric medical care, orthotics and dentistry. It is a great group, and you can visit their website to learn more about them.

Children of the Americas banner

Children of the Americas (COTA)

Sharing my blessings

Personally, there are multiple reasons why I do mission trips, but an overwhelming one is that I’ve been very fortunate. My parents blessed me with the opportunities and the resources to go to medical school. I’ve been blessed with a great, supportive wife and family who tolerated me during six years of residency and then an extra year of pediatric and craniofacial training.

Without the opportunities, support and good fortune, I may not have achieved the ability to do cleft care. I feel very grateful for what I have and want to give back to others as I best as I know how.

This goes beyond the state of Kentucky and extends to other places where they don’t have the resources even close to what we enjoy here in the United States. No matter how different the culture, people’s world views, socioeconomic levels, or resources available, it is always humbling to see to what lengths parents and families will go to in pursuit of the best care for their children.

Clinic waiting area

Families waiting for the clinic to open

Traveling abroad really brings into focus how fortunate we are in the United States and shows me how much we owe to our infrastructure and resources around us. With this in mind, although these mission trips can be exhausting both physically and mentally, it renews my desire to help. I find this important in the bureaucratic jungle of health insurance companies, institutional rules and electronic medical records. None of these are bad things – in fact, they are necessary to run the system we are fortunate to have – but they can be taxing and feel very removed from my goals of caring for children.

The logistics of mission trips can be formidable, thus the need to go with an experienced group, such as COTA or MME. Although I may be fixing clefts, none of this is possible without the rest of the team to help provide the necessary support and resources to allow quality care.

clinic-tent

Our “waiting rooms”

Who should be doing clefts overseas?

This leads to another topic: Who should be doing clefts overseas?

Realistically, many people overseas in developing nations require help. If people are willing to donate their time, finances and efforts, then that is a good thing.

However, in the craniofacial world, we firmly believe that unless you do clefts and pediatric craniofacial work routinely in your own practice, doing them overseas may not be in the best interest of the patient.

Unfortunately with cleft care, the best time to get it right is the first time to get it right. Corrections afterward are much harder to accomplish, especially when there is no follow-up, like we would have in our own practices.

Complications are not really acceptable in a mission trip overseas, and the ability to achieve this comes from team and surgeon experience. Unless you do them routinely in your practice at home, you should not be doing them overseas.

Cleft care is my passion and dedication. I draw on experiences and practice to benefit all my cleft kids.

James Y. Liau, MD
Pediatric Plastic Surgery

View Dr. Liau’s profile »

View Dr. Vasconez’s profile »

Comments, questions or suggestions? Please send them to us!
cleft care at UK HealthCare

Welcome to cleft care!

Stitches is the mascot for the Kentucky Children's Hospital

Stitches is the mascot for the Kentucky Children’s Hospital

A passion for cleft care is an official blog of UK HealthCare and the Kentucky Children’s Hospital.

As a pediatric plastic surgeon who specializes in craniofacial care, the subject of cleft care is close to my heart. It’s also important for patients and their families. This blog is meant to be a guide and a place where you can learn more about cleft care.

Hopefully, I will not be the only contributor since I will be inviting those who really know about cleft lip and palates – the patients and their families – to participate and comment.


Introductions

James Y. Liau, MD

James Y. Liau, MD

Henry C. Vasconez, MD

Henry C. Vasconez, MD

Allow me to introduce myself briefly. My name is James Liau, MD. I am one of several plastic surgeons in the state of Kentucky who has had an extra year of fellowship training in pediatric and craniofacial surgery.

The other plastic surgeon is Henry Vasconez, MD, who also works here at UK HealthCare.

Although this blog is associated with UK HealthCare’s Kentucky Children’s Hospital (where I work), it is really about the patients and families and their journey through cleft care.

Background about cleft lip and palate

Cleft lip and/or cleft palate are present in about 1 in 800 live births. According to the 2008 Kentucky census, there are about 58,000 live births per year in Kentucky. This means, statistically, there will be about 70 children born each year with either a cleft lip or palate.

This is NOT uncommon, and it is not anyone’s fault. As a plastic surgeon who has done extra pediatric and craniofacial fellowship training focusing on cleft care, I fully expect children who have clefts to grow up to have happy, productive and normal lives. My goal is to ensure these children get the start in life they deserve and continually to make sure everything is proceeding according to plan.

For me, cleft care is a passion. What I mean by cleft care goes far beyond just fixing a lip or a palate. It is much more than that. Cleft care means taking care of the child and the families for their entire lives.

Clefts can affect teeth, speech and facial growth, not to mention issues of self-image, teasing and peer relationships. Cleft care addresses all of this, and my goal is to go beyond fixing lips and palates, and also focus on the more complex problems of teeth, speech, facial growth and the issues of self-image and peer relationships later in life.

When we see cleft in popular media and daily conversation, it is usually about developing nations and how we can help provide care to those who have none. In my next entry, I’ll focus on the mission trips both Dr. Vasconez and I do since we feel cleft care should be something everyone should have access to, no matter where they are in the world.

James Y. Liau, MD
Pediatric Plastic Surgery

View Dr. Liau’s profile »

View Dr. Vasconez’s profile »

Welcome to cleft care!

A passion for cleft care is an official blog of UK HealthCare and the Kentucky Children’s Hospital.

As a pediatric plastic surgeon who specializes in craniofacial care, the subject of cleft care is close to my heart. It’s also important for patients and their families. This blog is meant to be a guide and a place where you can learn more about cleft care.

Hopefully, I will not be the only contributor since I will be inviting those who really know about cleft lip and palates – the patients and their families – to participate and comment.




Introductions

James Y. Liau, MD

James Y. Liau, MD

Henry C. Vasconez, MD

Henry C. Vasconez, MD

Allow me to introduce myself briefly. My name is James Liau, MD. I am one of several plastic surgeons in the state of Kentucky who has had an extra year of fellowship training in pediatric and craniofacial surgery.

The other plastic surgeon is Henry Vasconez, MD, who also works here at UK HealthCare.

Although this blog is associated with UK HealthCare’s Kentucky Children’s Hospital (where I work), it is really about the patients and families and their journey through cleft care.


Background about cleft lip and palate

Cleft lip and/or cleft palate are present in about 1 in 800 live births. According to the 2008 Kentucky census, there are about 58,000 live births per year in Kentucky. This means, statistically, there will be about 70 children born each year with either a cleft lip or palate.

This is NOT uncommon, and it is not anyone’s fault. As a plastic surgeon who has done extra pediatric and craniofacial fellowship training focusing on cleft care, I fully expect children who have clefts to grow up to have happy, productive and normal lives. My goal is to ensure these children get the start in life they deserve and continually to make sure everything is proceeding according to plan.

For me, cleft care is a passion. What I mean by cleft care goes far beyond just fixing a lip or a palate. It is much more than that. Cleft care means taking care of the child and the families for their entire lives.

Clefts can affect teeth, speech and facial growth, not to mention issues of self-image, teasing and peer relationships. Cleft care addresses all of this, and my goal is to go beyond fixing lips and palates, and also focus on the more complex problems of teeth, speech, facial growth and the issues of self-image and peer relationships later in life.

When we see cleft in popular media and daily conversation, it is usually about developing nations and how we can help provide care to those who have none. In my next entry, I’ll focus on the mission trips both Dr. Vasconez and I do since we feel cleft care should be something everyone should have access to, no matter where they are in the world.

James Y. Liau, MD
Pediatric Plastic Surgery

View Dr. Liau’s profile »

View Dr. Vasconez’s profile »