Just put your lips together and blow...

It's easy, isn't it?
Yes.
But for Reuben, no.
Today was the first time he has ever done it.
Why?
Because with the trachestomy, he had no means to blow out through his mouth or nose and with facial palsy on his right side, there are a few things which don't come to naturally to him.
I've been blowing on his face since he was born, because it makes him smile, it tickles him, it brings him back if he's deep in concentration.
And today, when I blew onto his face, he blew back.
And I was taken back.
And I smiled and laughed.
And it's the first time he's ever just put his lips together and blown...

He did a lot of other things today with me and they all went something like this:

At 9am he came to his old school at UCLA, now Callum's school and signed during Circle Time, nudging Callum to go up and collect his name card when Reuben heard it.

At 11am he came with Mama to UCLA hospital for the Craniofacial Clinic. Every year, previously at CHLA, we meet the team that includes pediatricians, plastic surgeons, neurosurgeons, speech therapists, audiologists, dentists, orthodontists, ophthalmologists, otolaryngologists, geneticists and social workers to determine a plan of action that will affect Reuben's self esteem, swallowing, facial expressions, hearing and speech. We get to see multiple specialists in a single day, in one location, at the UCLA clinic.

At 12pm he had lunch with Mama in the lovely, airy, modernist restaurant of the new hospital, hugged many strangers, was recognized by nurses and Drs whom I didn't even recognize, "Hello Reuben!"

At 1pm he met the geneticist to discuss CHARGE syndrome but I'm far ahead of anything she could offer, other than to offer say how I'd like to be contacted when new families have a diagnosis. This is nothing new; we all pay it forward. Yuka and Scott would visit us on their date night every week at Children's Hospital and I hope I've helped many other families through blogging since birth and visits in other small ways.

At 130pm he met the orthopedic dentist and she confirmed he has all his teeth and they're looking just fine, along with this gums. Without eating orally, ironically the teeth and gums can be badly affected.

At 2pm he met with the Gastric Intestinal Dr to discuss his reflux and how he no longer needs that stomach surgery and that we'll try to ween him off one of his meds, Reglin.

At 230pm he met with an Audiologist to discuss his hearing issues and he showed her how beautifully he could speak just a 5 months after getting his trach out.

At 3pm he met a large group of male Drs all crowded into our tiny room as I ran along the corridor to get rid of the dirty diaper and returned to see he was happily entertaining them. And here we discussed science fiction:
- That he has about a 5/7 severity of facial palsy
- Facial Reanimation surgery - transplanting a nerve and a muscle from his leg into his face through 2 surgeries so he can have a full smile, speak more clearly, perhaps eat with his mouth, continue to be sociable
- Botox as an alternative to the above surgery but which would be done every month under anesthesia (not an attractive prospect). I think though we could at least try this by combining the anaesthesia whilst under for the trans-esophageal heart doplar study to get a better look at his bicuspid valve and subaortic membrane in his heart (yes, he's going to be having another open heart surgery some day soon)
- Ear surgery to correct his pixie like ears, the first sweet thing I noticed after birth
- Ear surgery to insert new ear tubes to drain the fluid that's back again
- A more immediate surgery for his Torticollis, his head tilt to the right which was described as "severe", snipping a tight muscle so his head will sit straight and needing 4-6 weeks with a neck brace afterwards so he can relearn behavior and understanding how his eyes have had to readjust to see things straight ahead rather than the lopsided way he naturally does. This is one thing that other kids DO notice about him, but it's soon followed by Reuben teaching them to sign.
Gee whizz. These are tough questions: elective surgeries rather than the 16 essential ones he's had?

At 4pm when we were both tired, he went for a hearing test in a sound booth and the for the next two hours we tested his responses to conditioning exercises and I had the audiologists instead asking him to tell him the sign for something instead of having him moving his head when the pink elephant lit up (boring Mama!)

At 9am, 10, 11, 12, 1, 2, 3, 4, 5 & 6pm, Reuben signed his alphabet using both hands in symmetry (ASL alphabet is one handed so this is a funny thing to do) whilst speaking the alphabet sounds or names, whilst smiling, whilst being impeccably, unbelievably patient, 7hrs almost entirely in the same room, making people laugh, reading letters and little words, blowing on my face, loving being tickled. And I was once again aware of how utterly in awe of this little man I am, how beyond proud I am of how he's growing and developing, in his own right irrespective of his history, how he's the bravest person I shall ever know and above all, how happy he is.

At 7pm we got home after the long drive, and he had a bath, all stinky and sweaty from the hospital and we watched Toy Story til he fell asleep along with Callum and I drank a glass of red wine and dreamt of sleep.

And I blow on his face in the bath, grab my camera for one lazy shot and he just puts his lips together and blows.

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A little sample from the wedding as 2nd photographer.