Not many 8-year-olds can keep an entire medical team at bay as he entertains a throng of visitors. But not many 8-year-olds are as energetic, outgoing and simply full of life as Andrew Balsiger.
Last week, as a doctor, anesthesiologist and nurses waited outside his waiting room at El Paso Children’s Hospital, Andrew was more interested in telling visitors his favorite subject at school than in the operation he was about to go through.
“Lunch,” he shouted. “That’s my favorite subject.”
The room exploded with laughter. Andrew simply sat back, took it all in and smiled.
Andrew, the son of Heather and Bob Balsiger, was born with a bilateral cleft lip and palate.
“If you look at pictures, you can see how severe of a deformity it was,” Heather Balsiger said. “He’s had five or six surgeries from the time of his birth to 2 years old.
“When babies are born this way, they don’t feed very well, so the surgeries were done to try to correct the cleft and palate. We had to syringe-feed Andrew until he was able to go on solid food.”
You can hardly tell by looking at Andrew, a vibrant second-grader at St. Matthew’s Catholic School who loves dancing, video games and reading “Goosebumps” novels.
“He is always upbeat,” Bob Balsiger said. “He’s always had a lot of positive energy. He’s been a great kid since day one. He has made this process easier for us.”
Andrew’s latest surgery — his first since he was about 2 years old — is called a pharyngoplasty, or pharyngeal flap procedure.
In this operation, some of the tissue from the palate and the back of the throat are repositioned to help close off the escape of air through the nose.
“We do it to improve speech,” said Dr. Frank Agullo, a plastic surgeon with El Paso Cosmetic Surgery and a clinical associate professor at the Texas Tech University Health Sciences Center Paul L. Foster School of Medicine. “When a kid has a cleft palate, a lot of times they’ll have nasal escapes, so you’ll hear a very hypernasal speech with words with a ‘K’ or ‘P’ where you have to press your tongue into your palate and the air will escape through the nose and you’ll lose those sounds.”
Agullo called it a very common operation.
“I’ve done this one more than 100 times,” he said. “Andrew has nasal escapes, and you can see a hypernasal speech that’s going to set him apart from other kids, so we want him to be as normal as possible.”
Agullo said about one in 1,000 children a year is born with either a cleft lip or cleft palate.
“We did the numbers for last year and given the number of births in El Paso, we probably have about 50 new patients every year,” he said.
Andrew’s previous surgeries were done in Spokane, Wash., where the family lived. This was his first at El Paso Children’s Hospital.
“In Spokane, it was very clear as to where to go and what to do,” Heather Balsiger said. “There is a public health nurse there whose only job was to help families with kids with cleft. She was like an angel, she was so helpful.”
When the Balsigers moved to El Paso six years ago, Heather Balsiger felt overwhelmed, not knowing where Andrew would go for future operations.
“I really put this surgery off as long as I could because I didn’t know who to turn to for help,” she said. “We were ready to go back to Spokane, but I met Dr. Agullo and the Children’s Hospital was finally built, so I felt we were in the right place.”
The Balsigers wanted to go public with Andrew’s condition to help other parents who might be embarrassed.
“Andrew’s an inspiring kid,” Heather Balsiger said. “If somebody can read about Andrew and about the cool work they do here and about what Dr. Agullo can do, and if that can impact somebody else who’s having the same issues then that’s a pretty cool thing.”
A normal life
For the most part, Andrew lives a normal life.
He loves to tell stories. play fight with his 5-year-old sister, Emma; and eat junk food.
“I like all the unhealthy foods like pepperoni pizza, cheeseburgers, chicken nuggets and hot dogs,” Andrew said as he began to sing a song about hot dogs, making it up as he went along.
Socially, his mother said, his condition is not a major problem.
“He has been at his school and with the same kids since Pre-K,” she said. “They’re just so used to it now, they don’t even ask questions. They know this is just how Andrew is.”
Last year, when Andrew joined a baseball team with some children he didn’t know, there were some problems with players picking on him.
“He came to me after practice and said, ‘Mom, they’re over there saying things about my face.’ I asked him how it made him feel and he said it made him feel sad,” Heather Balsiger said.
“I told him, ‘Let’s look at it this way: Kids are going to be mean. And with you, there is something obvious they can pick on, but you have all the power because they don’t know anything about you personally. You already know what they’re going to make fun of you about, so you already know what to defend.’ “
It made sense to Andrew.
“He went over to those boys and said, ‘You know what, guys, my mom said God made me perfect,’ and that was the end of it,” she said.
The Balsigers have never asked “Why us?”
“I think of it more like I’m glad it is us, because some people might not have been able to handle it,” Heather Balsiger said.
That’s not to say 5-year-old Emma doesn’t have questions about her older brother.
“She is trying to put her mind around it,” Heather Balsiger said. “Just this weekend she asked me, ‘Mom, when you prayed for a son, did you pray for one with a cleft?’ I told her I just prayed for a son. Then she asked if I was sad when I got one with a cleft. I said, honestly, ‘No, I’m sad that he has to go through this, but this is how he was made.’ This is how he is. He is perfect.”
Victor R. Martinez may be reached at vmartinez@elpasotimes.com; 546-6128. Follow him on Twitter @vrmart.

