Brand-New Jaw Line

I'm down at MUSC in Charleston, SC today with Chris while he's getting reconstructive surgery for an "atrophied mandible"--more smashed or shattered than atrophied, but that's what I noted on his entry papers.

Chris went into the OR in very good spirits shortly after about 7 this morning. I expect to see him awake with a brand-new and very manly jaw line sometime this afternoon.

We're incredibly grateful to Dr. T ("T" the for sake of his privacy) who's doing this work for Chris pro bono. The approximately 5-hour operation Chris will be undergoing today is pretty incredible. Dr. T is going to make an incision in Chris's hip, detach the muscle from his bone there and remove some bone. He's then going to go in through Chris's mouth to avoid further scarring beneath his chin and use the bone he's recovered to rebuild Chris's jaw line. This will take several weeks to heal as you can imagine, and Chris may have some difficulties walking for the few days or maybe even weeks.

When this procedure has healed up, Chris will be coming back down here to see another maxillofacial surgeon, who will assist him with replacing his teeth. However, Chris may still need additional surgery to fix his TMJ, due to the lack of mobility he continues to have there. That procedure would involve removing some of his rib to replace the malformed bone in that area.

So, either way, Chris still has some extraordinary surgery ahead of him, as well as a lot of recovery time--doubtless for the rest of this year, at least. However, we're all grateful that he has these clear steps ahead of him towards a complete recovery.

Finally, Some Really Great News

First off: apologies for not updating this site more often, but as Chris I'm sure will concur, he went a long, long time without *any* news at all, though he did get intermittent bad news about his financial situation.

Recently, Chris did have to move his things out of his old apartment and move most of it over to our parents' house. This was very discouraging as you can imagine as it meant giving up a significant part of his independence. A number of us (Chris included) did try writing to his surgeon and to various state and local officials to see if they could help, and some of them were responsive. South Carolina Senator Jim DeMint was especially helpful. However, the first batch of news he received came from several different corners--all agencies telling him that he was not going to qualify for financial aid. This was very discouraging to us all.

Finally, however, Chris has gotten a whole lot of good news:

Early this month Chris went down to Charleston and the Medical University of South Carolina, after his doctor referred him there. Chris's new surgeon basically said he'd like to do the surgery on Chris whether he gets paid or not. This has to be the best news Chris has heard so far. The doctor did say that it may take up to three more rounds of surgery, that he'll have to break Chris's jaw again to do it, and that it may take upwards of another year to get it all done. He joked that "If you were a horse they'd shoot you!" So right now, Chris is learning about how this surgery will be scheduled and paid for, but it looks like *it will be done.*

And there's more good news: Chris also found out that he qualified for some financial aid and that his initial, astronomical hospital bill has been taken care of. He has a ZERO dollar balance there! Now, he does still have a sizable bill with the plastic surgeon for followup treatment, but still--well, you can imagine what a bill for a week in an intensive care unit looks like.

On the sobering side, Chris still has a very long and tedious wait ahead of him before his life gets back to normal, but, needless to say, this is great, great news.

Thank you to all of you for your thoughts and prayers. Please do keep him in mind.

An Update

Chris saw the TMJ specialist recently and got some tough news. The doctor is concerned that Chris's jaw hasn't been healing properly and that he may have to break his jaw and do the surgery over again. Obviously, this could add months of recovery time into the equation for Chris--just when he was hoping to finally have some attention paid to restoring his teeth. The problem is he still doesn't have nearly enough mobility in his jaw.

Chris is working with the doc to set up another appointment for new surgery. For this next round of surgery, Chris will have 7 or 8 teeth extracted, and the surgeon may also remove the stray piece of bone that found its way into Chris's lower lip, too, which has been bothering him for some time now. He will then have to return some time later for the surgery to rework his jaw. Then, hopefully, after several more weeks of recovery, the TMJ surgeon may be able to begin working on Chis's teeth.

Thank you for continuing to keep Chris in your thoughts and prayers. As you can likely tell from the above scenario, he still has a long, slow haul ahead of him.

TMJ

Chris saw his surgeon again last Thursday, and the doctor was concerned about the lack of mobility Chris has in his jaw after several weeks of recovery. He recommended Chris see a TMJ specialist. That doctor may be able to determine whether Chris has a problem with his TMJ or temporomandibular joint. This area is your jaw joint, which attaches the mandible to your skull. TMJ also refers to any condition affecting that part of your jaw.


This image depicts the area around the TMJ.

Some additional information from TMJ.org:

Some patients report having TMJ symptoms following dental procedures, the insertion of a breathing tube prior to surgery, trauma, or oral habits such as clenching or grinding the teeth.

Symptoms:
TMJ patients experience one or more of the following:

>facial pain
>pain in the jaw joint and surrounding tissues, including the ear
>jaw locking open or closed
>limited opening or inability to open the mouth comfortably
>headaches
>bite that feels uncomfortable, "off", or as if it is continually changing
>neck, shoulder and back pain
>swelling on the side of the face

This site has a lot more info about TMJ, too.

Chris hopes to hear from his surgeon tomorrow about the date for an appointment with the TMJ specialist.

Seeing Chris's Smile

Chris went to the dentist yesterday, who kindly gave him a complimentary panoramic X-ray. That's it above. You can click on the image for a larger version.

Dr. B. did say that Chris will need to have an additional eight teeth removed, five on the lower and three in the upper jaw. I believe those are the teeth marked with an "x." You can also see which tooth has been driven up into his sinuses. It's less accessible than it may appear. You can also see, running along the bottom of his jaw and above, some of the several plates he has attached to his jaw and keeping it together. Also clearly seen, the many half-inch screw securing the plates there.

Thanks, Dr. B., for giving us this view of Chris's smile.

Some Good News

A couple of good news items for Chris over the past couple of days. First, he was able to eat something approaching "solids" the other day--mashed potatoes. Man, those must've tasted delicious after about six weeks of nothing but liquids.

Second, Mum's dentist said he could give Chris a complimentary dental x-ray. This will be a huge benefit to Chris as it will help him to see the scope of the damage to his teeth and perhaps helps him to begin to understand what work can and may be done for him in the future. He goes in for the x-ray next Wednesday.

More Waiting To Do

Chris went to see Dr. Suber again today and he said Chris's graft is healing well. He recommended Chris exercise his jaw every day--opening and closing his mouth as much as he can, which isn't much at all right now. Dr. Suber asked him to come back in six weeks and said it wasn't worth Chris going to the dentist yet, as his mouth is still going to need to heal a lot more before any dentistry can be done. This means Chris will likely be out of work for many more weeks yet. That's got to be discouraging for him, as I know he'd really like to get back to work.

Additionally, Dr. Suber mentioned that when he did the graft last week, he took out some of the plates in Chris's jaw. I'm not sure how many of the total he took out, but it's likely the majority of them are still in there, since his jaw was broken in 14 places.