Saving Chris's Smile

Brand-New Jaw Line

2006-05-11T08:27:00.000-04:00

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

2005-09-11T11:07:00.000-04:00

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

2005-05-17T22:06:00.000-04:00

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

2005-03-27T21:47:00.000-05:00

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

2005-02-24T20:34:00.000-05:00

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

2005-02-17T22:16:00.000-05:00

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

2005-02-10T22:53:00.000-05:00

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.

More Surgery

2005-02-04T23:02:00.000-05:00

Chris survived some more surgery today. The doc used the underside of Chris's tongue as a donor site for some skin to cover the exposed bone of his lower jaw. He also removed two more of Chris's teeth. Fortunately, this time it was out-patient surgery, so after surgery and an hour of rest at the hospital, Chris was able to head on home and rest. The nasal intubation did tear up his throat a bit, so it's got to heal up all over again. Let's hope this is all the surgery he'll need for a good while.

He did find out that some of the plates and screws may be removed from his mouth sometime in the future, but that some of them would also likely need to remain there for good. The fracture was so severe that it's unlikely that he'll ever be able to do without them.

Chris's First Checkup

2005-02-03T22:33:00.000-05:00

It's been just over a month since Chris's accident, and he had his first checkup with his surgeon today, since being released from Greenville Memorial. He did get some good news. He was able to get the wires taken out of his mouth. Unfortunately, there was some bad news, too, and the description to follow gets a little graphic.

Chris noticed when he got home from the hospital that there was about a 3/4 inch area in his mouth below the gumline where the bone was showing. He was understandably worried about this and told us about it at the time. Well, he knew about, we knew about it, but when he brought it up with the doctor today, the doc was plenty surprised. Apparently, his jaw's not supposed to appear that way. Now, Chris was understandably a little alarmed that the surgeon wasn't aware of this since Chris had discovered the area very quicky when he got home from hospital and could check out his mouth in the mirror.

Anyway, the doctor has Chris scheduled for surgery again tomorrow. He's going to have to have a skin graft pronto to cover that bone. They'll likely take some skin from somewhere else in his mouth and use it graft over the bone, so it doesn't show through. Specifically, the surgery involves an "alveolaplasty and a mucosal graft." He will be given a nasal intubation and they'll have to put him under for the operation. Sounds like fun, eh? We're concerned that Chris will need to have this extra surgery, which it seems should have been taken care of weeks ago when he was first operated on. Hopefully, all will go well tomorrow.

I spoke to Chris this afternoon and Mum also emailed with some of these details. She said that the doctor believes Chris's jaw may take a long, long time to heal:

The Dr said it may take up to 2 years before he gets feeling back in his lip and jaw, if at all, due to the extensive damage. There were about 15 breaks in the jaw, the worst Mandible fracture he had ever seen. He is still shaking his head over it!

It's still too early to tell what they'll be able to do about Chris's teeth.

Also, in the good news column, Chris has gained a couple of pounds. Needs to gain more though. Unfortunately, he's not going to be eat solids for a while, despite having the wires removed. He still doesn't have a bite and doesn't have the full range of motion of his mouth and jaw. He's working on getting that back, but it'll take some time.

So thanks for the recipes ideas Saheli and Debby, he'll have to try them out.

Brief Update

2005-01-23T12:18:00.000-05:00

Chris continues to be on the mend. His next appointment with the surgeon is February 3rd, and we hope to hear answers to many questions about his progress. Specficially, at this time he may learn how his jaw healing, when and if the wiring can be removed, and when he can begin eating solid foods. We're also very concerned about damage done to his inner (left) ear when he fell and a tooth which was forced up into his sinuses. Due to the nature of the surgery, neither of these aspects of Chris's injury have been attended to yet.

Thanks to all who keep checking in and for your kind messages and advice.

Checking In

2005-01-17T22:54:00.000-05:00

I've been down in South Carolina visiting Chris again over the MLK Day weekend. He's on the mend and wil be for a long while. So it's very slow progress for now, but he is (almost) minus one big shiner and the feeling is starting to come back into his jaw. He has, however, gained little or no weight. Unfortunately, a diet of various Ensure-like products does little to help, but at least he's maintainingg and not losing any more weight. Especially since it looks like it's going to be *several* weeks before he's unwired and can eat again. Then, they can look at his teeth. In other words, it really is going to be a long haul. Chris is haning in there, though.

Also, he's been really grateful to have some friends drop by, so don't be shy to come visit!

Message from Chris

2005-01-13T10:53:00.000-05:00

Chris has access to email now and forwarded this message to post here:

I'd like to thank everyone who has been checking this blog to follow my progress. You're thoughts and prayers mean a lot to me. Many of you I have not even met, so it is a great encouragement to me that you would take the time to touch base even with a stranger. Thanks to those of you who came by the hospital to see me in my various stages of incoherency. I have felt tremendous support throughout this very difficult time and I cannot thank you enough. The road to recovery is a slow and grueling one, but having the support of people like you has made a world of difference. Thank You for all your kind words and support. Stay tuned for more progress reports.

In Gratitude,

Chris S.

Address

2005-01-09T16:08:00.000-05:00

If you'd like to write Chris or send him a card, feel free to email me and I'll give you his address. I'd rather not post it here in order to maintain his privacy. He'll likely be staying with my parents for a few weeks, so I'll probably send you that one and they can always pass on anything that comes after he's moved back to his place.

Safe at Home

2005-01-08T19:48:00.000-05:00

Chris is at our parent's home now and drinking plenty of fluids, mainly those chalky nutritional sort of drinks most of us generally try to avoid unless we're momentarily caught in the throes of a diet. We also got him some yoghurt and milkshake drinks, so hopefully those'll taste a little better. He lost quite a bit of weight in the hospital (about 20 pounds) and really needs to gain it back. We wouldn't recommend the ICU diet to anyone.

He's going back to surgeon in about four weeks to see how his jaw is healing. It won't be until at least then that he can see a dentist as well. We're hoping his jaw will show significant signs of healing by the time he visits the surgeon (specifically, he needs lots of bone growth), but it may take many months to heal properly.

Thank you for your continued thoughts and prayers.

Chris Released Today

2005-01-07T11:08:00.000-05:00

We just found out Chris has been discharged from the hospital. We were pretty surprised as he's going straight from the ICU to home. We thought he'd be in a regular hospital bed and be under observation for a while, but his doctors all gave him the thumbs up to head home. I guess after almost a week in the ICU, they figured he didn't need any more hospital!

He's going to be on a special diet for some time, of course, and will be wired shut for at least four more weeks. More details later.

A Good News Day

2005-01-06T20:54:00.000-05:00

As Sarah mentioned in the comments, they finally removed the intubation tube from Chris's nose today. He was able both to talk and to enjoy something he'd really wanted for the last few days: a drink of water.

Yesterday, they'd given Chris another CAT scan and some chest x-rays, but were unable to complete all the tests needed to remove his tube then. Chris was understandably frustrated. Thankfully, they were able to finish the tests this morning. Hopefully, this means Chris will be out of the ICU and into a regular room soon. No word on how his jaw is healing yet, though.

Thanks to all the wonderful nurses who are taking care of Chris and for the friends who've been able to visit. I know he really appreciates it.

I left Chris last night to head back to Charlotte for a couple of days, but he looked stronger and more active at the time.

Comments

2005-01-05T23:23:00.000-05:00

Thanks to the many of you who have left comments already. Some of you noticed that you had to sign up with Blogger to leave a comment. Sorry, that was the default setting. I've since reconfigured the blog so anyone can leave comments without signing in--even anonymously. Just click on the link that says "Or Post Anonymously" beneath the big blue login button. Then you can leave your name at the end of the post if you'd like to.

Some Good Results

2005-01-05T13:54:00.000-05:00

We got the results of Chris's last CAT scan today and his ear, nose and throat specialist said they look good. Other than expected trauma to his sinuses and throat from the accident, the surgery and the tube (which is run through his nose, not his mouth), his airway seems to be healing well and they may be able to take him of the tube soon--today or tomorrow. This doc also mentioned that Chris does have a tooth which was driven up into his sinuses, which will have to be removed at some point. However, they will have ot wait a while for that--I'm guessing until after his jaw is unwired.

Another doctor (he has a few) will be coming by later today to do a larygnoscopy. This should determine how his throat looks and allow them to tell for sure whether they can remove the tube.

Thankfully, Chris's welling has stayed down (he's still very swollen, but not relative to how he was initially), and this morning he was able to type up an email on my laptop, which I was later able to send to his friend, Sean in Singapore, who may or may not have heard about Chris's accident yet. (Hope you get it, Sean!) He's also had a few friends who've been able to visit in the last couple of days. Thank you all for visiting.

At this point, we still don't know the how his jaw is mending (the most important thing right now; then his teeth), though I'll be sure to post something here as soon as I know.

Steroids Help

2005-01-04T20:52:00.000-05:00

I got back from lunch and running errands today and in the three hours since they gave him a one-time steroid shot his swelling had receded *tremendously.* Hopefully, it'll stay down as this was the first time I've seen him be able to open his eyes without having to prying them open with his fingers. He's actually able to see what he's watching on TV now.

They also replaced the bandages around his head with a simpler, looser bandage--the original one was so tight it was driving him crazy. He was also worried about the hearing in his left ear, and when they removed the wrapping and some gauze from his ear, he was able to hear much better. They also tried, unsuccessfully, to put him on a feeding tube, and late in the afternoon, they gave him a CAT scan. We haven't heard the results from that yet.

Chris was writing more today and even showed signs of keeping his humor: he wrote that he'd never candy striped in a ward quite this boring before. Poor guy! I can't imagine what it's like to be unable to speak or see for almosr four full days, so far. A little later he wrote that he really wanted to get out of the ICU right away. He's also been craving some water or a Coke for quite some time since his throat is so sore, but they've not been able to give him anything due to the swelling and concerns about his inability to swallow.

Something very important we still don't know: will the surgery he's already had be enough? That's right, according to the surgeon, he may need more. We saving him from that information for now as we'd all like to think he'll be out of the ICU and into a regular room as soon as possible.

Contact Numbers for Friends

2005-01-04T02:25:00.000-05:00

We were able to arrange to pick up Chris's personal belongings (separate from his clothes), which previously we were told he could only procure personally when he left the hospital. This includes his phone, which has the contact numbers for some of his friends who we haven't been able to notify about his condition yet.

It's been three full days since Chris's accident. The nurse this evening said the swelling around his eyes seems to be receding a little, although he still can't open them. He does try to lift his lids with is fingers from time to time to peer out. He's also able to clean his face independently, though he's clearly weak and it proves quite laborious for him.

Save Chris's Smile

2005-01-03T20:51:00.000-05:00

My brother Chris suffered a terrible fall over the New Year's weekend and is going to be in the ICU in Greenville, SC for quite a while. He severely shattered his jaw and lost many of his teeth. He's had extensive surgery to insert plates and screws and may need more. The surgeon said it was the worst fracture he's ever seen. Right now, he's swollen up so much as to be unrecognizable. His eyes are swollen to the point that he can't open them, though he was writing some things down for us earlier before the swelling got too bad. His jaw will be wired shut for 5 weeks, *if* the first round of surgery takes. I'm very grateful to be able to get away from work for a couple of days or so to be with him, and I hope to make time regularly to update this site (or "blog") to keep friends and family apprised of his condition.

For now, please keep Chris in your thoughts and prayers.

Also, feel free to leave messages below any post for Chris and I'll be sure to relay them to him.