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A maxillary facial perspective & attitude adjustment

Warning: I was crying as I started to type this, so it may not be wholly cogent.

TL;DR: I read an article today that gave me a whole new perspective on my “dental issues.” And I cried.  Click here or keep reading and the link is at the bottom. 

I have a cleft lip and palate. It’s often the butt of (my own) jokes. If it’s not apparent, humor is my go to especially with less than comfortable topics. I think I’m funny and I laugh hardest at myself.

Years ago I started using because I have a cleft palate as an excuse if I messed something up (rare,ha!) or didn’t feel compelled to explain my stance or an action.  I had a classmate at DINFOS tell me, loudly, he was offended by that because “people have cleft palates for real and it’s a horrible disfigurement.”  Thanks, Senior Airman who shan’t be named.  I’m gonna leave the room (laughing) while the instructor explains the joke.

Once, as a civilian in charge of a Marine Corps Public Affairs office in California, I was pulled aside by the newly assigned Provost Marshal we’d just written a “get to know you” feature piece about for the base paper. The major, some 8 inches taller than me, leaned down and said “There’s something not right about your Marine. When I asked WHY he wanted that series of photos he looked me straight in the eye and said “Because my boss has a cleft palate, sir.”

I sniggered and assured him I’d handle it.  And I explained to my Marine that joke was better used in house and I used it less and less.

So. Cleft palate.  Sucked as a kid in foster care, sometimes making it to dental appointments, sometimes not. When I finally started to talk again at 5, my speech was bad (I still have a lispy slur when I’m tired *or drinking* and Siri absolutely never understands what I ask for) even after years of speech therapy.

My amazing* foster mom used to threaten to knock me across the other side of my face, straighten it out along with my attitude.  Mine is a left side unilateral cleft.

*She used to win awards for best of foster care in the city where we lived. I still laugh about that. If she was the best there are some really messed up kids out there from the other homes…

On a trip to Magic Mountain in the eighties I yelled on an upside down ride and when we were right side up again and stopped, I was missing my teeth.  Sketchy foster dad (I may never write that post)  told the ride engineers who immediately stopped the ride and searched the platform and all the cars.  For my teeth.  I was 12 and mortified.  We got them in the mail 8 months later when they were found during a maintenance project on the lake under the ride.

Kid you not.  Free family pack of tickets to return, too.

I dug through more than one Taco Bell trash can after throwing my teeth out with my tray; I used to set them on the corner while I ate.  That’s gross and I may delete that line.

I had a Leforte Osteotomy when I was 13 (I just googled that and nearly threw up when I clicked on the video.  Don’t. Please.) It was a surgery to address the sunken upper mandible (should have waited until I’d grown into my face, but I didn’t make the rules, and resulted in 12 weeks of my jaws wired shut. Awesome foster mom skipped the prescribed protein shakes and just put everything we had for dinner each night in a blender with a few eggs.  Because protein comes from eggs. I just dry heaved. I remember spaghetti and raw eggs in the blender.  That and, since my front teeth were removable she smashed stuff up for me to “poke through” and swallow. I weighed 79 pounds when I started high school that Fall. The only reason I drink protein shakes now is the simple fact I can’t taste them even though I know they taste scrumptious. That’s a separate blog though.  Two, actually.

I shipped for boot camp at 17 with removable front teeth and had two previously permanent teeth inadvertently misplaced after an accidental butt stroke at the hands of a frustrated junior Drill Instructor. That DI was later relieved, in part because the senior found out she actually confiscated my removable retainer/teeth as punishment for going to dental and complaining about the two bottom teeth that had decided not to stay in my mouth. I missed 6 hours of training. I didn’t even say how they came out. Just needed gauze or something to pack the gums.  Seriously.  Who takes away teeth as punishment? Don’t answer that. 

Somewhere in my first tour in the Marines I was ninja punched (NJPd) several times for fighting as a result of something someone said about my face. And maybe the cheap beer we were drinking at a club in Tijuana had something to do with it. Or maybe the tequila poppers.  I digress. I fought a lot, often about my face.

One of those fights was serious enough that the company gunny told me the only way to avoid losing rank (again) was to take leave and go to Tegucigalpa, Honduras with his wife. She was volunteering with Operation Smile. I didn’t know who they were.

Years later one of my brother’s best friends started serving as a smile ambassador for OpSmile and they made a trip to Tegucigalpa.  The experience was as eye opening for him as it had been for me.  I love knowing that group of friends works so hard to raise money for Operation Smile.

Check out NerdHq, too. Plenty of chances to get involved if Changing Forever is your thing.

Here’s two shots from Eric’s 2013 trip to Tegucigalpa.

My brother went to Honduras with Operation Smile last month. Here are before and after shots of Tatiana and Yitci, just two of the dozens of children treated while he was there. A simple, inexpensive surgery (45min/$240) reconstructed their smiles. Their motto, ChangeForever, is perfect. Posted on FB Feb 2013.
I asked Eric what the most memorable moment of his trip to Honduras was. He said meeting this baby. She was 12 lbs at birth and now, two months later, she weighs just 6 lbs. Her parents didn’t name her because naming her would make them love her more and that would make it harder when she died. Once they realized Operation Smile would be able to help her, they named her. Dakota. OpSmile’s occupational therapists taught her parents how to feed and care for her and when she’s a bit older and puts on some weight, they’ll reconstruct her smile. AMAZING. (posted on FB in Feb 2013)

Back to me though.  If you’re curious *and still reading* yes, I feel like a MeMonster when I talk this much about myself.  Even made a tag. Does anyone read all the way through and click the links or am I talking out loud for the sake of feeling better?  I’m going to keep writing either way. 

So I went because Gunny told me to. It was a simpler time, the Marine Corps of the early nineties. My whole perspective about my face changed.  Compared to the teens who’d never had any reconstructive surgery, the babies whose malformed mouths prevented them from eating, the little girls with shawls wrapped around their faces, hiding, my first world, lance corporal face was nothing to complain about.  Well played, Gunny. Well played indeed.

I returned from that trip with a new perspective, even with the same face.  I was kinder when responding to questions from kids, more appreciative of the amount of dental care I’d already had and I was slower to punch someone in the face at a club… and yet my mouth still plagued me.  My palate wasn’t closed (food got stuck, fluid came out through my nose) my lower teeth were still removable, my nose looked like I’d gone a few rounds with Holyfield. By then it’d been broken twice in fights, once “at home” and and once by an errant surfboard.

But I was better off than anyone I’d seen in Teguce and I knew it.

The Navy gave me a permanent upper bridge a year later and I remember being excited to have permanent front teeth for the first time in my life. I was 21. I smiled a lot that year.

When I was in college, married to an active duty Marine, I got a work up done for some restorative dental work. The request was routed through Tri-care who denied the claim.  “We only authorize this level of dental work in the case of a congenital anomaly.”  Wut?  I sent a letter back explaining their denial was valid because, instead of it being a congenital anomaly I’d actually bought my cleft lip and palate at a garage sale when I was 11.  By the time they approved the work we were less than a year from moving away from the area and the doctor wouldn’t agree to start the process.  Which was fair, even if it sucked.

Back on active duty after September 11th, I had an awesome maxillary facial team at Balboa who addressed my open palate (technically it was a cleft again, right?) by removing all of the 8o’s era rotted hydroxy appetite  (google that if you’re inclined, it grosses me out, not gonna write about it) from my palate, sliced my tongue open and sewed it to the roof of my mouth in 2004.  (cutting part of my tongue out is the real reason I have a lisp again but I think Siri just doesn’t like me if she knows I’m tired or tipsy) Then they wired my jaw closed for six weeks.  One of my greatest friendships in life was forged via Yahoo messenger in those weeks.  #cheetoeater Soft tissue closure.  It’s pretty awesome and much less leaks out of my nose. It still leaks, but not nearly as bad.  And I have a tongue on the roof… never mind. 

Pretty awesome skin graft, IMHO. Small victories.

In Afghanistan as a civilian on a cool project I don’t talk about, I smashed my mouth. That resulted in a week in Dubai with an awesome prosthodontist who rebuilt my whole lower bridge.  So, for the first time in my life, at 35, none of my teeth were removable.  It was a long week and, as ever, there were some funny moments.  And it cost me about $45k.

On my way out of country months later there was a blast.  And my Navy issued upper bridge took the bulk of the impact.  Well. My camera and one of my bags and the Toyota Tercel I was riding in took the brunt of it but my nearly 20 year old bridge didn’t fare well, I just didn’t know it at the time.

In early 2014 when a tooth cracked, right in front, I was fortunate to get an appointment with a great prosthodontist in NYC. She did a temporary repair of the smile and did a work-up of replacing the (fractured) bridge.  It’s in the tens of thousands. Even with a discount on her time.

I left that day elated (the work up came in the mail a week later) because I’d walked in after almost a month of feeling like a dejected grade schooler again and walked out with a fixed smile and restored self esteem. I didn’t even care about the parking ticket on my windshield.  I shot this photo out to my friends and my brother. image

Holy cow, that iPhone was so small.

I still need a lot of work done on my mouth (shut yours with the jokes about how it’s too big and always open) and for the near future, restorative dental care is out of the question.  At the NYC prosthodontist’s insistence I started the paperwork with the VA but I’m not holding my breath about it being approved because there’s no documentation about bootcamp dental shenanigans and, really? If the VA is going to work on my mouth it would have to be someone at least as high caliber as the prosthodontist in NYC who works for the VA one day a week. Oh, the dreams I can dream.

Read: It’s not going to happen unless I win the lottery. I have an uninsurable mouth, it seems. 

Which brings us to perspective.

I read an article this evening by a writer I follow named CJ Chivers.  Check out his work. Be sitting down first.  I used his Wikipedia page because it’s the one I found with the greatest variety of his work. The story I read tonight left me speechless. And crying.  And kicking my own ass for ever complaining, ever, about my dental problems.  I know we all have our own worst days, and I know we each have perspective shaped by our own experiences–I’ve been telling people that since I published HeroinDreams last week.  But really? If I ever complain about dental and I haven’t started extracting my own teeth with a Leatherman? Feel free to punch me in the throat.

Read the whole story here. 

…as he saved the life of a Marine, Colin Smith, who had been shot through the skull. Kirby’s own turn as a battlefield patient came on Christmas Day that year, when he was 22. He was standing on a rooftop when a single shot found him. The bullet entered through his left cheek and exited his right. Along the way it ripped out part of his tongue and seven teeth, and shattered the right side of his jaw. It also cracked part of his lower skull, near the roof of his mouth, and damaged his sinuses.

Doc knew none of this at the time. What he knew was that he had been hit, that his mouth was so full of blood and loose tissue that he could not talk and that if he did not act quickly and decisively he would die. Using his own knife, he pushed a blade into the base of his neck — opening a makeshift airway that bypassed the sputtering mess behind his chin.

The tracheotomy ensured his breathing would be maintained, at least for a short while. His wounds carried another set of immediate risks: Because of their location, there was no way for a tourniquet to stop his bleeding. By the time a helicopter had carried him to a military hospital, he was struggling for consciousness. As the doctors leaned over and the anesthetic fog carried him away, he assumed that he was dead.

And then…

Doc had dodged death to face a cascade of problems: chronic pain, migraines, PTSD, insomnia. His rebuilt jaw did not line up with his teeth. He retained enough of his tongue that he was able to compensate for speech, but the altered shape of his oral cavity and the damage to his tongue made eating difficult. Sometimes he had to chew food on one side of his mouth, then manipulate it toward his throat with his left index finger. By 2008 his brief marriage had ended. Within a few years he racked up 32 operations. He was jumpy, brooding and self-conscious. To manage pain and sleeplessness, and the loneliness, he took to drinking, sometimes to a restless stupor.

When he was medically discharged from the Navy in 2012, he was stripped of a sense of purpose and belonging. When I visited him that spring, he began drinking before we ate lunch. New physical problems presented themselves, in forms only a person who has suffered a devastating wound to the mouth can know – bits of teeth loosened and dropped out, later followed by a chunk of bone and a screw. Doc gained weight, added tattoos and grew a beard, which partly hid the fact that his jaw, his teeth and his mouth were getting worse.

And finally…

One night he pulled out an offending tooth with the pliers on his Leatherman tool. Two nights later he removed another. When his mother, Gail Kirby, understood what he had done, she pleaded with him, asking what he wanted, what someone might do to help. “He said, ‘Mama, I want my face,’ ” she said.

And I thought I had it rough because I threw my teeth away at Taco Bell. Often.



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