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The Team Approach is Best

Remember when I said that speech therapy and orofacial myology were near and dear to me?  That it was decades in the making?

I am the only girl in my family. I have four brothers and I am exactly in the middle. Yep, you read that correctly, I have 2 older and 2 younger brothers. I was and okay still am, a tomboy. Whatever my brothers did, I did and I was not about to be left out! As we entered our teenage years, I began to notice difference…okay NOT those differences. I noticed that my face was different, especially compared to my family. I didn’t have ‘cheek bones’, my face was flat. I had most of my early teeth pulled out and I had been in a retainer for years. I was now 15 and it was time for braces. I thought that would change the way I looked…at least my 15 year old self thought that…it wasn’t until I was 16 that it became apparent that my mandible was growing (bottom jaw) past my maxilla (upper jaw) and I had the typical mandibular, prognathic profile to go with it. A class III Malocclusion. Hence the ‘flat face/no cheek bones’.

The orthodontist informed us that I would need surgery and accordingly referred us. I was monitored by the oral surgeon and he worked collaboratively with the orthodontist to determine when surgery was to be scheduled based on several factors, once my growing was complete and my teeth were stable, yet not out of braces. They informed me the time was right….it just happened to also be my SENIOR year of high school. My oh my, for a teenager that is not what you want to hear! Nonetheless, surgery was scheduled for December, Christmas/Winter break, to allow time for healing before returning to school. So, there I was getting prepped for a major surgery my senior year of high school, at Christmas time.

I had the surgery in the early morning hours, and awoke in the ICU to our priest (yes, an Irish Catholic family) standing over me and praying…I honestly thought I had died and was having an out of body experience. It took a moment for me to hear the nurse remind me of where I was and why I was there and then to look past the priest to find my mom. I was nasally intubated (breathing tube through my nose to my wind pipe) and unable to open my mouth to speak in order to ask for water….I was using the American Sign Language sign for water over and over again. My mom didn’t understand the sign and asked the nurse. She brought over a note pad and I began writing down all my questions and most importantly at that moment in time all that I really wanted was water. I was unable to understand why I was unable to open my mouth or why I couldn’t have water. I was informed that the surgery took longer and was more involved than I thought. I had my maxilla (upper jaw) moved up and extended out with plates/screws put in told hold it in place and the mandible (lower jaw) moved back to align with the maxilla (upper jaw). They had placed a splint in my mouth and wired my jaw. Class III Malocclusion. The water, well it had to wait until they knew I was safe to swallow following surgery.

I was wired for 6 weeks while healing took place. I was on a liquid diet (if it couldn’t fit through a straw I couldn’t have it) and gargled with half water/hydrogen peroxide mix. I was swollen! I was hungry for real, regular food. I was a teenager. The last thing a teenager in their senior year of high school wants is to be dependent on a parent for anything. But, there I was, moody and dependent. AND thankful! Thankful that I had parents that worked with me to get the right amount of liquid nutrition to maintain my weight, took the time to talk with me when I felt down or depressed at my situation, and helped me to stay positive by realizing that this was just one moment in my life.

It was a tough moment. The surgery had narrowed my sinuses and with the wires/splint it was difficult to blow my nose, sneeze, yawn..all those ‘little’ things that you take for granted until they are gone.

Once the wires and splint were removed and the swelling was gone, I had cheekbones! And a new bite! It was difficult at first to chew, it felt weird….my teeth, tongue, and lips were touching the food differently and drinking from a cup felt foreign at first. And then, slowly, one day at a time, one meal at a time, one oral motor technique at a time my mouth and jaw had endurance for eating and it finally felt ‘normal’. I will tell you it felt scary when they took the splint and wires off.. it felt just like a broken arm when they take the cast off. Light, weightless and weak, like it’s going to break again. But, my mouth and its ability to chew and swallow a variety of foods and textures became stable and strong again…just like a broken arm. It is because of this personal experience, I am more aware of the positive impact a collaborative team approach can have in a person’s life. The doctors, nurses, therapists, my parents, and others all played an integral role in my healing. Because of this life changing experience, the quote credited to Helen Keller, “Alone we can do so little, together we can do so much” is far more than just a ‘saying’ or ‘inspirational quote’ it is the focus of my practice.

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