“Nice to meet you, too.” He moves to sit behind his desk and gets out a pad and pen.
“Have a seat, let's go over a few things before we do some x-rays and measurements. There's a lot to discuss based on your paperwork you filled out, and the information I got in the referral from Dr. Yamada. I saw the x-rays he sent, and it does look like there is quite a difference between your left lower jaw and right lower jaw. This is from your growth hormone treatment, correct?”
“Yes, it was one of the side effects of the treatment. It made me five feet tall, but it also made a few things grow unevenly.” He makes notes as I talk, nodding to himself.
“How is the pain on a scale from 1-10?”
“It's generally not bad at all, maybe a 4 on the worst days,” I tell him, while I watch him make more notes. Then he nods to himself and puts his pen down to look at me intently.
“Lyra, there’s no doubt this is an unusual case, but I'm more than up for the task. We can get your jaw to line up a million times better, which will help tremendously with the joint pain. Your front bite and chewing will be much more comfortable too. I just frankly don't know how you lived with being this uncomfortable for as long as you have. It's been 14 years since you stopped growing, you've been living like this for that long?” Again, he isn't being unkind, just like Dr. Yamada didn't mean anything by it. It still raises my hackles, though.
“The chewing and front bite was just something I was used to by the time I stopped growing, and I didn't even think about it. The joints didn't start hurting until much more recently. If I had taken care of this when I stopped growing would it have been an easier case?”
He shakes his head. “I’ll need to take much more detailed x-rays and measurements, but I don't believe so. The fact that you waited really doesn't have a bearing on it. We would have to do the reconstruction we need to do no matter what, and replace the joints anyway, regardless of whether they are damaged at this point or not. There's no other way to get your jaw to line up.”
Ice courses through my entire body, making it freeze in place as I process what he's saying. He's talking about an entire reconstruction of my jaw. My expression must be reflecting my anxiety, because he gives me a reassuring smile.
“Lyra, I can't promise 100% success, or that this will be an easy surgery. It won't be an easy surgery based on what I'm seeing so far. What I can promise is that I will do my utmost to get you a lot more comfortable and have your jaw work better.”
“It sounds like you're talking about my jaw being entirely reconstructed.” My voice is small and I hate it. I'm braver than this. I can handle this shit. It is just a lot to take in. I thought my major surgery days were behind me, but this is bringing up all of my feelings of being different again. With Taran in the picture now, it’s also not just me I’m thinking about. How will something like this affect our relationship?
“It actually will be, there is no getting around it. Why don't we head down the hall so my assistant can take a bunch of more detailed pictures of the bones and what we'll be working with, ok? Then we'll chat more about the specifics.”
He leads me to the room with the x-ray machines, and his assistant Lonnie gets me set up with the lead vest when Dr. Oren heads out. Lonnie takes x-rays of my face and jaw from every conceivable angle, many more than what Dr.Yamada took. Then he asks me to stand against the wall to get regular close up pictures of my face on the outside with a digital camera. Finally, he uses a plaster to take molds of my bite. I'm sent back to the waiting room once it's all done until Dr. Oren is ready to discuss what he needs to do. About thirty minutes later, he calls me back to the consultation room. He sits with a pile of x-rays and pictures on the desk, his notepad at the ready. I sit heavily on the other side of the desk, dread filling me as I look at my slightly crooked jaw up close and personal.
“Alright, Lyra, so let's go over a bunch of things. You ready?” He asks as if I have any choice in needing to know what he has to say. I appreciate him giving me an extra moment before he lays whatever news on me, I guess.
“I’m ready. What's the plan?”
“It is going to be quite a surgery, I won't sugarcoat that. We are going to have to basically take your entire jaw apart, and put it back together with screws and bits of titanium to reinforce everything.”
“Oh fun, I'll have a bionic jaw,” I murmur, half to myself.
“It sort of will be, pretty cool, right? You'll have a much more defined and square jawline, and there will be a chin implant put in to make sure everything is proportionate.”
“A...chin implant,” I whisper a little hoarsely. For some reason, the words “chin implant” leaving his lips have me reeling even more. I try to clear the spots in my vision, and keep my breathing controlled. Dr. Oren continues, seemingly oblivious to my panic.
“The chin implant will help make the shape of everything perfect and proportionate. It will give your profile more definition, too. If we're going to restructure everything, we might as well make it perfect, right?”
I nod, unable to speak around my constricted throat, before he goes on.
“This is going to take around eleven hours to do. Of course, being under anesthesia for that long poses extra risks, but we will have an anesthesiologist on hand at all times to monitor you.”
“Eleven hours,” I breathe. Apparently my ability to speak has been reduced to parroting. I think he's finally realizing that I'm having a moment, and his face goes soft with empathy.
“It's a lot to take in. I get it. Like I said, I cannot promise 100% that this surgery will be a success, because it wouldn't be a promise. It would be a lie. No surgery has a 100% success rate. This is nothing I can't handle though, ok? Based on your history, it's nothing you can't handle either. We'll get through this.” He leans forward and gives a quick, reassuring touch to my shoulder. I swallow hard, gathering myself back to being the tough chick who can handle anything.
“I obviously knew surgery would be involved, maybe some screws put in place. I guess I just wasn't prepared for how involved it would be. I was thinking it would be more along the lines of the palate expansions I've had in the past. Those weren't fun, but they were fairly quick and easy, and the recovery didn't take long. An eleven hour full reconstruction is definitely not what I expected when I came in today. I feel stupid for not managing my own expectations.”
“I truly wish there was an easier way, believe me. It's the only way we can get everything lined up properly and functioning better, so that you are comfortable and can chew much more efficiently. We essentially have to start from scratch.”
He shows me the external close up pictures of my face,x-rays, and the molds of my bite, explaining exactly where they will cut the jaw apart, where the titanium will go, why they are structuring it the way they are, and how it will all align once they're done. Getting into the hows and whys of it all helps ground me, keeping my mind on the logistics instead of spinning my worst case scenario thoughts of eleven hours under the knife.
“What will the recovery look like?” I'm trying to keep my voice steady and clear now, refusing to let myself freak out anymore. At least not until I'm home.
“This surgery is going to require a lot of healing. You'll be in the hospital for a week afterward on serious pain medication and round the clock available medical help for any complications that may arise. Your jaw will be wired shut for three months, and everything will have to be consumed as a liquid during that time. Protein shakes and nutrient rich smoothies are going to become your best friend.”
“I’m sure there will be a lot of people glad that my mouth will be wired shut for three months,” I mutter. He huffs a laugh at that.
