Journey to a smile

In response to The Daily Post’s writing prompt: “Journey.”

To be honest, I don’t really remember how it started or how my parents realised that something was wrong. I just remember that at the age of seven or eight I had been to the dentist more times than I would have liked, had enough injections in my gums to induce a fear of them deep in my psyche, and experienced the tugging, twisting, crunching tooth pulling sensation more times than I should. That was just the beginning.

Was all this happening because I was a naughty boy that ate too many sweets and didn’t brush his teeth? No, I admit that I did perhaps eat more sweets than I should have, however that was not the cause of my predicament.

I had too many teeth. Turned out that you aren’t allowed extra teeth to keep as a backup…there isn’t enough space. Bummer. Anyway, they had to be “taken care of”..hence the joyful procedure of injections and tooth pulling.

So finally the extra teeth were gone. Well they were sitting in drawer in the house for a while, but they were out of my mouth, and so the show could go on….little did I know that the fucker was only getting started, and it was going to be a hell of a show. The extra teeth had crowded the regular teeth and in consequence they became crooked.

My dentist advised my parents to consult an orthodontist as this was no regular case, and so they did. Accepting only the best, my parents consulted the best orthodontist in South Africa and soon after we drove up for a consultation.

Cleidocranial Dysostosis…yeah, get your tongues around that mouthful. This was my diagnosis. Basically I had too many adult teeth and once the surplus teeth were removed, the remaining were either crooked or refused to come down of their own accord.Oh yeah and I had an under bite. Shit just got serious. I was nine years old, and this was not going to be a short story. No wave of a magic wand would break this curse, oh no. Neither I nor the orthodontist realised just what this story entailed and how long this book would be. Book…that’s pretty much what my patient file looked like by the end.

So it was sorted, he was my specialist and a plan of treatment was planned and commenced soon after. First point of action was to convince the teeth that were hiding in the depths of my gums that they should come out and say hello. This brings me to the first of several operations that I was to have over the years.

Of course, as a patient, everything has to be explained to you so that you don’t wake up in shock and don’t know what the fuck is going on. Therefore I was told that a chain needed to be attached to the tooth in my gum and fed through the gum in order to fit a special plate that gently pull on the chain and slowly bring the tooth down into position. Fuck me! At nine I really didn’t know what I could expect, but I was scared shitless.

So off to the hospital I went, more nervous than I had ever been through all my exams or swimming races. Anyone who has had to have an operation before will know that you are not allowed to eat or drink anything for a while before you go under the knife. I just thought that was plain unfair. Eventually I was giving an awful tasting liquid and before I knew it I could keep my eyes open and I was gone. I woke up with the taste of blood in my mouth, a gum full of stitches and a little chain dangling from the gap between my teeth. Of course I didn’t realise all this straight away…I was still fucked up from the anaesthesia. Flashes, my parents saying hello as I opened my eyes. Their eyes full of pity, relief and all the love in the world. I think I smiled at them but all I remember was next being in a wheelchair, then being moved into the car. It takes a while to come round from anaesthesia…especially the first time.

You see the teeth could not be straightened until all the teeth were present, as without support they would just slip back out of position. Therefore the operation was followed with months wearing a removable plate that hooked into the chain and gently encouraged the tooth down, the plate being adjusted regularly to keep the correct amount of tension. After several months the tooth would finally show itself and another plate would be constructed to keep the teeth in place until the next operation.

The operations came and went and the tedious, painful procedures were repeated time and again. There were just three operations that I will never forget. The first being the one where I had swallowed so much blood during the operation that I spent the whole journey home throwing up blood. Throwing up into a cup as we could not pull over on the highway. How many cups…I couldn’t count. The second being when I woke up in the hospital room to a hysterical family.Turned out I had been out for hours and hours longer than I was supposed to be. I hadn’t woken up from the anaesthetic and had thrown up whilst I was out. The radiologist didn’t pick up the pneumonia. I spent the next four days in hospital and the next six months receiving weekly treatment for pneumonia. The third and final one comes at the end of my story, my final operation….but you’ll hear about that later.

So the years went by with visits to the orthodontist every six weeks, but sometimes I was lucky and didn’t have to see him for up to three months. The visits consisted of a series of checking progress, X-rays, operations, and when the teeth were finally all out…the application and tightening of braces. Braces, now weren’t those fun. Imagine tooth pain…on every single tooth, that’s what it feels like when you have your braces tightened. Another fun fact of braces is that as they work and the teeth straighten, the excess wire sticks out. It protrudes just a bit, but just enough to shred the inside of your cheeks as you talk or chew.

I was a teenager. I was supposed to be starting my life, learning how to form relationships, how to communicate and socialise. Instead I was self conscious, trying not to speak to much, making sure that I smiled with closed lips so that people wouldn’t see the mess that was my teeth. Teased for my braces. I tried not to let it deter me too much, but it was always there in my sub conscious.

I remember one visit, the orthodontist wasn’t very happy with me. I hadn’t been wearing my plate as often as I should have been. I was a kid, I was trying to enjoy life. After years of treatment I had gotten to a point of frustration. I hated it, all of it. I had to take the plate out whenever I ate something, and sometimes I just found I couldn’t be bothered to put it in. Other times I simply forgot. It delayed my treatment a whole year. I was devastated, I didn’t know how much longer I could bear it.  What I could eat, when I could eat, how I had to eat, sports and activities I had to refrain from doing….all dictated by my treatment. I was in prison.

Well the years went by and the treatment continued. I was my orthodontist’s longest standing patient and a record breaking one at that. He told me that I had had the most of a certain type of operation that he had ever seen performed on one person. As I mentioned previously, my file was like a book, easily twice as thick as any other file in their office. I made them rich and perpetually bankrupted my parents. I can never thank them enough for making it possible to receive the treatment I did. Not only that, but the comfort gifts that I received after my operations and appointments.

Well finally the end was in sight. Eleven years of operations, fitting plates, braces, making moulds and taking X-Rays. It would all be over soon, with one last operation. You see, though all my teeth were in the right place and straight, a remarkable transformation which I could never justly describe with words, it would all be for nothing if I didn’t fix my under bite. Therefore a final operation was required.

It was to be the longest operation of all. My jaws, both of them, were to be broken and moved into the correct alignment. My bottom jaw was to be broken, shortened and moved back whilst my top jaw was to be moved forward and tilted down slightly. A 10 percent risk of permanent nerve damage, a chance my face would be permanently void of feeling due to the stretching of the nerves that run through the jaw. A six hour operation. I was afraid that I was going to die.

Eventually the dreaded day came and with a mask pumped full of gas I fell, along with my fears, into a deep deep sleep hoping beyond all hope that I wake up this last time. I did.

I remember waking up in the ICU. The first time waking up without my family there, visiting hours are strict in ICU. It’s funny, thinking about that operation even now still brings tears to my eyes. I knew what had happened and where I was, but to be alone in that state felt like the worst thing in the world. My mouth was held shut by elastic bands around my teeth, and I was able to open it only enough to consume liquids, my medicine and a disinfectant mouthwash every two hours. My face, my mouth, it was all completely numb, and I later discovered it was as swollen as a balloon on the verge of bursting. Eventually my family were allowed to see me, and though I tried to be strong I was so afraid and I cried my eyes out. My heart sank when they finally had to leave.

I don’t know if it was the medication or the shock that made me so sleepy, but I slept a lot on the first day in hospital, waking every hour with the inflation of the blood pressure band around my arm and the loud beep of the machine that immediately preceded and initiated it. The uncomfortable momentary tightening of the band was followed by a desperate need to urinate, which was due to the medication. I was supposed to urinate every hour, on the hour. Now this was a task, and a highly embarrassing one at that. I was hooked up to an IV and too weak to move, so the nurse had to be called to….assist me. Later that night, I woke in a frenzy. The numbness had created an awkward sensation in my mouth that caused me to believe that my upper pallet was coming off. I think it was about midnight and several buzzes were required for my nurse to eventually show up. The restricted movement of my mouth left me unable to describe my worry to her and she simply gave me mouthwash to rinse out my mouth. I am not sure how she became a nurse at all, as she had no bedside manner what so ever. She was clearly annoyed at having been disturbed and I was told to go to sleep as she walked out of the room.

I spent the next four days in hospital in the weakest state I have ever experienced. The hospital food wasn’t to my liking and so I didn’t eat it. Instead I consumed packets of soup that my parents brought for me. Still it left me weak. The short distance to the toilet was a gargantuan effort as I relied heavily upon the IV stand for support. I was bathed by the nurse as I was unable to bathe myself. It was then as I looked in the mirror that I saw my face, twice its normal size if not more.

I was moved out of the ICU after two days and moved to a regular ward and remember there was one patient that came in. He had had his leg amputated previously and his stump was causing him a dreadful amount of pain, so that he spent the whole day and night howling like a wounded animal. I listened to him pleading with the nurse to give him more painkillers, and sympathised with him as they told him that they could not give him any more. He had taken too many already and I listened as he cried himself to sleep in agony.

The next night was my turn. I don’t really remember why but I was in so much pain and it was my turn to howl, and howl I did. Fortunately though, my painkillers worked, and my agony subsided. Finally I was discharged from the hospital and allowed to go home. I can’t describe how elated I was to get out of hospital.

The next four weeks consisted of systemically timed medication consumption and a liquid diet to allow the bone time to set. Soup, liquidised cereal and other liquidised foods quickly became unappetising, leaving me in a highly weakened state. Two weeks of soft food diet thereafter saw a slight improvement in the foods I was able to consume and with it an increased appetite and an incline in strength. By this time the swelling of my face had reduced drastically, though the bruising came out to leave a yellowy, greenish hue on the skin of my face. My greatest discomfort during those six weeks though, was not the pain or the weakness. It was the fact that I was not allowed to ride my motorbike, my beloved motorbike.

Finally my story comes to its end, a few more months of wearing a plate to make sure the teeth stay in place and my twelve year journey was complete.  Those years impacted my life in more ways than I could think possible. In some ways not so good, but for the most part it was beneficial. Of course the physical impact was the most obvious, however it taught me that I have the strength and determination to overcome anything. It taught me humility and so much more, more probably than I even realise, and for that I am grateful.

My condition was relatively mild and I was fortunate to not have more severe symptoms of my condition. I know also that there are so many brave souls struggling and fighting against numerous conditions rendering them in a permanent state of physical and/ or emotional pain. My heart and my soul go out to them, as I can only begin to imagine the struggle that they face and my admiration for their courage and determination is immeasurable.


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