24. Lyra
My fingers drum nervously on the steering wheel as I make my way over the Tappan Zee bridge into New York state. Dr. Oren”s office is in White Plains, a good hour and a half from my house on a decent traffic day. Today is not a good traffic day, so I”m glad I left my house extra early just in case. I”ve been on edge the whole drive since I don”t know what to expect when I get there. I”ve never met Dr. Oren, or been to his office. I”m not sure what he”ll tell me about my jaw and how much surgery it will need. All of the unknowns ratchet up my anxiety, so I try to focus on the comfort read I have playing through my bluetooth. The enormous bridge stretches out in front of me, suspended high above the water like a shining highway right to the sky, as the sun makes the Hudson River glisten all around me. It would actually be pretty nice and peaceful if there weren”t horns honking, and my nervousness wasn”t taking up most of my brain space. Once I”m over the bridge it doesn”t take that long to get into White Plains. It”s fairly easy to find the enormous office building, and luckily there is an actual parking lot. The most nerve wracking thing in the world is going somewhere new and not knowing the parking situation, so I made sure to look it up to know whether it was going to be a challenge. I haven”t been able to properly parallel park since my driving test almost 20 years ago.
Checking the floor and office number on the directory in the lobby, I make my way to the top floor. When I walk into the waiting room, I”m struck by how brown and black everything is. It”s all decorated in warm, deep colors that make it seem cozy. There”s a large table that looks like it”s made of reclaimed wood piled high with magazines. Squashy black leather chairs and couches line the perimeter of the room that look ridiculously comfortable. It all speaks to a rich elegance that”s not overdone. The smiling red headed receptionist takes my name and hands me the usual clipboard to fill out the ton of information about my medical history. It takes me a bit to write it all out before I get up to hand it back to her. I find out her name is Kay and that she”s been working here since it opened. She has on huge coke bottle glasses over her bright blue eyes that look permanently crinkled at the corners. I like her immediately. It”s about another thirty minutes until I”m called back to the consultation room. It”s another comfortable room very similar to the waiting room, where I sit in another squashy leather chair. There I wait for a few minutes until I hear the door click open. I look over my shoulder since my back is to the door.
Dr. Oren is towering. He must be at least 6”5. There’s a warm, reassuring smile on his face when he walks in, extending his hand to shake. I get up and give him the firm handshake I was always taught, looking him in the eye with a small smile of my own in spite of my anxiety. He has a calming presence.
“It”s nice to meet you, Lyra. I”m Dr. Oren.”
“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.
“If I had a nickel anytime a patient made a joke like that, I would be retired to somewhere warm by now. Once the swelling goes down, and you heal for a few days, you should be able to talk a little. Keep your phone or pad and pen handy if it gets too hard. After the wiring comes out, you still won”t be able to have anything you need to chew for another three months. You”ll be able to have mushy foods, like mashed potatoes, soups, things like that.”
“So it will be six months after the surgery that my life will be completely back to normal? What about work?”
“We”ll give you all of the documentation you need to take a medical leave for the initial month after the surgery, so you can rest and recover enough to function well. Are you able to work from home where you”ll be more comfort‐ able and not have to talk as much?”
“Yes, my job is completely work at home unless there is an emergency where I”m needed at the office. I have to talk in meetings usually, but if I speak to my boss and my team, I can write down what I want to say and send it to one of my counterparts that are there to read at the meetings. I can still be on the calls, just quiet, I suppose.”
“We”ll have plenty of time to work out everything. It”s December 1 now. Between the holidays and all of the prep work that will need to be done, I want to get you on the surgical calendar for early February. When you head out, please schedule a follow up appointment for early January with Kay. We”re going to get more molds, more pictures, and work out your pre-surgery testing.”
I swallow hard again, just trying to keep my game face on and be brave in the face of everything I”m taking in. It”s that feeling of disassociating and being outside of my body as I say goodbye to Dr. Oren, make my next appointment and settle things with Kay at the front desk, and start the long drive home. This is fine. Everything is fine. I can handle six months of not eating the way I want, and three months of not talking well. What I am starting to panic about is how this will affect me and Taran.
Alarm bells are blaring in my head that this is too much to ask of my boyfriend of barely a few weeks. It”ll be three months of him having to watch me eat through a straw, swollen faced and bruised. Another three months of not being able to go out for a real dinner date without worrying what I”ll be able to gum down like a teething baby. I”m already not easy to love at my best. This? How will he want to stay with me when I”m going to be like this? All of my insecurities come roaring back in spite of the work I”ve done on myself, and the huge strides Taran and I have made. My eyes sting as I spiral, and I just try to concentrate on driving home safely without tears blurring my vision.
When I do make it home safely, my phone pings with a text from Taran as I let Brody out.
Hey pretty Firecracker, how was the appointment? I was thinking of you all day today
I take a deep breath before I type out my reply.
Hey. It was a lot, but at least it”s all in motion now
Want to talk about it? I could come over in a bit
Thanks, I”m really tired though. I think I”m just going to relax for a little while and go to bed early. There”s a lot to process. Catch up tomorrow?
Definitely. I hope everything is ok. Talk to you tomorrow, beautiful