Wednesday, June 24, 2009

Hope in the midst of hopelessness

“Do not put your faith in hope, for it has abandoned this place.”
-Eomund, The Return of the King

So a good friend of mine was talking recently about hope in hopelessness and that triggered something inside of me. I guess because I feel like there was a long season of hopelessness that I faced in my life. Many around me, some who knew me and some just in passing openly expressed their pity for me and their judgment that there was no hope great enough in the world for my physical birth defects. Time and again this sense of hopelessness that others expressed concern for me centered around what they believed to be a fact. They believed I would never find a woman in this world who could accept me and love me for who I was because of how I looked. I struggled on and off with this hopeless thinking. I cried myself to sleep countless nights over how I looked and how unfair it was and how I never would find someone of the fairer sex who would accept me. I pleaded night after night that I be healed of this defect and have a “normal” face and ear like most of the rest of the population. My mom and my older sister always were supportive and encouraging to me. They often called me handsome. At the time I half believed them and half thought they did it out of obligation since we were family. Now that I’m older and wiser, I know that they truly meant what they had said.

A good friend of my wife and I was talking with my wife one day. He is still single and in his 40’s and struggles with hoping for the right woman to come along who will love him and accept him for who he is. He has an injury to his arm, an indentation and scar tissue from a burn injury, I think. It’s about the size of a half of a baseball. Anyway, he was stating how he didn’t think there were any women out their who could accept him because of this imperfection. My wife responded in a positive fashion stating that there was a woman out there. She continued by stating something to the effect of “Look at me, I married James.” He replied with a remark stating that if I had had the defects that mar my face before she and I were married that she certainly could not have been willing to marry me. You see, he thought the imperfections on my face and ear were the result of some sort of accident or burn injury that had occurred after she and I were married. She quickly defended her previous statement of encouragement to him as she explained that I have been this way since birth and she had accepted me just as I am from the very beginning of our courtship.

What an amazing woman! My lovely wife who took on a man with only half a handsome face. She was willing to stop and take a long enough look and see beyond the visible. This is the same woman who had faith that our children would come out fine and not carry the physical deformities that riddled my face while I feared for the worse. Even though my doctors reassured me that my kids would also come out fine. There was always that nagging fear in the back of my mind. My kids did come out just fine. Neither of them was “graced” with my physical trait. I say that with mixed emotions. I would NEVER wish my condition upon anyone else, and yet I cherish nearly every moment of the life that I have lived as a result of it. The only moments I don’t cherish are the ones where I made bad choices. The rest has made me into the person who I am today. I have accomplished much in my life and plan to continue down that road. I have touched countless lives, some of which I have not even had the pleasure of meeting. Do I still desire to have a “normal” face? Yep. But as I mentioned in one of my previous blogs, 99% of the time, I forget that I look any different than the people around me. I just don’t think about it that much anymore. (A little secret for those of you who are like me…people see you as you SEE yourself, they accept you as you ACCEPT yourself). Live as normal a life as you can. Fight the insecurity that is prevalent with this condition as you are growing up. It is incredibly hard and I suffered that insecurity for years. But at some point, my identity no longer hinged upon my physical deformities, it was based upon who I was. I feel so blessed to have the two beautiful children that I do. I feel so blessed that they both love me. They adore their Daddy. They see past the skin. They know my heart.

The title of this blog, that’s my challenge to everyone who reads this, don’t give up hope. When it feels like there is no hope, it may just be right around the corner, or it may be in the next chapter. Or maybe it’s just been misdirected. If you feel like you have no hope, contact me and I will stand with you in the midst of the storm until it passes. Sometimes things don’t always work out the way we wanted them to, but in my own life, I am a fighter, and I’m willing to fight long and hard for what’s worth saving.
Have a great day!
James

“To hear or not to hear”…that is the question…

Well in my case. I have normal hearing out of my left ear. It is my right ear that after extensive auditory testing while I was a youth it was determined that all my right ear nerves exist. I was just lacking an ear drum, ear canal and maybe another piece or two in the inner ear construction. So, about 4 years ago I started investigating hearing supplement options. I’ve learned to adapt to hearing out of one ear only. My main objective in obtaining hearing out of my right ear would be to gain stereo and in affect be able to better ascertain which direction sounds are coming from. As it is, I find it difficult at times, usually when outside to determine where a sound is coming from. The two main options I considered were the BAHA system and the natural solution of using skin grafting to fabricate an ear drum and the fabrication of an ear canal.

First the natural grafting solution. I’ll make this answer quick. There is the possibility of chronic infections and fluid drainage complications associated with this method, so, I lost interest pretty fast. I didn’t want to make my life more complicated. So, the cost/benefit didn’t appeal to me.

Second, the BAHA system. This method involves drilling a hole in my skull on the right side slightly above and behind where the right ear resides. A titanium button is screwed into the hole and for a few months the body adapts and adheres to the button. A special hearing aid snaps onto this button and the vibrations are transmitted through the skull bone to the existing and functioning hearing nerves on that side of my skull. As a result, I could actually hear from that side. I read several testimonies good and bad concerning the results of this method. There is about a 6 month period of time where the body/brain learn to mask out “white noise” like a constant “static noise” that is typical with this method. But your brain learns to ignore the noise after a period of time and it is not noticed anymore. At least that’s how I understand it. Some patients complained of acquiring head aches after the button installation or associated with the hearing aide noise? One patient mentioned that he couldn’t wear a baseball cap very easily because of the location of the hearing aid high on the side of the head. He also mentioned that wind caused a significant amount of noise that rendered hearing on that side ineffective. Those two last points, the baseball cap and the wind noise were the nails in the coffin for me concerning further pursing this option. I live on a cattle ranch and am outside a lot of the time. I wear a cap to keep the sun off of my head and it can often be breezy in southwest Colorado depending upon the season or time of day. My main pursuit of hearing out of my right ear was for the benefits outdoors and that is where this device seemed to have problems. The persons who often were very satisfied with the results of the BAHA device were those who only had partial hearing in their good ear, or they had hearing deficiencies in both ears, so anything was a tremendous improvement from their past state. And that is awesome and good.

I don’t mean to disqualify either of these methods. I am just sharing how I reasoned through the entire process as it applied to me and my circumstances and preferences.

SO, as it is. I still hear in mono and probably will for the remainder of my time on this good earth. It would be fun to hear stereo, however, being deaf in one ear does have its benefits. I can roll over on my good ear when I climb into bed and the world of noise becomes nearly silent to me. When I go out to a job site where there is substantial noise pollution, I can use my left hand to cover my left ear and still have a free hand to work with. My wife would suggest that there are other benefits to being deaf in one ear, but I can’t admit to that here.

I’ve considered ear prosthesis attachments as well and have not completely abandoned that option yet. I don’t know if I like the idea of gluing on or snapping on an ear every day. They make both. The snap on ear would be kind of like dentures, with fastening studs inserted into your skull. The cons for me, including the BAHA system is the studs or snap that are fastened to my skull are an added piece of daily maintenance. They have to be cleaned everyday with special attention. The snap is best cleaned with a tooth brush. I just couldn’t get past cleaning a button on the side of my head with a tooth brush. Again, great technology, great method, I am finding that I am content with my present hearing impairment. If I didn’t have good hearing in my left ear I would have definitely gone with one of the above solutions. Hands down.

So, I don’t want to discourage any readers from investigating or pursuing corrective hearing solutions. Check out your options thoroughly and go with your heart. Sometimes on this blog its just me sharing how I did/do things and how I came to this place in life.

Tuesday, June 23, 2009

Just one more surgery please

Okay, so this time I will talk about all of the surgeries I had in as much detail as I can recount. My first surgery was in 1970, when I was 5 years old. Actually, I think there were two or three, I'm not completely sure, but I am sure that there were at least two, since they did work on my jaw and my ear. First, a portion of rib was removed from my right rib cage and pieces of the bone were fashioned and grafted to my right jaw to reshape it somewhat to match my left jaw. After these types of grafting surgeries, the jaw is wired shut to permit the bone to heal. I must have blocked that part of my memory out because I don't recall what it was like being a 5 year old little boy going through that kind of trauma. The next surgery involved a plastic mold in the shape of an ear and some skin graft from my hip. The mold and skin graft were fastened to my right side of my scalp where there was no ear. (When I was born I basically had no ear on the right side). At the time, with the medical technology available, the doctors attempted to determine what my right ear would look like when I was full-grown, how big it would be and where it would eventually be positioned on my head. All of those factors change as a person matures from child to adult. The doctors also pulled the skin from the surrounding scalp to cover the plastic ear mold. Some from the facial area and some from the hair growth area. I've watched some home videos of me after the surgeries...a great big bandage on the side of my face and I was amazingly happy and smiling. Wow! Great family surrounding me.

Jump ahead to Jr. High in 1979. It was time for another bone grafting surgery to adjust the jaw bone again and try to align it better. This time a portion of rib from my left rib cage was extracted along with some hip bone. Both pieces of bone were connected to my right jaw bone as it was again re-sculpted. The side effects of this surgery were painful. The bone that they removed from my hip caused regular deep pin-like shooting pain in my leg on that side. That would flair up unannounced off and on for a day on a one or two week cycle for upwards of 6 months following the surgery. I think there was a teacher or two who thought I was faking it, but I sure knew I wasn't. This surgery occurred during the winter and I remember wearing a snow cap a lot, even in class because I was feeling very self conscious at the time as a teenage boy, wondering if there was a girl in the world who would notice me in a positive way.

Jump ahead to Spring break 1984, my senior year in High School. Apparently, the surgery that was performed on my jaw in 1979 was a failure. The bone that was grafted had dissolved. So, another surgery was scheduled. This time bone, muscle and skin were removed from my right shoulder blade all as a package. The bone was used to extend and shape my right jaw and the muscle and skin were used for shaping an sculpting that side of my face. There are a lot of details to this surgery so, it may seem like I am jumping around a bit, but stick with me. The surgery performed to fabricate an ear way back when I was 5 years old was the cause of the failed surgery in 1979 when I was in Jr. High. Apparently, the skin that had been pulled from my face and scalp to fashion the ear left the skin on that side of my face tight so when the bone grafting was performed in 1979, the facial skin was too tight on the bone grafting and caused it to dissolve. That was my understanding. As a result, the surgery in 1984 included the skin graft from my shoulder to ease the stretching effect on my facial skin when the jaw bone was extended. The muscle from my shoulder was added to my cheek area to provide material that the doctors could sculpt to shape the right side of my face and somewhat match it to the left side. This surgery was a one-shot deal and lasted just over 12 hours. Extra muscle was added to my cheek since they planned to go in later in another surgery and strip off some of the excess in the sculpting process. So, after the swelling went down, there was a larger sized lump on the right side of my face where before it had been slightly indented. Also, the skin that was transplanted from my shoulder to my cheek tanned a different shade than my natural facial skin and it had a two toned effect. I reacted in a self concious fashion to this new change. It bothered me. Everything that was different as a result of all of my surgeries that was not "perfect" as we always seem to see in Hollywood, had a negative effect on me. I used to let my hair grow long enough to cover my ears so I could hide my right ear. Just to note, it didn't turn out looking like my left ear.

Jump ahead to 1986/87, It was in college that one of my dorm mates asked me why I didn't have the "final" surgery where the doctors would remove some of the excess muscle they had placed on my cheek and sculpt my face. So, I took his encouragement and had another surgery. As a result of this surgery, in removing some of the bulk, and the bone being stablized, the two tone skin from my shoulder was completely removed and only my native facial skin remained. This was a surprise bonus waking up from that surgery. As I mentioned before, the two tone effect really bothered me. It was somewhere in this time frame that I started getting shorter hair cuts. I wasn't as self concious about hiding my defects. One day I walked into the barber shop asked for a crew cut and walked out with a Marine style crew cut, no hair on the sides or back and about 1/2 inch on top. I loved it. One of my house mates was concerned. He had never seen the detail of surgical scarring and defect as it was now exposed. He was concerned about how I would not be able to cope with being so exposed, but, something had happend inside, I had finally come to grips with my identity, and it wasn't dictated by my appearance, that was not what made me who I am. It was a spiritual stepping stone moment for me.

Jump ahead to 2005. The muscle tissue that had been inserted on my cheek all those years ago had turned fatty. It turns out that different parts of our bodies put on fatty tissue at different rates and proportions. So, the tissue transplanted from my shoulder developed fatty tissue at a faster rate than my native face tissue. So, the transplant was becoming a larger lump. Some people would mistake it for a tumor or cancer thinking that it was from chewing tobbaco use. People would come up with all kinds of theories as to why I looked the way that I do. Burn injuries, cancer, car accident, etc... Anyway, I had another surgery where the doctor removed excess buildup of fatty tissue. That brought it back down again and for a couple of years it actually look somewhat decent.

Now, 2009, fatty tissue has built up some more and the size of the lump has increased. The surgeon did mention back in 2005 that he thought a certain part of the transplant tissue was going to be a "bain" as I recall him putting it. So, I'm not sure if I will pursue another surgery in the form of liposuction to reduce that size. Maybe.

What I forgot to mention; there are countless scars on my body as a result of all of the described surgeries. One on my hip from the bone graft, one on my hip from skin graft, one on each side of my chest from partial rib bone grafts, multiple stitching scars on my face. A large stitch scar that goes from the center of my back all the way to my right arm pit where the bone/muscle and skin was removed from my shoulder area. That stitch stretched a lot since I lifted weights in High School and skin had been removed from that area. The remaining skin had to make up for the growth and there was a lot of scaring as a result. I think those are all of my surgical scars.

Gotta go for now. Have a great day!
James

Monday, June 22, 2009

sticks and stones may break my bones...but words will never hurt me

I remember, as a child, I faced a lot of name calling from other children who didn't understand my situation and didn't seem to really give a rip. I remember I used to try to lean on that age old phrase; "sticks and stones may break my bones, but words will never hurt me." And I am quite certain that I even believed what I was saying. Ha! I ponder the words of that phrase and I would conjecture that that phrase is a pile of lies. Let's face it, words DO hurt us. Sometimes simple words what were spoken with good intent were taken wrong because they were heard out of context, had the wrong tone of voice, were read in an email with no voice tied to them, etc...the list goes on. The bottom line is, words whether spoken or unspoken, written or missed, make a world of a difference in people's lives every day. Some spoken too often, others not enough. Some forgotten all too soon and others piercing deep into our souls and remaining for a lifetime.

So, not to make this blog too long this time around, where am I going with this? It's pretty simple, words and actions are critical in rearing children who share the facial differences that I have. Kids may or may not be publicly ridiculed for their appearance. The general public WILL do double takes as they pass a person like myself walking down the street. Most will do it after I have passed and my back is to them. I wasn't aware of this until my wife recently told me she catches people doing double takes on a regular basis, not everyone, but its common. Just as a side not, I do double takes when I seem someone "unusual", nearly all of us is guilty of it from time to time. And it's not necessarily a wrong thing, its curiosity. Ninety-nine percent of the time I just shrug it off. Really, I don't invest very much time thinking about how I am different from the majority of the world. I live my life as normally as I can and I have come to a place in life where 99% of the time, I forget I am even different. To those like me, I charge you with this: Live your lives as normally as you can, let me rephrase that, live your lives as exceptionally well as you can. Be a major contributor to society. Don't hide behind the curtain.

Words DO hurt and can cause much more severe damage than sticks and stones ever will. Acknowledge that, and realize that in that respect, you are no different than anyone else in the world. Sometimes life really does "suck". Parents, don't cover it up with catchy little phrases, just continually let your kids know that you love them. "Love NEVER fails". I always knew that my parents loved me, ALL of me. If you are an adult and this stuff is eating you up and dictating your life for you, rather than you living your life, then get a REAL friend who can help you learn how to "grab the bull by the horns" and start living life to its fullest. Yes, I do have a spiritual component in my life that is pivotal to my identity and contentment but that will come later. I promise my readers that I won't turn this blog into a site full of preachy warm-fuzzy izms. I'm sure there are already plenty of those to google.
Have a great day!

Thursday, June 18, 2009

The difference between Dads and Daddys

So, I hope I forewarned my followers that this blog would be eclectic! Sorry if you prefer the straight forward approach. I will write as I feel or as I think of things. I'm trying to follow a chronological methodology, but no promises. I warned about that in my first blog. So, this time I'm going to talk about a matter that is very near and dear to my heart.

My biological father had a drinking problem- which led to marital and parental problems as typically happens. I've been told that things went to hell in a hand basket when I was less than a year old. Being an Engineer, I think about a lot of things. All the options and possibilities- unless the answer is obviously right in front of me- then I don't have to deliberate. Sorry, I'm digressing. I know that my biological father already had a drinking problem before I was born, however, I have spent much time considering the "trauma" he went through, fathering an imperfect child. This observation is mixed with very genuine understanding as well as a bit of sarcasm. I also consider the grief that my mom bore through this process as well, but her story will be in a later blog.

So, back to my biological father. Some short time after I was born my mom and he were separated and at some point after that they were divorced. That was my last exposure to him until I was in college. But we're not ready to go there yet. First things first. My title "the difference between Dads and Daddys" is at the heart of this blog. When I was about 3 or 4 years old. My Daddy (my adoptive father) entered the picture. He began dating my mom and when I was 4 or 5 they were married. I have little bits and pieces of memories of those days, but they are quite sketchy. From the start I remember he treated me kindly. As I grew up into adulthood, I recognized the honorable thing that he did when he married my mom, taking on two kids- my older sister and myself. That takes a lot of love. He didn't just marry mom, he took us two kids to his side and loved on us and, in my opinion, raised us as his own. Even though at times, my sister and I were rebellious and even cruel in our remarks and hehavior concerning him not being our "real" Dad. I deeply regret those remarks. At some point after the marriage, we moved out to San Diego, California- Dad had enlisted to the Navy and spent the next three years serving in the Vietnam War. California was fun. I have a few more memories still lodged deep in my brain from that part of life since I was just a wee bit older. That is where I spent some time in the Balboa Naval Hospital for reconstructive surgery- bennefitting from my Dad's Navy service. After three years in California, we moved back to South Dakota (my native state). That was around 1971. We spent the next 5 or 6 years there and in 1976 or 1977 we moved to my grandad's cattle ranch in southwest Colorado. Dad had been given the opportunity to partner up with grandad in the ranching operation. That's when the hard work began. Being a youngster, I wasn't too fond of regular hard work and yet there was plenty of that.

I digress a bit again. Bear with me as I get a handle on this blogging. Back to the title- what is the difference between Dads and Daddys? It took me a long time to figure that out. It wasn't until some time in my adult years that I figured that out. As I mentioned earlier, I met my biological father for the first time, technically speaking (I had no memory of him when I was a newborn), while I was in college. I went back to my home town for a wedding and my older sister told me I could find our "Dad" at the local bar that he owned and operated. It must have been a Friday or Saturday night because the place was packed. I had to ask a person who my dad was because I didn't know what he looked like. They went and got him, I talked to him for about 1 or 2 minutes- the bar was busy and he had to attend to the customers. We exchanged some brief words. I told him I loved him and forgave him.

That was it. I tried communicating after returning home and received no replies. I respected the possibility that he had another family after mine and didn't want to complicate or jeopardize that, so I left it alone. It has been years now and in a recent conversation with my sister, the basic conclusion she presented to me was that our biological father was as the world has come to define them, a dead-beat dad.

So, I will try to conclude this session. My adoptive father is the greatest Daddy in the whole world. He has never abandoned me. He has tolerated my hurtful comments as he raised me up. He always introduces me as His son. He invested a tremendous amount of his life into mine to help me succeed in life. At times he was hard and at times he was gentle- he was not perfect, just like no one is perfect, but he earned the title "Daddy". Today, as I sit here writing this blog, a 44 year old man, I don't call him Daddy in his presence, I haven't gotten that brave yet. I envy those who have that kind of intimacy with their parents. I am working on that one. I know he loves me and is proud of me, and I believe he knows I feel the same about him. He may as well have been my biological father- his lifetime investment in my life has earned him all the privelages to be my Daddy. I know he may never read this blog-but, happy Father's Day, Daddy, thanks for making me a very real part of your life.
James

Wednesday, June 17, 2009

Hemifacial Microsomia i.e. facial differences

So, where do I start. I could start all the way back "in the beginning", but not yet. I'll get there some day. Ever watch the movie "Benjamin Button". Not the same condition as mine, he just got back to the beginning in the end and I guarantee you that I will get there with this blog at the appropriate time.

My blog title "facial differences", so I've learned today, is the politically correct and much simpler term now associated with "Atresia-Mircotia Hemifacial Microsomia". That's me. When I was born, I had no right ear and my right jaw bone was underdeveloped. Apparently, this congenital (meaning it happened in the womb, not genetic, not inheritable), birth defect occurs in anywhere from 1 in 6,000 to 1 in 10,000 depending upon which websites you visit. One website actually indicated that the chances of my offspring inheriting this condition to be 1 in 33. Yikes! My doctors always told me that it doesn't happen since my condition is congenital, not genetic, however, 1 in 33 has more of a chance of a facial difference than 1 in 6,000. Thank God, both of my children came out perfectly normal.

I was born in 1965 (see? we're already back at the beginning) at a time just prior to the pioneering days of "plastic surgery". I make that statement with the understanding that many reconstructive surgical techniques were "invented" and practiced in the fields of the Vietnam war. My first "corrections" occured at the Balboa Naval Hospital in San Diego. Those corrections involved skin grafting and a plastic insert to build an ear and bone grafting from a partial rib to lengthen and reshape my right jaw bone. I was about 5 years old when those surgeries occured. This was my first exposure to a hospital- military hospital- a ward full of children with a variey of infirmities. That was also back in the days when they knocked us out with a form of engine starting fluid, you know, ether. I remember being terrified and I seem to remember that my folks didn't get to stay there after visiting hours, maybe they did and I just don't remember it correctly- sometimes remembering back to my 5 year old days when I'm now 44 is a bit scewed. I remember being a very sensitive child growing up. Crying a lot about a lot of things. Of course that may have just been my born-in personality. I did manage to grow up with the average bunch of kids- did the average kinds of things kids did. One thing that was NEVER in question was my parent's love and acceptance of me regardless of my condition. I do know that it was a burden to them both financially and emotionally. They never expressed that to me, but I could tell.

And since this is a blog and it is getting late and I have to tuck my kids in for the night, I'll end this session. Please feel free to visit from time to time. I will try to dialog with myself and hopefully I can offer some sanity, encouragement and hope to parents of kids like I was or those of you out there that share my condition.
Until then-
Have a great day!
James