Goodbye Mr. Chipmunk

Shade, Aitza and I are back in the lovely township of Durham, NC, for Shade’s final (hopefully) procedure at Duke University Hospital. We flew up yesterday (My third day in a row in an airport. Oh, the glorious world of travel.) and got upgraded to Comfort, which means our legs were not folded up under our chins for the 1.5-hour flight. This is the Shade advantage. People like to give him stuff. He said he wants to monetize this situation by selling wheelchairs outside the airport but I explained that then the pre-boarding line for people with disabilities would have 200 people in it, so it would backfire on him. I like his entrepreneurial spirit though, however misplaced.

For those new to Shade’s medical journey, a recap: After 12-year-old Shade suffered a debilitating stroke on July 14, 2011, he had right-side facial paralysis (among many other traumatic issues), leaving him with half a smile, an eye that wouldn’t fully close, and some serious lip and cheek chewing. Imagine the feeling when a dentist has numbed your face for dental surgery, but it lasts for the rest of your life.  With no movement, his muscle deteriorated to the point that his cheek was flat. After much research, I found Dr. Marcus, the nerve/muscle graft guru known here as the Smile Doctor, whose specialty is facial reanimation, bringing back life to paralyzed faces. So last year he took a nerve from Shade’s leg and grafted it from his left cheek across his upper lip to his right cheek like an extension cord. He let that get cozy for 6 months and then last December grafted muscle from his thigh into his cheek. Because the skin on his cheek had tightened so much, Dr. Phillips, his plastic surgeon, had to add skin from his thigh as well to cover the extra muscle and fat added underneath. I just found out the graft area is known as the skin island, well named as the pale thigh skin seems to float in a sea of his ruddy facial skin.  I guess that makes the weird thigh hairs growing on this island the coconut trees. He ended up with what Shade deemed “a chipmunk cheek.” Between that and the scars and the skin island, he got his share of stares, but Shade is impervious to stares. It’s one of his super powers.

We checked in this morning to the hospital, and both Dr. Marcus and Dr. Phillips visited. They were all grins at Shade’s grin, which is getting more symmetrical as the right side of his face wakes up. Dr. Marcus was happy when Shade said he gets pins a needles in his face, another great sign of the new nerve and muscle coming to life, and he was pleased with Shade’s nasolabial fold, your vocabulary term of the day. That’s the groove on each side of your nose that go to the corners of your lip, which deepen as you smile. Shade hasn’t had one on his right side for years.

The doctors consulted with us about this procedure, which thankfully will be much less invasive. (The last one took months of healing including multiple stays in the hospital over Christmas.)  Dr. Marcus’s plan is to debulk the area under the skin. I guess the last procedure was the bulking part. They put extra fatty tissue under the cheek to ensure he’d have enough matter underneath, after the swelling subsided, to make the sides symmetrical. Had I known this term, his cheek would have been nicknamed the Incredible Bulk. Oh well, missed opportunities.

Dr. Phillips will next remove the skin island, or at least as much as possible. The grafted skin over the site is quite loose, and he said he’ll trim it little by little until the area is covered properly. At worst, Shade may have a small strip of grafted skin along his jaw line. We’re hoping for full removal because that patch is hell to shave.

Shade went into surgery at 11:08 a.m. I’ll update you, post-chipmunk removal.