It has somehow taken me three years to write about Eli’s jaw. I think my inability to write has something to do with the trauma I witnessed and the utter fear I experienced watching my son experience so many months of so much pain and discomfort.
It was Sunday, January 29. Dave, Eli and Kyle went skiing at Snowbird Ski Resort and met up with our friend Robbie and his boys. It was near the end of the day. Eli and Dave were skiing down a relatively easy run. Eli motioned to Dave that he wanted to jump a thicket of small trees. Our boys are fairly competent freestyle skiers, and to Dave the jump appeared very easy. At that, Dave motioned back with a thumb’s up. Eli jumped. In the air, his ski clipped a branch, and one of his skis flew off, into the air, and planted itself in the ground. Within a millisecond, Eli landed onto his planted ski, slicing his face open, fracturing his jaw in several places, and knocking out his lower right canine tooth.
In Eli’s words,
“I have never heard Dad swear so much. He was completely freaked out! But he made me put my ski back on and ski down to the lift. So I did. People always ask me why I skied down to the lift. I just say, ‘what else was I supposed to do?’”
Of course at the time, to Dave it only seemed like Eli had a deep cut on his face and was missing a tooth.
Within seconds Dave was texting me. Here is what he said.
“Eli crashed. Do you know a good dentist?”
“A dentist?” I asked.
“I think Eli might lose a tooth.”
I was in my pajamas and completely disoriented. I texted my neighbor. Her dad is a dentist. She wanted to know what was up. I had no idea.
Within seconds, Dave was texting me in a panic. I was struggling to understand what was going on. Thankfully, I was able to get ahold of Kyle, who told me that from the lift,
“Mom, there was blood all over the mountain. I knew it was Eli’s.”
I still was not sure what was going on. Eli had recently gotten braces. Because I was unable to really get ahold of a dentist, first I emailed the orthodontist’s office. Within minutes, the office manager called me. Within minutes after that, our orthodontist, Dr. Michael Richards, called me. Anyway, Dr. Richards insisted we do whatever we could to push Eli’s tooth back into place. To this day, I wish I would have. So, while I was juggling dentists and orthodontists, Dave was fervently trying to get Eli off the mountain. Since they were in the back bowl, they had to take the lift up to the summit. There, they were met by Ski Patrol with a stretcher, who were get Eli into the gondola for a direct ride down to the base area. They went to the on-site medical clinic, where the doctor said he was not equipped to determine the extent of Eli’s injuries, and told them to go to the hospital. I still think Dave was in shock. Neither he nor the clinic doctor yet realized how seriously injured Eli was. What he could see was Eli’s unflappable nature, his “missing tooth,” and facial laceration. As a result, Dave thought addressing Eli’s tooth and cut were most important. So he left Kyle with our friend and drove Eli down the canyon. On the way, he called again to see if I had found a dentist. What Dave didn’t realize is that Eli’s jaw was separated so significantly that it appeared Eli’s tooth was gone. The tooth was only pushed out of the socket. What I could hear in Eli’s voice, was the incredible pain he was in. I knew there was something more. I also know that Eli has inherited a lot of my Midwestern stoicism. Meaning, the more significant the pain, the more even keeled we appear. (Sorry, Dave. I know stoicism leads to mixed signals).
Because our home was on the route to the Emergency Room, Dave picked me up. We headed over to Primary Children’s Medical Center. (Pro Tip for Utahns: if your child has a dental emergency, avoid PCMC and head over to IMC). Again, because Eli was eerily calm the Primary Children’s Medical Center staff ER misread the signals and let Eli sit. They finally called a dentist, who said something like,
“It is Sunday and I will only come in if I have to.”
I asked again. The dentist never came. Eventually (and without pain medication), they stitched up Eli’s laceration. During this time, Dr. Richards (our orthodontist) kept calling. He stridently advocated for Eli and that we try to save Eli’s tooth. To no avail, PCMR was not having it. I begged them to keep his tooth right where it was. Eventually, they pulled his tooth. Again, to this day, I wish I would have taken the orthodontist’s advice and pushed Eli’s tooth back into the socket myself. Why, when a medical person speaks, are we so easily complicit? Anyway, still unmedicated, they finally X-rayed Eli’s jaw. I could see the look of horror on their faces. They could not admit they were wrong about letting Eli sit for so long, and without pain medication. Eli had two complete fractures with displacement: The first fracture was a complete open fracture of the lower condyle, which is an area of the jaw that sits about a half an inch below Eli’s right jaw joint. The second fracture was more severe. It ran from the bottom of his chin up through his right side lower canine tooth socket. His canine tooth was pushed out of the socket, and his jaw is completely separated at this point. His fracture was about 3 millimeters away from where his facial nerve enters his jaw. Additionally, he was now missing a tooth, had a deep laceration and a concussion. Then the hospital sent us home.
Here is a text I wrote right before Eli’s surgery: “n a few short hours this amazing, kind and handsome human, our son, grandson, nephew, cousin, brother and friend, goes into surgery. ❤🤕❤️ This week has been challenging to say the least. And Eli is extremely hardcore. His pain tolerance and patience with all of this broken jaw business is unprecedented! ❤❤ We know Eli has a long healing journey ahead (2 months of NO chewing/eating, for instance). And RIGHT now we need all the good energy. SO we ask you to hold Eli close in your thoughts & prayers. Thank You! ❤ And ELI, we really do LOVE you so much it hurts! ❤❤”
A few days later, and after Eli’s jaw surgery, we would learn that Eli also had several additional impact cracks in his jaw bone. The surgeon said that his braces most likely saved his teeth.
Funny story (not so funny story): As I mentioned, Eli needed surgery. PCMC referred Eli to a plastic surgeon. We were in between insurances. Our new insurance started on February 1. Nevertheless, I began the process of scheduling Eli’s surgery with the plastic surgeon. Between January 29 – February 1, we also tried to figure out how to survive until our new insurance kicked in. Oddly (and gratefully), this insurance SNAFU turned out to be a blessing. See, my mom radar kicked in and I never really felt good about a plastic surgeon performing jaw surgery. Consequently, I kept asking the hospital why they would not just send me to a maxillofacial surgeon and a dentist. They kept insisting that a plastic surgeon is the best person for the surgery. It wasn’t until later that I learned that PCMR has a weird relationship with maxillofacial surgeons and dentists. Meaning, they don’t actively contract with maxillofacial surgeons, at least not at that time. (I don’t get it either.) Instead, they cobble together other surgeons who could do the job.
So, there we were, killing time, waiting for Eli to get his jaw put back together. I still do not know how Eli survived these few days. Here is sort of how: Remember how I have this neighbor whose dad is a dentist? The day Eli crashed, I was able to get ahold of her, and she connected us with her dad. Over the next few days, and around-the-clock, my friend’s dad administered lidocaine into Eli’s jaw. Honestly, the reason Eli made it through is because of this man’s loving and generous care. We will always be grateful. This man also teaches in the school of dentistry at the University of Utah. Each time I brought Eli to get another shot, he and I discussed our options. Over and over again, we weighed the pros and cons of using a plastic surgeon versus a maxillofacial surgeon. Ultimately, we were convinced that a maxillofacial surgeon was the way to go. Our decision was affirmed when the maxillofacial surgeon told us that instead of risking damage to the facial nerve that he would wire Eli’s jaw shut to stabilize Eli’s lower condyle. As a result, he would only put screws in the most significant fracture, the complete open fracture through the middle of Eli’s chin. In contrast, the plastic surgeons were going to put screws in both of Eli’s fractures, which would definitely risk severing his facial nerves.
It gets better. Remember our rad orthodontist, Dr. Michael Richards? He continued to check in. Of course being new to mouth injuries, I was eager for his opinion. Remember, he was the one medical professional determined to save Eli’s tooth? Somehow our conversations led me to tell him that Eli would normally need screws put into his jaw so the maxillofacial surgeon could wire Eli’s jaw shut, but he pondered if we could use Eli’s braces instead of drilling screws into his bone. I passed this information along to the orthodontist, then connected the two doctors. Dr. Richards manufactured an extra-strong wire for Eli’s braces with hooks welded on at intervals that allowed the top and bottom to be wired together. The day before surgery, I took Eli, who was still unmedicated, to the orthodontist. Eli wanted novocaine, but the stupid assistant, who no longer works there, said it would take too much time to numb Eli up. So without any sort of pain medication, Eli calmly sat while the orthodontist pulled the separated parts of his fractured jaw together so he could install the new wire contraption. I honestly cannot imagine Eli’s pain. I am sure this is one of the reasons I have struggled to write about Eli’s ski accident. During surgery, and after the surgeon used a titanium plate to hold Eli’s jaw back together, he used the hooks to band Eli’s jaw shut.
Once the surgery was over, the recovery nurse at IMC insisted Eli swallow a pain pill. By that point, a groggy Eli had his phone in hand. He texted me the following:
MOM. I CANNOT OPEN MY MOUTH!”
I already knew that. The nurse did too. I told her she was nuts and was endangering my son.
“His jaw mouth is banded closed. His face is swollen. He will not be swallowing those pills.”
Again, Eli took one for the team. He said he was fine so he could go home. I knew he wasn’t.
For the next two months, Eli’s mouth was banded closed. During this time, his sweet friends brought him milkshakes and would often stand far from his bedside, a little freaked out. I remember mothers bringing their kids by and forcing them to talk.
“Come on, Jon.” One mom implored, “Say something. We didn’t just come over for you to stand there and stare.”
Here is a text I wrote at the time:
“A slog: that is how I would describe this week. Eli’s mouth is banded shut. His surgery went well. And aside from unexpected congestion, a possible popped stitch and a terrible sore throat, Eli’s healing is going as expected — painful, annoying and long. Eli cannot talk, unless you count inaudible sounds. He barely eats. Our house is quiet. And I am certain he is giving Netflix a run for its money. Nevertheless, Eli is hardcore. He is dealing with this most uncomfortable injury with grace and tenacity. Thank goodness for text-to-voice apps, very supporting friends & family, and an injured son who has an impeccable sense of humor! Go Eli! Heal well. And know you are LOVED! ❤❤ Also know how sorry we are that you have to go through this most crappy ordeal.”
In truth, Eli looked disfigured and was in pain. It was hard to be around him. He also loved being remembered. I did not blame these kids for being weirded out. Thankfully, there was one friend who literally saved all the days. Remember my friend’s dentist dad? Well his granddaughter is one of Eli’s friends. She is super calm and easy going. Initially, she came with a milkshake or a Jamba Juice because that’s what you do. Thankfully, she started coming almost every day. Each time, and without expectation, she would get right up next to him and quietly sit. She was never freaked out, or at least she didn’t show it. She never made Eli interact and she appreciated that Eli was starving. Soon Eli was asking me when she was coming by. I will always and forever be indebted to Olivia. She is a kind, empathetic soul and a forever friend. If only her parents, Dave and I could be more like she and Eli, if only.
Eli’s quiet pain was tough. His hunger was hard to see. There are only so many smoothies and milkshakes one can take. During this time, Eli lost forty pounds. He was also the Freshman class president at the time. His advisor would not let up on his responsibilities. So, like he always does, Eli took a deep breath and steadfastly followed through. I was amazed. I still am.
Recently, Eli had surgery to begin the tooth implant process. Because his bone is still so thin at the fracture site, they also need to attach a plate to the screw. Eli handled it with strength and calm, just like he did before. I am still processing.
Eli, we are glad you are ok.