VFW Magazine February 2011 : Page 25

most unassuming of names: the 59th Dental Training Squadron at Lackland Air Force Base, Texas. It’s there, in the Maxillofacial Depart-ment at Wilford Hall Medical Center, that Air Force Col. Alan J. Sutton and his team of technicians, artisans and healers transform the very terrain of a person’s persona. Sutton and associates don’t work in isolation. “There’s tons of support” for wounded service members, he says: medics, surgeons, nurses, therapists, psy-chologists, social and family service providers. “By the time they come to us, they have typically seen all these people,” says Sutton.“And if the surgeons can’t fix them up with skin and bone, then it’s our turn with silicon, implants and plas-tics.” Helping fashion facial features that belie the term “artificial” is Nancy Hansen, the only certified clinical anaplastologist in the Department of Defense. She describes her craft as “the art and science of restoring malformed and absent parts of the human body through artificial means.” The specialty focuses on face and hands. Harris’ case is representative of wounds wreaked by IEDs. Blasts slam the face because it’s comparatively unprotected. Warfighters “lose their nose and their ears because they’re appendages which stick out from the face,” says Hansen. These wounds do more than batter the body. They assault the soul. Society sees those who’ve sustained such injuries “a little bit differently,” she says. Certainly the loss is there for all to see. And as with any profound loss, these young warriors “go through the cycle of grieving.” “They remember what they used to look like,” says Sutton. “They get pretty mad about the fact they got injured.” Indeed, anger is the second step in Elisabeth Kübler-Ross’ classic five stages of grief: denial, anger, bargaining, depres-sion and acceptance. “Once they come to accept the reality of being wounded this way, then [they] have to deal with all the surgeries to try fix them up to look more normal,” says Sutton. “They have to be very patient and very stoic.” At first, Harris wrestled with the fates. “You start thinking, ‘Ya know, I’m not near the man I used to be. I’m not near the soldier I used to be. What am I going to do with the rest of my life?’ You’re looking at your family and everything that they’ve been through. And it’s over-whelming.” Professional counseling and the TLC of wife Kathreyn helped get him through the toughest times. Finally, he came “to terms” with his condition. One way of coping was crack-ing to buddies, “If I was to get some ears right now, it would slow me down. Because I’m so aerodynamic.” Humor may plaster over psychologi-cal pain, but it doesn’t heal it. It took Harris’ 7-year-old daughter Elizabeth to push him to take the final step. “Sometimes [other] children are ner-vous about talking to me, or kind of scared,” says Harris. “Elizabeth is right there telling them,‘My daddy got burned in Iraq. He’s a soldier.’ She lets them know that she’s proud of her daddy.” 3dMD device. “The other thing we like to get is a cone-beam CAT scan,” says Sutton. That reveals if there’s any damage to the skull itself. Carballeyra says getting a precise lay of the internal landscape is as impor-tant as the external—especially when there’s going to be an implant. There are two kinds of facial pros-thetics: implant-retained and adhesive-retained. The former are magnetic, and tend to stick better. Because the silicon prostheses they support are softer, they’re also more realistic. Problem is, this kind of prosthesis must be anchored to something solid. And that means bone into which has been placed—in the instance of ears— titanium studs. Carballeyra says that area of the skull is suffused with air cells, “which makes it very difficult to just free-hand the placement of those Harris is fitted for prosthetic ears at MacKown Dental Clinic. A wax model of the ear was first molded to ensure proper placement and fit before applying the prosthetic. But 7-year-olds can succumb to soci-etal pressures, too. Once, on a father/ daughter date night, Elizabeth seemed uncharacteristically sad. People were staring again. “Every now and then it gets a little old,” says Harris. It was then he decided to get prosthetic ears “so me and my wife, me and my kids, can have a day where it kind of feels normal, and not have everybody stare.” Step-by-Step When a wounded warrior gets to Wilford Hall, Sutton says,“The first step is to gather all the data.” That entails a trip to Alain Carballeyra’s stereolithog-raphy shop where technicians create a virtual three-dimensional, 360-degree model of the patient’s skull via an exter-nal photograph, using a four-camera [titanium] implants.” Scans facilitate fabrication of special-ly designed tools so surgeons and max-illofacial prosthodontists can precisely place anchor points. Once implanted, patients have to carefully cleanse the area, lest it become infected and set back the whole prosthet-ics process. If the patient is missing just one ear, Carballeyra can use the remaining one to make a mold, then scan it to produce a virtual mirror image. When there is no other ear, patients such as Harris “go shopping” and select one they like, per-haps from a friend. Then, Hansen sculpts a temporary ear out of wax and tries it on the patient. The subtle part of the process is tak-ing silicon and rendering it flesh-like. Fe br uar y 2011 • WWW.VFW.ORG • 25

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