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Chapter Twenty One.

Tara woke up on New Year's morning and immediately felt something was wrong.  It wasn't her pounding head.  As she went to roll over as she had become accustomed she realized she wasn't wearing her CTO.  She sat up and squinted at the bedside clock.  She could just make out it's oversized numbers saying 10:26.  As she instinctively reached for her glasses, she vaguely remembered the previous night and morning.  With her glasses on, she turned and looked at Jim.  He was flat on his back, mouth open, snoring.  Tara remembered the New Year's Eve party they had gone to.  It had been fun she remembered.  They had kissed passionately when the clock hit midnight.  Her memory was hazing, but she did remember them staggering in around 3 a.m. this morning after taking an Uber back home.  They had both obviously had too much to drink.  Her mouth was dry, so dry.  And her head hurt.  She made her way into the kitchen and grabbed a Pedialyte out of the fridge and washed down two Excedrin.  She made her way back to the bathroom, passing by their bed where Jim still lay snoring.  As she went to brush her teeth she realized she still had her daytime appliance in.  She popped it out and began brushing her teeth, hoping to get the taste out of her mouth.  After gargling with Therabreath she looked at herself in the mirror.  She looked rough.  And she felt rough.  And she felt guilty.  She hadn't worn her nighttime appliance or CTO.  Obviously neither had Jim.  She realized she had a whole night to make up, so she inserted her nighttime splint and applied her CTO and springs.  She then went and tried to carefully crawl back into bed without waking Jim.  It didn't work.

Tara lay stiff on her side looking at him when he stirred.  He shook his head and rubbed his eyes before looking in her direction.  He said "good morning baby.  Oh my head."  Tara giggled and said through her clenched jaw "ee too.  Buh we ad fun."  Jim reached up and felt his face and said "I'm not wearing my brace.  Am I in trouble?"  Tara said "nah, ah itten ere mah either.  Jus puh eh on.  Leh me hep you.  Oh bruh ya teef ah I weh geh ya shome tin ta dink."

Returning to the bathroom with two bottles of Pedialyte, her partially finished bottle from earlier with a straw in it and a fresh unopened bottle, along with the bottle of Excedrin, Tara found Jim brushing his teeth.  After he was done, she handed him a bottle of Pedialyte and three Excedrin.  She said "ere aby, tah thee."

After swallowing them and taking a long drink, he put his arm around her and said "you are so sweet.  Thank you."

Tara said "ank ya for getta these.  So thoughful ah ya." 

He leaned down and kissed her on the top of her facemask and then said "anything for you baby.  Ugh, I feel like hell.  But we had fun didn't we?"

Tara snuggled up against him and said "duh bes tahm."

He wrapped his arm around her and smiled at her.  He said "in addition to 'forgetting' to put my brace on, we forget to turn my expander.  Would you like to start our New Year by torturing me a little?"

Tara giggled and said "wuh mah me so appy."

After getting his expander turned and getting him into his brace, they snuggled up on the couch.  Jim was watching a football game.  Tara was glancing at it, but she wasn't a huge fanatic like he was.  Instead, she was scrolling on her phone, looking at all the pictures and stories of her Facebook friend's New Years Eves.  She was staring at her screen when she saw a text pop up from Beverly.  It said:

B:  Happy New Year!  I hope you had a great Holiday.  We need to catch up!  How are you doing?  How is your TMJ?

T:  Happy New Year to you too.  I am wonderful.  A little hungover.  But my jaw is feeling better.  So much better.  And yes, I do have a bit of a headache.  But I think that is from the champagne and not my jaw.

B:  Hahaha!  Oh to be young again.  So how are you managing with the sleep well mask?  Are you actually managing to sleep well now?  Hahaha!

T:  I am.  Well, not last night, I was bad last night.  Me and Jim both were.  But we are catching up now.  And I don't just have a face mask now.  No, I have a full body mask now too.  But it is ok.  Jim has been so sweet about it.  So understanding.  He even got one himself a couple days ago.  I think he was jealous.  Haha!

B:  Oh wow.  What do you mean a full body mask?

Tara swiped to her home screen and tapped the camera icon on her phone.  She flipped the camera around and squeezed up against Jim.  He asked "what are you doing baby.  Please, don't take a picture of me in this." 

Tara said "eezz baby.  I jus wah to sen eh to Bev.  She ah curus abou ou CTOs." 

Jim sat there a moment thinking and said "ok baby.  But please ask her not to show anyone.  Really.  I am pretty self-conscious about it."

Tara replied "ah ill baby.  An ya shouln be embarrsed.   Ya ah sho cute."   She pinched him.

After taking the picture, she sent it to Bev.

T:  Take a look.  A CTO brace with our masks integrated into it.  I looked it up, CTO stands for Cervical Thoracic Orthosis.  And not only that, check out our springs.  They are so much stronger than the elastics.  They really pull.  They were uncomfortable at first, but I think we are getting used to them.  And please, please do not show this to anyone.  Jim is still so embarrassed by his.  But, I just think he is the cutest thing in the world.

B:  OMG!   You two are both just the cutest.  And that is quite the contraption.  I am so glad you are doing well with it.  But just the same, I hope Dr. Brad doesn't give me one.  And tell Jim he soon won't be the only manly man that is getting treated by Dr. Brad.  I finally broke down the wall.  My hubby Tim has an appointment with him in two weeks to see about getting an appliance so he will quite freaking snoring in my ear.  But, if he has to get some braces and an expander, I can't say that momma wouldn't love it.

Tara noticed the little devil emoji she added at the end.

T:  That is exciting.  Well, you sound excited.  And good for you.  Both of you.

B:  Thank you!  And yes, I am the only one excited about it.  But he is doing it for me.  So I am happy.  I will leave you to alone to nurse each other back to health.  But seriously, let's catch up soon.  I would love to do another lunch.  You up for it?

T:  I would love that.  How about you shoot me some time/dates?

B:  Will do!  And again, Happy New Year!

T:  Thank you.  And give Tim my best.

Nine days later, Tara walked into Monty's to meet Bev for lunch.  After telling the hostess who she was meeting, she was lead back into the restaurant.  As she approached the table, Tara could see Beverly was alone.  Upon noticing her, Tara saw Bev look in her direction and give her a smile.  Something seemed odd about it to Tara.  Beverly had her mouth clamped shut, hiding her teeth.  Tara thought this unusual.  Bev always had a big, bright smile on her face; braces and all. 

Bev stood and hugged Tara as the hostess pulled out Tara's seat.  Bev stepped back and gave Tara a big smile.  Tara squeeled "You got them off!!!  Oh Bev, they look incredible!  Congratulations!  When?  When did you get them off?"

Bev beamed as she said "just now, like 30 minutes ago.  It feels so weird.  Good, but weird.  You are the first person outside of Dr. Brad's to see me sans braces.  What do you think?  Do they look good?"

Tara said "Bev, they look incredible.  And I am not just saying that.  They look so good!"  Bev began to seat herself so Tara followed.  Tara asked "so, did it hurt?  Getting them off?  And you're finished now?"

Bev said "I wouldn't say it hurt, but there was a little discomfort getting my expander out.  The braces though were a piece of cake.  But my mouth feels huge without the braces and expander.  And my teeth feel so slimy.  And I know it sounds weird, but I kind of miss them.  But I am not completely done.  I go back to pick my retainers up this afternoon.  And I will have a nighttime appliance I wear that will let me still wear my facemask at night.  Dr. Brad actually gave me the option of not wearing it for a few weeks just to see if my bite remains stable.  But, and I know this is weird, I told him I would rather just keep wearing it.  Better safe than sorry ya know?"

Tara couldn't take her eyes off of Bev's mouth.  Her smile really was that amazing.  Tara said "oh Bev, this is so exciting.  And no, that's not weird.  I mean, you have come this far, what is a little further?  I am so excited for you.  I am so excited for me.  I can only hope mine turn out half as well as yours."

Bev said "I know they will.  And thank you for the compliment.  I don't want to sound to vane.   But I think my teeth look amazing.  I finally have the smile I have always wanted.  Is that narcissistic?"

Tara shook her head and said "no, not at all."

Bev smiled again and responded "good.  But I will be honest, even if it is I don't care.  I am just so happy with my smile.  And I finally get to have chips again!  Which I have already ordered by the way."

As they wrapped up lunch, Bev looked over at Tara and asked "do you like your job?"

Tara finished swallowing her bite of salad and said "I do.  I enjoy my job.  Most of the time.  But... I mean it does have it's moments."

Bev said "I completely understand that.  Completely.  Would you ever consider changing jobs?  If the opportunity seemed right and the compensation was fair?"

Tara was unsure where this was leading.  She answered truthfully "nothing is ever carved in stone.  I would consider a change if it made sense.  Why do you ask?"

Bev said "I have been working on something.  Strike that, I am working on something.  I can't tell you what right this second.  But I am going to need a good team.  I think you would be perfect."

Tara said "ok, so what would this team do?"

Bev said "I can't tell you.  Not right this second.  But watch the 10 pm local news tonight.  Please?"

As Tara drove back to her job, she replayed the end of her lunch with Bev in her head.  It was all so strange.

That evening, Jim and Tara sat snuggling together on the couch, each wearing their CTO braces.  Tara held the remote as she clicked over to channel 6 at 9:55.  Jim asked "so, what is it that we are supposed to be watching for?  And what does this have to do with your cryptic conversation with Beverly?"

Tara said "eh doh no xactlee.  Bev ashed me to wash.  Mayee eh will mah sense."

Jim said "well, it certainly was strange."

About 10 minutes into the news, one of the anchors said "and if the race for Governor was not crowded enough, this afternoon someone else threw their hat into the ring."

The screen cut to a video.  On Jim's TV there was the image of Beverly Willingham, dressed in a very conservative navy blue ladies business suit, standing behind a podium.  She said "ladies and gentlemen of this great state, my name if Beverly Willingham.  And today, I am officially announcing my candidacy for governor of this incredible state we live in".  She then gave the camera a wide, straight, stunning smile.

If Tara's jaw had not been locked shut it would have dropped open in surprise.

Jim squeezed Tara tight and said "I think it makes sense now.  Beverly Willingham wants to hire you to help her become governor." 

Hopefully those last two don't have too many errors and mistakes.  It was pretty complicated.

Chapter Twenty Three.

Back at Jim's, Tara had her arm draped over Jim's chest.  She smiled at him and said "well, that is one way to make me forget about my anxiety."

Jim laughed and said "well, anything for a damsel in distress.  I have one more thing.  A surprise.  I know you are about to be really busy working for Bev.  And you will be working some crazy hours.  Before you really get to grinding, I want us to get away.  A little vacation.  We can get out of the cold.  Maybe I should have asked you.  But I wanted to surprise you.  I am hoping you will say yes, because I have already bought the airline tickets and put a non-refundable deposit down on the house.  Weekend after next, I want us to fly down to Key West.  A little fun, a little sun.  And I have already run it by Bev, she is all for it, so you can't use work as an excuse.  What do you say?"

Tara was surprised.  But she realized this was so Jim.  She snuggled up closer and kissed him.  She said "I would LOVE that so much."  She kissed him again.

As they packed, Tara asked "baby, how are you packing your CTO?  It just is so bulky, it takes up so much room in my suitcase." 

Jim said "I'm not.  This is a vacation.  I am not wearing that horrid thing.  I need a break from it anyway."

Tara said "but baby, aren't you supposed to?  Come on, please?"

Jim said "I am digging my heels in on this one.  I am sorry, but I am not bringing it.  And I won't tell if you don't either."

Tara stood looking at him.  There had been a few minor spats between them, but never a full-blown fight.  And she didn't want to get into one right before their vacation.  She said "ok sweetie, you are a big boy.  But I am going to bring mine."

Two weeks later, they walked into Dr. Brad's office for their appointment.  Both were still a little sunburned.  It had made wearing their masks uncomfortable since they returned, but they had done the best they could.  However, both had fallen short of their prescribed wear time.

Their appointment seemed to go smoothly.  Tara had gotten in the chair first, followed by Jim.  They thought they were finished.  They expected to hear 'you are doing great, keep it up' just like they had at every other appointment.  Instead Dr. Brad looked first at Tara, seated on a stool, and then at Jim who was still seated in the treatment chair, and said "I am disappointed in the two of you.  Would you come with me to my office please?"

As they followed along behind him Tara looked up at Jim, a look of concern on her face.  He mouthed "it will be ok".  After getting seated across from Dr. Brad, Jim reached down and grasped Tara's hand.  Jim could tell she was very nervous.  Dr. Brad looked at the pair and said "you two had been doing so good.  But, over the last two weeks the wear time of your protraction devices has plummeted.  Jim, there was a four day period where you didn't wear it at all.  During that same time period Tara, you only averaged 8.5 hours a day.  And since then neither of you has done much better."

Jim and Tara were flabbergasted.  Jim asked "wait... how do you know?"

Dr. Brad said "that is another feature integrated into my new appliances.  I won't tell you exactly how, but I can track wear time down to the half hour.  Patients can't cheat.  They can't lie to me about their wear time.  Tara, for you it is not as critical.  But for you Jim, this stage of treatment is crucial.  I thought I explained this clearly enough to you, but obviously I did not.  That is my fault.  So, what happened?  Why have you been so lax in your treatment lately?"

Jim explained about their vacation.  And about their resulting sunburns.  He said it was his fault that neither he nor Tara had been getting their wear time in recently.  He promised they would do better.

Dr. Brad looked at him and said "I appreciate you being forthcoming and honest.  And I do hope you had a wonderful time.  But vacation or no vacation you should have worn your appliances as prescribed.  I am sorry, I don't have much sympathy.  I hope you both now realize the importance of getting the prescribed time in.  You have some catching up to do.  Let me ask you two questions.  Do each of you care about your treatment at all?  And if so, do you want to get back on track?"

Tara immediately answered "Yes, we do care.  And yes we want to get back on track.  We are both sorry, so sorry."

Jim looked at her and said "baby, it is my fault.  I apologize to you."  Jim turned to Dr. Brad and answered "and I apologize to you.  And yes, of course we care about our treatment and want to continue.  Why else would we be here?"

Dr. Brad said "wonderful, I am glad to hear you both have that attitude.  I want each of you to schedule a follow up appointment with Becky for the end of next week.  In the meantime, let's go on back out to the treatment area."

Jim was seated in the treatment chair while Tara sat beside him on a stool.  They watched while Dr. Brad used a screwdriver to remove Jim's facemask from his neck brace.  Once done, Dr. Brad held it out and demonstrated how only two screws held the mask to the neck brace.  Then Dr. Brad said "let's get you reclined back."

Tara watched as Dr. Brad placed the mask onto Jim's face.  After attaching the springs in Jim's mouth, Dr. Brad used a pair of pliers to work on them.  After he had placed the pliers on the tray beside him, he attached the springs to Jim's mask.  He raised Jim back to a seated position.  He said "Jim, like I said, wear of your protraction device is crucial during this phase of treatment.  To help you, I have bent the hooks on each of your molars.  Now, you can't be tempted to take the springs off.  So, for the next week, you will wear your mask full time.  Eating, showering, brushing, all the time.  This will make up for the lost time.  At night, you are to still wear your CTO.  Use the screws to attach the mask to your brace.  It may be easier if someone else does it for you.  Perhaps Tara?  Now Tara, for you I need you to get back to wearing your CTO as prescribed.  Again, right now is not as crucial for you so I am not asking you to make up time.   The good news is, next week we will both get you into some new appliances that will make compliance easier for the both of you."

Jim glared at Dr. Brad.  In a raised, agitated voice Jim said "NO.  Take this off right now."

Dr. Brad looked at him and said "I can do that Mr. Simpson.  But, if I do, we are done.  Your treatment is over.  It was all there in the contract you signed.  I will do that if you want, though you will still be liable for the full cost of the treatment.  That was also in the contract.  Look, this sucks.  I know it does.  But ultimately it is your fault.  If you had asked me beforehand I would have ok'd each of you wearing your protraction aids for only eight hours a night on your vacation.  But since you decided to disregard my treatment plan and chart your own course, this is your new treatment plan.  It is only for a week.   You will be fine.  You will be glad you made up the time."

Jim glared at the doctor as Tara leaned in and hugged him.  She softly said "baby, I am sorry.  But please, please don't quit.  I can't do this by myself.  Please?  I promise, we will get through the next week."

With Tara on the verge of tears, Jim shifted his focus to her.  He said "don't cry.  Please.  If you want me to do this, I will."  He then turned his glare back to Dr. Brad and said "but I am not happy about this."

Dr. Brad said "I completely understand that.  If it makes you feel better, at least know you are not the only one.  In addition to my Megan, we also started two of our referring professionals into treatment last week.  Dr. Zan, she is a pediatric dentist here in town, and her hygienist Amara both were fitted with Miller's and protraction gear.  They volunteered for full-time wear.  So, you won't be alone.  Now, let's get both of you some spacers."

Chapter Twenty Four.

While Jim had driven them to their appointment, Tara got behind the wheel to drive home.  Jim sat in the passenger seat, reclining it back as far as it would go.  Tara realized he was trying to hide from any unwelcome stares from other vehicles.  She knew he was upset.  They drove in silence until Tara said "baby, it is going to be ok.  It doesn't look bad at all.  We will get through this.  It is only a week."

Jim snapped back "that is easy for you to say, you don't have a damn muzzle strapped to your face."

Tara didn't respond.

After a few second she heard him exhale deeply.  She glanced over and saw he had his eyes closed.  She had turned her attention back to the road when she heard him say "I am sorry baby.  Forgive me, please.  It isn't your fault.  I promise I will try not to take it out on you.  Please forgive me."

Tara reached over with her right hand and took his.  She replied "oh baby, of course I do."

That evening Jim was still sullen and moody.  Dinner had been a disaster as Jim tried to maneuver around the springs in his mouth.  He finally gave up and retreated to the bedroom to take a sleep aid and try to just go to sleep. 

Tara lay with him, her head on his chest, trying to simply comfort him.  From the sound of his breathing, she could tell when he nodded off.  Thinking of what had happened because he hadn't worn his protraction gear, she gently shook him.  She said "sweetie, let me help you into your CTO."

After he had fallen back asleep, Tara gently crawled out of bed.  It was only 9:20 pm and she couldn't sleep. She was too worried about Jim.  She tried to figure out how to make this better for him.  She drew a blank until she remembered that she had Alex's card with her cell phone number.  She picked up her phone and sent a text.

T:  Alex, I am sorry to bother you so late.  But can you please text me back at your convenience?  I need advice. 

She got an almost instantaneous reply back.

A:  You aren't bothering me.  What can I try to help you with?

T:  Jim.  He is so upset.  I am afraid he will stop treatment over this whole mask deal.  I don't want him to.  What should I do?

There was a long pause.

A:  Tara, there isn't a whole lot you can do.  Just be there for him.  Be supportive.  He will have to come to terms with it on his own.

T:  Alex, that is not a good answer.  Please, there has to be another way.  He can't wear this all the time. 

A:  I understand.  But it isn't my call.  It is Dr. Brad's.  How about this?  I will contact Dr. Brad tomorrow and explain the situation.  And I will be in touch with you afterwards.  Will that work?

The next day Jim hid at home.  Tara was at the grocery store looking to buy some protein shakes when her phone dinged.  She saw a text from Alex.

A:  So I talked with Dr. Brad.  He wants Jim to come in first thing Monday morning, 7:30 am.  Will that work for him?

T:  I am sure it will.  What is Dr. Brad planning to do?

A:  He didn't say.  He just said he would work with Jim to figure out something that would work for him.  He did remind me of how important this phase of protraction is for Jim's treatment.  I am sorry I don't have more info.  Just ask Jim to get through the weekend.

T:  Thank you.  I wish you had a more definitive answer, but I know your hands are tied.

A:  I don't know if this will help.  But maybe remind Jim that he isn't that only one that has had to wear his mask in public.  It is terrifying at first.  I know firsthand.  But it does get a little easier over time.

T:  Thank you.  I will.

Jim rushed across the parking lot of TMJ and Sleep Plus, head down trying to not be seen, at 7:15 on Monday morning.  It was the first time he had ventured out of the house since he had the mask installed.  He found the door locked so he knocked loudly.  After a minute of no response, he knocked again.  The door opened a few moments later.  Alex smiled at him and said "Jim, please come in."  Jim noticed she was not wearing her CTO or facemask.

He stepped inside as she closed the door and locked it back.  He said "thank you."

Alex turned and gave him a big smile and said "you are most welcome.  You are a few minutes early, but come on back."

As he followed along behind her he asked "are you done with your CTO and facemask?"

She said "I wish.  No, I can't drive wearing the CTO.  So, I take it off before I leave the house, and then put it back on here before we officially open at 8:30 a.m.  The same as Mandy and Lisa."

Turning the corner into the treatment area, Jim saw Dr. Brad standing beside a treatment chair.  As Jim approached, Dr. Brad stuck out his hand and smiled like everything was just fine.  Dr. Brad said "Mr. Simpson, good morning.  Wonderful to see you."  Jim was hesitant to shake, he was not very happy with Dr. Brad, but stuck out his hand and shook.  As he did Dr. Brad said "so, Alex says you have some issues with the facemask therapy.  What seems to be the issue?"

Jim said "the issue is this facemask.  That I can't take off.  I have a very successful business.  While I do want to continue treatment, I will not have it negatively impact my company.  If that means quitting treatment, then so be it.  But I will not wear this mask out of this office this morning when I leave."

Dr. Brad said "whoa now, no need for that.  Let's have a little talk.  Can we go to my office please?"

Jim did not say a word but instead simply nodded.

After both were seated Dr. Brad asked "Mr. Simpson, you are a builder and developer correct?  I know we have talked about it a little."

Jim nodded his head and curtly said "yes."

Dr. Brad continued "and do you think the quality of your work reflects on you?  That your reputation rides on the quality of your work?"

Jim wondered where this was going as he again replied "yes."

Dr. Brad said "I feel the same way.  My reputation rides on the quality of my work.  I am not a builder, so excuse me if I get some things wrong, but do you feel that the foundation of a home is more important to its structural integrity than the cabinets and trim?"

Jim replied "yes, of course."

Dr. Brad said "so, as a builder, you think that getting the foundation laid correctly is imperative.  Would you continue on with a build if you felt the foundation was substandard and would fail sometime down the road?"

Jim shook his head and said "no."

Dr. Brad said "so, like a concrete foundation is key to any home, so is correct occlusion key to a healthy bite.  And just like you only have so long to work with wet cement before it sets up, so it is the same with the maxilla.  There is a window we have to work with.  Right now, we are working on your foundation.  And we only have three to four months to get it right.  If we miss, everything else will be compromised.  So, even if I give you straight white teeth, the build won't be correct.   Just like installing the finest marble countertops can't fix a warped and cracked foundation, neither can I fix your smile if we don't get the forward growth we need now.

That is why I am so adamant about you wearing your appliances as prescribed.  I admit, I was a little angry you didn't communicate with me before you decided to just come up with your own treatment plan.  As I stated up front, if you had asked before hand I would have worked with you.  As I will work with you now.

But there was more to this than just you.  I wanted to make a point to you of how important this is.  But I also wanted to make a point to Tara.  You two seem to be in this together.  I didn't want her to also fall into bad habits.  For you, this is about your airway and snoring.  If you don't do this, you will be able to function.  But for her?  If she doesn't fix her TMJ, it will progress steadily until she is not able to function.  So you see, it wasn't just your treatment I was thinking about when I installed your springs, but hers as well.  I don't want you to stop treatment.  So, let's come up with a compromise.  Will that work?"

Jim thought of Tara.  He asked "what do you have in mind?"

Dr. Brad said "well, for starters, let's go out to the treatment area so we can take those springs off."

As Jim lay back in the treatment chair, he noticed that Alex was wearing her CTO as she stiffly bent over him.  As she worked in his mouth, Dr. Brad explained "so, you can't wear your mask at work in meetings, on job sites, and what not.  I get it.  So, let's do this.  I told you to wear your mask 16 hours a day on average, with the CTO incorporated in for at least 12 of those.  For the next two months, I am going to ask you to get 17 hours in a day with the mask on average.  Surely you can find one extra hour a day.  Even if that means wearing it some extra over the weekends.  Again, this time frame is critical to your success.  I am also going to integrate class III elastics into your treatment.  I will want you to wear them full time.  They will not be that visible.  And if you take them out for an hour here and there for an important meeting that is fine.  Will this work for you?"

With Alex working in his mouth, Jim mumbled out "oh aye".

As Alex lifted the mask off his face Jim took a breath and said "that feels so good."

Dr. Brad smiled and said "I bet it is a relief.  But you wearing it like you did has already made up for one of the four days you missed.  One down, three to go.  I know you will do it.  So, are we good?"

Jim said "yes, we are good."  He sat in silence a moment before asking "so what are these spacers for?  The ones Tara and I both have.  They suck by the way.  We are both nervous.  Tara is just convinced she is going to be getting a Miller appliance.  And she can't do that, not with her job.  And neither can I."

Dr. Brad chuckled and said "but the Miller appliance is the greatest thing ever.  But I hear you.  No, I am not fitting Tara for a Miller appliance this Friday.  I will be installing a TPA appliance with integrated hooks.  This way she will be able to wear her protraction gear without having to wear her nighttime appliance.  This will be easier on her.  And for you, I am going to install some bands on your premolars along with some TADS in your lower jaw.  This will be for your class three elastics.  I will be honest, I was already planning for this somewhat.  I didn't know if you could or would be willing to wear the mask 24/7, so I went ahead and had a plan B in my back pocket.  So, I think we are back on track. 

Thank you for coming in.  Just please, in the future if there are concerns communicate them to me ahead of time.  And also, please reassure Tara that the Miller appliance is not that bad."  He gestured over to a treatment chair that Maggie was standing beside, holding a Miller appliance and examining it carefully.  It looked huge in her petit hands.  Jim noticed there was also a CTO brace with integrated mask laying in the treatment chair.  Dr. Brad continued "really, if Tara's treatment does call for a Miller, she will do fine with it.  See that appliance in Maggie's hands?  That is her appliance.  As soon as we get you out of here, I am going to install it for her.  I know she has to be excited."

As Jim studied her face, he thought that she didn't look excited.  No, she looked scared.

   

Chapter Twenty Five.

Tara sat beside Jim in the waiting room of TMJ and Sleep Plus.  They had already checked in with Becky and sat chatting as they waited.  As they did, Tara took a discreet look around the room.  For some reason she felt disappointed that there appeared to be no adults in braces waiting with them, instead there was just a mother with her twin tweenaged daughters.  Jim and Tara had been there about five minutes when the treatment door opened.  Maggie escorted a middle-aged couple to the reception desk.  Tara knew that Maggie had gotten a Miller appliance, Jim had told her about it after his appointment on Monday.  To Tara's disappointment she saw Maggie was not wearing a CTO brace.  The woman she was holding onto and guiding to the front desk, the man holding onto her other arm, most definitely was however.  Tara noticed there was even more to her brace.  Attached to the CTO were two hip and leg braces.  As Tara watched the woman struggle to walk to the reception desk she felt pity for her.  She wondered what had happened to leave her needing such a conspicuous full body brace.

Once Maggie had gotten the couple to the desk, she turned and said "Margareh, ya ah thah gulls cah come on back.  Ah sowry fah mah speesch."  As the trio stood, Maggie looked over at Tara and Jim and said "hi ya two.  We ah a lil short haned today.  Alexsh ish out.  It may be ah few minutsh."  As she spoke, even from across the room, Tara could see the silver tongue crib hanging down behind Maggie's teeth.

Tara said "that is ok Maggie.  How are you doing with your new appliance?  Jim told me you were getting it after his appointment on Monday."

She said "ish an ahjushtment fa sho.  I wah teh ya abou it when we get ya back.  Jush be patient pleash."

It was about twenty minutes before the treatment door opened again.  Maggie popped back out and gave the couple a big smile.  She said "come on bah you two." 

As they followed behind her into the treatment area Tara asked "so, do you not have to wear a facemask or CTO?  Lucky you."

Maggie replied "I do.  I jusht doh have to wear eh full time yet.  Until my suture splitsh.  I am wearing it at home while I shleep.  Or try to shleep.  Alexsh saysh it getsh easier.  I sure hope sho  I am shtill wearing ma back bracsh, exchush me posture brace, here at work.  And the CTO ish not compatible with it.  I think Dr. Morales and Dr. Miller are working on that though."

Tara said "it does get easier."  She squeezed Jim's arm and said "but I am lucky I have had someone help me through the process that understands.  Speaking of Alex, where is she today?"

As they stopped beside an empty treatment chair, Maggie said "Alex twishted her ankle again.  She ish at Dr. Morales' getting it checked out.  Sho why don't you two go ahead and brush.  Then meet me back over here."

As they walked over to the sink, Tara noticed one of the tweenaged twins from earlier reclined back in a chair as Dr. Brad fit her with a bright pink Petit facemask.  Her twin sister was sitting in a chair pouting around the rubberbands that protruded from her mouth that were hooked to the matching pink facemask she was wearing.  Her mom had her arm around her consoling her. 

After brushing, Tara and Jim made their way back over to Maggie.  Once there, Maggie said "Jim, why doh ya shtart."  After getting comfortable in the chair, Maggie said "Dr. Miller ish almosht finished."

Tara looked back over to the treatment chair where the twin girls were.  To Tara's surprise, mom was now in the chair.  Dr. Brad was fitting her with her own bright pink facemask as her two daughters looked on smiling and giggling.  After a few minutes, Dr. Brad raised her back up and announced triumphantly "you three did AWESOME!  And you LOOK awesome in your matching pink masks.  So, like we discussed earlier, 14 hours a day during the week and 22 hours on the weekends. I know you can do it!" 

The look on mom's face didn't look confident.  She replied "I promish Dr. Brad, we will do our best."

One of the girls exclaimed "Dr. Brad, we will make sure mama wears hers!"

Dr. Brad laughed and said "that is right.  It is important that all of you wear your protraction masks as prescribed.  It is a vital part of your treatment.  And remember, I can tell how much you are each wearing it.  But I know you will.  So, that is it.  And congratulations!"

As the trio made their way out towards the reception area, all three still wearing their facemasks, Dr. Brad walked over and sat on a stool beside Jim.  He said "Jim, Tara, wonderful to see you!  How have you two been getting along with your protraction wear?  Getting the required time in?"

Jim said "it has been rather horrible, but yes, I have.  Tara has too.  And she is so much cuter in her CTO than I am."

Dr. Brad laughed and said "I totally understand that sentiment.  Well, how about we do something to make it a little easier for both of you?  Jim, I am going to install some hooks for you to wear class three elastics full time.  As long as you wear them as prescribed, I think we might can cut your CTO wear time back to 14 hours a day in a few weeks.  Does that sound like a deal?  And Tara, I am going to install some hooks for you so you can wear your's without having to wear your big bulky night brace.  You will still need to wear it while you sleep of course, but just around the house, or around town, you can just wear your daytime splint but still wear your CTO.  That should be an improvement right?  So, let's get started."

Tara squeezed Jim's hand as Dr. Brad administered a couple of injections into his mouth, Jim's face contorting slightly in pain with each shot.  Once done Dr. Brad exclaimed "great job!  All done with the needle.  Now Maggie will get those pesky spacers out.  I know that will be a relief.  And then, we will get Tara into the chair."

As Dr. Brad reclined Tara back she asked "so, what do you have in store for me?"

Dr. Brad reached over and picked up a stainless and acrylic device from the tray.  He held it up and said "just this little old Nance appliance with hooks for protraction.  We will anchor it to your molars with these bands.  You will hardly notice it is even there after a couple of days.  And it will be a lot less intrusive than your nighttime appliance, which you will still be able to wear with this when you sleep."

Maggie quickly got Tara's spacers removed and Dr. Brad fitted the appliance onto Tara's top back molars.  He had her bite down several times to seat it, then said "looks perfect.  How does it feel?"

Tara felt around it with her tongue, then noticed the sensation of the hooks on the inside of her lips.  She said "it feelsh like I...  oh wow, I have a lishp."

Dr. Brad said "you will adapt in no time.  I promise.  The lisp will be gone in a day or two.  Just practice talking.   How does it feel?  Any pain?"

Tara said "no pain.  It jusht feelsh like I have a wad of gum shtuck in the roof of my mouth." 

Dr. Brad said "totally normal at first.  By Monday it will feel like it has been there forever.  Now, let me get it bonded."

After removing it from her mouth he dabbed cement inside the molar bands and put it back in her mouth.  He again had her bite down to seat it fully and announced "there you go!  Your new Nance appliance!  Let's go ahead and get you into your CTO so I can show you how to install your elastics."

After getting her CTO brace on, Dr. Brad nor Maggie had assisted her, he said "good job.  The ease with which you put it on now tells me you are wearing it.  Even without the timer integrated into it."  He held up a pack of elastics and said "I want you to wear these now.  They are a little stronger than before.  And I want you to wear four.  Like this."  He quickly attached two elastics to each hook, then attached them to hooks on her CTO mask.  He said "all done.  Please, go ahead and wear it for the duration of your appointment.  Just to make sure everything feels ok.  And I want you to wear your CTO for 14 hours per day.  Now Jim, let's get you taken care of."

As Jim lay in the chair, Dr. Brad held up a little hook with two eyeholes in it.  He explained "Jim, I am going to install one of these on each side of your mouth, below and behind each lower canine.  They won't be visible when you smile or speak.  And the elastics you wear won't be readily visible either.  So, let's get these installed."

As he poked Jim's gums he asked "feel that?"  Jim shook his head back and forth.  Dr. Brad said "ok, you will feel it as I screw them in, much like your expander.  But, if you do feel acute pain, raise your hand."

Tara sat stiffly beside Jim holding his hand.  It sounded horrible as the ratchet clicked back and forth, the screws being driven deeper into Jim's gum.  But to Tara's surprise, it went rather quickly and Jim never exhibited any discomfort nor did he raise his hand.  With the fourth and final screw seated, Dr. Brad exclaimed "all done!  You did great!  Maggie, why don't you hold up a mirror.  Jim, smile for me."  As Jim smiled Dr. Brad said "see, can't even see them.  Now, they will be sore for a few days after the anesthesia wears off, but you can manage that will Tylenol and ipuprophen.  Now, let me get your elastics hooked up."

Maggie continued to hold the mirror as Dr. Brad hooked an elastic to the back right hook in Jim's mouth.  Dr. Brad said "it is simple.  Hook an elastic to your rear back hook, then attach it to the matching front lower hook.  Like this."  He continued "and you just repeat on the other side.  Like this."  Dr. Brad quickly and easily attached the other elastic.  "And all done.  I am going to have you and Tara in the same elastics.  That will make things simpler.  And you can steal each other's elastics.  I want you to wear these full-time except while eating or performing hygiene.  Change them out in the morning, at lunch, and before bed in the evenings.  I still want you to wear your CTO 17 hours a day for the next two weeks.  Just to catch up.  Then we can drop the wear time back to 14 hours a day, the same as Tara.  Speaking of which, why don't you go ahead and put it on."

Once Jim was all strapped in, Dr. Brad said "excellent.  You too had no problems putting it on.  Just like Tara.  And just like Tara, I now want you to wear four elastics on your mask, for a total of six."  Dr. Brad attached the elastics and said "and we are done!  You two are just doing incredible.  I think all couples should go through treatment together.  Any questions?"

Tara and Jim cut their eyes and made eye contact.  Jim said "I guess not." 

Tara said "oh, I have one.  That woman earlier?  Was that brace she was wearing part of her orthodontic treatment?  Please tell me it wasn't."

Dr. Brad said "well, I can't talk about other patient's treatment in depth.  Obviously her facemask is a part of her orthodontic treatment.  But the rest?  I will just say that we are now seeing more Ehlers Danlos patients.  And many of them need mobility aids.  But Ellen, that is who you saw, is doing great.  Dr. Morales is taking great care of her.  As she does all her patients.  Dr. Morales is a wizard at bracing.  She gives people back mobility that they have lost.  We are collaborating a lot.  In fact, that is where Alex is today.  Trying to figure out why she keeps having instability in her ankles.  But I know that Dr. Morales will figure it out and come up with a solution for Alex."

I can think of many things that could happen if Tara visits Dr. Morales...

Great story!

Sorry…. 

Not all of my characters have tragic outcomes.  Some have very happy endings.  Maybe these will too?