I think that fear is one of the biggest motivators on the planet..
what do you fear? are you motivated by fear? perhaps you're afraid to even discuss it LOL..living in fear particularly early in life, is very formative because it captures the young victim and it doesn't let go..you've read about PTSS (post traumatic stresss syndrome)..the young aren't wise enough to fight back..they are victims until they realize they must do something about this fear that rules their life
I think fear affects everyone..those who deny their fears I feel are liars and likely in need of counseling..those who recognize that they have fears unltimately realize they must face their fears..there are so many fears..and I'm not talking of psychotics..I speak of fear of failure..fear of being poor..fear of appearing stupid or too smart..fear of saying the wrong thing..fear of rejection..fear of loving or being loved..fear of appearing too sexy or ugly..fear of what others might say..fear you won't fit in or you will stand out..fear people won't like you..fear you talk too much or too little..it goes on and on ..
When Antonio came home from school, his grandmother asked him what he'd learned in school that day. Antonio replied, "Well, Grandma, we learned about penises and vaginas and sexual intercourse and masturbation. " Grandma slapped Antonio, hard, right upside the head. He ran to his room in tears. Antonio's mother walked in and cried, "Ma! Why did you hit Antonio?" Grandma replied, "Because when I asked him what he learned in school today he started talking about sex and penises and vaginas and masturbation! " "Ma! That's what they do these days--it's called sex education." Grandma felt so bad about hitting Antonio that she went upstairs to apologize. When she opened his door, she found Antonio masturbating on his bed. She said, "Antonio, when you've finished your homework, come down and talk to me."
An elderly couple were driving through County Kerry, Ireland. Irene was driving when she got pulled over by the police, who asks her, 'Ma'am did you know that you were speeding?' Irene turns to her husband, Mick and enquires, 'What did he say?' Mick yells out, 'He says you were speeding!' The policeman said, 'May I see your license, please ma'am?' Irene, once again, turns to Mick and says, 'What did he say?' Once more, Mick, shouts out, 'He wants to see your license!' Irene gives the policeman her driving license. The cop retorts, 'I see you are from Kerry. I spent some time there once and had the worst date I have ever had.' For the final time, Irene turns to Mick and asks, 'What did he say?' Mick yells very loudly, 'He thinks he knows you!'
Chrissy Steltz holds her 2-month-old son, Geoffrey Dilger Jr., in her Milwaukie apartment.
If her six-hour surgery goes as planned, Chrissy Steltz will wake up able to breathe through a nasal airway for the first time in more than 10 years.
She won't yet have a nose -- just a rectangular opening where the nose should be. But it's a start.
An accidental shotgun blast at close range when she was 16 blew away much of Steltz's face, including her eyes, cheeks, nose and upper jaw. The first page of her 725-page medical record at Legacy Emanuel Hospital & Medical Center in 1999 gives a stark summary, under Reason for Admission: "Most of face gone."
The surgery begins a new medical effort to give Steltz a new face. It will take months, possibly a year. The ultimate goal is to fashion a realistic silicone mask -- with glass eyes, fake lashes and lids, a breathing nose and cheeks -- that Steltz will wear over her ruined face.
That prosthesis will snap into place, attached to eight titanium dental implants that doctors will drill into her facial bones in three months. She plans to wear the prosthesis most of the time, removing it for daily cleaning. In public, she'll also wear tinted glasses, to camouflage the inability of her eyes to move.
The rare total mid-face reconstruction is a collaboration of teams led by Dr. Eric Dierks, a Portland maxillofacial surgeon who specializes in treating trauma and cancer patients, and Larry Over, a Eugene dentist and prosthodontist.
The prosthesis will replace the black nylon sleep shade Steltz wears now to cover her vacant eye sockets, missing nose and heavily scarred face. But that won't come until next year.
First, Dierks must cut a hole in the skin graft where her nose used to be.
The sideways, point-blank blast from a 12-gauge shotgun entered just below her right eye and exited her left temple.
It was March 21, 1999, a Sunday evening. About a dozen teenagers had gathered to party in the Southeast Portland apartment where Steltz lived with her boyfriend. She was an A-minus student at Franklin High School. Her mother let her move in with the boyfriend as long as she kept her grades up.
One of the teenagers found the shotgun under a couch in the laundry room. He was fooling around when it went off.
"Everybody was drinking," Steltz says.
Police investigators called the shooting accidental. The 18-year-old who fired the gun was sentenced to 27 months in prison for second-degree assault. Steltz's boyfriend, also 18, was given probation for theft of 15 guns, including the one that nearly killed her.
She spent six weeks in the hospital, mostly in the intensive care unit -- on a respirator, her jaws wired shut, a feeding tube in her abdomen. She had more than a dozen surgeries. The record of her in-hospital medications runs 129 pages. She remembers nothing from the first 38 days.
"From her upper lip to the hairline was blown away," says Dr. Mark Buehler, an orthopedic surgeon who treated her. "Her nose was gone, her cheeks were gone, her eyes were gone.
"There was nothing there."
Chrissy Steltz, who will undergo the first of three surgeries today to repair her face, does the dishes in her apartment with some help from Rebecca Derscheid, her brother's girlfriend.
The Legacy Emanuel trauma team's priority was to make sure she didn't bleed to death, then stabilize her and close the gaping wound. They used pieces of the fibula, the slender shin bone, as well as metal plates, to make new cheekbones and "bridge" the middle of her face, which they covered with a large "paddle" of skin from her leg.
"It's almost like a jigsaw puzzle inside my head," says Steltz, now 26.
View full sizeRandy L. Rasmussen/The OregonianDr. Eric Dierks will be performing today's surgery to begin building a new face for Chrissy Steltz.The first she remembers is waking up disoriented five weeks later. She didn't realize she was in the hospital or that she'd been shot or even, at first, that she was blind.
Now she refers straight forwardly to the "unfortunate chain of events that changed my life." She says "when I went blind," rather than "when I got shot."
In the decade since, she has settled into what passes for normalcy in the life of a blind woman who wears a black mask. She learned Braille. She worked briefly in a legal office, answering phones, but mostly as a daytime caregiver for her younger sister, Shyanne. She lives in a two-bedroom apartment in Milwaukie with her partner of seven years, Geoffrey Dilger, who also is blind, and their 2-month-old son, Geoffrey Jr.
Aside from her traumatic injury, Steltz is healthy. The only prescription drug she takes is for headaches. Her short-term memory occasionally plays tricks on her. Her jaws don't open fully, so she can't eat a sandwich without squishing it first. She has no sense of smell. Her voice, paradoxically, will sound less nasal once she has a nose to breathe through.
The only time she can see, Steltz says, is when she dreams.
What she misses most about having sight is the independence and spontaneity. "You can't just randomly take a beach drive," she says. "Nothing is random.
"I had a driver's license for four months and 11 days, and I loved driving."
Steltz has never seen her 10-year-old sister, born four months after the shooting.
"I miss not being able to visually see my sister or my son or my significant other," she says.
Having an infant son provides an extra incentive to get her face rebuilt. She wants little Geoff to know Mom with something besides a deformed face.
"I look at him like I would if he could see my eyes," Steltz says. But instead of eye contact, he gets what she calls "sleep-shade contact." Even if it's a year before she starts wearing her new face, "he'll grow up knowing me that way."
For a patient such as Steltz, the line between cosmetic and functional need blurs.
Steltz is on the Oregon Health Plan, the state's Medicaid program for disabled, blind and low-income residents. That plan probably won't cover most of the cost of her facial reconstruction, including the prosthesis, because it is considered cosmetic.
Surgeon Dierks and prosthodontist Over agreed to absorb the uncovered costs. Zimmer Dental Inc. will donate the implants, which run about $2,100 apiece.
Breathing through her nose as well as her mouth, Dierks says, will help improve Steltz's sleep, keep her sinuses from drying out and prevent sleep apnea -- interruptions of breathing -- as she ages.
"It's not like I hit an age where, say, I got wrinkles and want to go have some laser surgery done," she says. "This is something that just needs to be done so I can walk around and actually feel comfortable with everybody else in public.
"I would like to look like what I used to look like." The last time she saw herself in a mirror, she was 16. View full sizeRandy L. Rasmussen/The OregonianChrissy Steltz, who will undergo the first of three surgeries today to repair her face, does the dishes in her apartment with some help from Rebecca Derscheid, her brother's girlfriend.Steltz's face will be rebuilt in three phases.
Today, Dierks will make an N-shaped incision in the middle of her face, creating two flaps of skin. One will fold in to form the "roof" and the other the "floor" of her new nasal passageway. The opening must be larger than normal, because scar tissue will shrink it over time.
Dierks also will straighten and trim the piece of leg bone that bridges her face from cheekbone to cheekbone and cut away other scar tissue.
In about three months, after that surgery heals, he will set eight dental implants into Steltz's face -- to secure the prosthesis that Over will assemble. It takes at least four months for the implants to fuse with the bone.
Then they'll fit the prosthesis to her face.
"We want to make it comfortable and durable enough so she can put on what is basically, for us, a Halloween mask, and wear that all day long," Dierks says.
The team of surgeons and nurses in the operating room at Emanuel today "will probably not see a case quite like this again," Dierks says. In his 25-year surgical career, he has performed hundreds of facial reconstructions but "nothing this big."
Still, it's not a face transplant. When doctors at the Cleveland Clinic performed the first face transplant in the United States last December, they removed a face and its blood supply from a brain-dead donor and grafted it onto a 46-year-old woman. Like Steltz, the woman had been horribly disfigured by a shotgun blast, but the injury also left her in severe pain and unable to speak clearly or swallow easily.
Steltz's injury is not life-threatening. A face transplant would entail much higher risk -- and expense -- than her prosthesis. It would require her to take anti-rejection drugs for the rest of her life, at a cost of more than $1,000 a month. Suppressing her immunity would expose her to further risk of infection and disease.
"A face transplant would still not give her seeing eyes, nor would it give her mobile eyelids and lashes," Dierks says. "There's no way we can return that to her." The prosthesis will look "as good, and debatably better, than a face transplant," he says, even though it won't move.
The best possible outcome after the elaborate handiwork on her face would be for no one except Steltz to notice.
"Hopefully," Dierks says, "a year from now, Chrissy will be able to go to Kmart or Fred Meyer and not have people crane their necks -- (and think) 'What happened to you, lady?'
"I don't think she'll get those stares and comments."
Three Labrador retrievers - chocolate, yellow, and black are sitting in the waiting room at the vet's office when they strike up a conversation. The black lab turns to the chocolate and says, "So why are you here?" The chocolate lab replies, "I'm a pisser. I piss on everything - the sofa,the drapes, the cat, the kids. But the final straw was last night, when I pissed in the middle of my owner's bed." The black lab says, "So what is the vet going to do?" "Gonna give me Prozac," came the reply from the chocolate lab. "All the vets are prescribing it. It works for everything." The black lab then turns to the yellow lab and asks, "Why are you here?" The yellow lab says, "I'm a digger. I dig under fences, dig up flowers and trees, I dig just for the hell of it. When I'm inside, I dig up the carpets.But I went over the line last night when I dug a great big hole in my owner's couch." "So what are they going to do to you?" the black lab inquired. "Looks like Prozac for me too," the dejected yellow lab said. Then the yellow lab turns to the black lab and asks what he's at the vet's office for. I'm a humper," the black lab says. "I'll hump anything. I'll hump the cat, a pillow, the table, fire hydrants, whatever. I want to hump everything I see. Yesterday, my owner had just got out of the shower and was bending down to dry her toes, and I just couldn't help myself I hopped on her back and started humping away." The yellow and chocolate labs exchange a sad glance and say, "So, Prozac for you too, huh?" The black lab says, "No, I'm here to get my nails clipped."
One Sunday morning, the pastor noticed little Michael standing in the foyer of the church staring up at a large plaque. It was covered with names and small American flags mounted on either side of it.
The six-year old had been staring at the plaque for some time, so the pastor walked up, stood beside the little boy..
And said quietly, 'Good morning Michael. Good morning Pastor, he replied, still focused on the plaque. Pastor, what is this?
The pastor said, 'Well son, it's a memorial to all the young men and women who died in the service.
Soberly, they just stood together, staring at the large plaque. Finally, little Michael's voice barely audible and trembling with fear asked
There was a midget down in Texas who complained to his buddy that his testicles ached almost all the time. As he was always complaining about his problem, so his friend finally suggested that he go to the doctor to see what could be done to relieve the problem.
The midget took his advice and went to the doctor and told him what the problem was. The doctor told him to drop his pants and he would have a look. The midget dropped his pants.. The doctor put him up onto the examining table and started to examine him. The doc put one finger under his left testicle and told the midget to turn his head and cough, the usual method to check for hernia.
Aha!" mumbled the doc and putting his finger under the right testicle, he asked the midget to cough again. "Ahhha!" said the doctor and reached for his surgical scissors. Snip, snip, snip, snip, snip, snip on the right side then snip, snip, snip, snip, snip,snip, snip on the left side.
The midget was so scared he was afraid to look, but noted with amazement that the snipping did not hurt. The Doctor then told the midget to pull up his pants to see if they still ached. The midget was absolutely delighted as he walked around the doc's office and discovered his testicles were no longer aching. "Gee, Doc, what did you do?" he asked.
The doc replied, "I cut two inches off the tops of your cowboy boots."
