Smiling Underneath

It has been a long time since I wrote a blog about anything of note… but as I find myself halfway through my battle with a very particular demon of mine, actually I could use the chance to talk to myself a little, just to ease the journey and to keep myself going to be perfectly honest.

The first point of note is that this journey really means a great deal to me. Enough for me to have now written two songs about my experiences with dentists and the utterly opposite encounters I have had with them. This was very much in an attempt to further my own mental health and strength, and writing these songs has helped me immensely as a form of therapy, to the point where I could not have continued my journey without them.

First I need to explain the back story, before I explain the meaning and specific references from the two songs… So here goes:

The start of the story goes back to 1981. I was 4 years old, running around the living room like an idiot and I tripped and fell in such a way that my face landed on the metal corner of the coffee table, which went straight through my lip. I still have the scars, but the hospital visit even at that age stayed in my memory forever. I received stitches in my lip with no anaesthetic. My mum played blue murder with the hospital, as my screams could be heard throughout the emergency department. I’ve struggled with trusting surgery ever since that first experience.

At the age of 8 I was to have eight teeth out. I was blessed with too many teeth as a child, and I went in like a lamb to the slaughter. I was completely unaware of the pain that awaited me. I was put under gas, and woke some time later, eight teeth had been successfully removed but the pain was more than I could cope with as I was not given any pain relief. I was inconsolable for 2 days and in absolute agony.

Then when I was 12 years old I needed more dental work on my molars. The dentist opposite Pontefract bus station was at least a place I could get to on my own on the way home from school, and I was to have a molar on the bottom left of my mouth removed. I went in alone. In hindsight this was a bloody stupid idea. The dentist was absolutely fucking sadistic. He was short with me, impatient and passively aggressive to me, a 12 year old boy on his own. He got on with it and paid no mind to my stress and anxiety and rushed ahead. He simply pushed down horrendously hard in my mouth and twisted and I felt every crack and splinter as the tooth shattered under the pressure he had over applied. He ignored my signals and noises to say STOP. Then he spent another 20 minutes fishing around to find the bits of root that had stayed behind. I was again utterly destroyed and when I got home a piece of me had changed forever. He destroyed any trust I had and therefore I decided to never go the dentist ever again.

23 years later in 2012 and unbeknownst to me I am about to have my journey with Crohn’s disease. My teeth were in a bad way and had been causing me serial instances of pain through abscesses and teeth cracking and breaking regularly. 23 years of not seeing a dentist and not looking after my teeth had really taken its toll. I simply had to go and find a dentist. My oath to myself was always going to have to be broken at some stage, but I was in a good place and needed to take control. I went to MCM dental services in Wakefield where I met an older male dentist. He seemed OK, nice even, but I was clearly under prepared for the visit and was there under duress more than choice, and so I had to go along with it. This was the wrong situation for me to take this demon on at this time.

I sat in the chair after a good 10 minutes of procrastinating. I sat bolt upright and couldn’t sit back. I wanted to trust this dentist so much! I just had to go for it and explain my situation because I would not let him near me until I knew he understood why I was in the mess I was in and what my anxiety’s were. I wear my heart on my sleeve, always have… but this person needed to understand where I was coming from and why I was so utterly terrified. I started at being 12 years old and covered that quickly, and then went on and explained about my dad.

My dad died from cancer of the colon, which spread to his liver and that is what ended his life. However, he also experienced a tragic death that came sooner than it might, thanks to malpractice of surgery. The short version being, that he needed a TPN line putting into his artery below his collar bone. He was 4 stone, 6 foot 1, and jaundiced and was terminal. Sadly the TPN line was not secured by the surgeon and in the night he moved and the end fell inside him. The surgeons went in again the following day to fish out the end but sadly they slipped and punctured my dad’s lung. He died a week later.

I explained all this to this new dentist who I was placing all my trust in to look after me, in a 20 minute burst of anxiety and tears which was essentially a plea. Please look after me. I need to trust you.

What happened instead was that he finally got me to sit back to have a look, and as the tears were still drying on my cheeks the dentist peered inside my mouth and said “Ryan, your mouth is a disaster area.”

I was at my utter lowest. I had just revealed my most intimate fears and he kicked me mentally with the worst sentence he could have ever said to me. I absolutely fucking hate that man for doing that. So much so that I refuse to even utter his name.

What he did do, was to have a poke around and said that what needed doing first was an operation to remove 4 molars at the hospital. Then with some audacity, he tried to suggest that he wanted to be the one to work on my teeth after that operation, but unsurprisingly I have never been back to see him, because he had no empathy or tact whatsoever.

The hospital papers came through and despite being absolutely fucking terrified I went through with the operation. I woke feeling euphoric, and utterly relieved that the cause of so much discomfort for years of my life were finally removed. I went home and drank lots and lots of luke-warm tea. The only drawback was I ached all over, like I had been moved around like a giant slab of meat. I felt like I had run a marathon without knowing about it. That sensation lasted over a week.

It was actually pretty soon after that operation that problems began elsewhere. I had Crohn’s disease but wasn’t aware of it at the time. I was about to have another operation, this time on my colon, and I was really scared of the procedures I was about to undergo. It is only relevant here because after that operation I spent the next 18 months taking steroids to mask my Crohn’s symptoms, but my teeth that remained were hit hard by the steroids. Steroids weaken bones and your teeth. They make them brittle and my teeth soon started to crumble. Suddenly I realised that years of smoking were being magnified over this time and as I continued to smoke, my teeth blackened and fell apart.

One thing that kept me going though was my song-writing. After my awful experience with the “disaster area” dentist, I was hit with Crohn’s in a really huge way so it took a while before I was able to start writing music again. As I recovered from the colon operation, the reality of what he had said rattled around my brain and I simply had to get it out. While I sat, unable to walk for 6 months, I wrote “Smiling Underneath” in the summer of 2012.

 

Smiling Underneath:

 

There’s something hidden up my sleeve,

I’m taking notes about the, way I’d rather be,

In perfect harmony, the roots don’t work out…

Biting my lip through gritted teeth,

Unstable dental health, disaster area,

It’s much more scary, when the words don’t come out…

 

All of a sudden see my soul descending,

Somehow it feels just like a stone is sinking me,

I’m punctuating through a life-long sentence,

Despite what you see,

I think I’m smiling underneath.

 

There must be something in the air,

I’m taking special care to, find the reasoning,

The rhyming treason is the truth won’t come out…

There’s only so much I can bear,

I’m breathing easier, it’s hard to swallow but,

It’s much more shallow, when my breath won’t breathe out…

 

All of a sudden see my soul descending,

Somehow it feels just like a stone is sinking me,

I’m punctuating through a life-long sentence,

Despite what you see,

I think I’m smiling underneath.

 

I really hope it goes well,

This is my version of hell,

I’m passing control to the ones who I distrust the most.

I guess it’s time to man up,

But I’m as scared as fuck,

I’m hoping to wake up on Sunday but smiling a beam.

I guess I’m smiling underneath…

 

Is there something I need to sign?

I’m taking all my time to, read the smaller type,

Extracting all the hype, the chair won’t go down.

There’s only so much I can do,

The rest is up to you, there’s just no doubting all the,

Screams and shouting will not stop this man now…

 

All of a sudden see my soul descending,

Somehow it feels just like a stone is sinking me,

I’m punctuating through a life-long sentence,

Despite what you see,

I think I’m smiling underneath.

 

Hold my head up high…

Hold my head up high…

Hold my head up high…

Hold my head up high…

 

This first song, “Smiling Underneath” was written from the negative perspective of the dental journey. It was written to help me cope with the psychology of what had happened and therefore it was quite a cheerful tune, designed to lift me up, despite the subject matter being about things that I was mortally terrified of. I needed the music side of it to make it all better. Now, when I listen to that song, it does make me feel better, because something catchy and hopeful came out of that horrible experience, as is the way with using music as a form of therapy. I simply had to write it. Maybe my explanation of what transpired has highlighted exactly why the lyrics say what they say and those who know me and who know the song, might smile to see the truth of the matter in retrospect. This song means a great deal to me because it gave me a way to not lose hope. It made me want to get my smile back. I wanted to prove the ‘disaster’ dentist fucker wrong.

I finished the song and even made a music video set in a hospital to reflect how utterly terrified I was. I chose to have my face in black and white, to mimic how you lose the colour from your face when you are about to go through something traumatic but kept the background in colour. The people in the background are walking backwards and I am walking forwards, again another reference to being scared as your legs feel heavy as they take you closer to something you do not want to walk towards. The relief comes in the form of Seb and Reg, two sock puppets I made especially for the video, with perfect grinning teeth who are excellent backing singers. That whole experience of making the video to that song all helped to maximise the therapy from it. I needed to do it to move on from the hurt that the disaster dentist had caused me. That is how deep his comments had gone. I was finally in a position to start thinking about seeing someone to see what other options were available to me and my teeth.

Just then though in 2015 and again in 2016 my left lung collapsed in my sleep. It is called a spontaneous pneumothorax and I was diagnosed with active lung disease in both lungs. After an aspiration in 2015 that released 1.8litres of air out of my shoulder, the following year when it happened again it was necessary to go for an emergency operation. After a CT scan it was revealed to me that at 38 years old my lungs were what the main lung surgeon would have expected to see of a 60 year old man. This was a big deal. I had to wait for 6 weeks with a collapsed left lung until finally on 10th August 2016 I had a VATS bullectomy and TALC pluerodesis to glue my left lung to my chest cavity. My right lung actually has worse disease than the left and should have been the one to collapse… and the right one still might collapse at any time.

As my left lung had collapsed in my sleep when it was completely inert, it made sense that doing something as traumatic as an operation on my teeth would be too much for my diseased lungs to cope with. Even so much as a sneeze could make it collapse and that will always be the case as the lung disease will never heal. I was left simply feeling grateful to be alive because sadly my lung operation failed on the first attempt as the left lung did not fuse and as such collapsed again. My body then went into shock and I nearly passed away. My sister and best friend raced to grab a surgeon, who acted quickly enough to re-inflate my lung and between them they saved my life. I have been dealing with the impact of that ever since and I owe them everything.

So after all that I resigned myself to a life of shit teeth. An operation on my teeth was a risk that was a step too far for me to be able to take. After I realised that, my self-esteem slowly packed its bags.

Life got interesting as I tried my best to avoid all illnesses and colds. My lung issues still control every single thing that I do and they always will, but the biggest thing that I needed to work on now was my mental health. The damage being so ill did to me was much, much bigger than I ever realised. It is something that you can only truly understand if you have gone through it yourself. Going to sleep every night and not knowing whether you are going to wake up is a terrifying thing to comprehend and that changes you forever. I did not feel safe, and even now I live in a situation that is unsafe every single day. I simply had to find a way to exist with a much stronger outlook to cope with the risk that doing something stupid might make my right lung collapse. I had to get vigilant and also bring the anxiety down at the same time. I had to start prioritising my health and my mental health simultaneously.

I went into a sort of ‘healing mode’ and slowly started to get my guitar out now and again and began going for little walks. My friends and family were fantastic and are still very careful and tell me whenever they have a cold and I quite rightly avoid them if there is so much as a snivel. Sometimes I get sneeze attacks from unsettled dust which gives me one night of a nose like a tap and constant sneezes and it is absolutely terrifying. At the back of my mind was always this sense that I wanted to get back to a kind of zero point, like my own version of a base health for myself that despite my Crohn’s and my lung disease taken into account… How could I get to the best ‘I’ can be knowing, even if my best is still in minus numbers compared to others without these things holding them back? I decided I still needed to try and I am still trying every single day.

It is now 2018 and I had heard a rumour from the same best friend who had saved my life that she was enjoying going to St Michaels Dental Practise, ironically at the end of my street. I listened to her reports of how good they were there, but I stayed quiet for a long, long time. Then one day I just thought sod it, I deserve to get my smile back despite being absolutely terrified. I walked in and asked about how to register. That took some balls if I’m honest. I just did it. Scared to death, I took a leaflet and did exactly what they said, which was come back in May, which was 2 months away. I did go back, and again I had to wait longer, but eventually I got a preliminary appointment. That was a scary day, but I went in and that is the day I met Miss Connelly.

I sat in the chair with great trepidation, but Miss Connelly was all ears and seemed properly and genuinely interested in actually helping me properly. I began at the beginning and told her all of it. Everything that you have just read, and again I was in tears by the end. This time though, I added everything about the ‘disaster dentist’. She was absolutely horrified. When I got to the end I had to calm down and get my composure back. Miss Connelly smiled warmly and asked me to sit back to have a look, but she said that at any time if I needed her to stop that I should just say so. To this day she has never once ignored a request to stop. She took an x-ray and prodded my gums behind my teeth and said some dental jargon to her assistant and then sat me back up.

“Ryan, your mouth is not a disaster area at all.”

More tears.

“I honestly believe we can absolutely get you your smile back”

“Does that mean you are my dentist now?”

“Yes!”

I got up and gave her a huge hug.

She seemed totally fine with that (not that she had much choice to be honest!) and said that we would see each other in a couple of weeks to review the x-rays and talk about a plan of action. She also said that no treatment would happen in the next visit whatsoever, and that just getting used to sitting in the chair was fine for now. We would simply talk about how to proceed in a way that I was comfortable with, at my own speed.

A couple of visits later and we have decided that I need 8 teeth out. At the time, I agreed rather rashly that it would be an operation, in a hospital just in case any issues with the lung surfaced mid-procedure and for a while I was OK with that. I was wrong. As the operation approached, my lung developed another issue. Compressed alveoli. I felt as though I was drowning and was getting stressed super quickly and had no idea why. I went back to hospital and had a CT scan and correctly cancelled the operation until we could work out what was happening to my lung. We left it a bit until my lung got a little better and then I went back to see Miss Connelly.

 

“Miss Connelly?”

“Yes?”

“Is there any chance that you could be the one to take my teeth out? I think I might be too scared to go under general anaesthetic”.

“Of course!! Are you sure?”

“Yes. I trust you completely. I actually think if I am awake and can control my anxiety that we may get somewhere instead of risking it being asleep.”

“In that case let’s do that. We’ll make a treatment plan and see you in a week to discuss how we move forward.”

The simple fact was I now absolutely trusted this amazing lady. She has never ever hurt me once. We drew up a plan and got busy doing the fillings. Every filling was a few seconds of rumbling and then she would stop, ask if I was OK… remind me to breathe and only would continue if I said OK. She really is that caring and careful.

Now, I am 2 teeth out with 6 to go. I am not scared in the slightest. Actually the fillings were probably the worst bit, and they did not hurt. The only pain has been after the anaesthetic wears off after the teeth are taken out as you would expect, and even then strong painkillers hide that for a couple of days and then I am just careful to rinse with salt water and to eat soft food on the other side until things heal.

I now KNOW hand on heart, that I can get my smile back. It is a team effort, and every time I go in to see Miss Connelly we laugh and have a good gossip and I feel completely at ease because that trust is there. She has completely fixed my trust of dentists, with just a little dash of being brave at the right time from me. She is my absolute HERO. I also have to mention the amazing Georgie and Charlene who are two of the best dental assistants you could ever wish to have… who have also kept me laughing and helped me to get my confidence up enough to keep coming back to get my smile back.

I am so heavily invested in this emotionally and mentally that I simply had to write another song to finish the story which would turn out to be the sister-song to “Smiling Underneath”. I went for a walk a few weeks ago and the title appeared in my brain. “Laughing Out Loud.”

I asked Miss Connelly’s permission to include her in the song and she seemed absolutely delighted, although she has yet to hear it. I think I will show her it once the teeth are all out and we’re closer to the end of the process.

 

Laughing Out Loud:

 

Passing broken mirrors and trying not to flinch,

Scarred with bad decisions and yellow fingertips.

A blackened smile, used to haunt my self-esteem,

I spent a while, in a haze of smoky dreams…

Time to wake up,

Never or now…

 

Trusting hope can weather the reign of many storms,

Find the strength to gather momentum through the doors,

Beside myself, are the shadows of my past,

Decide to hell, with the glances that they cast,

Bite the bullet,

Line every cloud…

 

No it doesn’t hurt,

It could be much worse,

So I’m laughing out loud…

No I won’t look back,

Chose a different path,

And I’m laughing out Loud…

 

If Miss Connelly says it will be alright,

Then I know in the end it will be just fine,

So I open wide and I hold my breath,

And the light closes in and I’m scared to death,

 

But I’ll go through the motions, I won’t fall apart,

Cos I trust you with every inch of my heart,

So I close my eyes but I cannot believe,

It’s not nearly as bad as I thought it would be,

 

And I hope you see but I’m really not sure,

But well, thanks to you I’m not scared anymore,

I’m on the way home and I feel a bit proud,

Cos I’m smiling underneath and I’m… Laughing out loud.

 

No it doesn’t hurt,

It could be much worse,

So I’m laughing out loud…

No I won’t look back,

Chose a different path,

And I’m laughing out Loud…

 

Got my smile back,

I can’t thank you ever enough.

 

And there you have it. The full story behind why I had to use music as a therapy to get me through this battle against my demons. It has been a belter of a journey, with more lows than there should have been, but the good news is that I did not let the disaster dentist win. I will get my smile back. It is already much better than it used to be.

My appointment list was 18 appointments long and I am exactly halfway through so far. I finish in early September just a week or so before my 42nd birthday. I will be smiling my head off by then. I need 6 more teeth out and some dentures putting in here and there but once the decaying teeth are removed my health should really start to improve as the decay has been poisoning me for an awfully ling time now. My self-esteem is already on the way up and August 10th will be my 3 year anniversary as a non-smoker. I refuse to let that horrible disaster dentist spoil my journey, and I am very glad to say that thanks to Miss Connelly, Georgie and Charlene and a little self-belief and determination, that it is absolutely possible to get my smile back. As you can see, I cannot ever thank Miss Connelly enough for the outstanding work she has done and for how amazing she has been with me.

If you struggle with dentists too, and you are scared to move forward, feel free to get in touch with me. I will advise and help you as much as I can, if I can. It would be my pleasure and honour to help.

 

Believe me, if I can beat it, then you really can do it too.

 

Ryan Mitchell-Smith (Smiley Ryan)