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December 2010 Issue

James Joseph Lail, pictured with his wife, Amanda, and their foster children (left to right), Marcos, Gabriel, Homero and Pablo
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UC Health Surgeons Reconstruct Jaw

By Amanda Harper
Published December 2010

In 2008, James Joseph (JJ) Lail took a leap of faith aimed at improving the lives of others. He left the security of his suburban teaching job in Loveland, Ohio, and moved with his wife, Amanda, and two young children to the city of Monterrey in northeastern Mexico


That life-changing moment instantly expanded his family from four to 12. Through the faith-based nonprofit organization Back 2 Back Ministries, the Lails became foster parents to eight orphaned teenage boys.


Their mission is to help orphaned and impoverished children overcome their life circumstances and break free from a cycle of poverty.


"Mandatory education is done after ninth grade in Mexico, so a lot of kids we were serving in the orphanages were leaving to go off on their own at 15 or 16, completely unprepared to take care of themselves as adults,” explains Lail. "Our foster home is one of six that were created to give these kids an opportunity to continue their education in a safe, supported environment while also growing spiritually and mentally to help heal from past experiences.”


Shortly after embracing this gratifying new life purpose, Lail began experiencing pain and swelling in his mouth. Routine tests with his dentist ruled out common problems like cavities and he was referred to a periodontist, where he had more testing that led to taking antibiotics to knock out any underlying infection.

"Unfortunately, it became clear after about 18 months of tests and treatment without relief that something else was going on, and I was referred to an oral surgeon for a biopsy,” recalls Lail.


That is when he experienced another life-changing moment: a stage-4 squamous cell carcinoma diagnosis. The cancer was so advanced it had invaded his right jaw and affected a portion of his face and inner lip.


"The next day I was on a plane back to Ohio to seek a second opinion and find an oncologist.”  Through  two friends of the family—an oral surgeon and an ENT doctor—  I was referred to Dr. Casper and Dr. Patil at UC. 


Yash Patil, MD, and Keith Casper, MD, are the only head and neck surgeons in the Greater Cincinnati area fellowship trained in microvascular reconstructive surgery.


Patil and Casper removed the cancerous tissue and bone, and then performed a microvascular free tissue transfer to reconstruct the portions of Lail’s face and jaw affected by the tumor. The technique involves using existing skin, tissue and bone from another part of the body—in Lail’s case, the lower leg—to build a new jaw and restore function.  


"This is very delicate surgery. It involves using a microscope to meticulously connect small blood vessels to give the tissue graft a blood supply that will allow it to survive.  We use a suture finer than a human hair,” explains Patil. "The procedure generally lasts six to eight hours.  By taking time to properly reconstruct our head and neck cancer patient, they have the best possible cosmetic result and function.”


Lail finished radiation therapy in late October and returned to Mexico in mid-November.


"I’m looking forward to celebrating my daughter’s seventh birthday, getting back to my family and putting cancer behind me,” he says with a smile.

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