Facing the future
Thousand Oaks couple try to restore normalcy after husband
battled two often fatal diseases
By Colleen Cason,
January 15, 2006
Kathy Cavanaugh examined her husband's new face.
It was the third one that Scott Cavanaugh has had in less than
three years of marriage.
had been the handsome, 23-year-old version that now exists
only in their wedding photographs. By their first
anniversary, that face was gone, replaced by a gaping wound
in the left side of his head.
And last summer, in a narrow, mirrored hallway of a Van Nuys
medical office, Scott stood before her wearing a synthetic
face with skin and nose sculpted from silicone and an eye
made of acrylic.
As Kathy waited for Scott's reaction, he placed a finger
on either side of her mouth and gently pushed her lips into
She gave him a peck on his mouth.
"It's nice to have a nose there when I kiss you," she
This face was another attempt by the Thousand Oaks couple
to restore normalcy to their lives after Scott battled two
often fatal diseases in 2003.
Already immune-compromised by chemotherapy for leukemia,
he contracted the fungus mucormycosis. It attacks the sinus
cavities and, if left untreated, will destroy the brain.
To save his life, surgeons removed his eye, eye socket, all
of his nose -- except his nostrils -- his sinuses, the roof
of his mouth and six teeth. His remaining eye lacks bone
support and slants at a 45-degree angle.
Nine surgeries later, Scott Cavanaugh remains severely disfigured.
For more than a year, he has worn a 4-by-4-inch white gauze
bandage over half his face. His appearance draws stares and
occasionally unwelcome comments when he goes out in public.
He has not been able to work as a software designer since
he was diagnosed with leukemia three months after his July
2002 marriage. Kathy supports them as a third-grade teacher
at Rio Rosales School in Oxnard.
It put their newlywed plans of children, homeownership and
further education on hold. They have accumulated at least
$50,000 in medical bills that their health insurance does
By all accounts -- and against all odds -- it strengthened
After two months of living with the prosthetic face, the
Cavanaughs say it is far from the perfect restoration that
they had hoped for.
But it is a beginning. For Scott, 2006 will bring more surgeries
and, before the year is out, Kathy will see at least one
Scott Cavanaugh was ready to face his battle with leukemia
within minutes of being diagnosed in October 2002.
On Kathy's 27th birthday, in the emergency room of Los
Robles Hospital & Medical Center, the doctor told
him that he had a blood cancer.
"Is it curable?" Scott asked.
When the doctor said it was, Scott replied: "All right,
Seven months into his chemotherapy, around Memorial Day
2003, he developed facial pain. An orange discharge seeped
from one tear duct -- both symptoms of mucormycosis.
Although this fungus is a particular danger to leukemia patients,
seven days passed before he was diagnosed, according to court
records filed in the Cavanaughs' suit against USC/Norris
Only surgery could save his life. The surgeon told Kathy
that they might have to take Scott's eye, but with plastic
surgery, he would regain his looks, she recalled.
Scott emerged from the operation with his head wrapped in
bandages; he could neither see nor talk.
On their first wedding anniversary, Kathy said, doctors told
her that Scott probably would die and she should prepare
She refused. Instead, she read Harry Potter books to him
by the hour. She slept in a bed in his room and gave him
a bell so he could summon her.
Eventually, he battled back. But at the same time, Scott's
mother, Irma, was hospitalized at City of Hope, recovering
from a bone-marrow transplant. She, too, had developed leukemia.
Scott wanted to delay telling her about his crisis until
she was stronger. So Scott's sister, Jenny Cavanaugh, and
Kathy became cheerful actresses, assuring Irma Cavanaugh
that all was well.
Finally Scott wrote his mom, telling her what had happened.
"Three paragraphs into it, I broke into tears," said
Irma Cavanaugh, who has survived the cancer and lives
Scott recovered enough to leave the hospital but plunged
into an abyss of depression.
"I felt like I was at the bottom of an empty
swimming pool with no ladder or stairs. Each time I tried
to climb out,
I slipped back to the bottom," he said.
He confided in his sister that Kathy would have been better
off had they not married.
Tapping a pool of strength
But there was a pool of strength in their marriage that he
had not fully tapped.
Jenny Cavanaugh shared with him the words that Kathy spoke
when she saw Scott's devastated face after the surgery.
"That's still my Scott," she had said.
In early 2004, the Cavanaugh consulted with William Clearihue,
a Los Angeles anaplastologist who creates artificial
facial features. With Scott's leukemia in remission,
that plastic surgery to restore his face finally could
Clearihue broke the devastating news to the couple. It came
down to the bone, he explained. Too much bone and cartilage,
especially around his eyes, were missing to make Scott a
candidate for reconstructive surgery or even an experimental
The best that could be done was a prosthesis.
It took days for that to sink in for the Cavanaughs. Finally,
Scott came to terms with it. "Life is not ideal. I get
what I get," he said.
But at that first meeting, Clearihue was more concerned about
Scott's remaining eye. It was red and dry because his eyelid
failed to close completely.
Scott underwent three more operations to stabilize his good
The land of almost
With the swelling down from the eye surgeries, the process
of creating Scott's prosthesis began last summer in a low-slung
building beneath a runway at Van Nuys Airport.
The office of American Medical Prosthetics & Orthotics
is the land of almost. Almost natural, almost normal.
Almost, but not quite, Clearihue admitted.
"They want to look the same as before," he said of the
legions of disfigured that he treats. "Reality is
it will never happen."
Scott's prosthesis is the second largest that Clearihue has
created in his 30 years in practice. Scott is only the fifth
mucormycosis patient Clearihue has seen in the past three
"No one used to survive it," he said.
A facial, as Clearihue calls it, takes high-tech materials,
old-world craftsmanship and a dash of artistry. Clearihue
is a medical MacGyver, using a creme brulee torch and precision
ophthalmology scissors -- whatever it takes to re-create
what disease and disaster destroyed.
As the final session began and the moment of truth neared,
Clearihue rested the silicone facial on the table beside
"It looks like a pastry," Scott quipped.
In the land of almost, a compromise had to be made. Scott's
remaining eye slants downward from the inside corner. When
Clearihue positioned the artificial eye in the prosthesis
at a normal angle, it looked awkward. Scott decided to split
the difference and skew the artificial eye at a slight angle.
This session, as the other five did, lasted several hours.
Restless, Scott played with a hand-held video game and made
He said he is grateful he lost only a nose and an eye. He
still has his hands. Since his illness, he has become an
"I can deal with what happened to me," he said. "But
if I had lost my hand, I don't know what I'd do."
As he spoke, a technician in the hall behind him carried
a prosthetic hand into an adjacent examining room for an
Meanwhile, Clearihue attached the prosthetic to Scott's face
and told him to look in the hall mirror.
"Beautiful," Scott mouthed, as he observed his face
with contours for the first time in two years.
But before the session ended, the elation had dimmed.
The skin tone is off. The color that had matched Scott's
coloring when Clearihue began painting now appeared too pink.
"Scott has that chameleon kind of skin," Clearihue said. "Some
day, I will make him one for when his skin is ruddy and
one for when it's pale."
Clearihue, who had invested 70 hours in the prosthesis, admitted
disappointment in its pigmentation.
In the weeks that followed, Scott, too, developed mixed emotions
about the prosthesis.
To wear it, he must first douse his face with rubbing alcohol.
He then applies Liquid Bandage and a strong adhesive. The
chemicals smell bad and sting. And despite these harsh measures,
the adhesive can weaken and the prosthesis can gap.
Nobody would mistake it for his real face, Scott pointed
Recently, he and Kathy attended a concert at a Ventura nightclub,
which has a rule against patrons wearing hats and sunglasses.
Scott uses shades and a cap to camouflage the margins of
When he removed them, the bouncer politely told him that
the rule did not apply to him.
But during a meal at a Newbury Park breakfast house, few
appeared to notice Scott's face.
Kathy encourages him by noting that the white gauze he once
wore attracted stares from a distance. People only notice
the prosthesis when they are very close to him.
Already hidden beneath the prosthesis is Scott's next step.
Almost a year ago, Dr. George Rudkin, a professor of plastic
and reconstructive surgery at UCLA, embedded five screws
in Scott's skull. Eventually, magnets will be attached that
will allow Scott to have a snap-on prosthesis.
With the magnets, Scott will no longer need noxious chemicals
to attach the face. The snap-on face also can be made thinner
and look more like skin, Clearihue predicted.
Later this month, Rudkin is scheduled to open Scott's face
to make sure that the screws have fused perfectly into his
skull and will stand up to the magnetic force.
For Kathy, the attraction she felt for Scott when she saw
him the first time is still there, she said.
"If Scott had died, we wouldn't have had this
time together and hopefully have children and continue
with our dreams.
is it? Mucormycosis is a fungal infection
of the sinuses, brain or lungs that occurs primarily
in people with
What causes it? A common fungi frequently found
in the soil and decaying vegetation. Most individuals
are exposed to
these fungi on a daily basis, but people with immune
disorders may be more susceptible to infection.
Symptoms: Acute sinusitis, fever, eye swelling
of eye orbit, dark nasal scabbing, redness of skin
overlying sinuses, coughing blood and shortness of
abdominal pain and vomiting blood (gastrointestinal),
flank pain and fever (renal).
Who is at risk? It should be suspected if
in individuals with diabetes or those with weakened
immune systems such as transplant recipients or leukemia
undergoing chemotherapy. Symptoms of rhinocerebral
mucormycosis are most likely to occur among people
with suppressed immune
How is it treated? Early surgical intervention
all dead and infected tissue, along with intravenous
antifungal therapy. Surgical removal of involved tissue
may be disfiguring
because it may involve removal of the palate, nasal
structures or eye structures.
Is it fatal? Mucormycosis has an extremely high
mortality rate even with aggressive surgical intervention.
rates range from 25 percent to 80 percent depending
on the site
involved as well as the underlying immune problems.
How can it be prevented?
Because the fungi that cause
it are widespread, the most appropriate preventive
are improved control of the underlying illnesses associated
Source: MedlinePlus http://www.nlm.nih.gov/medlineplus/
An account to cover some of Scott
Cavanaugh's medical bills has been opened at
Washington Mutual. Should
you wish to
contribute, send donations to the
c/o Washington Mutual,
148 W. Hillcrest
Karen Quincy Loberg / Star staff
Scott Cavanaugh, 26, of Thousand Oaks, is fitted with a prosthetic
face to cover the gaping hole left after the fungus mucormycosis
caused the loss of his eye, eye socket, nose, sinuses and part
of his mouth.
Karen Quincy Loberg / Star staff
William Clearihue an anaplastologist, uses earlier photos
of Scott Cavanaugh to help build the prosthetic face, sculpted
from silicone, for him. Clearihue attempted to perfectly
Cavanaugh's skin, but had trouble with the color.
AUDIO/SLIDESHOW: Life in transition