21st November - 2 weeks today since my face was surgically rearranged

Recovery is still going very well but the intended weight loss is definitely eluding me! With the weather as cold as it is outside, my face aches when I go out, so I'm at home cooking.... Cyril is being treated to two home-cooked meals a day and is starting to wonder whether having me at home permanently might not be such a bad idea! Here's a photo of me creating yesterday's dinner time dessert: Poires Herisson (pear hedgehogs - made with baked pears, roasted flaked almonds and a hot chocolate sauce). You can see that the swelling in my face has come down considerably in the ten days since I last posted a picture. But the main reason I'm including this one is for John Hickey, who phoned as I was busy with culinary fine art. John, if you're reading, since making edible hedgehogs is the only current vent for my energy, I reckon you'll be seeing me back at work before too long!



I have check-ups with both my orthodontist, Mr David Young, and my surgeon, Mr Ken Sneddon, today. I see David Young first and he enthusiastically imprisons my teeth in a series of rubber bands. This is the last stage of the treatment and designed to move the teeth post surgery to their most optimised position before the retainers are created. The top teeth are now in their perfect position, but the bottom ones have some way to go, and it may be the end of March 2008 before I am officially de-braced..... Still, I have come this far now and those extra few months should just fly past.

The meeting with Mr Sneddon was a short one. He's very pleased with recovery and doesn't need to see me for another three weeks. He's also given me the green light to start exercising again (as long as I steer clear of boxing...). He's pleased to hear that I've started to get some tingling and throbbing in that dangerous lower lip. It's a really good sign and suggests that I may not be one of the very unfortunate 3% who lose sensation permanently in that region. However, he does say that the swelling won't go down fully (and therefore I won't be able to see the final results) for three months. Even though my voice will sound normal well before then, visible progress from here on in is likely to be fairly slow. I digest this information further this evening. Two weeks on and I'm bored and a little frustrated by the numbness, particularly in the chin. I'm hoping that it's something you learn to live with.

My x-rays arrive by email. I should definitely make an interesting skeleton now; look at all that metal inside my face! There are three pins on each side of the lower jaw, and quite a bit of fancy joinery going on either side of my nose. No wonder it all smarts a bit:

One week on...

I go back to the hospital for my first post-operative appointment today. The surgeon describes my recovery as "very good; remarkable in fact" which pleases me greatly...It's his opportunity to check that I'm on track, and my opportunity to ask questions. But as everything is coming along so well, the session is not a long one. I do, however, get a chance to ask about the changes in position of the jaws made during the operation. Here's what I'm told:

Maxilla (Top Jaw)
- Back of mouth: rightside up 6mm; leftside up 4mm (this corrects the "cant", also known as "wonkiness" ;-), in my bite)
- Front of mouth: both sides up 2mm
- All: forward 3mm and 1.5mm round to the right (to put the centre line between my front teeth in the right place)

Mandible (Bottom Jaw) N.B. this is a conservative estimate as the jaw was moved to fit snugly behind the top jaw
All: rightside forward 8mm; leftside forward by 5mm (the difference in measurements is to correct the "condylar hyperplasia" (one side of the jaw was shorter than the other)

The strange popping noise I'm occasionally experiencing in my ears, as you would a change in pressure on a plane, is due, apparently, to the eustachian tube not functioning 100% yet. The bleeding from the nose is due to the fact that they've sawn through my sinus and understandably it doesn't like this very much. And the slight jabbing pain I'm getting in my left lower jaw goes undiagnosed for now (I'm hoping this is not why I am sent off for an X-ray at the end of the session).

The radiologist is also extremely surprised at how good I'm looking after a week. All this incredulity lifts my spirits. It makes me think that the path to recovery really could be much shorter than I have been expecting.

I am promised emailed copies of my x-rays. I'll post these up here when I have them.

Sunday 11th November - Recovery Day 4

Here are some photos that were taken this morning. As you can see, the swelling is not too bad and I don't seem to have any bruising yet. The small pieces of tape on either cheek are from where very small incisions were made to put the pins in for the lower plates. I'm told that there should be no scar from these when the tape finally comes off.









My mood is very upbeat today. I'm up, dressed and enjoying spending a fairly normal Sunday at home. I'm even beginning to master the drooling ;-)

Saturday 10th November

I speak with my parents first thing. They sound very happy to hear from me and relieved that everything has gone so well. Later I receive a bunch of flowers from them....very nice!

I have a bit of a lull in spirits later in the day and poor Cyril takes the brunt of it. I feel like my face is enormous (potato head is how I describe myself) and I'm finding it difficult to control my saliva when I'm upright - sorry readers, but the long and short of it is that I now drool! This is a pretty unpleasant side-effect that I hadn't really anticipated, and I'm hoping that it won't last too long. Cyril is great and reassures me that the problem is all in my head. I just need to keep thinking positively and I'll be fine. He's so right. I feel like I am making great progress and healing faster than I expected to.

I spend most of the day reading, but also start to eat some proper foods (up to now I have been on clear soups and sorbets). I can't chew anything for the next four weeks, so we have to get creative with menus. Tonight I have minced up Bratwurst with steamed couscous. It makes me feel a bit more human.....I've already lost 2 kilos (about 5 lbs) since Wednesday. Whilst the weightloss is welcome, I need to ensure that I am getting the right levels of nutrients to heal and also to stay sane!

I have another good night's sleep - 7 hours - I'm obviously getting used to sleeping in the propped up position!

Friday 9th November

I am much more with it today and only spend most of the morning sleeping! By the afternoon, I notice a bit of a sea-change. I feel much better and more lively. I suspect that the anaesthetic has worked it's way out of my system.

I chat with Eva, one of the nurses, who watched my operation. She hadn't seen an osteotomy before, and I am pleased that she is happy to share details with me about what she saw. She's amazed by the op and describes it as watching someone doing DIY - filing things down and then making sure the plates are the right size to fit.

I am still experiencing nausea, though it isn't making me actually sick. The ward doctor realises that I am reacting adversely to Codeine, the painkiller I am on, and switches my prescription to Paracetamol. It works.

Cyril arrives to pick me up around 5.30pm and I am delighted to be going home. It feels like I have jumped a huge hurdle and the rest of the work on my mouth will be straightforward orthodontics.

Thursday 8th November

I get a phone call from Cyril first thing. He sounds very relieved to hear that I am OK and that I can actually speak - we had equipped ourselves with a whiteboard in case I couldn't! However, seconds after I start speaking to him I experience my last and worst bout of nausea. Unfortunately the nurse and I were unprepared for it and a change of bedding and gown follows!

I spend almost the entire day sleeping but in the waking periods I get a number of visitors:

- Mr Sneddon, my fantastic surgeon, comes to see me first thing...says how well the op went and is very pleased with how little swelling and bruising there appears to be. The op had only taken two hours - I was told to expect 4!! Given that my temperature is high, he decides to err on the side of caution and prescribes anti-biotics to ensure I don't get an infection in the wounds. I'm glad that he's cautious - I don't want to have to repeat the surgery to remove the plates that are now holding parts of my jaw together!

- Charlotte, my colleague and friend comes around 1.30pm, laden with wonderful light-weight reading material. It's lovely to see her and hear a bit of the gossip from work and her life, but I can only stay awake for a portion of her visit. She witnesses the adminstration of my drugs - anti-emetics, anti-inflammatories, pain-relievers and anti-biotics, quite a cocktail. She goes off to get herself a cup of tea and I drift off to sleep. I awake to find her gone and a note left to say goodbye

- Cyril, my partner, comes to see me in the evening. It is so lovely to see him, but I can barely keep my eyes open. Poor love, he's battled through the traffic for best part of two hours and then has about 20 mins with me. He's really pleased with how I look. I obviously set his expectations pretty low...but I figure it's always better that way.

I get a number of lovely texts from people who have been contacted by Cyril. Thanks to everyone for your good wishes and thoughts!

Surgery Day - Wednesday 7th November

My bags are packed and I am experiencing a rush of adrenalin as I wake at about 5am. Cyril is taking me to the hospital at 6.30am for an 8am admission and a 10am appointment at the operating theatre. I don't feel too nervous, just keen to get this hurdle behind me after all the waiting (initial diagnosis of the problem had been in May 2006, so 19 months of anticipation!).

Everything goes smoothly until, undressed and gown on, I learn that there is a staff shortage and one of the theatres is not going to be working today. There is talk of postponing my op :-( until the following week, but then I am told that I can have surgery today but that it won't be until 6.30pm.....I kill time with reading and walking in the local park. As the hours slip away, any sense of nervousness disappears and by the time I finally go in for my op at 8pm, I am just relieved to be getting on with it.

I awake in the recovery room and am told that the op has gone like clockwork. I check to see if I have any sensation in my lower lip (the biggest risk with the op is permanent loss of sensation in the lower lip) - I do - but am completely out of it for the next few hours. I awake feeling nauseus and my jaw is very stiff. For the next few hours it is as if I have flu. My temperature goes up, I get increasingly uncomfortable and then vomit. The nausea is due to the amount of blood that has found its way to my stomach. I get round-the-clock nursing for this first stage. Something that I am incredibly grateful for. It would have been quite frightening to face those few hours on my own. My nurse, Rekka, is incredibly kind, encouraging but firm. A bit like having your Mum around!

Before Photos

I thought it would be appropriate to post some photos of my jaws so that progress can be assessed. Unfortunately I don't have access to any official ones, but here are some home shots of me at various stages of treatment:

These were taken before my surgically assisted rapid palate expansion (SARPE) surgery in July 2006:





And here are a couple of me from 2007, poste SARPE and after my teeth have been moved with orthodontics for the correct position for surgery. You can see how my upper jaw is now much wider and the teeth more prominent. The orthodontist pushed the upper teeth outwards and pulled the lower teeth back to correct their positioning:

In this first one, I am the cute one on the right.



Talking and even closing my mouth properly has become much more difficult. However, I discovered that as long as I keep smiling it tends to hide a multitude of sins!



This one, though deeply unflattering (ugh!), shows the extent of my overbite!