Day 21 – Hitchin' A Ride

Three weeks since surgery!

I went to the pub today. My third such social event since surgery at which I have not imbibed an alcoholic beverage. There will be many more to come until I am back at full-fitness.

It was also time for me to take my stuff back to London. When I went up to the Midlands for surgery, I took a ridiculous amount of clothing. I wasn't expecting to be well enough to return to London so quickly, so I had packed pretty much all my worldly goods:

• CIMA textbooks, lecture notes, and revision cards.
• Many polos.
• Two WBA tops and two Hot Sweaty Beavers tops.
• Penguin onesie.
• Fleeces.
• Tracksuit bottoms.
• Tiger onesie.
• And more.

Of these, I wore very little¹.

So, my case was pretty full when I went to Walsall. The mother had also raided the local supermarkets and bought many bottles of isotonic drink, blackcurrant squash, Nurishments, and soup. It's hard to explain that shops also exist in London...

Today's menu:

Big breakfast for... breakfast.

Salmon sandwiches for tea.

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1. Regular readers will have noticed the great diversity of my outfits over the last three weeks.

Day 20 – Loose threads

The stitches are dissolving. According to the hospital, I should be brushing them away by now. But I don't like it when my gums bleed, so I'm ignoring that piece of advice. I had enough of experiencing blood coming out of my mouth in the first few days after surgery when I had to stand over the sink periodically to let the blood pour out.

Some of the stitches have dissolved at one end but not the other. When I wash my mouth, I can feel the loose threads flapping about against my gums, which is quite strange.

Today's menu:

Big breakfast of sausage, egg, toast, baked beans, mushrooms and hash browns.

Chicken dinner.

Day 19 – Easter Bunny

The swelling continues to decrease and the pins and needles have nearly gone.

As I have said before, I have very little enamel on my teeth. The front teeth have been heavily built-up as an interim measure before I can get them veneered at great cost.I first had this done 14 years ago and have had to have them redone several times as they are not meant to last very long. As the maxfax said last time, the extent to which they have been built-up doesn't quite suit my new bite. That is a polite way of saying that my top incisors are enormous. Like a rabbit.

The "upper-right-one" is particularly huge. The downside of being able to bite normally is that when I close my mouth, the the top-right front tooth is in heavy contact with my bottom teeth. This is quite annoying, but I have noticed it much more over the last two days. It's probably a good sign, as it means the elastics are doing their job to fine-tune the final positioning of my teeth. I imagine the problem "tooth" will chip relatively soon. Fingers crossed it holds for another couple months, by which time the braces will be off and I'll be able to have a permanent¹ solution.

The veneers will really be the final stage of the transformation (unless I get a nose job too²), so I am really looking forward to getting that started. I'll definitely need something done to all eight incisors and maybe the canines, so I will be a work-in progress for some time.

Today's menu:

Banana for breakfast.

Tomato soup for lunch.

Faggots and pays for tea. Faggots are a local Black Country delicacy, similar to haggis. Pays are what we call "peas". Bostin'.

Chocolate log and cream for dessert.

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1. I say "permanent". Veneers can last for 10 years, but they can't be replaced ad infinitum. Given my lack of enamel, I may only be able to have the veneers replaced once or twice. After that, the teeth will have to come out.

2. I used to get a lot of nosebleeds. When I first had my nose cauterise I was told that the cause was that my nose is crooked, and that if I ever had another nosebleed I'd be elligible for rhinoplasty on the NHS. Sure enough, when I bled again after five years, I was offered a nose job. Unfortunately, a different consultant disagreed that it would be beneficial.

Day 18 – Good Friday

Today was Good Friday, I've headed back to the mother's for Easter to see the family.

I said that yesterday I ate pizza properly for the first time. Whenever people used to express scepticism about my jaw problems, the easiest way to demonstrate my inability to bite was to attempt to bite paper.

I would not have been able to hold this train ticket between my teeth prior to surgery.

The eldest brother and niece were visiting the mother when I arrived. He was as amazed at my recovery as everyone else has been. But the hilarious thing was, he could not recognise me in a photo taken last month.

He has had two nose jobs, so is as expert in nostrils and bridges as I am in mandibles and maxillae.

He noticed some improvements to my nose. The surgeon had told me that there was a risk that my nostrils would widen as the upper jaw was reshaped. What has actually happened is that the tip of my nose is less bulbous than it was.

When my top jaw was shorter, the tip of the nose would have been pulled back slightly. Now imagine it being moved forward. That would cause the tip of the nose to point upwards. In a normal person, that would make it a bit snub. For someone with a bulbous nose, this slight difference is sufficient to balance things out.

Today's menu

Banana for breakfast.

Sausage sarnies for lunch, with jelly and cream dessert.

Cheese and potato pie with salmon and peas for tea.

Day 17 - Back to School

Another day in the office. When I tell people I have had a major 5-hour operation to break both my jaws, they can't believe it.

I am in a slight quandary. It is a nice quandary in which to find myself, but a quandary nonetheless.

For years, I have attempted to use my hairstyle to mitigate the visual impact of my jawline. When I was a teenager, I attempted to divert attention from my chin my having 6-inch-long spiky hair, dyed beetroot red.

Since I have grown up/matured/aged, I have opted for a more discreet approach. My bottom was used to stick out 6mm to my left. To compensate for this, I wore my fringe to my right. This gave the impression that my head was merely tilted, rather than shaped like a hockey stick or a banana.

Now, however, my bottom jaw is 1mm to the right. Not noticeable, but my fringe is still designed for the old face-shape. Here is my quandary. My fringe is not yet long enough to be moved to the other side. Unfortunately, my sideburns have reached the length at which they go curly, so I need a haircut. My initial plan was to let my hair grow until the swelling had completely subsided, then go to somewhere like T&G to get an expert opinion on a new hairstyle to suit my new face, giving them enough hair to work with. But I'm not sure for how long I can tolerate these sideburns.

Another slight dilemma I have regards shaving. You know when babies sometimes get a rash around their mouths from dribbling? Well, I have such a rash. I guess shaving may aggravate it. But my beard has now reached the length where the 25% of my genes which originate from Ireland begin to express themselves. Patches of ginger are appearing in my beard. Not a great look for most people. Orange and black facial decorations are definitely not good for a West Bromwich Albion fan.

We went to a bar after work. To mark the occasion, the boss' boss sent a photo from last month. It was of me, and I can't believe how profound the transformation is.

One of the most frustrating things about life pre-Jaw-Breaking was think crust pizza. I simply could not eat it like a normal human being. If I tried to put it in my mouth and bite, the pizza would simply emerge from my mouth intact when I pulled it away. Even worse, was thicker pizza. The toppings would be stripped off and the pizza would disintegrate into my lap. Not good. This was because the only biting surfaces that I had week at the very back of my mouth. The front teeth did not meet at all, so the only way I could eat a slice of pizza wad to roll it up and shove it to the back of my throat.

You can probably guess what's coming next... This evening, for the first time in my life, I ate pizza as if I was a normal person with a fully-functioning mouth.

After that, I went back to my old uni¹ to catch up with some mates. "You are recognisably you. But you look different. It's hard to say, but you just look better." was a common theme².

I realised another benefit of being on the wagon: It made keeping my New Year's Resolution never to go to return to Saucy³ a hell of a lot easier.

Yesterday I left my wallet at home when I went to work. Today I left my flat keys on my desk at work when I left for the pub. Yet another advantage of being on the wagon is that I was able to retrieve my keys and go home: It is instant dismissal to set foot in my workplace having consumed even a drop of alcohol.

Today's menu:

Whole, unchopped banana for breakfast. I trust you can imagine what one of those looks like.

"Authentic" beef madras for lunch, with an onion bhaji. Having recently had a madras in Chennai (colonial name: Madras), I can testify that it was indeed authentic.

A couple of slices of pizza for tea, followed by some tandoori chicken nugget things in Wetherspoon's.

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1. We refer to it as "School".

2. Apologies for the heinous grammar crime.

3. Saucy is the awful student night that I went  to far too many times when I was a student. And once since.

Day 16 - Hi Ho

Today I went back to work. Well, technically I went back to work on Day 10. But today I actually went into the office. Which is about 120 miles away from where I had been convalescencing.

The Tube

On the Tube, I couldn't help but stare at other blokes, checking out their side profiles. I've noticed since the op that my top lip is now slightly in front of my bottom lip. It looks strange on me as I am not used to it, but my visual survey of Londoners reassures me that I now have a top-quartile side profile.

Work was nice. My workmates were added to the list of people who were amazed at the speed of my recovery. I got some compliments about my new side profile, even from people who didn't know that that was the aesthetic improvement I was most looking forward to.

Despite the epic speed of my recovery, I have actually lost a bit of weight. The trousers that had been a bit tight post-Christmas and post-travel fit comfortably again.

The mother has recently moved house, so there are still some bags of unpacked stuff around the place. As I was packing to return to London, one such bag spilled open. Out spilled loads of packets of blue elastics from the last time I had to wear them. So I now have a packet of elastics in every place that I am likely to be and every jacket I am likely to wear over the next few weeks.

The only problem with going back to work today was having to think about what to take to work. When your commute involves moving the few yards from the bed to the desk, there's not much to think about. Stupidly, I left my wallet at home. Fortunately, I managed to wrangle an invite to a lunchtime meeting which included a buffet. More on that in the menu section.

We had a team night out today, venturing into the doughnut for a pub quiz. We were doing pretty well until the fountain of knowledge of 1980s pop culture and to leave... and there was then a stream of questions on 1980s pop culture.

I am on the wagon at the moment.

There are several reasons for this:

• I don't fancy getting drunk and falling over and smashing my face up.
• I haven't yet returned to the gym, so I want all the calories I consume to be productive calories that will aid my recovery. I don't want to be the first person in the history of double jaw surgery to actually put on weight.
• I have a tendency to smoke when I am drinking. Filling my mouth with carbon monoxide probably isn't the best idea when I still have stitches in my gums.

Anyway, going teetotal over Easter isn't something new. At uni, one of my golden rules was to not drink from the start of the Easter break until my last exam. So, from mid-March to mid-June.

The added bonus of a few dry months is that the first few nights out after I fall off the wagon tend to be cheap due to reduced alcohol tolerance. Cheers to that!

Menu for today:

Breakfast was an unchopped banana.

Lunch was a buffet. It included chicken salad, spring rolls, prawn dumplings, and watermelon. Unfortunately there is no photo: The meeting was with a team I haven't worked with before, so it may have  left a bad first impression if I'd have taken a photo of some lettuce.

Tea was by far the most adventurous meal post-surgey: burger and chips at the pub. I was going to play it safe and go for some mini sausages. I'm glad I didn't. 

Day 15 – All around me are familiar faces

Today was my second post-op visit to the orthodontist. As you will be aware, she is quite risk-averse and doesn't think I should even be doing the light, virtual working I have been doing since Day 10. At the last appointment, the mother took the side of the orthodontist – just as you would expect a mother to do. This time would be different, though. I told her she could come into the clinic with me on the condition that she sat in silence. Gagged.

We got to the hospital a bit early, and we saw the orthodontist walk past in the waiting room. She said hi and apologised profusely for the delay – apparently the maxfax was coming to the appointment too and he was held up in surgery.

I said in the Day 10 post that after the eight years which I have been regularly attending clinic, the orthodontic team feel a bit like family. Here's why:

• The orthodontic nurse I've known the longest walked past, asked me how I was and apologised profusely for the delay. The maxfax was still in surgery
• The orthodontic nurse who always expresses amazement at my travels with work¹ walked past, asked me how I was and apologised for the delay. The maxfax was still in surgery. I guessed he may have been called into an emergency for a car crash or something as maxfax surgery happens in Wolverhampton, not Walsall. Fortunately not – he pulls teeth out on Tuesdays in Walsall. 
• The orthodontic nurse whose son has recently started at university, studying economics, walked past, asked me how I was and apologised profusely for the delay. She'd just been in surgery with the maxfax and he would be here soon.
• The newest orthodontic nurse walked past, asked me how I was and apologised profusely for the delay. The maxfax had to quickly see someone on the ward.
• A nurse I've only seen around a couple of times walked past, asked me how I was and apologised profusely for the delay, and said the maxfax would be here soon.
• The last two nurses headed out for home, joking that they weren't abandoning me, and that the maxfax was on his way.

It's quite fitting that due to the most awful advert on Earth – the Lloyds one with the instrumental from Gary Jules' horrendous cover of Mad World – I've had an annoying earworm for the last few days. Fortunately, since Deutschland 83, I've fallen in love with 80s music. The Tears For Fears original works well to rid me of the awful sound. ♫All around me are familiar faces...♫ Pretty fitting.

Anyway, I digress...

Maxfax arrived.  The total delay was about half an hour, which wasn't bad considering he'd just come out of surgery. It definitely wasn't worthy of all the profuse apologies.

The gagged mother joined me in the clinic. Maxfax and ortho were both very happy with progress and amazed that I am fit and well. Apparently, recovery is not meant to be this fast. But it is.

Maxfax offered me another doctor's note. I declined. Ortho shot me a look that could kill and turned to the mother for back-up. The mother abided by the gagging order. Maxfax laughed and said it makes his life easier if he doesn't need to write.

I explained that I feel completely fine, apart from slight pins and needles on my chin. If I were to take time off sick for this, it would follow that I should take a week off every time I get so much of a hint of a runny nose. Ortho accepted that.

So, the outcome of the appointment was that the slight misalignment post-surgery will be partially corrected by the remaining orthodontics. Also, it is exaggerated by the fact that my front teeth have been built up² and one is slightly bigger than the other.

I found out why Days 2 and 3 were so horrendous. Apparently maxfax injects a drug that causes the swelling to be delayed. It gets us out of hospital faster, but it's a shock when the whole head inflates, with the bruising gradually working it's way down to the neck like a goitre. Thankfully that stage didn't last too long for me.

I've got to go back to ortho on the 31st. If the teeth and jaws have mooved as hoped, I may move onto a different configuration of elastics. Maxfax cancelled the appointment I have in Wolverhampton with his clinic in April, which is a bonus.

I'm typing this post from the train.

I'm on my way back to London for a couple of days. The adverts were too much to take.

The mother tried to send me back with a cupboard full of soup, and enough drinks to survive a trek across the Sahara. I'm coming back in two days...

After the formatting debacle with yesterday's food photos, I'm going back to basics:

Today's menu was chopped pear for breakfast, sausage sandwich for lunch, and burger and mash for tea. For supper, I had a banana on the train. Which I managed to eat without chopping. And I kept the elastics in. Impressive.

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1. I have no idea how this cover got to Christmas Number 1.

2. I have not been blessed on the mouth front. As well as the deformed jaws, my teeth are also deformed with enamel hypoplasia. This means that there is very little enamel on my teeth, causing them to have a mottled appearance, need to be filled frequently, and break a lot. The front teeth are almost entirely filling. The next big project will be veneers.

Day 14 – Ca Plane Pour Moi

Again, nothing much to report.

Compared to all the other blogs that there are about bimaxillary osteotomies, this blog is pretty boring. I've been reading these blogs for a long time to prepare me for the surgery. Two weeks in, most authors are still in considerable distress with exhaustion, poor range of motion, swelling, numbness, inability to eat solids, and struggling with horrendous elastics.

Let's go through each of these:

Exhaustion

Put simply, there is none. Granted, I haven't done much in the way of physical exertion, but I am back working full-time (albeit from the mother's place), and studying. I'm seeing the orthodontist again tomorrow. No doubt she will be horrified – I had a phonecall from her secretary to say that she has managed to wrangle another sick note for me. Her estimate for how long I'd need off sick was three months. The surgeon said 4-6 weeks. The doctor at work said I could come back whenever I was felt I was ready with appropriate adjustments, but was sceptical that I would be able to talk or be free from agony within the two-week optimistic target I'd set myself.

Looks like they were wrong.

Range of motion

It's not fully there yet, but the width I am able to open my mouth is growing exponentially by the day¹. I can yawn and brush my teeth reasonably well. I can't yet see my tongue when I stick it out – this will probably be the next big milestone.

Swelling

There's still a bit of puffiness around my cheekbones and my top lip is a bit fat. But I'm not a hamster.

Numbness

The vast majority of sensation has fully returned. I've got slight pins and needles in my chin and the corners of my mouth tingle a bit. There are two tiny patches of total numbness somewhere in the corners of my mouth, but these are shrinking (hopefully not exponentially)². They are so small that I struggle to find them. My method of testing sensation is to rub a pen lid around my face. When I find the areas of total numbness, I can feel the lid on the skin just next to the patches.

That's how small they are.

Diet

Sadly, I am not yet eating steak. But for all intents and purposes, I am on a solid diet.

Elastics 

I have mastered the parallelogram. Compared to some of the patterns I've seen, mine is pretty easy. And I can even fit the elastics without looking. It no longer takes me half an hour to put them on, so that means I have time for a non-liquid lunch.

So it's going pretty well for me.

As if this song is nearly 40 years old.

It's going so well, I'm going back to London tomorrow. Just don't tell the orthodontist...

Today's menu

Breakfast

Chopped pear and banana.

Dinner

Salmon sandwiches! I've been craving these.

Tea

Penne and potato bolognese.

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1. It's an overused word, but the rate of improvement is actually exponential to a first approximation. Trust me, I'm a mathematician.

2. If the numb patches were shrinking exponentially, they would never disappear completely. So I'll settle for linear decay for these. Or straight-line rather than declining balance depreciation. Can you tell I'm a trainee accountant?

Day 13 – White Powder

Again, not much to report today.

Here is a picture of my face:

It's two weeks now since I had my last supper before surgery. I can't believe how quickly I've been able to get onto a relatively normal diet.

Here is my breakfast: Full English.

Now the Six Nations is over, I managed to do some CIMA. This week's topics were about Marketing and the Consolidated Statement of Financial Position. I work in Marketing Finance. Shamefully, I've done a lot better this week at the Marketing than the Finance.

James also studied for his CIMA.

I yawned today. Since the operation, I hadn't had the range of motion to yawn. It's weird though – I never felt the need to yawn while I was unable to do so. Must be the body's way of protecting itself.

Since the orchid was expelled, I haven't had to take any co-codamol before bed. Which is a good thing – I wouldn't want to get addicted to opiates. You may be aware that codeine is a mere methyl group away from another drug available OTC, so it has much the same effects. Time to go back on the the white powder¹.

The mother surprised herself with the menu for tea and served a chicken chasseur. 

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1. No, nothing too exciting. Just cholestyramine, my IBS medication.

Day 12 – Grand Slam

Not much to report today. England beat France in the rugby, giving us our first Six Nations Grand Slam since 2003. Which is nice. Even better news is that I can now do other things at weekends than watch the rugby. Six Nations tournaments always have a habit of decimating my attempts at studying. Zero CIMA was done today. Tomorrow will be busy.

I'm getting better with the elastics. When I had to wear them years ago, the orthodontic team were impressed at how easy it was for me to put them on and take them off without using a mirror. "Mark Malik has great manual dexterity" said no one else ever.

The swelling continues to recede. I'm well-chuffed with the new jawline that is being revealed. I can still see ever-so-slightly the 2mm of misalignment between my top and bottom jaws. The bottom jaw has been moved a little bit too far to the right. But before surgery, it was 6mm over to the left and was glaringly obvious. So it's a huge improvement.

  

Natural

Going out of my way to put the jaws in line

God knows what is going on with my left eye. 

In other news, I found Basil. Unfortunately I am not in line for a £20k reward from the Flying Squad. But the fact that I have been able to smell basil is not due to new-found olfactory powers. I realised that we have a bar of soup that is meant to be peach-fragrance.

I smell basil. The mother is inclined to agree.

To celebrate the weekend, I partied hard for breakfast and had sliced banana and pear. Exciting.

Lunch was tomato soup. 

The mother cooked a beautiful cottage pie for tea

Days 10 and 11 – 007

Apologies. Day 10's post literally got lost in the aether. Here is Day 10 and 11 combined.

Day 10 kicked off with a family trip out with the mother and my aunt. I was seeing the orthodontist at 9am; they both had to go to the warfarin clinic. The mother came to my waiting room (007) after she'd finished spraying blood at the warfarin nurse.

All the orthodontic nurses and the orthodontist were amazed at my progress, I've known them for eight years now, so they are like family. They all came over to chat while I was waiting. Apparently it's pretty unusual to even be talking decently at this stage. And to have such little swelling.

I must be pretty good at healing.

When I had my fingers chopped up, I was told that I'd be left with two nailess, mangled fingers for life. But they look perfectly normal.

The orthodontist was very happy with how the operation went, which is good. She did have some very bad news for me however: Elastics.

These will strike fear into the heart of anyone who has ever had to use them. I've had a three-year break from them, so I'm a bit gutted that I'm having to go through the at least four-times-daily ritual of replacing them and taking them off to eat. What's more, instead of just simply hooking them onto my braces, I need to attempt to make a parallelogram on each side of my mouth. Or failing that, a trapezium will do.

There was a funny moment when the consultant asked if I was taking it easy. I said that I was going back to work (virtually) after the appointment. She wasn't happy. Contrary to what the junior MaxFax surgeon said on Wednesday, and what the Registrar said at my pre-op (laughed quite condescendingly when the mother asked how I will get a sick note for more than two weeks), the orthodontist said I need six weeks of bed-rest and daytime TV to recover. Lots of relaxation.

It's a fair point. I have had major surgery. But the main problem is that I am bipolar. I don't do relaxation. 

This is how I have been relaxing while I have been on the box:

• Writing this blog
• Watching the news
• iPlayering a documentary about Henry VII's rise to power and his reign
• Reading every news item on the internet
• Playing on Brilliant
• iPlayering Horizon documentaries
• Poking my nose into the latest LSE scandals
• Studying for CIMA
• Playing chess
• Watching cat videos
• Proving by induction the formulae for the sums of the first k natural numbers, their squares, and their cubes
• Proving de Moivre's formula
• Writing an algorithm in Java/pseudocode for how a line of platooned driverless lorries could slow down to allow cars to leave the motorway at an exit that is within an variable-speed limit section of motorway¹

I guessed going back to work virtually would probably be more relaxing than the above.

The orthodontist was also a bit concerned that if I went back to the office, I might trip and fall. I chuckled at this: My company takes safety VERY seriously. If your priority is to not trip and fall, I'd recommend that my office would be the best place for you to be. 

James is probably much more likely to cause me to fall.

Speaking of which, it was James' birthday. Well, it's the day we celebrate his birthday. 

This is the story of James:

James walked in the house on 31st July 2000. He was a stray. The lad over the road had seen him in the street and decided to call him James. We have no idea why. Then James moved in with us and refused to leave.

The name James suits him quite well actually. He is a tuxedo cat, and his tail is bent like the number seven. So he's a bit like James Bond.

The vet said in summer 2000 that he was "last Spring's litter". Which makes him 17.

Compare and contrast these photos James and I, separated by more than 15 years.

The mother has an orchid that she has been slowly killing. I have hayfever. I am not allowed to sneeze for another two to three weeks. I sneezed. The orchid had to go.

The menu for Day 9 was chopped banana for breakfast, and tomato soup for lunch. To celebrate St Patrick's day, we spag bol for tea, then jelly and ice cream. Our spaghetti bolognese recipe includes potatoes for some reason². 

Day 11 consisted of me going to work in the bedroom.

Breakfast was a sliced banana. I'm sure you don't need a photo of that.

I was planning on having chicken soup with bread for lunch, but then I realised I would need to removed the elastics. It's taking me about half an hour to make the parallelograms each time I put the elastics back in, so I settled for a Nurishment drink.

For tea, it was my signature student salmon dish.

There would normally be a heavy sprinkling of black pepper, but given the orchid incident I wouldn't want to risk my top jaw shooting off or my mouth and nasal sinuses merging into one single cavity.

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1. Those who know me IRL will know that I absolutely HATE algorithms in Java. I did this to win an argument with my brother about the feasibility of driverless vehicle technology.

2. Technically, it isn't "our" recipe. It was invented by a lady who goes by the name of Alice in Wonderland.