Did this work?

One thought has been nagging me since the first week: Am I sleeping better? I know that the answer is yes. So, the real question is, how much better am I sleeping? Is my apnea "cured"? Or, at least, better to the point where it's not really a problem? I wish I could answer those questions. I'm writing about it today because I feel that same, familiar apnea-driven malaise that plagued me for so many years. It's sort of a compulsion to head back to bed and lie down, the type of sleepiness that a 15-minute micro-nap will usually cure. I slept for about eight hours last night, though not straight through. I'm still waking up an average of two to three times a night, though not for very long. I also expected to have more vivid dreams and, though I've had a couple, most of them are still sort of indistinguishable from the faint, jerky, static-y ones I had been having before the surgery.

I've also noticed myself snoring, though not like I did before. The snoring I've noticed has seemed to be entirely on the exhale and entirely nasal. So, it might be connected, at least in part, to the congestion that remains from the surgery.

So, did the surgery work or not? I browsed some other blogs and boards to see what people's experiences have been. Some report better sleep within the first couple of weeks. Others take much longer. So, that's not much help. I know that my body is still recovering. And, I'm sure I'm not resting as well as I could be if my jaws weren't locked shut and I didn't have this splint in my mouth. I still haven't tried using ambien or any other sleep aid, so that's still a possibility. Tonight, I think I'll give melatonin a shot. I have some capsules that I can open and mix into water. It doesn't taste like anything, really, so I won't notice it.

The whole point of this was to unlatch the vampire that's been sucking away my energy for so long. I know that I've had some days where that seems to have happened. I have energy and ambition and I want to get things done. But, I've also had days like today where it's hard to tell whether I've had much impact at all. I guess I'll have to stay patient and wait to see what happens. After all, it'll only be three weeks this coming Tuesday. I know I'll be scheduled for another sleep study in the coming months. We'll see if, as Roger asked, I get to change my username from 57rdi to (that's a zero->) 0rdi.

The 'worries' post

This is an ongoing page of things that were both real and false concerns. I've tried to list the major ones here and I'll update them as things proceed. Keep in mind that not everyone goes through the exact same procedure or recovers in the same way. Even so, if you're facing an MMA or anything in the same vein, you might find some of this helpful.

Things I worried about that turned out to be nothing

It will hurt: Especially as the day got closer, I worried that I'd be in lots of pain for several days. I have a fairly high tolerance for pain, but I'm no fool. I avoid it whenever possible. Turns out, pain really wasn't an issue. I got a few twinges every once in a while during the first few days, but for the most part, I had almost none. Most people have described the sensation as more like a pressure, and that's probably the best way to put it. It's like parts of your lower face are in a tight mask. Frankly, I thought the issues from the pain medication (constipation, strange dreams, cloudy head) were worse than any discomfort it was meant to address. I was off the pain meds completely by day four. The most intense discomforts were at the hospital the day after the surgery, when they removed the tube that kept my stomach clear and the Foley catheter. I still shiver when I think about that last one.

I'll look different: I really wondered how much my looks would change. I was never leading-man material but I also didn't want my appearance to change to drastically. I don't think it did. Keep in mind that my jaws had a decent amount of movement: 1 cm for the lower jaw and 3 mm for the upper. Plus, I had a genioglossus advancement. Not the biggest movement in history, but still fairly large. Even so, the biggest difference is I have a chin, now. Other than that, I think I look almost the same. Secretly, of course, I was hoping they'd unwrap the bandages and I'd be looking back at a movie star. It will take a while for all the swelling to go down. Most of it had subsided by after day 10. Eventually, I'll post some before and after shots so you can compare for yourself.

Things I worried about that turned out to be something

I'll be numb: Yep, I'm numb all right. Although it has improved somewhat since the first day, there are some fairly large size patches that have no feeling. Most of it is on my left side. There's an arc that runs from below my eye near my nose around my cheek close to my lips and wraps around the whole front of my chin and lower lip. Most of the feeling has returned to my upper lip and the right side. I do get some sensations in the numb part, so I'm hoping I'll get that back.

It'll be hard to talk: This has been a bigger issue for me than for most others because the doctor locked down my jaws with heavy bands after the first week. He did this because I was (involuntarily) moving my lower jaw forward out of the splint and out of alignment. Oh, and not everyone has a splint, apparently. It's essentially like an athletic mouth guard. It stays in for six weeks. That also makes talking a chore. Even so, my experience has been that I'm understandable most of the time. It can get frustrating, though. It helps to use words that have as few syllables as possible.

It'll be hard to eat: Again, this has been tougher for the same reasons as talking has been. Although I was able to eat pureed foods toward the end of the first week, I've since been on an all liquid diet. So far (wrapping up week 3), I've lost about 10 pounds. But, I seem to have stabilized. See the food page for things I've done to try to keep my nutrition up to par.

It'll be hard to clean the teeth: This wasn't so much of a problem during the first week when I had light bands on. Now, it's really tough and getting the insides is impossible. So, I clean after every meal. At the very least, I swish with warm salt water and brush using my kiddie toothbrush and a little paste. About the end of the second week I started swishing about once a day with diluted mouthwash and toward the end of week 3 added the WaterPik on the lowest setting.

Things I didn't think about that turned out to be something

Shaving can be rough: Numbness (mainly) and swelling (less of an issue) both made shaving hard in some places. I didn't even try shaving until around day 4, so I was pretty scruffy. At first, I couldn't really do much to my upper lip, my chin or the patch below my lower lip. Since then, I've got more feeling in my upper lip and I've been able to chip away at the other two spots, even though they both remain pretty numb. I found that I had to rinse the razor more often than normal and keep it and my beard as wet as possible. I'm still a bit nubbly on the chin and have a small soul patch. It pays to be patient.

Keeping your nose clear is essential: Especially with my jaws locked down, clear sinuses are important. I started a routine that seems to work well and from which I've had no ill effects. <anti-lawyer emphasis>THIS IS NOT ADVICE. BE SURE TO ASK YOUR DOCTOR FIRST.</anti-lawyer emphasis> I make a solution of two parts lukewarm water and one part hydrogen peroxide. I dip cotton swabs into this and use those to gently clean out my nose. Yes, it's kind of gross, but it seems to work. I do that a couple of times a day and have had no problems. Of course, you've got nose spray, but you can only use for three days straight before you get that rebound effect, which is terrible. So, I've tried to be judicious with that. I use it only at night before I go to bed and try to have a day or two break between three-day stretches.

Drooling is not pretty: Holy molé. I never knew my salivary glands were capable of such sustained production of such large amounts of spit. The first week and half was the worst. I had to carry hand towels with me everywhere I went. It also didn't help that I sometimes didn't know I had a large string of it swinging from my chin. Luckily, Mary had no qualms about pointing it out. Now, I should point out that part of my problem stemmed from the fact that my jaws became improperly positioned around day 4 and were essentially stuck open. That contributed heavily to my inability to keep the saliva in my mouth. After my jaws were locked down, this pretty much vanished as an issue. I still produce a lot of spit, but it's mostly an issue at night when I'm lying in bed. I have to keep a towel on my pillow.

Things I didn't think about that turned out to be nothing

This category seemed to be needed to keep the thought process symmetrical. I guess I could list a whole boatload of things here, but, well, that would just waste your time. Oh, I guess it's too late for that. Sorry!

Two more weeks of lockdown

Well, it could be worse, I guess. ...

... I went to the doctor today expecting three options: removal of the heavy bands and jaw freedom (good), continuation of the heavy bands (not so good) or having to face another procedure to get plates installed (definitely not good). Things turned out not so good: I have to stay locked down for another two weeks.

When I got there, the doctor started removing some of the bands to see how things are going. The more bands he removed, the more my jaw started trying to move to where it wasn't supposed to be. The way he explained it, my jaw muscles have spent more than 40 years compensating for my recessed chin. Now that that's unnecessary, they're having a hard time relaxing. So, the plan is to keep them in the right position with the bands in the hope that they'll get the message. Stupid jaws.

Anyway, I did take the opportunity while unbanded to brush the insides of my teeth. As you might imagine, that's been pretty much impossible for about a week and will be at least until May 10, my next appointment. The doctor did say I could start using a WaterPik, which should help. I've been using some diluted mouthwash, too. Between all that, saltwater rinses and brushing the outside, I hope I can keep things in check for now.

So, I continue on the liquid diet. The good news is that my weight seems to have stabilized. The last time I was there, I weighed 155. Today, I was a half-pound over that. My ideal weight, though, is more like 165 or so.

I can't wait to start munching on stuff. The sound of a tortilla chip being eaten can bring tears to my eyes.

Visitors

I had a couple of visitors today. On the left is Veronica Gonzalez, one of my reporters. On the right is Bill McIlwain, a great newsman and a good friend.

They stopped by to drop off some food -- pudding and 15-bean soup (Bill said he counted them) -- and see if they could actually understand what I was saying. They seemed like they did. Or maybe they were just nodding politely. No, really, they could understand most of what I was mumbling.

I head to Chapel Hill again tomorrow to see if I get to ditch these heavy bands or if I'm going to stay locked down for a while ... or if I have to go in for another operation to get plates attached to my jaws to shore them up. Obviously, I'm hoping for Door Number 1.

The food tips post

Since I'm kind of in a holding pattern until my appointment tomorrow, I decided to start some tips pages to centralize some of the things I've learned that might help others going through this. This food page is one of a few that I'll start keeping and developing. I'll update these pages as I learn and adapt, so if you're interested, check back later. Other people also have created tips for food. Among those who've offered theirs are Annabelle and Mary (no, not that Mary. A different one).

In any case, this isn't everything I do, but these are probably the most important parts of my diet right now. I have lost weight, but I don't think I'm malnourished. I can't take credit for all of these ideas. Some, of course, came from Mary (yes, that Mary). I hope these help.

Essentials

A good blender: That old Waring that served you well through countless margarita parties during your college days is probably not going to work. Expect to spend at least $50 on a decent blender. I got mine on sale and it works great. Remember: You're going to be using this thing every day. You want it to work and you want it to work well.


Chicken and vegetable broth: This is a must-have if you need to thin soups and bisques. I'm not talking about bullion cubes or powder. Get the stuff in the cans or cartons. I got Trader Joe's organic free-range chicken broth for $1.99 a quart. It's going to be more at most stores, but it's worth it. You add calories, fat, a little protein and taste.

Butter and other oils: It is really hard to make sure you get enough calories, especially when all your nutrition has to get slurped through whatever gap or gaps you might have after you're banded or -- god forbid -- wired shut. I melt about a tablespoon of butter into each of my soups and bisques. That adds 100 calories. Yes, I know, lots of saturated fats. At this point, I really don't care. A few weeks of that isn't going to kill me. Malnutrition might. Olive oil works well too, but remember that it can add a taste that might not work well with all foods.

Whey protein: This is a great way to ensure you're getting enough protein. Obviously, it works well in smoothies and shakes, but I also stir about a teaspoon or so into soups and bisques and never know it's there.


Baby food: Most babies won't tell you this, but the dinners with the meats and veggies mixed in don't taste all that great. OK, in general, I wouldn't think about having baby food regularly, but since I have to, I'm going to make the best of it. The point is, buy the meats and the veggies separately. I mix these into the bisques to increase the nutrient density. I never really notice.


Meats: I get mainly turkey and a little bit of beef. I'm not normally a red meat eater, but it does have a higher concentration of protein. We want that.
Veggies: I got mixed veggies. Remember, potatoes aren't really vegetables. Again, stir them into soups and bisques.


Powdered vitamins:


Buffered C capsules: Your gums have been traumatized. This is a great way to give them something they love: Vitamin C. It also helps your body heal in general. I dump about a half of a 1,000 mg capsule in a smoothie. Doesn't taste like anything.


Fiber:



Psyllium: This is soluble fiber. I usually tried to get about two teaspoons of this per day, spread out over three or four meals. You can easily stir it into soups and bisques and never know it's there.
Wheat bran: Mary taught me that this is insoluble fiber. You need this, too. I usually try to work in about a half-teaspoon in a smoothie.


Raw eggs: Remember Rocky? Look, I'm not going to try to tell you it doesn't look gross. Yes, yes, yes, eggs have (gasp!) cholesterol. Of course, if you've already got a problem, ask your doctor first. But, eggs are incredibly high in calories and nutrients. And after a 15 seconds on puree, you'll never notice it in your smoothies. I'm not suggesting you go for a whole carton, but one a day is great. Note: If you put it in soups, it could start to solidify at higher temperatures, which is not a good thing if you're jaws are locked down.

Frozen fruit: I always have a supply of frozen blueberries and strawberries for smoothies. I've also used frozen peaches.

Water: Drink lots of it. Drink a glass or more with every meal. Keep track of what you drink and try to ensure you're downing at least eight glasses a day.

The liquid diet: If you can slurp it, you can eat it

Basic premise: Eat several times a day. Make each meal count by getting the nutrient and calorie concentration as high as possible. Try slurping over the kitchen sink. First, it makes the cleanup easier. Second, sometimes the gaps clog up and you'll want to rinse. Have a glass of water handy.

Bisques: When my doctor locked me down with bands, he told me I could eat broths. I was already down to 155 pounds by that time and didn't really want to wither away. I had a few vegetable bisques, which are creamy soups made from stuff like butternut squash, tomatoes and sweet potatoes. I found that if I thinned them with chicken broth, I could stir in baby food, protein powder and psyllium and slurp this out of a mug. IMPORTANT: Add butter or oil to max out the calories.

Smoothies: I already liked smoothies, so this wasn't a problem for me. The basic ingredients in my smoothies are: vanilla yogurt, about a half-cup or more of orange juice, fruit (I like strawberries and blueberries, but peaches and bananas work, too), protein powder, a raw egg (in the morning) and some fiber. Be sure to run the blender a while to make sure it doesn't have chunks. Although some people have strained theirs, I never have I just rinse my mouth at the sink when things clogged up. I figure I want to try to get some solid stuff down me if I can.

Two weeks and a dream

I peered over the balcony railing and saw the floor about 30 feet below. No problem, I thought. I was standing on the second floor, looking down at the first. Why take the stairs? Swinging myself over, I lowered my body down to where I was hanging over. Then, dragging my toes along the wall to slow me some, I dropped. See? No sweat. Next thing you know, I'm out on the beach, grabbing a board and heading toward the water. Look at those waves! Why are there so many lights in the surf? Why, I must be dreaming. ...

Yes, I had a long, complete, real dream last night. I've probably been having a few all along since the surgery, but this was the first one I remembered. Sleep seems to be getting better, though I'd still like to have my energy level higher. I still need a nap in the afternoon. But, my head seems clearer and I am now consistently making it through the night without waking up more than once or -- rarely now -- twice. That's a sharp contrast to pre-April 10, when I'd wake up several times a night that I knew of and probably even more that I didn't consciously notice.

Below are the obligatory two-week mugs. Not much different from a couple of days ago. The only bruising left is that stripe on my chest. Other than that, I've still got a little swelling on my chin and around my cheeks. The splint still makes closing my mouth completely a little hard, but my jaws seem to be positioned correctly.




The numbness hasn't changed much. Most of it is on the left side, where I've got a patch about three-quarters of an inch wide. It runs from under the eye where the nose meets the face in an arc down around my cheek and chin. Most of the chin is numb as well, including my lower lip. That's what makes eating so hard. I say eating. It's really slurping out of a cup or glass. Essentially, I take the glass and find my upper lip (which is only a little numb), then I will my lower lip to come up and (I hope) form a seal. Then, the slurping begins. Have you ever heard a 3-year-old drinking from a cup? I think it goes like this: PFPUP, SPURP, GUP, SPURP, PFPUP, GUP. That's what I sound like.

Turning 45, wrapping up two weeks

I was 44 when I went to bed last night and 45 when I awoke this morning. That's right: Today's my birthday. I like to remember that I share the same birthday as William Shakespeare, as though that means something in some sort of a cosmic sense. That's Billy S. on the label of the bottle on the right above. More on the wine -- and the straw -- later.

We celebrated by going for a walk on the beach to enjoy this gorgeous weather. Then, we stopped by Baskin-Robbins, where I picked up a LARGE milkshake made with chocolate mousse ice cream. Wow. Probably about 1,200 calories just there. It was so thick that I had to add milk and put it in the blender again just to drink it.

One of my brothers, John, who lives in Monterey, Calif., sent me the two of bottles of wine and the straw. What a funny guy. I can't use a straw. I guess I'll have to just slurp down the wine the old fashioned way. Thanks, John (clink)!

Sleep continues to be pretty good. My goal would be to go to sleep around 10 and wake up at 6 or later. Gotta have goals! This is the 13th day after surgery day. I can't believe that was almost two weeks ago. Man, time seems to be flying by.

Day 12: More than six straight hours

Somewhere in the North Carolina Division of Tourism is a job description for a guy who, early each spring morning, sits in the back of an old beater truck atop a pile of dead possums, squirrels, raccoons and other smaller members of the varmint family and tosses them out at random on the state's roads.

As we headed home from the grocery store this morning, I noticed -- and not for the first time -- that you can't drive more than a 100 yards in North Carolina without seeing some critter squashed on the asphalt. It's no wonder that the buzzard is the state bird of North Carolina. OK, it's not really the state bird, but there are a heckuva lot of buzzards here, due in no small part, I'm sure, to the, um, bumper crop of road kill that each spring provides. If you're in North Carolina, I'll bet you could go out right now (assuming the sun's out) and look around the sky wherever you are and see one or more circling its latest snack. In any case, I thought I'd offer you that little observation unaccompanied by a picture. I'm sure you know what I mean.

The first time I awoke this morning it was still dark. I looked at the electric clock: 4:30. Wow. I actually slept more than six straight hours. You might not be impressed, but I am. That's quite unusual. Almost every night for the past several years has been punctuated by several episodes of being awakened, usually because of breathing or snoring issues. I pondered that for about five seconds this morning before I rolled over and went back to sleep until about 6:30.

I also spent the whole night in the bed. I guess the La-Z-Boy gets relegated to the living room again. Even with the sleep, my energy level is a little low. It may be any number of things, including the fact that getting food into me is a little more difficult with my jaws banded shut. Plus, I'm sure I still have quite the sleep deficit from so many years of apnea.

The tradeoff for the banded jaws, though, is that the drooling has become much more manageable. I'm still producing prodigious amounts of saliva, but I seem to be dribbling only a few times a day now, compared with the pre-Friday geyser. The swelling in my face has gone down, though I still have some chipmunk-ishness going on with the cheeks. Anyway, judge for yourself below.



While we were at the grocery store this morning, I ran into one of my coworkers, Pam Sander, who edits the Wilmington Magazine. I tried not to spit on her too much as we chatted about what's been going on at work. It made me sort of weepy because I can't be on the job right now. I've since got over it.

Today, Mary and I are going to go to a book sale at one of the brances of the local library. I'm sure I'll find something appropriately obscure and bizarre to keep me occupied for the next few weeks.

Day 11: Sleeping in a bed

I managed to spend all last night in the bed. At my visit yesterday, the doctor said it was fine to sleep on my side. I'd got used to at least starting out there, because it lessened the effects of my apnea. I woke up a few times and still needed a drool towel, but it was much nicer than the recliner. I think my sleep was pretty efficient -- definitely much better than the past couple of days. So, I'll count that as progress.

Ever since yesterday's visit, I find myself obsessed with whether my jaw is in the right place. It seems to move some when I swallow or cough. When Dr. Blakey first locked me down yesterday, I could feel my muscles fighting against it. That seems to have calmed down for the most part. Maybe they're just biding their time until Thursday. In any case, I'm going to call Blakey's office on Monday if I'm still concerned about my jaw position. If there's something going on that shouldn't be, I want to be on top of it right away.

It's a beautiful day outside, sun shining, cool breeze. I've been noticing I'm a little pale, so it might be a good day to roast my bod out in the back yard. My next-door neighbor appears to be obsessed with the height of his grass. He cuts it like clockwork every week, whether it needs it or not. So, I might have to contend with the mower. I suppose I can deal.

LOCKDOWN!

The crime: Fighting (however involuntarily) against recent jaw surgery, causing misaligned bite.

The punishment: At least one week of lockdown.


So, as you can see from the picture above, I'm definitely the Rubber Band Man, now. I took that on the drive home. Remember my concern about my open bite? I should have heeded it. Turns out that I've been "posturing" (an observation that might come as no surprise to some people). In this case, posturing means that while I've been pretty pleased with the results of my surgery, it turns out that my jaw muscles sort of liked things the way they were and have been secretly working against me and pulling my jaw out of shape. That's what left me with the open bite I began to notice a few days ago. I don't think any harm's been done, but I got a little bit of a scolding from the doctor for not coming up the minute I noticed something different.


All of this happened this afternoon at my first followup visit. Dr. Blakey comes strolling in (after I've been sufficiently aged in the waiting room and the dentist's chair you see me in above) and says, "What's going on here?"

"I was wondering the same thing," I said.

He immediately began moving my jaw around (only a minor ouch -- one benefit of being mostly numb) and slid it back where it's supposed to be. Then he grabbed one rubber band after another and began wrapping me shut.

At first, he wondered if maybe I had a screw loose (not an uncommon question about me), or, perhaps more accurately, whether one of the little screws holding my jaws together had broken?

He grilled me about what happened but I swore on everything I could mumble through the bands that I had no idea. That I noticed it around Day 5. "Should've come in then. The next time you notice your bite out of place, you get on the horn and get up here." I nodded like a 5-year-old.

After cooking my head with some X-rays, he and some of his residents huddled around to look at the results. They all looked fine. All the screws were in place. Dr. Blakey speculated that I might have even had my jaw out of socket.

"I know you don't want me to do this, but I'm going to have to lock you down," he said as more bands twanged their way onto the wires on my teeth. "OK. Can you open?"

I tried. "Mwo," I said.

"Good. We're going to need to keep you like that for at least a week."

He said it's possible (though not necessarily likely) that I might have to have another procedure to get plates put in my jaws to hold them in place. He said it's not nearly as serious a surgery as the MMA and GA I had. So, I guess that means it's not quite like being hit by a truck. He also said that about 1 in 15 people end up "fighting" against their change.

The good news is my bite is better and I seem to have more control over the drool. Unfortunately, I'm back to very liquid foods until I go for another visit next Thursday. Sigh.

Oh, well. We stopped by Trader Joe's in Cary on the way back. I stocked up on organic (of course!) chicken broth and assorted other liquid-like things. One thing I found out is that my weight is already down to 155. Yikes! I thought I'd been trying to pack it away. Now it's going to be even more difficult. Hmm. Beer has a lot of calories. ...

Where's the arboretum cat?

We took a short trip to the New Hanover County Extension Service Arboretum today. That's where I took the photo above, of one of the many gardens there. It's a great place to stroll when the weather's nice. Plus, it's the home of this fantastic cat, a calico with fur that looks as though it's got a coating of dust, but it doesn't. On most of our visits, the cat has sauntered up to get petted. Today, it was nowhere to be found. Probably snoozing or torturing a small animal.

Day 9: A concern

Sleep continues to be an up and down thing. I think maybe my body is starting to rebel from having to sleep in the recliner. I had some sharp nerve pain in my left elbow that kept me awake last night. Tuesday night was much better, very similar to Sunday night. I'm certain that there has been improvement in my sleep, but I don't think I'll know just how much better things are until my sleep habits get closer to normal. That means sleeping in a bed, recovered sinuses, better drool control and, probably, just my body figuring out that sleeping my back is OK. I've tried lying on my side, but the pressure on my face feels too odd. I've also tried lying down in the bed, but the nasal drip issues leave me coughing too much.

One concern I have is about how my jaws are coming together. As you can see from the picture below, they don't meet in the front.



That's pretty much as far as I can close them. Now, I know that part if it is due to the splint I'm wearing: It's sorta like an athletic mouth guard, only much more rigid. Plus, there's assorted other hardware in there and still a decent amount of swelling. But, I'm not certain how my bite is supposed to be or will be after the splint is gone. It's not clear how it can close correctly, unless I'm in for another year or so of braces. But, my orthodontist said two to six months more metal mouth and then I'm practically home free. Of course, things can change.

In any case, tomorrow's my 10-day followup with the surgeon. I have a whole list of questions to ask him and this one's at the top. It's a two-and-one-half-hour trip to Chapel Hill and the appointment's at 10, which means we may hit rush hour in Raleigh. So, we're going to leave an extra hour early, just in case. If we get there too early, we'll walk or something.

I'd wanted to post a picture of Mary, but she won't let me. I'll keep trying.

Dinner tonight

I was getting tired of the same meal options, so we decided to try something a little different tonight:

Chicken and Broccoli Mousse

1/2 cup of chopped cooked chicken
1/3 cup of chopped cooked broccoli
1/4 cup of mashed potatoes
1 garlic clove, minced
1/4 cup chopped onion
1 Tbs butter
2 Tbs olive oil
1 dash onion powder
1 dash black pepper
2 Tbs chicken broth

Simmer onion and garlic in small skillet until soft. Add chicken, broccoli and mashed potatoes. Simmer for about 10 minutes. Add seasoning.

IMPORTANT: Let mixture cool to lukewarm.

Put in blender and puree. Add chicken broth and puree again. Spoon into a bowl. Serve on table covered with newspaper and lots of napkins.

You can see the chunky, before-the-blender and the mousse versions below. Interesting shade of green, but it was tasty!

After 1 week

Mary and I went walking in Halyburton Park today, which is near our house. The park features a sort of swampy pond that, according to the sign above, may have alligators. I make a point of stopping by the pond every time we're there. I've never seen an alligator there (although there are some in other nearby bodies of water). Maybe they're just polishing off a small child or a peekapoo they dragged into the water while mom or dad was texting on a cell phone, but I'm thinking that this is an gator-free spot.

Since we didn't have to worry about getting eaten, we went ahead and took the Day 7 progress shots there. You might not be able to see as much detail as previous photos because of the lighting. What you probably can see just below my chin is that nice purplish slash of a bruise around my neck. I think that was from one of the many tubes they had draped over me at the hospital.





Sleep last night wasn't as good as the night before. The main problem has been post-nasal drip, from which I awoke coughing a few times during the night. The sleep I did have seemed to be fairly decent, though. Again, I was on my back and, again, I dreamed. In one of the dreams, I was talking to my buddy Joe Pascal, whom I haven't seen in a few weeks. I was trying to show off my new chin. Joe wasn't all that impressed.

I think that yesterday, my recovery has pretty much segued from "recovering from major surgery" to "dealing with a plague of minor annoyances." The main ones are, in order of aggravation level:

Drool: If I had a swimming pool, I could have filled it up by now. I had no idea a human being could generate such a steady supply of spit. I try to carry around a rag pretty much everywhere I go. And, because my chin is numb, I sometimes don't know that I've got a long thread of it hanging off my chin as if I'd eaten French onion soup.

Nasal congestion: Obviously, moving one's upper jaw 3 mm forward is going to leave the sinus cavities with some issues to recover from. The occasional nosebleed still happens, but it's rare. The real problem is the post-nasal drip, especially when I'm sleeping. I'm guessing that I don't notice as much otherwise because I'm fairly distracted. I think it's what is keeping me from enjoying the full benefits of what I've been through. But, I should point out that it's getting better.

Incoherent speech: Let's see, in my mouth I have an assortment of stitches, braces, bars, a splint, plenty of pokey things that stick my lips and some swelling. Toss in some numbness in my tongue and lips and lips that still won't come completely together and you've got a perfect storm of speech impediments. To her credit, Mary's been very good at understanding most of what I say. Come to think of it, the people I have spoken with seem to be able to make out what I'm saying or trying to say. So, I guess it's getting better.

Sloppy eating: OK, again, getting better. But, I don't think I'd want to sit next to me at a restaurant. I am able to spoon in stuff now and drink out of glass or cup. Some stuff still dribbles out but most goes where it was intended. And, I seem to be getting enough nutrition. I'm doing four meals a day -- not four big meals, but four fairly decent ones. Lots of soup. A real find was canned beef stew. It purees nicely and is very filling. Maybe I'll take a picture of the post-meal site to give you an idea of just how bad it is.

So, again, those are fairly minor and most are improving, however slowly.

'All your honest hard work has paid off ... .'

About 5 o'clock this morning, I woke up for only the second (miracle!) time and immediately thought of a piece of music that I really like. Now, don't try to pigeonhole me after this little revelation. I like a huge vareity of music. But, this morning, in my head played the beginning of Beethoven's Symphony No. 6. No, no, no, not that dah-dah dah-dah thing. The next one. This is much lighter, sweeter. It's also known as Pastorale. If you haven't heard it, I highly recommend it. Trying to describe music in words is like trying to describe a color. Hmmm. Let me try this: This music, especially the first movement, is the color of a slow sunrise, culminating in brilliance and promise.

That's what was in my head at 5 this morning, after the best night of sleep I've had in quite a while, counting many of my pre-op nights. I was able to go back to sleep, too, and slept again until about 7.

I slept on my back, on my La-Z-Boy, which Mary and I had dragged into the bedroom, because it's darker and quieter than the living room. That was Mary's idea and a stroke of genius. I'd tried lying on the bed, but the post-nasal drip is just too much right now. So, about 9:30 I climbed onto the recliner, cranked it back about halfway between sitting and prone, wrapped a blanket around myself and put a towel on my chest. Yes, a towel. The gusher of drool continues pretty much unabated. In any case, it took a little while, and I had an ambien standing by just in case I wanted some help, but by around 10 or so, I think, I was out. I woke up once around 2 or so, but was able to get back to sleep. I didn't really get up until 7:30.

I did dream. Nothing special about the content, that I can recall and they weren't particularly vivid. What does make it special is that it happened while I was on my back. Before Tuesday, trying to snooze on my back was pretty much a nonstop cacophany of snorts and grunts. I'd constantly wake up. None of that last night.

And, so, Day 6 begins with a lot of promise. My horoscope (which is free and worth every penny) for today says this:

It's altogether possible that you have an extraordinary day to look forward to, V! Today's planetary alignments will make a kind of synthesis of your experiences over the last two weeks, V. Perhaps you have recently demonstrated certain of your more attractive qualities to someone. It was certainly appreciated! You just might receive an offer that you can't refuse... All your honest hard work has paid off for you, and the stars are on your side!

I'll take that.

So, below are pictures taken this morning. I look more rested, right? Mary suggested that I include one to show you the yellow/purple/blue pennant that starts essentially at the upper lip line of my face and tapers down to a point near my breastbone. I'll leave its creation to your imaginations. Still can't really close my lips, but the swelling is receding. Oh, I also made a little progress on shaving. I got most of it, but my body seems to want to hang on to a soul patch and a little stubble on my chin. Hmm ... I need a haircut.









Today, my goal is to go for a short walk. I think we'll head over to Hugh MacRae Park for a little while. The sun is shining after yesterday's storms. The temperature is perfect. I'm starting to feel a little more human. Queue music, maestro. ...

Researching the new toothbrush

For the past few days, I'd been using a toothbrush that had a fish tail on it. Today, I broke out a new one. I figured out that it has the Yellow Power Ranger on it (along with some sparkles). Because I'm bored out of my skull, I decided to do a little research.

Just who is the Yellow Power Ranger? Here's what the Power Rangers Central Database says:

Full Name: Aisha Campbell
Ranger Designation: Yellow Power Ranger, Yellow Ninja Ranger
Weapons: Power Daggers, Blade Blaster
Gear: Wrist Communicator, Power Morpher with Power Coin, Metallic Armor, Yellow Shark Cycle
Zords: Griffin Thunderzord, Bear Ninja Zord, Yellow Shogun Zord


Spirited and full of energy, Aisha was always up to the challenge as a Power Ranger. She met the Power Rangers on a trip to Angel Grove, where she competed in the Ninja Competition along with Rocky and Adam. Aisha and her friends assisted the Rangers in the rescue of a baby in danger. She continued assisting the Rangers when they needed it, proving herself a formidable replacement for Trini as the Yellow Ranger. Trini left Aisha her powers by transferring them to her with the Sword of Light. Yellow Ranger's power weapons are the Power Daggers, powerful blades used for defense and for throwing. Her weapons combined with the others to form the Power Blaster. As Yellow Ranger, Aisha gained enhanced strength, speed, durability, and limited energy projection. Her Yellow Ranger powers were lost when Master Vile turned the team into children, and Goldar destroyed the Power Coins. Upon retrieving the Yellow Zeo Crystal, she sent Tanya back to the team in her place, and stayed in Africa to help the animals. ...

Jeez. That's a lot more complicated than I thought it would be. So, a little more clicking and we discover that the actress who played Trini died in a car accident. Good thing they wear masks or that would've made that power transfer a little awkward.

So, when in doubt, go to Wikipedia:

Yellow Ranger is a designation given to one character in all seasons of the Power Rangers TV series. The Yellow Ranger is usually a subordinate member of the team and are usually the teams' morale boosters (with the exception of Taylor who once was the Wild Force Rangers' leader before Cole's arrival and a rather strong-willed individual) or level-headed in the time of crises. Yellow Rangers are primarily female with a few males.

Hmm. This is starting to sound a little bizarre. Kinda sounds like Yellow Power Ranger is Chinese for "temporary job." Good thing I have a number of weeks of free time to study up. ... I wonder which Yellow Power Ranger my toothbrush is?

Day 5: Sllllooooowwwww progress & pics

My energy level continues to be very low, in part because sleep is still pretty crappy. I actually had insomnia last night. I think that the pseudoephedrine is contributing to that. I'm going to back off on that by lunch. I also may take an ambien tonight just to help things along.

One of the things that has helped me is to have small but specific goals for each day: eat something in particular or a certain number of times, drink a certain amount of water. Today, I got a little more ambitious and have decided to work on, uh, getting my entire digestive system on track again. This diet has left me feeling a little queasy at times and not exactly my regular self. I've been trying to take in some fiber in the form of psyllium and some wheat bran since Day 3. Today, I pulled out some bigger guns. I took some (gag) epsom salt in water this morning and had a (choke) small glass of prune juice with breakfast. Then, I had a (yum!) cup of coffee after breakfast. It worked, a little, anyway. Definitely, uh, moving things in the right direction. OK, that's my pun RDA for today.

As you can see from the photos below, the swelling is down a very small amount, but the bruising is starting to show up. I've got a technicolor one shaped like a triangle that runs from my chin down to the center of my chest. I won't share that with you. But, you can probably see the sickly yellow tint to my skin in the three photos below. I know I look a bit bedraggled in the first one. Chalk it up to extremely poor sleep since Tuesday night.





I continue to have twinges in my cheeks, lips and chin. Last night I also had a few little jabs of pain in my palate. Although none of it is all that pleasant, it is, regardless, a good sign that I'll probably regain some feeling in those spots.

Eating is still a chore. It's almost impossible to close my lips completely so I leak a lot. It's also hard to talk, although Mary seems to be able to make me out most of the time and the couple of very brief phone conversations I've had with family have gone OK. I'm not spouting off any soliloquies, though. Mainly, it's just a couple of one and two-syllable words. I'm pretty sure that the lip situation will improve as the swelling goes down and my lips recover from being stretched during surgery.

Today, I think I'll watch a movie or play a video game or some other mindless task. Outside, it's been raining all morning and it's likely to stay that way for a while. It's a good day to be laid up.

Day 4: A little better and a tough shave

My sinuses started to clear a little last night. That made it significantly easier to breath and did wonders for my ability to sleep. It was probably the best night I've had since the surgery.

One worrisome thing is that I caught myself snoring a little. It's probably from all the post-nasal drip and swelling and such, but the last thing I'd want is to go through all of this and not make a big dent in my apnea.

Like just everyone else whose mma blogs I've read, my sleep has been spotty these last few days after surgery. I go to sleep and wake up about 10 or 15 minutes later. I'm not sure if it's the medicine or the aftermath of the surgery or my body just used to all the years of waking up from my airway closing.

I have had dreams but they aren't particularly vivid yet, probably because of the pain meds. I've been able to back off on the oxycodone quite a bit and hope to be off completely today. The dreams have been pretty much non-stop, and that's pretty much unheard of for me.

Before I got up this morning, I decided I wanted to start the day at least somewhat normally. So, for breakfast, Mary made me some oatmeal and ran it through the blender. She also cooked a soft scrambled egg. That's more like the kind of breakfast I had pre-op.

Keeping my teeth clean has become interesting yet again. I already had adapted to the more stringent regimen that braces require. Now, I've got a new routine that I have to get into. I've got all sorts of new hardware in there, including a splint and new wires and god knows what else. Plus, my lips are still pretty swollen, which creates pockets that weren't there before, and I can't really move my mouth much. I'm not wired shut. Instead, I have these little rubber bands on either side of my mouth. They attach to hooks on the top and bottom and help hold my jaws in place and keep the lower jaw forward. I have to take them out to eat and clean and then replace them.

So, here's my routine:

Rinse: First, I swish and gargle with warm salt water. I go through about two or three glasses.


Syringe: Eventually, I'll use my WaterPik, but I think it's just too dicey right now. So, I have this Monoject syringe that a dentist once gave me to rinse out my mouth.

Kiddie toothbrush: The surgeon's office gave me a stash of cool junior toothbrushes. I can just barely get the head to go between my cheeks and teeth and to fit between the upper and lower jaws to get the eating surfaces. I use just a tiny bit of paste and very, very carefully, try to clean the teeth.

I guess I do the best I can, but it is far from perfect.

This morning, I also tried to shave for the first time since Tuesday. I have a pretty light beard, but I tend to just get Yasser Arafat-scraggly after a couple of days. It was very difficult, in part because of the numbness, but also because my face is swollen. I made a few dents in the fur, but I gave up after a couple of minutes. It just wasn't worth it. Hell, when you're already drooling and puffy, a few days' growth sort of goes with the outfit.

Mary talked me into getting out of the house for a while. It was just a short road trip, but I didn't feel like staying gone more than a half-hour. I felt wiped out and a little woozey. I felt better after lying down for a while.

I don't think my looks have changed much from yesterday, perhaps a little less swelling than yesterday morning. Oh, and my lips aren't shedding skin quite so much.

Tomorrow, I'll post some progress pictures.

A REALLY GOOD PART OF ALL THIS: I've gone back into this post to mention something that I've been meaning to say from the beginning. A lot of folks have listed must-have items and they're all great lists. The one that would be at the top of mine would be to have someone who really, really loves you with you 24/7. I don't know what I'd have done these last few days without Mary. She hasn't blinked an eye through all of my sloppy eating, drooling, teeth cleaning and general physical scariness. I hope everyone who has gone or will go through this is even half as fortunate as I have been.

Day 3 ... a little rocky

Here's a great mystery: How is it that my mouth can feel dry yet still produce quantity of drool worthy of Old Faithful? I pondered that question overnight as I kept a paper towel under my chin to catch the excess. I'm assuming that my mouth is dry because of the splint and because I can't keep it completely closed. And, given my experience with the TAP device, I'm pretty certain that the splint and assorted other hardware in my mouth are causing my salivary glands to go into overdrive.

There's a bit more swelling today. When I woke up, my upper neck and cheeks actually felt a little taut. I think I'm going to have to use ice today. Sleep wasn't all that great, for the same reasons as before -- crazy pain meds and the stuffed up nose.

Speaking of the nose, my right nostril keeps springing a nosebleed. Nothing major and it usually goes away after less than a minute. But, it is enough to be annoying. It happens when I move after being in one spot for a while or if I hold my head down for even just a little while.

I've read some blogs where people said they went back to work after two weeks. I cannot even conceive of it. I'm hoping to go back mid-May. That's plenty ambitious, I think.

I have numbness, but not as bad as I thought I might. The doctor explained that the nerve (which he described as looking like a piece of spaghetti) runs the length of the jaw. Since they're juggling that thing around, it's likely to get at least some damage. And I think pretty much everyone experiences some numbness. For some people, it goes away completely or partially. For others, it's permanent.

I have some feeling in my upper lip and radiating out to the end of my nose and nostrils and around my upper cheeks. My lower lip and chin are very numb. Every once in a while, I get these little twinges in my upper lip that feel like a spring uncoiling. I've also had some itchy feelings in my chin. I'm thinking those are good signs.

So, same plan for today: drink, eat, rest. Except, I'll add ice to the face.

The visuals, baby

OK, look, there's a whole lot of swelling going on, but it don't look so bad, considering I got both jaws broken and a chunk taken out of my chin and moved forward. The colors haven't reached their full splendor yet, but I'm sure they will over the next few days. I hope I was able to Photoshop out all the drool ...

The Money Shot: Taken by Mary about eight hours after surgery


Two days into recovery






I saw the X-rays yesterday. My airway is huge. Unfortunately, I can't really get the full benefit of that right now for a couple of reasons. First, as I've already said, my nose is stuffed up. I finally got some liquid decongestant, so I'm hoping that will help. Second, they had a tube up my left nostril, down my throat and into my stomach until Wednesday morning. My esophagus is somewhat swollen, so that's adding to my troubles breathing and eating. It seems to be going down though. I slurped down a smoothie made of Ensure, frozen berries, some OJ, protein powder and a little bit of psyllium.

As for the hospital experience ... well ... let me say that my doctors are great. In fact the only thing I could really complain about (other than the waiting, of course) was the surgical ICU. That's where I spent Tuesday night. Apparently, that's also where half the staff of the hospital gathers to socialize at the tops of their lungs in the middle of the night. I don't think anyone can expect a hospital to be quiet, especially not an ICU. But, at one point around 3 a.m., it sounding like an actual party was going on. There must have been about 10 different conversations going on, laughing, even a few howls. Really. It was pretty ridiculous. Thankfully, I didn't have to spend another night there.

Overall, though, the surgery seemed to go well. I still have a lot of healing to do. But, the big part is done.

As for today, it's eating and drinking and sleeping.

The other side

If you're reading this, it must mean I survived the surgery ... so far, anyway. My doctors discharged me yesterday and Mary drove me the two hours home. Spent last night sleeping in the La-Z-Boy. The sleep wasn't all that great, in part because breathing is a little hard right now (see below) and because the pain medicine gives me odd dreams. This is just day two, so I'm certain things will get better as the days progress. Well, maybe in a week.

I'll post more, including scary pictures, later. Right now, I have three short-term goals:

Rehydrate: Drinking and eating are both difficult. Everything about the inside of my mouth seems different and unfamiliar. Plus my lips are numb and I've got quite a bit of swelling. The oxycodone probably just makes it all the more interesting. Warm seltzer water seems to go down best. I drank about a quart this morning.

Eat: See goals one above. I've taken to wearing a towel over my chest like a bib and covering the table with newspaper. Essentially, I'm a baby again. Plus, everything I eat is soft, including some baby food.

I did pretty well this morning and put away some yogurt, half a jar of turkey baby food (very bland), some mango sauce (like apple sauce, but out of mangos -- thanks, Trader Joe's!), some vegetable juice and some prune juice (for other qualities as well).

Clear my sinuses: I think I'll sleep better if I can get my sinuses in better shape. The surgeons moved the top jaw forward 3 mm and that really messed things up up there. I'm sure I bled a lot during surgery. The doctor cleaned out my nose before I left yesterday, but my nose is still pretty stuffy. Plus, it still bleeds some if I bend down. So, I've been working at it here with Q-tips and warm salt water. It seems to sooth the sinus passages. Also, I need to pick up some liquid pseudoephedrine. The doctor prescribed it, but the hospital pharmacy didn't carry it. We'll try to get some today.

So, that's the plan. That and sleeping.

THE day

So, here's what my horoscope says today:

Your creative side will be highlighted today, V. You could be in the mood to listen to your favorite CD's or take in an exciting musical concert. Your appreciation for the arts could inspire you to see a great movie. Or you might try reading a classic work of literature. Let yourself absorb beauty and inspiration today. Your spirit will be moved by the rhythms and colors that are around you.

Now, it is possible they'll have music on during the surgery. It is four to five hours, after all. I don't think they'll have a chamber orchestra in the room, though. Movie? Saw, maybe? Probably won't be reading, either, though I might have the same state of consciousness I had when I was reading in college. I'll take all the beauty and inspiration I can get. Colors? Now, those I'll probably be seeing -- black and blue, most likely.

I actually was able to go to sleep last night and slept most of the way through. Even though it was apnea sleep (the last night of that, if all goes as planned), it was good not to lie away all night thinking about this morning.

Mary and I went for a nice, long walk yesterday in the late afternoon. Chapel Hill has beautiful greenways that lead through the campus and much of town. Dinner was at Whole Foods (I can hear my co-workers groaning).

I'm to report to the hospital at 9:30. I think my surgery is around 10:30 or so.

This is it. ...

Mmmm, scallops ...

So, there it is, in all its glory: the last homecooked chewable dinner for several weeks. Looks good, doesn't it? I was going to upload a dot-smell file so you could really experience it, but I haven't upgraded my computer yet. I guess I'll have to let your imagination work, instead.

I took some Japanese scallops from Trader Joe's (nice and tender -- not too big, but not those chewy bay scallops) and sauteed them in butter and a little bit of bacon grease. I seasoned them with some garlic and onion powder and a touch of pepper. On the side, we have roasted sweet potato medallions (the word restaurants use when something is round and they want to charge you more) and sliced avacado and tomato. Oh, and to finish it off, a nice glass of Napa Valley zin. Here's a napkin for the drool.

My belly definitely approved.

Below, you can see me pre-op. Small chin, right? When I sleep, that sucker falls back even more and essentially closes off my airway -- several times a night, all night long. Well, we're taking care of that on Tuesday (gulp). If I were you, I'd say something like, "Keep your chin up!" Heh. Uh, yeah. Anyway. ...





Sigh. The waiting. It's hard.

'Can you pee?'

I had my last pre-op appointment yesterday, a four-and-one-half-hour extravaganza of waiting, obtaining various molds of my mouth, measuring my face, waiting some more, talking with my doctors, a bit of waiting and visiting Memorial Hospital at UNC-Chapel Hill, where I'll have the surgery Tuesday and where I was officially registered, gave up various bodily fluids, got X-rayed, EKG'd, and, of course, waited.

They made two different sets of impressions of my mouth. The first one -- actually two sets of the same thing -- was a standard impression of my teeth. In case you've never been through it, essentially they mix up some goop that's the consistency of soft bubble gum and tastes like window caulk and cram a large wad of it in a U-shaped container designed to fit over either the top or bottom set of teeth. That's held in place long enough to make a mold of that set of teeth. The process is repeated to get the other set of teeth.

The second impressions involved a two-step process to develop models from which they'll make splints for my mouth. The first part was very mysterious. The doctor put a couple of dabs of some blue gunk on a U-shaped piece of metal, which he had me bite down on with my back molars. Then, he attached this to some sort of gadget that looked kind of like a large caliper with a head strap and some sort of doohickey sticking out of the front of it. He fitted the contraption over my head, with the ends of the calipers sticking in my ears. The doohickey (not its technical name) had a clamp to which he attached the U-shaped piece of metal as I held it in my mouth. Really. I'm not lying. He said this was needed to make the splint, but it is entirely possible that it was being videotaped and is being uploaded to YouTube right now for the amusement of millions of viewers like yourselves.

The second step was a bit more straightforward: I bit down on two planks of warm wax, one for the top and one for the bottom.

Sometime after that (this was one of the waiting portions of the day), I got to chat with Dr. Blakey, my surgeon. That's when we got down to the details of what he'll do. We're going to move my upper jaw forward about 3 mm and my lower about 12 mm. They'll fit together because, thanks to genetics and about 16 months of orthodontia, I have a 9 mm overbite. Then, we're going to take my chin and move it forward a bit as well. That's to bring my tongue forward a bit and, ultimately, give me a bigger airway. I keep saying "we." I'll be doing the lying down part. The surgeons will be doing all the work. At this stage of the game, anyway.

After all of that, they sent me with paperwork over to the hospital, which is a few buildings away. Right after I got out of the building, I looked at the top sheet, which was my schedule. There, it said I was to have my surgery on "04/11/06." See something wrong? Anyway, I went back, got that straightened out, and headed up to the hospital. After some waiting, I registered, then waited, and was ushered into a room to wait for a nurse. Actually, I didn't wait more than a couple of minutes until she arrived with a tray of tubes and a needle. She drew blood and then a second nurse came in, evidently a specialist. After she asked me an apparently random set of questions, she left and came back with that familiar little plastic beaker that anyone who's applied for a job recently knows on sight. She held it out to me without saying anything. I looked at it. She looked at me.

This is EXACTLY how the conversation went. Really.

"Can you pee?" she asked, as a second nurse came in.

"Well, I've been practicing for about 44 years, so I'm pretty sure I can do it," I said as I took the cup, smiling to show I was joking. She didn't smile, but just stood there.

Honestly, I was starting to think they really doubted I could pee and wanted to see it for themselves. "So ... uh ... where ... ?" I started.

"Well, not here," she said.

"Right. So, the restroom is ... ?"

She showed me to the restroom, where, for the record, I did, in fact, pee.

Anyway, after a relatively quick set of chest X-rays and EKG, I was sent on my way. Just in time to hit the afternoon rush hour traffic through Raleigh.

So, all that awaits now is the trip to Chapel Hill on Monday and checking in on Tuesday. Between now and then, I might post a pre-op, small-chin picture of me. Otherwise, don't expect to see much of anything until late next week at the earliest. Then, assuming all goes well, I'll let you know how I did and, probably, how I look.

I got lugs

The latest addition to my dental hardware is a set of lugs: pointy things on which the surgeon will attach rubber bands that will keep my jaws in place after he moves them.

Today, the helpful ortho tech who put on my lugs and the extra steel wires that provide additional support showed me one of the bands. I asked because, apparently, I'll have to take them off and put them back on for cleaning. When I first heard about the bands, imagined (did I mention that I'm a worrier?) these industrial strength loops of rubber. Actually, they're pretty small and very pliable. I shouldn't have a problem.

Tomorrow is my last pre-op visit to the surgeon's office in Chapel Hill. They'll probably take one last set of impressions to make the final model of my jaws. Other than checking into the hospital early next Tuesday morning, that'll be the last step before the big break.

One week from surgery

About four years ago, I sat across from a doctor in Santa Barbara, Calif., conducting the usual first-visit interview. I'd just moved back to Santa Barbara after a couple of years away and had a new primary care physician. Dr. Sim looked like he hadn't been out of medical school more than a year or so, a factor that probably worked in my favor. Thinking back, I probably am very lucky to have met with him. During the interview, we touched on the fact that I always seemed tired and that I grew more tired as the day wore on.

In fact, in recent years I'd taken to scheduling important meetings in the morning because I knew that I definitely wouldn't be at my best after about 1 o'clock in the afternoon.

"Might be sleep apnea," Dr. Sim said. Back in 2003 I'd never heard the term. Three sleep studies, two different CPAP machines, a TAP machine, various ways of trying to sleep and countless visits to about a dozen doctors and dental specialists later, I'm exactly seven days away from having major surgery -- maxillomandibular advancement with genioglossus advancement, if you want to know the details -- and, I hope, a chance at getting my life back.

Me? I'm a 44-year-old man, in pretty good shape (5-10, 165lbs) -- not exactly your typical apnea patient ... though, the more I read, the more I see that there really isn't one anymore. I live in Wilmington, North Carolina, though I'm hardly a native. Heck, they just got a Trader Joe's in this state and I actually have to drive 140 miles to get there! The horror!

I'm pretty sure I've had apnea for several years. Up until that visit with Dr. Sims four years ago, always felt dog tired, but I just thought that's the way it was for everyone. So, keep in mind that I've been giving you a handicap all this time. Just you wait!

Like I said, I've had three sleep studies, tried CPAP and BiPAP, but couldn't find a mask to fit because of the shape of my face. Tried the TAP appliance, which for those who don't know, looks a little like a medieval torture device. Essentially, it allows you to ratchet your jaw forward ... and then sleep ... and drool ... a lot. It actually worked a little, but not really enough.
Turns out, my unusually small chin -- retrognathia, if you want to get technical -- is the chief culprit. Which led me to the oral surgeon and the BIG DECISION. I've been in braces since January 2006. My teeth are certainly much straighter, though my overbite has increased significantly. I'm not a pretty eater.

In March, my most excellent orthodontist told my oral surgeon I was ready to go.

I'm scheduled to check into the hospital at UNC-Chapel Hill on Tuesday, April 10. There, a very talented (so I'm told) doctor will perform a maxillomandibular advancement (MMA) and a genioglossus advancement. In short, they'll move my lower jaw forward about a centimeter, my upper jaw forward enough to compensate and fiddle with my chin to move my hydoid bone (that tough part around your Adam's apple) up. All this to give me a bigger airway. And, as a bonus, make me an even more handsome devil.

They say I'll be in the hospital for one or two nights, then, if all goes well, go home. Likely, I'll be banded, rather than wired shut. I guess that means I'll be able to talk. I've heard or read about other MMA patients feeding themselves with syringes. My doctors said they want me to start spooning in anything I can puree in the blender ASAP. No syringes. The sooner I get used to my newly aligned bite and numb chin the better, they say. Fine by me.

Am I worried? More and more as the date approaches. Am I excited? Yes, but the worry tends to cloud it. Do I know what to expect? I think so, but who ever really knows? Do I know what I'll look like afterward? Not really, but I have suggested to my doctors that, since they'll be in there busting it all up anyway, why not put it back together looking like Tom Cruise or George Clooney? No, I say, really, I mean it.

Actually, I'll settle for the ending my apnea. After all, that's what this is all about.