My first thought on waking up?

“Where is my tongue?”

It was there, no doubt, but something was wrong. It had been clamped in place on the right side by my freshly aligned and immobilized teeth. In the post-anesthesia haze, I managed to wriggle it free before passing out again.

After years of consults, research and fear – and a whole lot of waffling – I had just completed the orthognathic double jaw surgery that would bring my teeth into proper alignment. The upside was the promise of fewer cavities and toothaches, better digestion thanks to better-chewed food and – I’d be lying if I denied it – the prospect of a more symmetrical, attractive face and smile.

The downside was that my doctor was cutting my gums open and breaking my jaw in four places, then screwing parts of it back in place. It would all heal immobilized in surgical braces, a metal band strapped around the gums by individually tying metal wires around the base of the teeth. My teeth would be fixed in place, tightly clenched, for the next month.

What if I freak out? Won’t it be claustrophobic? Won’t I waste away relying on liquids for sustenance? What if I hate the way my new face looks? Fucking hell: what if I throw up?

That last possibility, perhaps the most revolting for one with a newly bound jaw, is one the doctors plan for, at least for the first 24 hours or so, running a tube through the nose down into the stomach to capture any blood that accumulates. The tube down my throat made swallowing feel a herculean task, one I had to brace for, wince and inhale a deep breath each time before attempting. I couldn’t speak either, or at least, really did not want to. I typed messages to my nurses and family in blank email drafts like “more ice plz” and “time for meds?”

Plus, as anyone who has ever breathed air is probably aware, there are exactly two ways to do it. My nose, usually a good option, slowly closed up in the hours and days after the procedure as my nasal and sinus passages swelled. Forced to draw air through my immobilized mouth, my swollen lips would, on each inhale, suction closed and for a moment I’d suffocate before flinging my lip back open.

The morning after surgery, my doctor showed up early and passed me an ominous looking clear syringe with a red spout. This would be my only eating and drinking utensil for the next several days. I’d draw my food and water into it, direct the spout between my teeth and cheeks and push the plunger down. Slow and steady is best, I quickly learned.

I handled the physical horrors of my surgery by powering through when I had to. But I still had to face the psychological reasons why I’d put off the surgery for so many years even as I convalesced.

Many people who already had the surgery reported bouts of depression, angst and frustration that scared me far more than the promise of pain or inconvenience ever could. And I wondered if my concern over my underbite the kind of thing that just translates into some other insecurity once it’s handled.

At a party about five months before my operation I met a guy around my age who told me how, during his recovery, he had become addicted to painkillers, broken up a long-term relationship because of the stress and still, a year later, wasn’t confident enough in his jaw to take a bite out of a whole apple. But when I asked if he was still glad he had gone through with it, he didn’t hesitate to say yes.

“Now all I do is smile; I love smiling!” He was smiling when he said it too, big and bright. I was touched.

But I wasn’t naive. I pre-emptively enlisted the help of a psychiatrist to prepare for what seemed like an inevitable breakdown from the constriction, pain, hunger, isolation and the like.

But funny thing: after the first couple days, for the most part, I was fine. Most of the worst moments were at worst sort of pathetic, in a funny way. I pawed longingly at a Burger King whopper sandwich in an online ad with so much force I nearly knocked my laptop off a table. Hunger does funny things. I swear solid food, real or digital, started to glow.

Lots of drool. Embarrassing. Lots of mess when I ate, like a four-year-old with an ice cream cone. Gross. But mostly OK.

By a week in, I was the master of epic, hearty 96oz smoothies. Fruit, check. Greens, check. Protein, check. Oils, check. Enzymes and probiotics, check. I drank it with my lips, like a boss.

My second week of recovery, on a video chat session with my psychiatrist, he noted how much better it was going than I anticipated and asked: “So, do you want to talk about something else?”

And in retrospect, the mental and emotional satisfaction of having dealt with something that terrified me so deeply, and occupied such a big place in my mind for so long far, eclipses whatever medical or aesthetic gains are to be made or not.

A week from today, six weeks and a day since the procedure, all the metal and latex will be out of my mouth. Already, I smile more, and my solid food choices expand daily. And thanks to the absurdities of the US healthcare system, the only scary part left is the bill.