Gracious. Where do I start?
Let's start with airway and breathing, since those are always your first two concerns. My airway is basically unchanged with one exception: I can no longer block my oropharynx off from my mouth. What that means in practice is that if I lean over without the obturator in, saliva drains from my nostrils. I also have to be careful with swallowing without the obturator in, because it's much easier for liquids and semisolids to enter my sinuses.
I cannot suck on a straw unless I hold my nose. Likewise, I can't blow out candles or blow up a balloon without holding my nose. Whether or not that will change as the obturator situation changes, I don't know. Suffice to say that for now, I have no suction capability and no blowing capability.
Aside from those minor concerns, and the fact that carbonation bubbles head straight into my sinuses, things are pretty much unchanged.
Swallowing is a little different. I prefer to eat with the obturator out for two reasons: it's easier to swallow neatly (ie, without stuff getting stuck up on top of the obturator) and quickly, and I choke less. With the obturator in, I can eat and drink fine--don't get me wrong--but it takes considerably more concentration than it used to.
It almost feels normal now to take a small mouthful of fluid and turn it into four or five swallows. I can no longer gulp liquids. Shots are right out; each ounce of liquid that I swallow equals six to eight separate swallow cycles.
I miss that first gulp of cold Perrier Citron that would make the back of my throat burn. Otherwise, no big deal.
I have a very hard time lying either on my front or my back with the obturator in; soft tissue tends to collapse around it and obstruct my breathing or trigger my gag reflex. The answer to that is, if I'm getting a massage (say) to lie however and just breathe through my mouth. It's snorey, but it works.
One of the most common side effects of a transoral surgery, and the one that concerns me most right now, is trismus, or jaw stiffening. I have a minor case of trismus, which is defined clinically as not being able to open wide enough to insert two fingers between your front teeth. Mine is classical in that the sensory portion of my right trigeminal nerve (CN5) is also affected. What that means is that I have a beard-like distribution of numbness from just in front of my ear to about halfway across my chin. The right side of my lower lip is numb, as are my teeth and jawbones on that side.
Simply put, when I'm brushing my teeth, I have to look carefully at what I'm brushing to make sure I'm not brushing the top of my newly-enlarged mouth. I can't feel a darn thing.
Eventually, with enough jaw stretches and enough time, both mobility and sensation will come back. In the meantime, what this means practically is that I don't eat in public and I stretch my jaws six or seven times a day, whether with fingers or stacked tongue depressors.
There's also some tongue numbness left thanks to the fact that my tongue was retracted during surgery. Imagine Bill The Cat--that's apparently what I looked like. Only the tip of my tongue is numb now, thank God, because before (when it was most of my tongue) it was a pain.
Overall, I have been incredibly lucky. Because everything was cauterized during surgery, the post-surgical pain was actually less than came with the original biopsy. I have the occasional ache where they removed the one tooth, and of course I wear out quickly trying to talk. Aside from those problems, though, and a pretty constant jaw-ache, I'm quite comfortable.
And, since I don't look any different, I have a lot less to deal with than I would've if I'd had an open neck dissection.
So, yeah. That's how stuff works now, or doesn't. The "doesn't work" column will have to be updated nearly continuously over the next year as the obturators change. We'll see what happens with the next fitting, two weeks from now.