OK.... back at the hospital today for FL's Maxillofacial Review.
You probably won't be surprised to hear that although they had found his file this time, it didn't have any of the notes from his last appointment on it... so we had to start again, again. But as before, this had the advantage that the junior doctor had to call the Consultant, and FL had the benefit of a third actual Consultant-consultation. We like Mr R. He is a very fine man: he inspires confidence. "A gentleman and a scholar," you might say.
So Mr R. looked up the CT scan from two weeks ago on the computer: "Small bony defects, but no cysts". He also did a clinical examination (i.e. looked inside FL's mouth) and said that it looks much worse than the CT scan shows. This is a good thing. From where I was sitting I had a pretty good view, and FL has an area of exposed bone of perhaps 2 centimetres in length along his upper jaw, where there used to be teeth. This bone is clearly decayed. Not a pretty sight. The site of his extraction has not yet healed but it is not misbehaving, or in medical terms there is "no infiltration of pus ". This is an improvement on his last appointment. The antibiotics have done their work.
Mr R. was clearly frustrated that FL's notes had gone AWOL again. He said he distinctly remembered FL's case, and writing a letter to Haematology... but that was not on the file either. He instructed the junior to make sure the file went on his desk immediately the appointment ended.
He was quite matter-of-fact about the need for vigilance and oral hygiene. Although he does not want to see FL again for 3 months, we can call for an earlier appointment at the slightest hint of trouble. FL is going to have his case added to the UK's BONJ database (Bisphosphonate-induced OsteoNecrosis of the Jaw). A statistic at last, eh?! Mr R said he had seen another BONJ patient only that morning - a woman, who had "pus-y infiltration of the sinus". Uh huh.
Then Mr R. said: "Did you have a beard at your last appointment?" to which my brave lad replied in his best Highland accent*: "Aye... and I still do, Doctor!" Oh dear - ever the joker! It certainly lifted the mood.
So there we go: he's "fine".
* ETA: It has just dawned on me that I need to explain why a Highland accent was funny. FL was referencing Dr Finlay's Casebook. No, I don't suppose anyone else in the room got that bit of the joke either! They were all too young / not Scottish!