Thursday, December 4, 2008

6 Weeks Post Op





Today marks six weeks since surgery. I've only been taking pictures weekly now so I don't make myself crazy analyzing my face, as changes are most noticeable week to week at this point. The right side of my face and chin still have considerable numbness. Its odd - I have "sensation," but its not the same as having the feeling back. Hard to explain. The roof of my mouth around the border of the upper teeth is still numb, but the rest finally has feeling again. The only way I can really explain how my face feels is: if you've ever been outside in the extreme cold/snow and gotten a really cold nose and cheeks and fingers and then gone inside where its warm. There's this transition when you're "dethawing" that almost feels like your skin is burning and your fingers and face feel tight with blood flowing to them. Well my face feels like its on the verge of dethawing ... but it just never does! I also feel like its tender and sore (not bad, but I hadn't noticed it before.) If I even slightly bump my nose or cheeks it hurts as if it was bruised. I'm not really sure if that is only my brain registering it as pain because I'm still numb or if it really is pain. Its all very strange. My lips are moving much more normally when I talk now. I've stopped telling people the second I open my mouth that I've had jaw surgery (it was compulsive because of how awkward I feel.) I've realized that most people can't tell anything is different until I point it out in detail. I'm very aware of every change of course, but I'm relieved to know that others don't notice much at all. I had one full week back at work and then Thanksgiving week, which was short and I feel much better this week being around everyone. I'm even eating in the cafeteria instead of in my office. I feel like this week was a breakthrough in the recovery in that I feel like (because mostly people don't notice anymore) that I can transition back into society. I'm going back to church and I went to the Celine Dion concert on Tuesday and we decorated our Christmas tree last night. I'm not hiding out at home anymore - I feel like I can sit back and take my time with recovery now that I'm past the stressful stage of explaining myself to everyone. I still have moments where I feel anxious to be ALL healed, but I'm always reminded how blessed I am to have had an amazing doctor and amazing friends and was told that I'm "ahead of the curve" in healing. Patience, patience, patience. I had been going back weekly for check ups, but now its every 2 weeks. I'm supposed to have 3 fingers ROM by December 10! I feel like it was such a victory to get 2 the other day. I don't even work on it as much as I'm supposed to. I'm wearing 2 rubber bands at night and for a few hours during the day - no problem! Oh, and I only have a slight bruise left under one eye that is easy to cover with makeup. I can't believe how fast it seems the recovery went, but I vividly remember that it did not feel "fast" the first few weeks. I'm actually still feeling up and down emotionally and hoping that will also get better ... not sure what that's all about. But overall I really am SO HAPPY with the results. My teeth make contact in places I've never felt and I no longer have any space where there used to be an open bite. The most dramatic facial difference is in my profile - such an improvement. I hope everyone is enjoying the holidays!!!

4 Weeks Post Op




A week back to work and I was very self conscious. Although I'm allowed to eat soft foods it's not a pretty sight. Its a victory to just get the food into my mouth - slide it through the small opening and then my teeth don't know what to do. I wouldn't exactly call what I'm doing "chewing." I'm trying to stay very low key and not have to explain my absence too many times. I didn't feel ready to go back yet, but it worked out okay. It built my confidence a bit to realize that I at least wasn't stopping people in their tracks. Twice I was asked if I had gotten Botox because of my limited facial movements. Too funny. But it makes sense when you're all swelled up it puffs out any wrinkles and without being able to smile your eyes don't crinkle either. My coworkers kept saying I looked so "fresh." But of course they were seeing me with makeup to cover up the black eyes and I had just gotten my highlights done.

I can get one finger in my mouth this week. Oh and the orthodontist took out some more stitches and it freakin' hurt!! But what a relief though - the ones inside my upper lip directly under my nose are causing a lot of swelling and tenderness there.

Pictures from THREE WEEKS post-op



Monday, November 10, 2008

Just over 2 weeks (already?!)





I must be a big baby because compared to everyone else's perky posts that I read ... I feel like this whole process has been super tough! Laura's blogs have helped me to be able to put words to the things I've been experiencing. I've been taking care of myself since just after a week and I feel like no one else understands. But I was happy to read that she had also been experiencing that burning/bee sting type feeling in her lips. I was concerned that I wasn't feeling more tingling and that it meant I wasn't healing well or something. My lips and chin and a lot of my right side are still totally numb! After 2 weeks! I'm just concerned because I have to go back to work in a week. Am I going to be able to converse with clients without my face looking awkward? These black eyes are STUBBORN too. At least they distract from my lips and swollen cheeks when I go out. People keep looking at James weird ... like he hits me or something! Now that I'm less numb I can feel the stitches pulling when I smile or talk - it sucks. The ortho said he can remove them this Thursday at my 3-week check up. He's also going to take an x-ray and then hopefully I can switch to "soft" foods. Just today I started putting Traumeel on my eyes for the bruising - hope it helps. I've been doing that externally and also taking the oral homeopathic. I've only done moist heat once ... does this really help? Maybe I should do it more because today my jaw was SO MUCH TIGHTER than before. What is that all about? I know I can't really complain in comparison ... after all I'm not even banded shut, but man am I anxious to "move on" already. When I look in the mirror I don't look as swollen as I "feel." I've been trying so much harder to not talk since I'm supposed to take that easy until next check up. And when will I be able to smile again?

Saturday, November 1, 2008

8 Days Post-Op


Today is 8 days after I had a Leforte I Osteotomy, Bilateral Sagittal Split Osteotomy and Chin Osteotomy to treat my "open bite." The feeling in my face is coming back SLOWLY but surely in a top-down pattern, with my chin still being the most numb. Makes for inevitable dribbles down it whenever I eat and for some reason nobody seems to mention it. I have to find out when I get to the mirror. I don't know why I didn't think more about the numb factor before surgery. I just kept thinking I would be swollen and sore, but almost forgot that I'd be numb too. That itself is an interesting experience. Blessing in disguise as I imagine my gums and face would hurt even more if they had feeling! As my nerves come back to life I notice the pain is like a dull headache, but in my jaw. My 2 day depression has lifted. I slept more last night than any other so far. Its good to sleep longer, but what usually happens is I end up ON my face and not elevated, so I'm extra swollen when I get up. I am still not able to breathe through my right nostril so I get a bit of a dry throat at night too. Overall everything on the right is a bit more numb and swollen and I'm giving credit to my cheek bone procedure on that side (doctor used extra bone to cover over an old, improperly healed fracture). As far as how I look ... really hard to say, but I don't doubt for a second that I am going to be happy with the results when I can see them. My nose looks wider from the front because of swelling and I look forward to that subsiding. My profile already looks better, less harsh. I feel like I look overweight from the side though because my throat and chin are still swollen, but sure that will go away too. My days are consumed by food preparation and teeth cleaning. People keep asking if I've watched a lot of movies. But I've only seen 1 1/2 so far. I really don't have as much time as you'd think because I spend so much time making food, blending it, syringing it, washing the blender, tending to mouth cleaning, icing etc. and then starting over!! I've been trying to go out for walks though. With a hat and my head down. I've worn my huge Hollywood sunglasses to get Starbucks, but they actually hurt my nose so I only put them on for emergencies like that. Hmmm, now I want some Starbucks. Shoot, was thinking I could kick my addiction in this process. Ah, but why deprive myself at a time like this right?!

Thursday, October 30, 2008

One Week Post Surgery TODAY




To the left is DAY 2 in the hospital, above that is DAY 4 and in black DAY 5.
I've emerged momentarily. Little surprised at how emotional I feel. I think it has a lot more to do with the last year of my fight and a lifetime of anticipation. Recovery is tough! Yesterday I did too much talking and today I'm paying for it. I feel like all the swelling from the sides of my face moved forward into my nose and lips - like they might actually pop. Its a very odd feeling. I'm still numb from below my eyes down. I have two black eyes and bruising (yellowing) all over my chest from the breathing tube I had for what seemed like forever, even after surgery! I ended up staying an extra night in the hospital and getting a blood transfusion. But the surgeon did say it was one of the "best" he's done ... whatever that means, but glad to hear. It took less than 3 hours. Oddly he also said that he found that I had a facial fracture on my right cheek that hadn't healed properly. My dad doesn't know of a time when my face got broken. So the doctor somehow used bone from somewhere else and put it on the cheek (how amazing is that?!) Can't wait to actually be able to see the results. I had my first post op orthodontist appointment today and he moved the two bands to go from the bottom back molar to the 4th from the upper midline. That's it - 2 bands only and I can take them out whenever I want. Also ... my eyelashes are falling out ... is this normal?!

Wednesday, October 22, 2008

I'm getting surgery TOMORROW!!!!



Okay, I know I haven't blogged in a while. Forgive me; things have been a bit CRAZY lately. But to make a month long story short: I switched surgeons to Dr. S and my procedure is TOMORROW!!!! 3pm. I can't believe it. I have had to fight so hard for this that I'm not even nervous (yet). I never thought I could be so excited to have somebody cut into my face. For my "Last Supper" I had pizza and this amazing, organic, Chicken and Fuji Apple Salad and then ... Ben & Jerry's Cherry Garcia. Yum! Since my procedure is so late in the day tomorrow though I'm allowed to eat until 7am so I'm happy to know I can have coffee (I am completely addicted). James (see picture) is helping me pack and gave me a "Get Well" basket with all sorts of important stuff like a dry erase board, relaxing cds, neck pillow and chapstick. Everyone has been really supportive as everything came together last minute and I haven't had much time to plan for this! I'm taking 3 weeks off work and I'm excited about that. I'll have more time to blog :)

Well all - you have no idea how much your own stories have helped me along this journey already. Thank you SO much :)

"Talk" to you again soon!

Sunday, October 5, 2008

Never Ending Story


So, since I have decided to take my employer's "offer" to cover 80% (of contracted charges) for my surgery I went ahead and set the date for October 27th with Dr. D (who I've been a patient of for 2 years). But then last week I went to Dr. S, who I had been waiting over a month to get in with, for a second opinion. Now I have quite the predicament as I have for sure decided to change doctors. The 2 doctors seem at this point incomparable. Dr. D had told me I would be in surgery for 11 hours for both jaws, 2 days in the hospital with the usual, dreaded wired shut forever, liquid diet, then soft foods recovery and off work 4-6 weeks. But Dr. S tells me (for the same procedures) it will take only 3 hours in surgery, 1-2 nights in the hospital and ... I will wake up WITHOUT MY JAWS WIRED SHUT! The orthodontist apparently comes to me in the hospital the next day to apply the bands and I will be back to work in 3 weeks. The longer you're under anesthesia, the more bruising and swelling, hence the vast difference in recovery time. I feel so much more confident in Dr. S. Now I have had to request that my "offer" instead include the new doctor. I'll be paying a whole lot out of pocket (and of course it would be worth it), but because he requires payment in full before the surgery ($36,000) I have to see how much my portion will be before I can know for sure if its realistic. He is available on October 25th at this point and I so badly want this over with. Next week I should have the details on the cost and therefore be able to decide if I will financially be able to do this.

Why does this story seem never ending? I'm so grateful to have found a doctor I'm much more confidant in, but now there are still all of these new "what ifs." My body and mind are tired. Please keep me in your prayers and thoughts.

Monday, September 22, 2008

I have a date!!!!!

My surgery date is set for October 27th (I can't believe it). The doctor has decided to do both jaws which means a longer surgery and tougher recovery.

I need your honesty here ... my biggest fear is not pain or swelling or bruising. I am terrified at the thought of waking up with mouth wired shut, throwing up when it has nowhere to go ... and then CHOKING.

Please tell me - have any of you had a throwing up incident? What do you do?!

Sunday, August 10, 2008

My Newest Obsession


At a recent dermatologist appointment I was asked politely about my braces (how long? etc.), and I mention that I have to get jaw surgery - not really wanting to go into too much explanation, considering my current stress with it all. But immediately, and with complete confidence she tells me all about some orthodontist and doctor in Pacific Palisades that a lot of her patients' children go to ... supposed to be "the best," they have all this high-tech imaging that will show you what you will look like before and after (I have to admit I have been more than slightly influenced by Holly's experience in having such a dramatic facial change after surgery). She encouraged me to at least just go and get the imaging done, even though I already have my doctors. I don't know why (I feel like I'm a pro on the subject by now and there's nothing new you can tell me), but I went ahead and made an appointment. I went to the orthodontist and sure enough there is an entire darkened room with all 4 walls projecting facial images in 3-D. It is such up-to-date technology they can move your entire head around at every angle and essentially perform the surgery virtually before they ever touch you. (My current surgeon has only ever referred to my teeth models when showing me what he's going to do.) It felt sooooo much more professional and got me all concerned that I should have done more research on my own doctor. I only met with the orthodontist because the surgeon he works with is actually out of Standford and comes down once a month to perform the operations. But I was absolutely sold me on someone I'd never met. Dr. S is not only an Oral & Maxillofacial Surgeon, he's a Plastic Surgeon with expertise in: surgical correction and the study of growth and development of craniomaxillofacial anomalies and deformities, Histochemical Analysis of Facial Muscles, Cranial Sutural Manipulation, Stability of Mandibular and Maxillary Surgery, Growth Factors in Infant Cranial Sutures, Virtual Surgery, 3-D Biocomputation, Osteodistraction ... AND he travels to impoverished countries to perform and teach on techniques for cleft palate surgery. Oh yeah, AND he takes no longer than 3 hours to do the surgery, when the average is 6 hours for most surgeons! You can google him (this is my newest obsession) - he is top in the field. Thus enters my temptation to switch surgeons, especially considering I'm not even sure if I'm going to use insurance to cover any of the costs - in which case I'd have to stay "in-network." But the catch: he costs three times as much! Ugh. I have a consultation set up with him September 25 (next time he comes down to LA). The orthodontist office says he'd likely be able to do my surgery the following month - around the 3rd week of October. And in the meantime I'm still working out my options with my current surgeon, who now says with his schedule he couldn't do surgery until September or October either. Either way people - this is going to happen!

Wednesday, July 30, 2008

What would you do?

I'm still waiting to be able to schedule my surgery, sad to report. But I'll give you a quick rundown. All the squeaky-wheel stuff got me a somewhat better response than a blatant denial from my employer. But after all that wasted time, they have presented me with a 3 page legal contract, stating that if I agree (to sign my life and rights away) they would cover 80%. Under different circumstances this would appear to be good news. Except that they are still pulling out the old "TMJ Disorder" exclusion as the reason they will not cover it completely. This makes me SO mad because it is otherwise stated that surgery for "congenital deformity" is a covered procedure - at 100%. So, now we're dealing with a "principle" issue. It would certainly be easier to take the offer and run with it, but then I'm knowingly letting them get away with something that is actually illegal. And they will continue to do this to people because they can. I'm stuck between a rock and a hard place. As bad as I just want to get the surgery over with ... I am SO a principles person. What I really want to do at this point is first get the surgery and just take them to court later. I know that I would win in the end, but it could take a few years (mind you, I am fully aware they will try to settle outside of court), but if they force my hand on this issue I have no intention of settling anything. I have extended one too many Olive branches already. I could have hired an attorney after the very first denial and been on my way, but I have tried to work something out internally before pursuing it in court. Ugh. What to do?

Tuesday, July 1, 2008

Very Long Story


As of today, I do not even have an approval for my orthognathic surgery. Very, very long story. But tomorrow (or latest - the day after) I am "supposed" to have an "answer." I know - pretty vague. You see, my situation has been a WAY long time coming. I remember at around 12 years old in my first set of braces, the orthodontist was leaning over my mouth pointing and explaining to my dad that I would eventually need surgery to correct my open bite. What?! Now I'm anxious. Two reasons: 1) surgery?! 2) even then I was obsessed with having good teeth (blame my mother), and I was now convinced that something was wrong and it HAD to be corrected. (Note: I am also a very big worrier). But a skeletal jaw "deformity?!" I'm deformed?! How would you feel?

Well, my dad scoffed at the idea. Yep - "scoffed." That's the only way I can describe it. I only ever witnessed this disgusted-at-the-thought reaction when money (his) might be involved. I didn't have health insurance. And he certainly was not going to pay out of pocket. I don't know if he was questioning the necessity or he thought the orthodontist had an ulterior motive - making a few extra bucks, but my dad was acting like he had just been insulted by a stranger. These damn braces were already costing him an arm and a leg, right? Needless to say, the surgery never happened and my dad never brought it up again. Throughout the next four years, I had several dentists (of whom a friend's family consisted entirely of) talk to me about what could be done for an open bite. They could always grind down some of the back teeth, pull a few, maybe crown a few to fill in the space between the upper and lower teeth that did not make contact. (Another note: if your upper and lower teeth don't make contact you can't chew food very well and you choke all the time - no fun). But, I was absolutely not willing to compromise my real teeth. I felt very lucky to have my own. My mom would always talk about how important it was to take care of them so I didn't have to ever get dentures. So, no pulling or grinding for me. I brushed and flossed and cared way to much about these babies to go and grind them up. It needed to be done right. But later, after moving states and having another orthodontist reiterate the same suggestion for jaw surgery (along with wisdom teeth and tonsils needing to go), the braces came off without the procedure (again, issue of no health insurance), but my teeth "looked" perfect. The braces had really seemed to close up the front pretty well and for a while I forgot about the whole surgery issue and just relished these gorgeous, white gems showing off for my senior year.

Fast forward a few years. Inevitably if you have this problem, the teeth will go back. Back to the open bite after all that effort. I was devastated. Chewing, eating, breathing, and pain all became a problem again. At 19 I sure wasn't making enough money to go out and pay for surgery so I (blindly) went and got my first ever health insurance policy. I did this before going to a surgeon because I was afraid of being excluded for a pre-existing condition. I was so worried about that part that I just had it in my mind that I had to pick a plan, submit for orthognathic surgery and then hope I got lucky (anyone like gambling?) Well, of course there's that waiting period. Blah blah blah. Broke as I was at that age with only a part time job, I made payments on that high premium every month and held my breath. Finally when I was able to even start submitting anything, I went to the surgeon. He submitted for the surgery. And they denied the claim. Devastated. Again. I didn't know what I was doing or what to do - the whole insurance thing was intimidating as it was. I can't remember if I tried to appeal or if I just gave up. But eventually I stopped paying for that worthless insurance and let go of my dream for 6 more years.

After college, I move to LA, and get a job with moderate pay, but great benefits (including health insurance). For a while I didn't even think about the surgery because I just tried to bury those hopes so that I wouldn't be disappointed again. But then, I go to the dentist for a regular check-up, he mentions my open bite, I say I know, he suggests an orthodontist, ugh, another one?, and I call him up. I go to the orthodontist who says to go to the oral surgeon who checks my coverage. And ... its a covered freakin' benefit! Oh. My. Gosh. I am practically hyperventilating. I know this won't make sense unless you've been there, but for those of us that have lived with teeth/jaw problems which equal chewing, choking, breathing, pain and speech problems, you can imagine my excitement. Now all I have to do is come up with $4,000+ for braces again (those fancy new clear ones are an extra $1,000). Ugh.

Whatever. It's worth it. I get the braces again. I am SO not excited to be an adult brace-face, but I just cannot pass up the opportunity to finally get the surgery I need to correct this problem permanently. It's been exactly 19 months in braces now and my teeth are in perfect (read: uncomfortable) position for surgery. The new problem is this. Today is July 1st, 2008. In December 2007 my surgeon submitted the authorization for the procedure and it was approved, no problem. So happy. January 2008, less than a month later and before I actually get the surgery however, my employer decides to change health insurance plans. But not to some familiar, comparable plan. To a self-funded Employee Benefit Trust. Tell me if you've ever even heard of this. The company, instead of paying a set premium each year to an insurance carrier, covers all medical costs themselves out of this newly created Trust. Good for them - they only pay when people use their benefits and this saves them A LOT of money. I can appreciate that. Thing is - because of this, the Plan is only, I repeat ONLY, subject to Federal Law (ERISA). Not state laws. This is a whole different set of rules. I re-submit to the new Plan for my (previously approved) procedure, scheduled for March 29th, 2008 and I am DENIED. Then, after appeal, I am DENIED AGAIN, based on an exclusion for the "treatment of TMJ Disorder Syndrome." What the hell?! Did they overlook that dreadful diagnosis of my "Skeletal Jaw Deformity?!" Are they idiots? Are they calling my doctor a liar? Well, worst part is this: once you have exhausted all internal processes (one appeal = exhaustion) you're (only) right is to bring suit in Federal court. That is where I'm now at 6 months since I have been waiting to have this surgery, with all orthodontict progress stalled indefinitely. I feel trapped.

But, with new pissed-off motivation I have been in our HR Director's office everday, emailing, calling, having other people call. And apparently they are "trying" to work it out. There's all these technicalities and liabilities and procedures that have to be figured out because of the subjective nature of our fabulous freakin' Plan.

So, I sit and wait and hold my breath and get sick to my stomach in anticipation. I "put my foot down" today though and said I could not wait any longer than THIS Thursday (before the 4th of July holiday) to have confirmation in writing if they're going to turnover the 2nd denial. I really don't want to (but will) exercise my one available right otherwise. (Of course I didn't say that out loud).

So, here I am. Waiting.