Thursday, December 13, 2007
Last Friday I hit a wall of sorts. It was the cheeseburger wall. As helpful as the soup was it just wasn't cutting it any longer. I had to bite into a burger. I might be addicted, Jughead style. At any rate I discovered come pain or discomfort I can eat a McDonald's Double Cheeseburger. And if I can eat one, I can eat three. Granted, this is the bottom of the Burger Bell Jar but I'll take what I can get. Come new years you'd better believe I'm gonna lay into a fat sirloin burger smothered in provolone and mushrooms from one of my favorite hole-in-the-wall establishments.
I'm not sure that I've deliberately broken any of my surgeons rules. He was very vague about the chewing/no chewing. I think he said I wouldn't "be able" to chew anything until the new year. There was no mention of soft foods easing back in at any point. I'm not sure I care. He's a great doctor and I trust him, I'm just really stubborn. Wait till I ask him when I can start playing hockey again ;)
I'm going back to the east coast tomorrow for the holidays. I'll try to post a picture before I leave. I wonder if I could pry my old ortho records out of my former OD. That'd be fun for everyone.
Tuesday, November 27, 2007
...aaaaaand here's the after:
...it was pretty awful. Maybe a beef broth instead of the shake? I wasn't sure. After some contemplation I noticed the cheddar soup my mom had bought earlier. Hm. Intriguing. So a couple days later after the shock of the initial attempt had passed I gave it another go.
This is a Jack-in-the-Box Ultimate Cheeseburger (no lettuce or tomato which helped I think) with a small order of onion rings in a bowl of Vons Cheddar Ale Signature Soup.
It came out the consistency of a stout oatmeal and while the flavor was exactly wht one would expect when chomping into such a greasy-cheesy-melty-mound-of-heaven, it wasn't exactly the same without the actual chomping. Until then, I'll be enjoying my Cream of Burger Soup.
Friday, November 23, 2007
Monday, November 19, 2007
So I slipped in for a early appointment with him this morning to give him a gander at my ever-increasing ghetto-fabulousness. He basically said I've healed really well and that I was ready to be passed on to Dr.Styrt's care until the next surgery. I'll see Dr.Tawfilis again in 6 weeks to make sure everything is healed for real (no foolsies) after the expansion is done. I asked when I could start lifting again and he said I could go easy now but any over exertion will lead to broken blood vessels, soreness, and re-swelling. So I'll go easy until the new year I think. It'll be nice to ease back into it anyway.
And off I whisked (can one whisk or does one have to BE whisked?) off to see Dr.Styrt. And this, I think, is a great indicator of how well I know my body and it's healing capabilities. I lie down in the chair and he takes a peak inside.
Checks my file.
Looks again, and says, "So did you have the surgery on the 3rd?"
("No I always look like a field goal post.) "Yup, I did," I said.
"Wow. You healed really quickly."
Bam. No sweat. I thought that was cool.
So we're on for a date after the new year to get bonded and wired. The best part is I'll get brackets on my lower 6 & 7's instead of bands so I won't need spacers. Pow. AND, I only have to click my way to 19 instead of 24. How ya like me now?
Sunday, November 18, 2007
On a serious note though, I can't help but think that only the right side of my jaw is moving over and not the left side. I'm sure it can all be fixed when the expanding is done but it's weird to notice.
Wednesday, November 14, 2007
Tuesday, November 13, 2007
Monday, November 12, 2007
I'm so happy I've finally gotten to this point, where things are happening. In theater, sometimes you have days where you can work hard for 10 or 12 or 16 hours and at the end of the day the theater looks the same as at the beginning of the day. Other days you can have half a crew working only 8 hours and it feels like a different world when you lock up. We like those days.
Friday, November 9, 2007
I go in bright and early Monday morning to start clicking but am getting this kiddish impatience about the whole thing. Don't make me do the pouty lips. I'll do it. I have no shame.
Thursday, November 8, 2007
-point of information, all four of mine were erupted. I'm sure they would not have come in as smooth as they did had I not had a set of premolars removed in middle school. I will say that I'm pretty sure the swelling would have been 10 times worse if they were impacted.
-pain, during the first day or so the pain from the extractions was more noticeable than from the osteotomy. After the 5th or 6th day when I was completely off the pain meds they again became the more annoying of the two pains. It's sharper and more localized for obvious reasons.
-bleeding, when blood spills out of your mouth while you're rinsing it's hard to say exactly where it's coming from. But I'm fairly confident that there was very minimal bleeding after I left the hospital 27 hours later.
Two-piece Leforte I-
-what makes this surgery above and beyond an extraction is how it effects everything around you for a much longer period of time. Putting the gory details aside let's look at the two side by side. Longer operating time, more blood loss, liquid/soft food diet for about 5 times longer, pain meds prescribed are much more serious (morphine for crying out loud! They give that stuff to dying soldiers)
-from a lifestyle point of view, if I wanted to go lift weights or play hockey after an extraction I could do it that day. Might sting no doubt, but it'd be possible. After surgery? My maxilla is being held in place by the meat in my mouth. That's all. When I bite together I can feel my upper arch moving closer to my brain. Walking is now considered a jarring activity. Let's just say that that sort of instability changes the way you do simple things like sit in a chair, turn your head, and swallow your juice.
-pain, during the first couple days it felt like a burning sensation at the line where the cuts were made below my nose. But worse than that, when re-learning to swallow the maxilla does a whole lot of clanking around. And feeling it clank together up there was enough to stop everything around me. These last couple days have gotten better with that scar tissue starting to grow in there. The stitches are tight and dry up there and smiling is still very painful.
-bleeding, the bleeding thats going on seems to be leftovers from the procedure. A couple times a day I'll lean forward in just the right way and my nose will start dripping blood. Not a nosebleed, just leftovers that've pooled up in the nasal cavity. Gunks of blood have become slowly coughed up from the throat and the nasal area and I'm sure this is ok because it feels so relieving when I get a good piece.
With this in mind, I'd like to say that having your wisdom teeth is like hitting your thumb with a hammer. But jaw surgery is more like being splattered across the sidewalk by a bus.
Wednesday, November 7, 2007
Swallowing is still a little disturbing at times but not as bad as it was. I'm carrying around a towel for saliva so I don't have to swallow for swallowing's sake. Still lots of pressure in the sinuses and the very few times I've tried to utter a word it sounds (as it should) very, very congested. I'm not taking any more Vicodin during the day but they do help me get to sleep. So the pain isn't too bad.
Oh, I am taking daily pictures but won't be able to post them until next week.
Tuesday, November 6, 2007
The surgery went well. Dr.Tawfilis said everything went as planned, wisdom teeth caused no issues. We showed up at 5:30am to check in and you'd think I was the only person having surgery that day. There wasn't a long wait from getting into my gown till I was in the room. I met my anaesthesiologist just prior, Dr.Cochran I think. I asked him where he went to med school. University of Michigan, he said. Some of the best hockey in the world there so I'm at ease ;) It didn't take but a minute after actually getting into the operating room that Dr.Cochran told me he was going to give me some stuff to sleep and that I should just relax. After the night I had before believe me I was ready to relax and go to sleep. No counting. Just relaxing and I was probably out in a second or two. When I woke up I was able to recall exactly what was going on, knew that I'd have gauze in my mouth etc. The wisdom teeth were the most painful part right off the bat. I got nauseated twice and it felt like a precursor to passing out but the nurse was able to give me something that calmed me down immediately. I think I remember her using the word "Dulotid," mmmm. Then they wheeled me to my room and got me hooked up on Torridol. I had the option of that or Morphine. I gave the Morphine a chance once and absolutely did not like it. They only gave me 1mg instead of the max 4mg but it was enough to make my breathing race so much that I couldn't sleep. So no more morphine for me. Later that night they started trying to get me to take in some liquids which was a challenge. Without rigid fixation you really can feel the maxilla shifting around when you swallow. It's disturbing. Sleeping through the night was hard because the pain came back. This time it was like my nasal area was on fire. The next morning I got up to use the bathroom and watched some football until The Chainsaw came to check up on and possibly discharge me. I felt ok and he said I looked good so I was free to go.
Friday, November 2, 2007
Thursday, November 1, 2007
Here's a picture of the device. For the rest of the world, see that slot just left of the two dots? That slot is where you put in the key which is basically a small wire comparable to a paper clip. By rotating that wire towards the back of the mouth (as indicated by the arrow) it spins a screw which pushes the two sides apart. Each "turn" of the key is actually about a quarter turn of the screw. At the prescribed 24 turns for my treatment and the desired 6mm expansion I figure it's a 1tpm screw (1 thread per millimeter. 24 "turns" times one quarter turn per "turn" divided by 6mm = 1 thread per millimeter)...I'm a mechanical person, this is what I think about :)
I'm gonna go shopping for recovery stuff tonight and then play hockey one last time before the thurjeree.
Wednesday, October 31, 2007
Kira, my tech, made me try to say "spaghetti" and "green grass" before she let me go and I'm not sure if there was any medical practice to it or if it was solely for her enjoyment. Fringe benefit of the job I guess. I don't blame her :)
I was curious how much expanding he'd like to do and the measurements look like 6mm. Dr.Styrt said this would be about 24 turns. So one week after surgery (which is an IMPOSSIBLE word to say right now) I'll start cranking twice a day and go back in after one week to check my progress at 14 turns.
Good thing I bought all this saltwater taffy to enjoy for Halloween tonight. (jk)
What are Orthodontic Spacers?
...and why do you need them?
Your orthodontist may have told you that you need to have spacers before your braces go on. What does this mean?
Some of your teeth may need brackets that are attached to metal bands that go all the way around the tooth.* Usually, the bands are used only on molars. If the space between your molars is very tight, it will be difficult for the orthodontist to put the bands on the teeth. Therefore, space must be opened up to fit the bands in. This is where spacers come in.
Spacers are little rubber nodules that fit between the teeth. In some cases, your orthodontist may use a metal spacer, which looks like a tiny metal hinge. The spacers stay between your teeth for several days and move the teeth apart slightly. You wear the spacers 24/7 until your orthodontist removes them. Do not floss teeth that have spacers between them (it will be impossible)!
Are spacers uncomfortable? Yes, they usually are. It feels like you have something stuck between your teeth -- and you do! In some cases it may be more than just uncomfortable; it may ache. If so, take pain reliever (such as ibuprofen) as needed.
Spacers usually stay between your teeth for several days; sometimes for as long as 10 days. The spacers are taken out before your braces are put on. The braces don't hurt like the spacers; in fact, when the spacers are removed, it feels so much better, even after the braces are put on!
Many people on Metal Mouth Forum have remarked that spacers were the worst part of the entire process. Perhaps that's not very encouraging, but remember, they're only in your mouth for a short period of time. You can deal with it. They'll be in, then they'll be out, and you'll be done with it. Hang in there, you're on your way to a better smile! And if those spacers really bug you, drop in to the Metal Mouth Forum and spill your guts. We love to commiserate! :-)
*Why do some teeth need metal bands instead of regular brackets? Fillings. If you have a filling that protrudes to the outside of your tooth, brackets cannot be glued to these fillings. Therefore, a metal band must be wrapped around the tooth instead. The bracket is attached to the metal band.
I ate 24 oz. of unadulterated Porterhouse fury.
It. Was. Amazing. They certainly give Ruth's Chris a run for their money. I brought my two favorite wines from Chile, a vanilla-y Cabernet Sauvignon and a leathery Malbec. They worked very well with the slabs of heaven upon our plates. I meant to take pictures of the event but forgot my camera. Shoot. Anyway it was a great time. I love a nice dining experience with good friends.
Thursday, October 25, 2007
In other news, the fires are dying down and my family got to go back to their respective homes yesterday. I don't think I'll have to be postponed afterall (knock on wood). Makes for dramatic reading though, ¿qué no? Thanks again for the thoughts.
Wednesday, October 24, 2007
Tuesday, October 23, 2007
To start off, I got called in to Jury Duty. Yes, I was actually on a jury. Well better to get it over with I guess. I was there for the better part of a week deliberating over a Battery Against a Dating Partner. They were both shady characters and honestly none of us really knew how a case like it could have made it to trial. (Not to make light of domestic violence.) But we didn't trust either of them and it ended up being a hung jury. Not so bad, a good week before surgery taken up in an interesting way.
Then I go play hockey and decide to block a puck with my hand. Slapshot right to the palm where there's no padding to speak of. When I get home I figure it's better to check into the ER at 12am than it is the next morning so I cruise over there for an x-ray. They send me home with some Vicodin and tell me it's not broken, just needs some rest and deswelling. The next morning I take a sick day to enjoy my Vicodin on the couch and get a phone call from the radiologist. He sees a fracture and I need to go to an orthopedic. Great. I've broken my hand before and it's not super painful but being in a cast for 6 weeks is more annoying than a little brother. So I go to the ortho(pedic) and he squeezes my palm near the wrist and says, "Is this tender?" "No"I say, "it's up here by the fingers." "Have you ever injured your hand before?" he queries. "Yeah about 6 years ago I punched a wall" quoth I. (This story deserves its own telling over a couple drinks.) You guessed it. The radiologist saw the old fracture. So I'm fine and on my way.
Well whew, I made it through the week and it's Monday morning, 6am. Imagine the contentedness on my face in the middle of a cozy slumber after a busy weekend. Now imagine my heart palpitating and lungs gasping when I become jarringly awoken by my phone. My family got evacuated for the fires. They're staying with me now. Everyone is fine and the houses are ok so far but god damn if I can't get a break. Thanks to everyone for the well wishes. We're native San Diegans. This ain't our first barbeque.
Oh yeah, if the fires keep going there's a chance my "elective" surgery will be postponed again.
Sunday, October 7, 2007
Sunday, September 30, 2007
Friday, September 28, 2007
WARNING: The following is not for the faint of stomach or jealous of nature.
Example #1- Breakfast- Chocolate Protein Bar
Brie and Pesto sandwich
Lunch- Grilled Cheese sandwich
Exercise- Ice Hockey Game
Dinner- Cheeseburgers (3)
Vanilla Protein Shake
Example #2- Breakfast- None
Lunch- Sushi- Pizza Roll, Philly Roll, Tuna Sashimi, Yellowtail Sashimi
Exercise- None, day off
Dinner- Endless Shrimp at Red Lobster- Caesar Salad, Broccoli, one order each of Popcorn shrimp, Scampi shrimp, Buffalo shrimp, Breaded shrimp
Bar- Irish Coffee w/whipped cream
After Bar- Sourdough burger
Granted, these are some of the more grand forays into the culinary world, but it paints the picture. To be fair to the other part of the equation this is what my exercise routine is like:
Inclined Bench Press
Every other day, no lifting if I have hockey that day.
It's not a very precise or focused workout. Very general. Get everything done all around. But I haven't gotten bored yet or hit a plateau which is nice. I think being able to see progress every day (even if only by a couple pounds) keeps me motivated.
So that's what my life has been like lately. Sorry I don't have any good ortho news. Still just watching the days pass by until things get picked back up again. I get my spacers put back in October 24th so you'll have to hear about my phys ed program until then.
Friday, September 14, 2007
And I love it.
I've been trying to gain weight since high school and have always had a hard time at it. Now, for the vast majority of you who are scrunching your face and about to get all uppity with your sarcastic I-wish-I-had-that-problems and your oh-life-is-so-hard-having-a-fast-metabolism retorts this is what I have to say to you: I have no doubt in my mind it is as much effort for me to gain five pounds as it is for you to lose five pounds. Now that we've established that this is not an easy task for me let's move on.
Granted, that's not to say that it isn't without its interesting benefits. If I want to eat ice cream in the middle of the day, I do. Even if I don't want to eat ice cream in the middle of the day, sometimes I do. I had a cheeseburger and chocolate shake for breakfast the other day. But other than the decadence of it all there are other perks. I no longer hold back on ordering the food that I really want just because I'm trying to save money. I consider this an investment in my health and I don't mind shelling out a little more per week for that. Also, it forces me to workout religiously. I don't want to just gain weight, I want to gain good weight. When you're sitting around doing nothing (like I'll be soon) muscle mass disappears way before fat mass. So just skipping the salad and gorging on pop-tarts will not help me out at all. Going to the gym and using up those calories however creates nice dense muscle mass. So I'm happy about the way I look. I've also convinced myself with no scientific evidence that by being as strong as I can I'll be able to heal quicker. Can't be complete rubbish right?
The downside of all this is like any diet or workout regiment I have to stay on it. Keeping a high calorie intake is difficult when you're not used to it and sometimes you just don't feel like lifting.
I've gained about 6lbs in three weeks and would like to reach 200 by the surgery. So if you'll excuse me, I have to finish my last Zinger.
Thursday, September 13, 2007
Seriously? Seriously. Seriously??
The way she posed this as a question struck me as odd. Especially when she explained that The Chainsaw is having some family issues that make October bad for him. Would it be ok with me? "He doesn't want you to be mad" she says.
Despite how much I tried to explain to little Veronica that I will work my life around the surgery and that whatever needed to happen will happen, she was really trolling for my approval about the whole thing. No I'm not mad at him. The man is going to chop my skull apart, I think resentment of any kind is not the path to take here. Not to mention I don't mind waiting another two weeks if it's the difference between a good procedure and one where my surgeon is half-occupied with his sick mother or brother in rehab or child with chicken-pox or whatever. I don't care. Sort your stuff out and tell me when you're on your game. Don't ask my permission or beg my forgiveness. Doesn't want me to be mad. Seriously.
So November 3rd is the new day. Still a 7:30am procedure. After it was confirmed by the hospital I called up Wonderful Jessica and my dentist to reschedule the expander and cleaning. (I was supposed to have this cleaning in August. Sheesh.)
With the new date there's a chance I won't be back to work for tech rehearsal of my next show but it's a much smaller show with a much less important director. But it'll be fine. If I were to really push myself I'd be able to get back for a couple hours a day but really I think the show will be fine. This way I'll get more time to prep on the front end anyway.
Wednesday, September 5, 2007
Monday, August 27, 2007
Here's a question for those of you hip on the lingo, Veronica said I was up for a BSSRO (bilateral sagittal split ramus osteotomy.) Now from a little googling it seems that this is basically the same thing as a BSSO (ramus just means 'bone' apparently) but all the cases I can find have been mandibular. I'm more of the maxillary flavor as I understand it. Am I missing something?
I'm almost part of the club guys!
In other arenas, I chewed through a spacer again this Friday past. As I replaced it with my little floss trick I may have overdone it a tad. Yeah, that sucker got jammed waaaay up there. So I went the weekend with more than normal soreness (shrug) and squoze myself in to see a technician (Carrie Ann) today at lunch. Here's where it gets interesting. The particular space that this spacer was occupying was between my two crowns. This little bastard was wedged so far into my gums I could feel it getting hung up on the root side of the crowns. Carrie had to slide it around to the side to get it out. Talk about a weird feeling.
Now I'm ok though. Well, except for the waiting part.
Friday, August 24, 2007
Tuesday, August 21, 2007
Friday, August 17, 2007
Now on to more pertinent subjects. I did manage to chew through two spacers while I was out. Both from the same place. The distal on the left side tends to stick down lower than the rest so I kinda knarl it up when I chew things. Eventually it just gets worn down and breaks. Who knew.
I was hoping to come back to a voicemail from The Chainsaw telling me my surgery date. I was welcomed by no such message. (Strangely, I had zero voicemails and zero texts. Odd I think) So I checked up on them today and Kim told me they had not yet received approval from insurance. She gave me their number and said I could shake the tree if I wanted. Yes, please. Me likey shakey.
I gave them a ring and lo and behold, they have not received a request for any operation. I call back Kim and let her know and hopefully this will be squared away soon. I'll be checking up on them again tomorrow just in case.
I was starting to feel a little bad about bugging Kim so much about when I'd get a date but now I see that It's not a bad thing to be as proactive as possible if you want things to get done.
Thursday, August 2, 2007
Tuesday, July 31, 2007
And now I know that surgery is an awful mistress who will do as she pleases, when she pleases.
So I guess I'll just keep my spacers in for awhile so I don't have to get re-used to them. I'll postpone the cementing of the I-make-food-impossible-to-eat device and wait.
At least I won't be stressing about it on my trip.
Thursday, July 26, 2007
She gave me some more extras in case I have another escaping bandy while I'm away. I'm getting a touch nervous about the surgery date because I still haven't heard back from The Chainsaw's office. I think he's waiting for me to be approved by the insurance people before he schedules me. I just hope it happens before I get on a plane so I can tell my family what's happening when exactly.
Wednesday, July 18, 2007
Tuesday, July 17, 2007
So it has begun. I've got spacers on my upper 6's and I'm ready to rumble.
Monday, July 16, 2007
So Dr. Styrt wanted a consult for a Lefort I expansion and posterior impaction in addition to lower mandibular advancement. Three things happening there: Upper jaw gets cut vertically and is spread apart, Upper jaw gets tilted forward, and Lower jaw slides forward. Dr. Tawfilis said he prefers to be minimalist when it comes to surgery and believes that the lower advancement won't be necessary but if the chin deficiency is a problem for me that he recommends just a genioplasty. (He showed me some pictures of other genio patients and I'm not sure how I feel about it but I've got plenty of time to ponder.) He also said he isn't sure that the Lefort expansion will be necessary and that seemed to think that SARPE (surgically assisted rapid palette expansion)would do the trick. This confused me a little bit. I guess by Lefort I expansion they mean like a three piece expansion? Anyone have any insight? And the prize indeed goes to Erin for calling the wisdom teeth extraction. He said we could do it at the same time as the SARPE since I'd be under anyway. As for the implant down the line, the bone grafting will happen at the same time as the Lefort I and the actual implanting will happen around the time I get the braces off. The great news is he said I can save some money by doing the grafting at the same time because implants aren't usually covered.
Speaking of coverage. He said my insurance is usually really good about approving this type of treatment and that yes indeed, we're talking 100%. Sweetness.
So we talked a little bit about timeline and here's the big rundown:
1. Make an appointment with Dr.Styrt to get the hyrax (hirax?) cemented in, meanwhile Dr.Tawfilis will put in the request to insurance for the SARPE.
2. Have SARPE, remove wisdom teeth, and start clicking. (For those of you out there who've had this done, how long post-op until the braces go on?)
3. Get braces on and start closing "the gap"
4. 12-18 months later, have a Lefort I and bone grafting and perhaps a genio (I really think I'm going to decide against it though.)
5. 6 months later, get braces off and install implant post.
6. Then whatever the timeline for the implant is, I didn't see any need to go into it in detail since it's so far away yet.
As I'm writing this I got a call from Dr.Tawfilis who had a chance to speak with Dr.Styrt. They're in agreement about The Chainsaw's plan and now I need to get that awful thing cemented in. Here's the rub. I'm going on vacation to Chile in a couple weeks and think I'd like to wait until I get back to get everything started. I'd hate for something to go wrong while I'm there or have to deal with that thing any longer than I have to, especially when I'm supposed to be enjoying myself.
The only bad part of the appointment was with the confirmation of the SARPE means I'll have to stop playing hockey 12 months sooner than I was hoping. *shrug* I guess that's the way it'll have to be then.
Sunday, July 15, 2007
Thursday, July 12, 2007
-Will I need to have my wisdom teeth pulled?
-Will I need a palette expander?
-Will I need SARPE?
-What will the timeline for the implant be like?
I saw Wonderful Jessica today when I picked up my files and models for tomorrow and she said he's really cool and that I'd like him a lot. Perfect. I'm not used to letting people I don't like peel my face back and break my skull apart.
Tuesday, July 3, 2007
Tuesday, June 26, 2007
Sunday, June 24, 2007
Trivia for the day- The first recorded orthodontic-like method of treatment was performed by the Roman writer Celsus (25 B.C.-A.D. 50).
Thursday, June 21, 2007
I got a call from Wonderful Jessica a couple days after I faxed her the info from Dr.Keefe. She had been out of town I guess, but she's back on the case now and the insurance people need more recent x-rays. That's what happens when you have to wait three months to see a specialist. (Which by the way I'm still not convinced is any kind of norm. Has anyone else had this problem?) So I'm scheduled to come in the next day for a quick visit. Wonderful Jessica is ready as soon as I walk in the door and now it begins. She asks if I'm ready to make my down payment. What a wonderful feeling. Now I'm committed. No backing out. Let's roll! I get all set up and she hands me off to one of the technicians, Kari. We do some panographs and make some impressions. That paste tastes way better now than I remember. And within 15 minutes I'm free to go. Now I'm waiting for word from Wonderful Jessica to set up a time with my OS to be.
Rollin rollin rollin.
Wednesday, June 20, 2007
Anyway, Dr.Keefe seemed to have been down the orthognathic road before and gave me a list of things to send to the insurance people (letter from ortho, x-rays, etc.) In addition, he said, and I quote, that my septum "shanked to the right" and that I have "HUGE turbinates." Very technical stuff here. But it goes along with the not-as-easy-as-it-should-be breathing issue. He said they might be able to take care of that all in one shot along with the jaw surgery but they'd have to see how things pan out. Another little peak into my insurance packet and again, as long as it's "Medically Necessary" nasal surgery also is covered. I'm starting to wonder if by "covered" they really mean "75% covered" or "50% covered" We shall see I guess.
So I gave the list of things Dr.Keefe gave me right to Wonderful Jessica and she's taking care of it. I got people.
Getting an appointment to my PCP was no problem. She's a very nice lady who knew little about orthognathic surgery. With my x-rays and consultation papers in hand she saw I was prepared and was more than happy to give me a referral to one of the network's ENTs. I figured, "Cool, about a week's time from seeing my ortho to seeing my PCP. Between the ENT and the OS I should be in braces by March."
Apparently I'm not so good at figuring.
The earliest appointment I could get with the ENT was three months away. Despite bugging their receptionists everyday for a week or two and getting on their "short-notice-will-call-wait-list" I still had to wait it out. Wait. Wait. Wait.
Tuesday, June 19, 2007
It's f***ing impossible.
Pizza, onion rings, and balogna sandwiches can also cause annoyance. To adapt and try not to look like a complete fool while eating I'll use my tongue to push these sorts of food up against the bottom of my top teeth. I thought it was rather clever. So all these things that, while obvious improvements on my current lifestyle, require me to admit that I have these problems and that they need fixing.
Enter cocky, proud, stubbornness. I don't want to say this is a male thing but it is most certainly a male thing in my family. We don't ask for help. We don't take charity. At gift-giving time it's usually only something functional that we ask for. "But this surgery is totally functional. You just said so yourself," you say. Well yeah but it also carries with it a vain reward of aesthetic value. Besides, I'm still alive. I've made it this far. I can eat and breathe and sleep and do a lot of things and a lot of things better than most. So why "fix" something that obviously works fine? This is the connundrum and the conflict. I feel that by admitting I need this work done I am betraying 27 years of perservering and overcoming and "being myself" and being ok, no, more than ok, with who I am. At the exact same time though, I am elated by the knowledge that all these things that have always been an issue are all related and can be solved relatively easily. So I did what any American young man would do in my situation.
I called my mom.
She gave me a little perspective and in the end made me feel pretty certain about my choice to go through with this. She also told me something interesting that I had completely forgotten about. When I had braces the first time they knew I needed surgery. In fact they had actually asked me if I wanted it done. I had completely forgotten! Why wouldn't I have it done before? Not because I was in school. Not because I was young and young people can be terrible and insensitive to each other. Because I was completely misinformed. See, my older brother also has an open bite but also has a large underbite. So when they explained it to him they said his chin would be pushed back. When they explained it to me they explained it as "you need surgery just like your brother." As mentioned, I don't have a chin to begin with! Why would I want you to push it back more!? Needless to say I didn't want it. Then. But after chatting with Mom I'm rearing to go. And now I get to pay for it.
Boy did I get hornswaggled.
Monday, June 18, 2007
Dr. Crowe's office is located in a small medical complex where a lot of doctors have their practice. A Medical Strip Mall of sorts. One could reasonably get their braces tightened, warts lanced, hair permanently removed, and relax for a spot of accupuncture all in an afternoon while only having to park your car once. As wonderfully odd as that visual may be, it didn't bother me as my first ortho in middle school occupied the same sort of facility.
The consultation went very much the same way as with Dr. Styrt with the exception of some details. Dr. Crowe needed to use a measuring device to determine my midline deviation etc. Once or twice he was interrupted to show one of the girls at the desk some paperwork or other. Maybe she was new. I don't rightly know. And lastly his quote had to get worked up and was eventually emailed to me. All in all yes I would have felt fine having the work done there. But I felt that with the surgical ramifications of my treatment Dr.Styrt's office would be able to take care of me better.
Dr.Styrt is about 30% more expensive than Dr.Crowe, but already they've been handing all the insurance stuff which is well worth it.
Sunday, June 17, 2007
Dr. Paul Styrt is the ortho and his office is immaculate. It's in a very upscale office complex so instead of getting that nauseous "I'm-going-to-a-clinic" feeling I felt like I was going to a training seminar or conference for work. Which was nice. The office is very open and well designed. Italian marble countertops and a colorful fishtank gave the feeling of a spa rather than a medical office. When you arrive you find your name on a computer screen at the receptionist desk and click to let them know you're here. (I'm not exatly sure why they need a receptionist at all.) They took some pictures and some x-rays and then I got to meet with Dr.Styrt. His examination was quick and knowledgable as if he had seen a thousand people with a mouth just like mine. Rattling off the number of mm's my midline was off, my bite was open, etc. I felt reassured by his confidence that he knew what he was doing.
There was no question in his mind I needed a surgical treatment to fix my bite. While I could just opt for braces alone it would straighten my teeth but the bite would never come together and ultimately the TMJ problems I have would keep getting worse and worse. 12-18 months in braces, surgery, and another 6 before the braces came off. A bit shocking but not unbearable.
Meanwhile, Jessica, the treatment coordinator, had written up my treatment plan with quote and pictures and x-rays and laid it all on me in a cute little pocket folder. She explained to me different payment options which were within my range but it was the surgery that concerned me. I hadn't saved anything for what would inevitably be at least, what, 20k? 30k? "I can't go through with this unless the surgery is covered by my insurance." Which I had no idea if it was or not. But that's why Jessica rules the roost. She asked what kind of insurance I had and immediately called someone and asked what their procedures were for this and in 30 seconds had a detailed list of what I had to do and who I had to see for this to be covered.
I hadn't even signed anything and they knew I was seeing another ortho next week.
So out I went with my cute pocket folder and a plan of attack and smiles and waves from the girls in the office.
Saturday, June 16, 2007
When I finally secured some permanency in my job and began receiving dental benefits (which was actually about two years after I graduated college) I figured I should probably start taking advantage of them. Stop. Hold on.
When I finally secured some permanency in my job and began receiving dental benefits it was probably a toothache that made me take advantage of them. I'll be the first to say that despite many spells of dental hygiene mantainence attempts (both obsessive and completely non-existant) I have always had difficulty avoiding more than routine cleanings.
During college I went to the dentist once a year over the summertime when I was home and that's it. After I graduated I was no longer under my parent's insurance and had to wait it out until I got my own. Needless to say those first couple appointments with my newfound dentist (Dr. Anton Misleh) were spent ruthlessly cleaning the years of crap now built up on my teeth and eating my gums away. Eventually things got up to snuff and I was no longer a dental biohazard zone. Throughout my dentist would ask me when and if I planned on getting braces. I'd tell him I already had braces in middle and high school and hadn't thought about getting them again. (I'll tell this story some other time as it really does deserve its own post.) He'd tell me that straighter teeth would obviously look better but he was more interested in the fact that it would make my teeth easier to clean. Hence, less bacteria hiding and causing problems. Over the last year or so things have been good dentally and financially so I started thinking about getting braces again. I have to be honest though, much of the decision was based on getting my dentist to lay of the badgering about when I'd have it done. So "The new year" became my lift-off date. I went home for Christmas this past year and when I got back the search for an orthodontist began.