orthognathic surgery,janell smith,jaw surgery,lower jaw surgery,over bit,overjet,the quest for less character, character blog, braces, adult braces,mandibular advancement, jaw The quest for less character: 2011

Oct 23, 2011

2 weeks - Back to work tomorrow

Ok, I'll just put it out there, I stink at keeping up with this blog.  As I mentioned before, my plan was to do this daily but it definitely has not been the case.

There really hasn't been anything Earth shattering to report other than just steady progress.

This week, on Monday, Tuesday and Wednesday, I felt really energetic and was productive around the house.  Thursday and Friday, not so much.  I crashed, hit a wall, melted, fell down, whatever you want to call it, I did it.  I had absolutely no energy and was completely lethargic.  I was depressed and didn't feel like doing anything at all either day. I literally slept all day, pretty much both days. Friday night, we left the house to go to Sonic and get a Java Chiller, and you would have thought I ran a marathon.  Not sure what happened, but those were my worst days.

Saturday morning however, I woke up feeling great and full of energy.  Canyon's school carnival was Saturday so that was my big outing.  We walked about 4 blocks there, hung out for about 2 hours and I did okay.  I had to sit in the shade a couple of times because I got light headed, but for the most part, I felt fine. I did come home and take a big ole fat nap, but got up feeling fine.

Today, got up again feeling great and full of energy.  Went to church and felt great through the whole service.  It was a little awkward during the time when you turn and greet those around you, you know the drill, when I couldn't really be understood. Sharon pretty much handled the talking for me. I just smiled and looked oh so cute with my big hunka plastic in my mouth.

Came home from church and took another fat nap, then got up and made dinner. I love to cook so its actually therapeutic for me to be in the kitchen.  It doesn't even really bother me that I can't eat what I'm making.  Tonight though, I grilled steak and as I was cutting it up for my son, and I couldn't stand it.  I put a big chunk of beef right in my mouth and just sucked on it for a minute, like a piece of candy. HA!  Not proud of it, but it just had to do it.  It tasted yummy. 

As far as other progress.  My swelling is pretty much non-existent at this point, except for maybe just a teeny bit right in the lower part of my cheeks and the Shrek neck is gone as well.  There is a tiny bit of bruising left on the lower part of my chest, but you have to look really hard to see it.

I'm off the pain meds except for one at bedtime.  For some reason, the only pain I'm having now is at night.  I suspect I'm clenching my jaw in my sleep, but I'm not sure how to stop doing that. Anyway, during the day I haven't been having any pain at all. I'm a bit sore if you touch my jaw, yawn, laugh or talk to much, but as far as the throbbing pain that I was having last week, that is all gone.  I am managing the pain now with ibupofen and a heat pack.

I'm down 10 pounds and eating is still a challenge for me.

Its probably the hardest part of all of this.  Not because its hard to eat, but because I don't want to. Because of having a gastric bypass in my past, things like dairy and sugar terribly upset my stomach.  So high caloric things like Ensure, milkshakes and cheese don't set well with me.  Its been really hard for me to get enough calories in in a day and its just getting me down.  I found Boost glucose control which is a nutrition shake with low sugar, but it only has 190 calories, as opposed to the 350 that Ensure has.  I like them though and they sit okay with my tummy, so that is my new focus.  Boost, Boost Boost. I still have no appetite and would just rather drink when possible, so I'm packing a 6 pack of Boost to take to work tomorrow.

That's about all that's happening in my world right now.. Just steady progress daily.  We'll see how tomorrow goes with my first day back at work. I am planning on working a full 8 hours so keep your fingers crossed that I don't crash.

God has been so good to me throughout this entire process.  From my doctors, to the insurance coverage, to Sharon taking such good care of me, to how well I'm recovering.

Based on all the blogs that I have read, and research I have done, my recovery has been WAY better than I ever expected.  God definitely had his hands on me throughout the whole ordeal and I thank him daily for getting me through this.

Will update soon with progress at work.

Oct 17, 2011

Day 7 and 8 - Just Call me Elvis!

I have found a new snack that is quickly becoming my best friend.  A mashed up banana with a tablespoon of peanut butter. The combination is quick and easy to get down, very tasty and packs a whopping 290 calories and 9 grams of protein.  Guess I have have this in common with "The King."  Minus the sandwich bread of course.

Prior to surgery I prepared some meals for my family and put them in the freezer to make it easier for them while I was recovering.  One of the things I made was chicken enchiladas.  As they were baking yesterday, the smell was really making my mouth water so I decided to put one in the blender with a little chicken broth. The texture is something I will need to work on getting used to, but it was actually very yummy. Tasted exactly like a chicken enchilada.  Even if it did look like baby food.

Today I felt well enough to be in the kitchen cooking. I am already beginning to tire of canned soups, so I decided to make some of my own.  Today was Vichyssoise and butternut squash soup.  They both ended up very tasty and I had a little bit of both for dinner. I love cooking and it makes me feel human again to be in the kitchen.  I probably over did it a little, as I am quite tired this evening, but it felt good to be productive.

As far as swelling goes, it is going down more and more each day.  Its still there and is still quite noticeable but you can tell I have cheeks now.  Its a little weird though, in that it seems to move around.  Since each side of my face seems to have its own personality, we have lovingly given each side a name.  The left side of my face is "Lucy" and the right side of my face is "Ethel," and of course my neck is named, "Shrek."

For the last few days, Ethel has been the one acting up.  She has been where most of the pain and swelling has been, while Lucy has been fairly quiet.  Today however; Lucy was being rowdy. She was more swollen and had a bit more pain. Its weird how they take turns.   As for Shrek, he is about the same.  Green.

My pain still seems to follow the same pattern as it has been all week.  Less in the early part of the day, increasing as the day goes on, worse at night. My middle-of-the-night pain has started to lessen though, so that's a huge relief. For several nights in a row, about 4 am I was awake and in tears from my pain level. Sharon, bless her heart would get up, get my heat pack for my face and neck and rub my feet until the pain medicine would kick in and I would fall asleep. She has been such an Angel.  So patient and kind, and selfless. Whatever I need, or even think about needing, she is right there with it. She is truly the perfect nurse!

My plan is to start decreasing the frequency of my pain meds starting on Wednesday. I need to be completely off of them, or at least only taking them at night by the weekend, so that I can prepare to go back to work next week.

Honestly, I'm not as worried about my pain tolerance as I am not being able to speak clearly, when I go back. It will comical I'm sure.  I work with a great team of people with great senses of humor.  They are very supportive and will be sure to make fun of me every chance they get, which I have already given them free reign to do so. That is how I cope.  Laughter.

Anyway, that's all to report today.  Time is flying and I'm gaining on this healing thing!

Oct 15, 2011

Days 4 - 6..... Where did Week 1 go?

Well, I haven't been keeping up with this as much as I had intentions of doing.  My plan prior to surgery, was to post every single day and not miss documenting a thing. Unfortunately, that has not been reality for me.

My last 3 days have been fairly similar to each other. I have been waking up in the morning feeling really well and having some energy, and then by late afternoon my pain level seems to soar and I hit a wall.  Then it seems to take until the wee hours of the next morning to get my pain level back in check.  Haven't figured out how to change this pattern yet.

Thursday morning, (day 4) we woke up at about 4 am to Canyon running out of his room because he needed to throw up.  He came into the living room where we were and in my Hydrocodone-induced coma, I was still able to recognize "that look" and I immediately jumped and grabbed the trash can just in time to catch it as he almost threw up on my feet.  LOL.. Guess the drugs can't put my Mommy instincts to sleep.

We thought maybe it was a fluke upset tummy, because he tends to do that a lot, and we sent him to school anyway, I mean, he wasn't running a fever afterall. We received a call by 9am that he had thrown up in class. Oh no! I don't know whether to say poor Canyon or poor Mrs. Sparks. She requested that we keep him home Friday as well, just to be safe, said he was like the 5th kid that had thrown up so far that morning.

So Sharon ended up with another patient.  He stayed in his room and watched movies all day to keep me from being and we seemed to do fine.  As of today, knock on wood, I don't seem to have caught anything from him. By Thursday night was fine and he left Friday evening to go hang out with his Aunt and Uncle.

As far as eating goes,
I started throwing things in the blender to try to change up my diet.  I still don't have much of an appetite and eating is more of a chore for me.  Its not that its hard.  I mean, I'm very lucky in that I can slurp from a cup and get a baby spoon in my mouth, its just that its tiring, and it takes so long and I have to eat every 4 hours in order to take my meds, and I'm not keeping my calories up and blah blah, yada yada, you know the drill.Still working on this part of the recovery process.

The bruising I have been experiencing is rather strange.  The majority of it is down in my chest, as opposed to in my cheeks. It definitely shows up more when I am outside than inside.  Guess the nasty yellowish-green, Shrek-like coloring prefers natural light. Anyway, I do think I have dodged the face-bruising bullet, and my chest can be covered with a shirt!  So I'm not too much of a freak after all!
See Shrek Neck below!

 Follow-up OS appointment with Dr. T. 

Friday morning, (day 5) I had my follow up with Dr. T.  It went really well, got some really cool X-rays and got some really good news and some really not-so-good news.

 He was really happy with the way things turned out. Said I was a perfect patient!  Well not really, I threw that part in there, but he did say that things went perfectly.  He was REALLY pleased with how everything lined up and with the fact that I have very little-to-no numbness at all.

I asked why I didn't have incisions and stitches on my cheeks as expected, and he said, "Well that's why your lips were so split."  He said he was able to get my mouth open enough to be able to do everything he needed to do from the inside. Which was awesome!  He also said that the final measurement was about a full CM forward. 9-10mm!  Last I heard from Dr. Simon we were looking at about 6.  WOW!  That's a big jump!

I still can't really tell yet what my new face is going to look like, but I'm starting to see a teeny bit. Today Sharon's mom took me in the bathroom found a mirror to help me see my profile.  I could see how my chin and lined up with my face now, like it should be.  It was sort of surreal.  Like I am still not looking at myself in the mirror. I can't wait for the swelling to go all the way down so I can really see.  This is exciting stuff!

Oh, the bad news?  Splint stays for 4 more weeks! *sigh*

I'm not really complaining, I am starting to get used to it a little, it just makes it REALLY hard to speak and when I do its completely exhausting.  I am more thankful each day that I have already recorded my voicemail at work that says, "Please leave me your email address and I will get back to you."  LOL.. It was hard for me to get through it without giggling, but now I'm really glad I did it.

That's about the summary of my last 3 days. Not a lot new.
Swelling is going down.
Bruising is minimum.
Pain level is still high.
Weight is down 10 lbs.
Have been getting lots of flowers and cards from family and friends and the Ninja Blender is quickly becoming my new BFF!!

 Flower table!
 Photo taken today, 10-15.  Swelling WAY down!


Oct 12, 2011

Day 3

Major bright spot today...... I received a beautiful flower arrangement of roses and hydrangeas from Dr. Simon and Dr. Tiwana.  Throughout all the surgeries I have had in my lifetime, and there have been a few, I have never received flowers from the doctors.  This was awesome!  Such a sweet touch!

This was perfect timing, since this has been the worse day so far.

Pain has still been at its peak and swelling seems to be there as well. The swelling has moved down into my neck and is putting pressure on my throat, which is causing me difficulty in swallowing and breathing. It feels like someone is sitting on my chest. Rather a strange feeling actually. I have a pocket of swelling that is sitting right on top of the middle of my clavicle. So strange.

We put a call into Dr. Tiwana's to ask if we could increase frequency of my Norco and to ask if the difficulty breathing and swallowing was normal. He called back himself and said it was very normal and that it should pass.  He also said I could increase the pain med frequency..

This morning I tried eating cream of wheat.  It actually tasted really good. It did however take me over an hour and a half to eat a small bowl of it, but in the end I was victorious!  I ended up having more chicken broth, some squash soup, chocolate Ensure and an orange smoothie as well.  Felt like all I did was eat / drink all day.  Not really that much when you look at it on paper, but it felt like a lot as I was shoving it down all day.

Each time I tried to sleep the swelling in my throat made it feel like I could swallow and breathe.  This was very difficult to handle.  I kept having to remind myself to just breathe and not panic. Each time, it ended up passing, but still caused me quite a bit of anxiety. Had a bit of an emotional low today. The pain and swelling ended up getting to me and I just sat and cried for a bit.  Sharon was so supportive and just held my hand and prayed us through it. She has been so amazing and so supportive. It got me through and I was able to face the rest of the day.

Last but not least, let me say that I took a hot bath today!  That felt so amazing to get clean and refreshed!  It has also felt great to be able to brush my teeth and swish with mouthwash several times a day. It is exhausting but the baby toothbrush is genius and fits so well in my mouth!  The prescription mouthwash is actually pretty refreshing as well. I am an obsessive tooth brusher and was really concerned about being restricted, even if only at first, from being able to brush my teeth.  Yet another reason I'm thankful for not being tightly banded.

Another day of recovery down. They are already starting to run together but hopefully I will have more and more progress to report as the days go on!

Day 2

Swelling has taken up residence!

Being home from the hospital made such a difference.  It just felt good to be home, in my own space and, even if not in my own bed, I was in my own recliner.  Not to mention its also comforting when your little dog takes up post at your feet to protect you from whatever it was that caused your face to look like that in the first place.  LOL.

She hasn't left my side since I got home. Once she figured out who I was!

My pain level has still been pretty high. Most of the time 7 or 8 out of 10.  When the pain meds kick in, I get a good 2 1/2 hours of pain relief and then it escalates.  I must admit I have spent most of the day watching the clock waiting for more pain medication.  I hate this feeling, not to mention I have been getting severe headaches that I feel are caused by the pain medication.  But I do know its part of recovery, and again, I am very thankful that I'm not numb. I started alternating Ibuprofen with the Norco and its helping with the headaches a little.  Hopefully, it will help with the swelling a bit as well.

I haven't mentioned this, but a big thing about my lips and tongue not being numb is that I can speak.  The splint makes it difficult to speak clearly, but I am fairly understandable. Its very exhausting and I work pretty hard at it, but its still easier than using a white board.

My appetite has been fairly non existent, so not being able to eat hasn't been a problem yet.  Sharon has been very good at making sure I get something in my tummy before taking any meds.  This is a good thing because if it were left up to me, I wouldn't be eating anything. I say "eat", but what I really mean is, Ensure, chicken broth, or apple sauce.  Actually, I had forgotten how much I like apple juice and apple sauce. I have rather enjoyed them.  Chocolate Ensure isn't half bad either.

Sharon's Mom dropped by and brought a beautiful plant with pink flowers.  She is such a precious woman and just her presence made me smile.  Well... at least half of a smile!

Tried to watch a couple of movies today and just can't seem to get through a whole movie without falling asleep. I know rest is good and is a requirement, but I have about an hour of awake time during each "cycle" and then I'm groggy again.  Put on Steel Magnolias in the middle of the night to pass the time while I was awake.  It was good because I enjoyed the funny parts and passed out before it got to the sad part.

That's really all there is to report today.  Lots of pain and swelling.  Eating (drinking) okay, a little nauseous here an there, but for the most part, just a day of sleep.

Oct 11, 2011

The Big Day!!

I apologize for the delay is posting updates.  I have had a bit of difficulty adjusting to the pain level, and each time I get the pain to a manageable spot, I have been too exhausted to sit and post, or the medication knocks me out!  I am hoping to give it a shot now, so here goes.

The morning of surgery was a normal morning, getting Canyon off to school and getting packed for the hospital.  Nerves did not arrive until about 10am when we pulled into the parking lot. They took me right back into the holding area and did the standard vitals, got me changed into a gown, got a urine sample for a pregnancy test,  (HA! that one really cracked me up), and then it was time to start the I.V.

I have terrible veins so this was the most difficult part of the morning. The first nurse tried twice, called in an "expert", and he tried twice, then he called in the anesthesia team. The first N.A. came in, tried, and failed, and then called in the 2nd one.  She finally got it, but it was in the bend of my arm.  Not the best place but it was in and I was off.

I was given some medicine to relax me and was taken into the O.R.  I scooted myself onto the surgical bed and was hooked up to various wires and monitors.  They sprayed, or dripped Afrin into my nose and then put the gas mask over my face. That was the last thing I remember.

The next thing I remember was waking up and thinking, "why am I not numb, and what the heck did I just do?"

I had it in my mind based on what Dr. T had told me, as well as what I had read on so many other blogs that I probably wouldn't feel much in my lower jaw due to the nerve being stretched out. Well, I guess Dr. T was really good at protecting the nerve because I can feel everything!  Not numb at all.

My pain level upon waking up was immediately at an 8-9 and the nurse started giving me morphine. It was only helping a little and it seemed only to make me violently ill.  I got dry heaves each time it was given and going through the motion of wretching was making the pain worse.

The next thing I can remember noticing was that I wasn't banded tightly shut.  I have a few tiny bands in the back but I can still get my mouth open quite a bit. I was also expecting two tiny incisions on my cheeks from the screws, and I didn't have those either.

It was VERY awesome that I could open my mouth and not numb because I can take pills instead of liquid pain medication and I can already sip from a cup.  I am not having to use a syringe.  I feel like I'm already light years ahead of many patients that go through this.

After they changed my pain meds to Norco instead of the morphine, and added some Zophran for nausea,  my dry heaves started calming down and I started to rest a bit more.

The room I had a Zale was awesome!  It was more like a hotel room with a beautiful view of downtown Dallas, than what you would think a hospital room would look like.  AND to top it off, I arrived in my room just in time to see the tie-breaking Nelly Cruz home run that gave the Rangers the win in Game 2 of the ALCS!  There was a long couch that made a comfortable bed for Sharon and they brought her plenty of blankies and pillows. We were well taken care of.  Check out this view of Downtown Dallas!

The nurses I had were awesome!  So incredibly sweet and helpful. I couldn't have asked for better care. The night in the hospital was mostly just sleeping and taking pain meds. My pain level was pretty high so I was taking it every 4 hours.  Watched a lot of Animal Planet and Food Network. Pictures below are immediate after surgery.

By Tuesday morning the swelling started to kick in, and oddly enough no one had thought to put ice on my face. I wish I had brought my jaw bra to the hospital but I thought there would be something there for my use.  Tuesday morning Sharon said, "Should I ask for an ice bag?"  I thought, "DUH!?"  We asked and once applied, my jaw immediately felt better.  I was afraid that the cold would be painful, but it really helps with the pain.

About 6am, the resident that assisted with my surgery came in and saw me and told me that everything looked great!  He was very proud of what they had accomplished with my jaw. I asked about antibiotics and he said I wouldn't be needing them because everything went so well and was so closed up and locked in perfectly.  He asked if I wanted to go home then or about lunchtime.  We decided to wait until after Canyon would have left for school and then go home.  Sharon wanted to make sure to have some extra time to explain things to him before he saw me.  Even though we had been preparing him for quite some time, he was still anxious, and I think I looked worse than what we both expected.  I went ahead ate breakfast and got ready to head home.

My breakfast was chicken broth, apple juice and some orange jello.  I was so proud that I could actually get the tip of a spoon in my mouth.  I never thought apple juice and orange jello would taste so good. I got tired trying to eat the jello so I gave up on that adventure pretty quickly, but I at least took a few bites!  I felt victorious!

Overall the hospital stay was great! The doctors were really excited with how things turned out and because of Dr. T's skill, things were much better than I had expected.  Great job Dr. T.!!

Oct 9, 2011

Final Preparations

The weekend has been filled with lots of final plans and preparations.

Plans made for a responsible adult to come and stay with our boys - Check!

Lots of soup - Check
Lots of Ensure - Check
Applesauce - Check
Juices, Gatorade, teas - Check

Eyebrow Wax - check
Pedicure - Check
Hair cut - Check

Pumkin patch trip with Canyon - Check
Canyon and I even had time to decorate said pumpkins to have some Mommy-Son time before surgery.  See pictures of Matilda the pumpkin (Matilda has the bow in her hair) and Pigman the pumpkin.  Well, it was Pigman until Canyon decided he/she needed some earrings.  I'm not sure what the new gender-appropriate name is, but for now, its still Pigman.

The weekend was actually very peaceful.  Except for my haircut.  You see the girl that always cuts my hair, took it upon herself to volunteer to teach on a mission trip in India.  Without giving any regards to who was going to cut my hair, she just picked up and left the country for a few months.  Can you imagine the gall?  HA!
So against my better judgement, and because I didn't really have a choice, I let someone else touch my hair.


This has to be the worse hair cut I have ever had!  I feel like I have been scalped, or that I look like a dog with mange!  The only thing positive is that it is UBER low maintenance and I won't have to worry about it while I'm recovering.  I just hope it grows enough while I'm out that I can do something with it when I go back to work. Oh well... There are worse things I guess. I mean, after all it IS October, and I could shave it completely off to support Breast Cancer awareness month.

Other than that, I feel completely prepared and at peace regarding this entire process. I thank God each and every day for my support system of family and friends and for such a great team of Doctors!

Before Photos!

I figured since it was the night before surgery, I should go ahead and post some before photos of my bite, before it went bye bye. 

Here's what we got!
Surgical hooks! (teethed are shoved together to show both rows of hooks)
 Profile of Crazy overbite!
 Overbite shot from the bottom.  Excuse the nose shot!
 Profile shot showing my recessed chin.

have everything that I can think of ready!

Let's do this thing!

Oct 7, 2011

The countdown is REALLY here!

Surgical hooks on yesterday.....

Less than an hour left of my last day of work today. 

Everything is clear off my desk and I have even created the voicemail that I will need to have on my phone when I get back to work, that basically says, "I can't speak, please email me."  I knew I wouldn't be able to do it when I get back.  People would think they called either Kenny from Southpark, or Charlie Brown's teacher.

I plan on reading Jeff Dunham's book while I'm out so that maybe I can learn a thing or two about  ventriloquism.

Its really here....

Lots of stuff to do this weekend to prepare for Monday.

Oct 1, 2011

Pre-Op Event!

Yes!  It was an event.

Let me start by saying that I TOTALLY don't mind working with student doctors.  I mean, we all have to learn somewhere right?

The line up at Dr. T's office is this:  Dr. Tiwana is the director of the Maxo-Facial program at UTSW in Dallas. He will be doing the actually surgery with only assistance from a resident doctor. At his office, he has a resident doctor that assists him with everything, does a lot of the leg work in the office, like photos, measurements, impressions, etc.  He is Dr. Simpson. He is AWESOME!  So smart, and informative. He is still such a new doctor, and hasn't had the opportunity to lose his bedside manor yet. lol.  I love me some Dr. Simpson.

So yesterday I arrived at Dr. T's office for an 830 appt.  They got me right back and Dr. Simpson came in to start doing my work up. He took new photos of me to start. He is very comical about taking photos.  Very OCD. Every photo has to be at exactly the right angle, at exactly the right focus, in exactly the right light, and goodness don't even think about blinking.  He has to have the PERFECT photos, and not just one, but at least 3 of every shot. I told him if things didn't work out as a doctor he could always rely on his photo hobby for a living.

So he then started going over all the paperwork, the procedure, the risks, the possible outcomes etc.  This was the FIRST time I had heard ANYTHING about the possibility of doing the chin movement.  He called it something other than "genioplasty" because he said that if it was an "Osteotomy" it wouldn't raise the "cosmetic" flag with the insurance company. He said he didn't think I was going to need it, but just in case, he wanted me to consent to it prior to surgery.

He then started doing things like measuring the distance from my top lip to the top of my teeth when I smile, and the distance of my top lip from the bottom of my top teeth when I am not smiling.  Do you have ANY idea how hard it is to relax your face with your mouth open when someone is telling you NOT to smile? 
Not easy!  I felt like basset hound trying to keep my cheeks relaxed and saggy.

He then said, I'm going to call in Dr. X, (I'm calling him Dr. X because I can't remember his name), so I can show him how to do the facial symmetry analysis. The two of them then proceeded to analyze every angle, every contour, every measurement of my face. It was a bit awkward to have two men right in my face having a very robust conversation about my face.  LOL!  Just a bit surreal.

But, the end result was that it was for sure that my top jaw was perfect! Everything is lined up, not too gummy, not too little gummy, no cant... etc.

They did keep going back and forth about my chin though. Dr. Simpson would say, "I think the advancement will take care of the deficiency, but you could argue that there is a fold that indicates the need..."  and then he would say, "Well I can see how that might need to move a bit more forward," and then say, "I think that it will be fine."  *sigh*  I guess I will see if I wake up with a new chin or not when I have surgery. It IS after all, Dr. Tiwana's final decision.

I went and had X rays taken and was then back for the impressions.
Ahhhh,.  Those lovely dental impressions that we all love so much.  First, Dr. Simpson pulled out what looked like a caulking gun. I had never seen that before. He said he going to squeeze stuff all over my bottom teeth and then have me bite down. I was TOTALLY expecting this to be the nastiest thing ever, but surprisingly enough, there was no taste.  It was perfectly fine.  So I thought, I can do this, this is no big deal.

Next came out the impression trays and the icky, ucky impression plaster.  I know its not technically plaster but I'm forgetting what its really called. These impressions are a bit more tricky with braces on because the plaster gets caught on the brackets. It seemed as if Dr. S. put a little too much of the plaster on the tray because as he was holding it in place it was oozing out the back and onto the back of my tongue which made me start gagging.  SO EMBARRASSING! Dr. S said, "Let's get her a napkin!"  and then said, "Its okay if you need to drool, this is a Drool-Safe zone!"  and I thought, DROOL?!  I'm about to puke!  Is this a PUKE SAFE zone?  LOL.  I managed to breathe through it and get to the end, only to have the plaster not want to come off my brackets. I felt like my teeth were going to be ripped out one by one and he was trying to pry the molding off my teeth. So much so, that when they did finally get it off, it tore. So, Dr. Simpson said, I'm going to let Dr. X do this again and I need to run to the next room and start another workup.

I immediately thought, NO!  Don't leave me Dr. Simpson! But as quickly as I thought that he was gone.

So I was left with Dr. X and his very VERY green, timid, non-confident self. Don't get me wrong, he was very sweet, just not very experienced with what he was doing.

Mold #2... Stuck worse than the first one, and caused Dr. X to panic a little bit because he couldn't get it off. You can imagine what was going through my mind, as he's prying and pulling and he himself is panicking. Finally he was able to get it off, only to have it tear again.

So on to mold #3, and we're not even to my bottom teeth yet.  *sigh.  All I can do is just pray for patience and try to relax.  It had to be done and they had to get it right.

Try #3 worked, THANK YOU GOD!

The bottom took 2 tries and we were done.  Goodness sakes! When he was done, I had "plaster" all over my face, all over my shirt, and even down my neck.  It was CRAZY!  I have to say that I did have to giggle a little bit last night as I found some on the inside of my ear when I was brushing my teeth.  LOL..  Bless his heart!

About the time I thought I was done, Dr. T came in and mentioned that he wasn't happy with the angle on my xrays, so he wanted those redone. Um, did I mention my surgeon was a perfectionist?  HA!

Finally got the xrays done and I was off to Zale for hospital pre-op.

After about an hour wait, I got back with the Nurse to realize I didn't get any preop orders from Dr. T's office. Had to wait another half hour for her to get the orders faxed over so she could complete my preop testing.  Nothing exciting, urine, blood and vitals. Gave me my instructions, time to be there, and I was off.

Whew!  Glad that is behind me.  One more pre-op appt with my ortho on Thursay to get my surgical hooks placed on my wire.

As for today, I have lots of baking to do.  My oldest son is turning 20 on Tuesday and we are celebrating tomorrow with ginormous steaks and Italian cream cake!

Also have 2 cakes to makes for work.  Great way to pass the time.

I really thought these last 2 weeks would drag but it seems to not be the case.  This last week FLEW!

Our countdown is in single digits now so it will be here way before we know it.

Next stop.........

Sep 22, 2011

UHG! Date and location change!

So, Dr. T's scheduler called and verified my insurance coverage, and then informed me that I would be having my surgery at Zale Lipshy, instead of Parkland.

Dr. T. prefers to work at Zale because he's trying to build up his hours there, and come to find out, he ONLY takes his self-pay patients to Parkland.  Otherwise, its Zale.

Thursdays are his Parkland days, so the next available date was October 10th.

Not too terrible of a wait, but it cuts off 4 days that I would be normally taking off from work.

So, instead of 2 weeks and 2 days with an extra weekend off, its just 2 weeks.

But all in all, I'm thankful that its all set in stone.

I have a pre-op appointment with Dr. T and the hospital next Friday and an appointment with my ortho to get my surgical hooks put on the following week.

17 days and counting.

Will be a busy couple of weeks.

Sep 15, 2011

The Answer is in - Less than 24 Hours! Praise God!

Philippians 4:6
Be anxious for nothing, but in everything by prayer and supplication with thanksgiving let your requests be made known to God. 

I finally found that place.. That place where I was able to trust that God was going to take care of this whole entire process.  

I prayed and I let go.  And I found the peace place.

Yesterday, I got an email from our HR Director at work.  It just said, "Call me."  

She also left a voice mail that sounded very urgent so I immediately called her back. 

Her news?

She said, "I just couldn't send this in an email."

She then proceeded to read the email she received from her contact at BCBS that said my appeal was approved and my surgery would be covered.

Thank you God!

He is so amazing.  He just takes care of everything!

Of course I cried and was so overwhelmed I was shaking.  

What a way to end the work day!

Philippians 4:19

19 And my God will meet all your needs according to the riches of his glory in Christ Jesus.

Now we just wait for the pre-op fun to begin!

Sep 10, 2011

The verdict is in!

Lower Jaw Surgery ONLY!

Thank you God!

The visit with Dr. T was awesome.  He was so kind and informative, and answered all of my questions.
Only having the lower jaw surgery means a better recovery, no overnight stay in the hospital, out of pocket expense goes to less than 10K and best of all, no restrictions on blowing my nose.  That was really freaking me out!

Unfortunately, it doesn't keep me from having to wear the splint. 
The mean, hateful splint that I keep reading about. 

Oh, AND, he seemed to be perfectly fine with my October 6th date! He said nothing about waiting for more space.  He mentioned that he and Dr. Simon had a chat about me last Wednesday and they were both happy with the course of action.

His scheduler was going to submit all info back to BCBS by the end of the day yesterday so you bet your booty I will be following up on Monday! Hopefully we can get an answer back quickly.

All in all it was a great day with great news!

More to come when we hear from BCBS....

Sep 6, 2011

Parkland Hospital! COME ON DOWN!

You're the next contestant on, THE PRICE IS RIGHT!..

I finally got the answer to the long burning question of, which hospital do I choose.  I have been waiting to make that decision, based on the quotes I received for paying out of pocket. I am still very hopeful mind you, that Blue Cross is going to come through for me, but I am going forward with my plan of paying out of pocket.

So.... First contestant.. UT Southwestern - Zale Lipshy
The discount they offer is strictly 25% off the hospital fees only.  Not supplies, not the anesthesiologist, but just the hospital.  Their facility fee? 
Anesthesia? $3400
Yeah... Right!

Next contestant!  Parkland Hospital.
Their discount?  They have a list of "codes" that are frequently denied by insurance companies in which they offer a "package" price.  This means hospital + Anesthesiologist.
Their rate?  For upper and lower jaw surgery...

Get this....

Wait for it...


I asked Dr. T's surgery schedule if she was absolutely sure that was the price, and she said she also did a double take and verified the price as well before she called me.  So...

Parkland it is...

At this point, even if insurance did approve my surgery, I would still chose Parkland.  I feel like even if its not my money I'm spending, its and act of faith to be a good steward of the money, regardless of where it's coming from  I can't see going with a choice that is so outrageous just because I can.

Still praying for insurance.

The space crisis

As noted prior, Dr. Simon wanted me in this morning to make some adjustments and create more space for the surgery.  I wasn't sure what that meant, but just as I had suspected she placed some springs on both sides of my upper teeth, between my canines and incisors.  She said my front teeth needed to be "flared" out more, to give my bottom jaw room to slide forward the 6+mm that it needed to move.  As it is now, my bottom teeth would crash into my top teeth and not go as far as it should.

She feels as if we have enough time to make the change, but I'm a little worried.  She made the comment, "I think this is what Dr. Tiwana would want us to do, but I don't know, he may decide we need to give it another month or so for more space."

Another month?!


I am stream rolling down this path and I don't want to get off now!  I have prepared mentally, physically, have my pantry stocked with Ensures and soups and have even cooked ahead and have frozen meals for my family to heat and eat while I'm recovering.

I need this to happen the first week in October as scheduled.

Please say a prayer that it continues as planned.

I am FINALLY meeting with Dr. T this Friday to have a chat and have him let me know if he feels I need upper and lower, or just the lower surgery done. I have been waiting for this appointment for what seems an eternity.  I have my list of questions ready and I hope he has the answers I have been desperately seeking.

To be continued.......

Sep 2, 2011

Never under estimate the power of the MOLD!

No, not the green kind.  Although that is equally as powerfully, hence penicillin, etc.

However; in my case, we are talking about the pink kind. 

In my last post I mentioned that Dr. Simon had taken new molds and that it would take about 2 weeks to get them back, and that we would need to wait until then to resubmit to BCBS for approval.

Of course, knowing that prayer can accomplish anything, I have been very prayerful that by some miracle they would come back early and we could submit sooner.
Well, praise God, they came back today.  One week later.

Immediately, Dr. Simon sent the records over to Dr. Tiwana's office for submission. The young lady I am working with at Dr. T's office was off today, and won't be back until Tuesday, so it won't happen until next week, unfortunately.  I guess she is entitled to time off from work.  I just with she would do it AFTER we get surgery approved.

Then Christi from Dr. Simon's office called back and said Dr. Simon needed me in ASAP.  Said that after looking at my molds she feels like Dr. T will want more space in a couple of places.  What does that mean? Guess I will find out first thing Tuesday morning when I go in for the adjustment.

Sounds like I may be taking advantage of my "soup" diet earlier than expected.  The good news is, she feels as if Dr. T. will be able to get by with only doing my bottom jaw.

I am going to be making my white chocolate mint ganache filled chocolate cupcakes on Monday to take to Dr. Simon's office on Tuesday.  Her office has been so supportive, and Dr. Simon is one of the best doctors I have ever worked with.  She is so patient, kind and informative, always calls me back herself and goes above and beyond to make me feel as if I am her only patient. Just a small gesture to say "Thanks."

Although, she is about a size 2 and probably never touches sugar! 
BUT, I'll bet she won't be able to resist the ganache!.

More on Tuesday....

Aug 30, 2011

We have a date! Well maybe.........

So, after a long chat with Dr. T's surgery scheduler, I found that she still does not have quotes back from the hospitals on what the surgery will cost if I end up having to pay for it.

She did however; have a strong knowledge of both hospitals and has every confidence that Parkland will be the less expensive option.  She said Parkland offers "Package" pricing for situations like mine and that is very much discounted.  She also said the Zale only offers a 25% discount off of hospital fees and the rest, (medication, anesthesiologists, supplies, etc), are not included.

With that information, I went ahead and requested that I be put on his schedule for Parkland. Either way, insurance covered or not, I am having the surgery.  So.......

October 6th it is!

The only qualm is......... Parkland has been getting some TERRIBLE press lately...

Things like, hygiene issues, Doctors not washing their hands, or wearing surgical gear outside of the operating rooms. Its been quite the buzz here in Dallas.
The good side is, insiders are saying that these are isolated incidents and that the oral surgical suite at Parkland is pristine.  AND now that the microscope is on them, they will DEFINITELY be on their toes and providing TOP NOTCH care.

Anyway, if for some reason BCBS approves my claim and I can get a surgery date at Zale that same week, I will switch, but otherwise, October 6th it is, at Parkland Hospital in Dallas.

Now we just wait to see if it will be lower jaw or double jaw surgery.

Still waiting............

But at least a step closer....

Aug 25, 2011

Hurry up and Wait!!

Hurry up and Wait!!

And................. exhale!

I went in to see Dr. Simon today to get a new set of records done in hopes of getting insurance coverage of my surgery.  I was hoping that she would be able to determine if I needed both jaws, or just one jaw repositioned.
The answer?
"I won't be able to tell until I get your new molds back, but feel free to give me a call.... it should take about 2 weeks...."

2 weeks?  Seriously?

And to top it off, the new request won't be sent back to BCBS until the molds are back.  Of course, that IS the best way to get the surgery approved, but for goodness sakes already.. I need some answers...

Patience Janell.... Patience....

Pray.... Breathe.... Pray.... Breathe.....

Or as Julia Roberts did, "Eat, Pray, Love."

I have been praying, relentlessly, and my life is FULL of love, but unfortunately, the anxiety of today caused me to not be able to eat tonight. 

Not sure if it was the build up of excitement to finally get some answers, only to be let down, or if it were the layoffs at work today that has gotten my tummy all in knots, but I can tell you, its definitely not my favorite feeling.

I feel like I'm in limbo on the surgery thing.  I don't have a quote back from the two hospitals so that I can pick one based on if I'm self paying, I have to have the rates before I can schedule a surgery date, AND to top that all off, one of the hospitals in question is Parkland Hospital in Dallas and if you haven't seen the media lately, DON'T LOOK ETHEL!  It will freak you out!

I have really been trying to aim for the first week in October for a surgery date. Q4 at work is really crazy and I want to have this behind me and back at work before mid October. Now, my thoughts are....
2 weeks until the molds gets back.
Then submit to BCBS.
They have 30 days to respond.
That puts us with a surgery date already into the 2nd week in October.
Sharon has a major project launch in Riverside,CA the last weekend in October and we just has such a tight window for both of us.

Again, Pray and breathe.

God's got this!  Dang it if my human brain doesn't try to take over all the time.

I am going to take a hot bath, relax and try to find my patience somewhere in the back of the dresser drawer.  I'm pretty sure that's where I left it.

Phillipians 4:6-7
Do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God. And the peace of God, which surpasses all understanding, will guard your hearts and your minds in Christ Jesus.

Aug 22, 2011

A Glimmer of HOPE!!!

August 22, 2011 – A Glimmer of HOPE!!!
I woke up at 4:30 a.m. this morning thinking about funding this surgery.  It just happened that Sharon was awake and restless at the same time.  Not sure if she was already restless as I was, or if she just didn’t want to admit that I was keeping her awake.  She’s sweet like that.
Anywho, my brain was on money for the surgery and hers was on impeding layoffs at work this week, and neither one of us could sleep. I shared with her my thoughts and immediately she began to pray with me.  In all things we give thanks, and the more we can let go of and give to God, the better off we are.  We know that he is going to take care of us, and this circumstance is no different.
Seemed like we prayed for an hour and finally found some peace.  I know that he will provide so I just have to let go.

After arriving at work, I decided to put a call into our HR Benefits department, just to ask if there was any chance at appealing the denial.  (Thank you Sharon for suggesting that).  I left a voice mail on the benefits line and then received a phone call back from the benefits director.  She said there is a possibility that BCBS will pay for the surgery if we can prove that orthodontic therapy didn’t work to correct my problems.  Correct them?  It has actually made it worse!
She told me to submit again, with very detailed information on how I have been in braces and that due to my recessed jaw, or “micrognathia” as the medical word calls it, that the braces aren’t enough to correct the problem.  She also said to provide any additional details of TMJ that was available, and then call her when it was done, and she would follow up herself with BCBS.
I then looked at our policy outline and not only did I NOT find the exclusion they were referring to, but  found this..
  • Treatment of the mouth, jaws and teeth (preauthorization required), including:
·         Diagnostic and surgical procedures to treat temporomandibular joint (TMJ) disorder (appliances not covered)
·         Alteration of the jaw when appliance therapy does not work
Does that not say it should cover me?

Immediately I got on the phone with my OS office and ask her to resubmit.  Dr. T’s office of course didn’t have detailed records because Dr. Simon had all of those. I immediately called Dr. Simon and she said that the records she had were from September of last year prior to going in to braces.  She had me make an appointment this week (Thank you for working me in) to get a full set of records done again.  This should definitely show how much of an overbite I have and how there ain’t amount of brackets and wires going to fix it!
I am also hoping that she can tell me if I need one or both jaws corrected.
Praise God for putting hope back.
I have not stopped praying about this and I’m sure this may be God’s way of providing.
Holding my breath until we hear…………

Aug 4, 2011

The Time in NEAR!

Fall it is!
Routine visit with Dr. Simon reveals that October is the month!  It works with me at work, and my mouth is ready. Well, except for this pesky bottom canine that doesn’t want to turn around and behave!  Other than that, we’re ready!
Knowing I had a very tight window, due to when I can take the time off from work, I immediate get on the phone with Dr. T’s office to schedule an appt to see him and get a surgery date.
2 months out was the earliest!  NO WAY!
I, of course panic.  How can I see him on 9/23 and have a surgery date 2 weeks late?
I called Dr. Simon’s office and asked if she could make a phone call to Dr. T. and try to get me in sooner.  Which of course, because she is the most awesome Doctor EVER!  She texted, emailed and called him immediately, and he told her he would handle it!  They are buds like that you know!
We went to S. Padre island and put this behind us for a week.  Vacation was awesome.  I really needed the break. The surgery has consumed me and the forums, the blogs, websites and videos have been an obsession.  I feel like I just can’t get enough information of read enough on the surgery. I keep reading the same things over and over, and yet I still keep looking to find something new.  I have had many surgeries but none have quite been so daunting as this one.
Anyway, I followed up with Dr. T’s office when we got back and his office was able to move me up to 9/9 and the surgery scheduler said she would call the 2 hospitals where Dr. T. is on staff to see what they quote for the procedure to self-pay patients. I told her Dr. T. said around 6K and she said, “Um, well, I think that is just Dr. T’s fees.  I have seen the surgery upwards around 20K.”
Immediately, my heart stops. How on Earth can we pay for this?
You wouldn’t believe the thoughts that went through my head when I heard 20K.  We are really going to spend more on my jaw than we did on either one of our cars? Will they allow me to make payments? Is it really that much? What are we going to do?
Pray Janell.
Pray through it.  God will take care of you.  He always does.
That’s all I have done since I heard that is…..  Pray….. Pray … Pray…..

Mar 1, 2011

Bottom's UP!

Bottom’s Up!
The braces have become very uneventful.  I have stopped waxing them as my mouth has gotten used to them, and aside from the occasion lisp that they cause, I feel pretty normal.
Now it’s time to get the bottom ones on.  FINALLY.
In January, Dr. Simon said I only needed about 9-10 more months before I would be ready for surgery!  WOO HOO.. That’s about 6 months earlier than I expected.
The bottom braces felt really strange.  The first thing I did was take a bite of a bagel and pop off a bracket. HA!!  I would end up having to chew very carefully until my bottom teeth moved a bit because of the way my upped teeth overlapped the bottom.
It took me about 2 weeks to get used to the bottom brackets.  Had to wax for about the first week, but it seemed like the process of getting used to these took SO much less time than the upper ones did.
No we just wait.
Wait for the surgery date.
Save money to pay for surgery.
Save money.