Surgery Day!

We had a fantastic surgery day thanks to the amazing, amazing staff at Swedish Hospital in Seattle. No kidding - I was never really nervous! We had to be there around 8:45, and managed to arrive there at the exact time as my mom, who was coming from Shelton. I checked in and spent maybe 10 minutes in the waiting room before being taken back to pre-op (sans mommy, but with Nick).

Had to do the pee-in-the-cup pregnancy test and change into my lovely hospital gown, pants, and robe, and slippers. We didn't have to wait terribly long for a nurse to come over and ask me the same million questions I was asked in my pre-surgery interview. She was really cheerful and reassuring, could answer every question I had.

She then had us shipped off to the surgery waiting room, where they started the IV (not a SINGLE problem, despite being dehydrated!). They had comfy recliners for the patients (there are pictures, no worries), and Dr. Lee and her resident Dr. Kelley came over and talked to us, and the anesthesiologist talked to us. Dr. Lee and the anesthesiologist were concerned about my nose - apparently it wasn't really wide enough for me to get sufficient air through it OR for them to get the breathing tube down without lots of bleeding... so Dr. Lee said she was going to widen it. I'm not sure if that meant just on the inside of my nasal passages, or if it'll show on the outside, as well. Either way, I'm grateful for it now as breathing isn't really all that comfortable WITH the wider nose. :)

After a while of waiting, they came over, put my hair into the net, let me kiss Nick goodbye and we were on our way to the surgery room. The room was a lot smaller than I expected, but there were lots of scary looking tools and huge lights and it was FREEZING. We're talking, downright cold as a meat locker! It felt kind of good because I was a little warm from the waiting room, but then they put a "hot air dryer" blanket on me and another blanket above that. I remember staring at the lights, and then nothing - they didn't even warn me that I was going under!! (Hah!)

So... the next thing I remember is pretty funny. It was dark (my eyes were closed but I wasn't really aware of this at the time), and I was trying to figure out why they were taking my blood pressure on both legs instead of my arms... which led me to think... wait... do I have arms?... which led me to think, "Hey! My eyes are closed!" So I opened them and the recovery nurses put my glasses back on. The "blood pressure" things on my legs were really there to keep clots from forming. They kept asking me to breathe because apparently I wasn't getting enough oxygen even with the oxygen going straight into my nose. I drifted in and out and was coughing a lot - I wasn't really aware enough to use the suction tube yet so they were helping me off and on. I don't remember being wheeled up to my room but I do remember having to scoot over from my operating-room bed to my hospital-room bed because my hip hurt for the first time when I had to move it and it shocked me.

My mom and Nick came in just a few minutes later and I was out of it for the next few hours - my grandparents stopped by and Heidi and Fred stopped by, which I remember but I don't really remember what I "said" to them (HURRAY white board!! I would have been really frustrated without it). I was REALLY shocked and scared to be still bleeding - I had a big cough and blood went EVERYWHERE - all over my gown, the bed, my whiteboard, the table... it was a little too much like a slasher-flick-horror movie for my taste. But then the nurse gave me a rag to cough into, so it wasn't so scary the next few times. I kept having to clean out my nose because it would get clogged up with all the dried blood.

I had a rough night - I kept choking on something HUGE in my throat (probably a blood clot) and I was gagging and coughing. The ice that they were keeping on my head felt really heavy and the cold HURT my joints. Whenever they would change out my ice my pain level would take a turn for the worse. I never slept for more than an hour at a time, and it seemed like the night took forever to pass. I was really lucky in that Nick could stay with me the whole night - they even brought him in a cot to sleep on.

That night I was already up to go to the bathroom with Nick's help (the hip was pretty miserable) and I could kind of drink from a cup. The next morning I got to pick from a "clear liquids" diet menu and got some chicken broth. My surgeon and her resident stopped by again to say how well the surgery went, and to explain my post-op medications and all that. There were a few fiascos getting the medication (the hospital didn't have liquid oxycodone so they filled a pill version.. but hello?! so we had to wait for a different prescription to come over for the demerol.

Post op meds:

• Hydroxyzine (Atarax) for nausea
  
• Demerol for pain
  
• Liquid motrin/ tylenol for pain


• Peridex rinse
  
• xephalexin (Keflex) for anti-biotic.
  

Okay, I'm completely worn out from all the typing. Naptime :) That's about all I can remember.

new date

I have a new date for surgery. It's now July 1st, as Swedish Medical Center's same day surgery unit is closed on the 3rd. It's pretty much my perfect date in the world - I wanted June 30th or July 1st, and July 1st it IS!

So many appointments to make - I have to have my surgical hooks on before my appointment on June 25. On June 25th I have my records appointment at at 9am, my pre-surgical consultation at 10:15am, my business office appointment at 11am. I also have to make a pre-admissions appointment with Swedish Medical Center. I'm hoping to do that in the afternoon on the 25th, because that way my mom will only have to come up and miss work for one extra day, instead of two.

I'm scheduled to check in at 8:45am on Wednesday the 1st. I can't eat or drink after midnight on the 30th. I have a post-op appointment on July 9th at 1:00pm.

With help from Stephanie (thanks, Stephanie!) I am almost done with my personal statement. I am hoping the letter from my orthodontist will come in the mail... I think that's all I'm waiting for before turning my packet into the school district. I want to get this appeal show on the ROAD. On one hand, I keep telling myself that there is no way they'll see my condition and still deny me, but on the other hand it's so much money I'm worried they won't approve it. 13,000 dollars is a LOT. AND, I'm struggling with whether or not to share that my former insurance (the one most school districts carry as it's the insurance through our union) was going to cover the surgery, no questions asked, at 95%.

I'm going down to talk to them tomorrow at their office tomorrow. Everything seems like it takes so long. Once my forms are all filled in and filed, the "Executive Director" has 15 days to assign a claim review number. This claim review has to be received at least 30 days before a Committee meeting, and if the next meeting is full it could be postponed to another meeting. If I don't attend that meeting I waive the right to initiate a review of the claim at another date. The committee then has 30 days to get a transcribed copy of the meeting. Then (later) the committee votes and within 30 days of THAT they have to notify me of the result. WHOA!

In THAT kind of time-line, surgery is TOMORROW! I'm pretty much freaking out.

mark your calendars...

Because I have a DATE! July 3rd, 2009. I have my pre-op appointment on June 25th to do all of the bloodwork, tests, etc.

Now, to just get it paid for. After I got the denial letter, I made a phone call to my insurance company. They told me I needed to go through my surgeon for the appeal. I called my surgeon. They didn't call back. I called my surgeon. They said that I had to go through my human resources department or benefits coordinator - because I could appeal until the cows come home - and medically necessary or not, my plan automatically excludes orthognathic surgery of all kinds.

So, this morning I called my benefits office. THEY told me I have to be denied AGAIN by the insurance company before they become involved. Tomorrow (or tonight if they're open past 5pm) I'll call the insurance company again and tell then what I've been told since our last conversation. What a giant joke.

But I have a DATE!!

ready for the next year

I have goals. Before my surgery, I am determined to do the following:

1) Keep healthy. I have been more susceptible to colds and flu's this year than ever before. I know it's probably due to all of the new germs at a new school, but I would like to be better about taking vitamins to do some preventative work.

2) Get healthier. I'd like to get back into running - I ran a 10k just two months ago, but then with my new job and all this illness and jaw pain and migraines I've let my training slack. I'm not terribly overweight, but I know that excess weight can hinder recovery and your reaction to anesthesia.

3) Stop complaining and focusing on pain. Now that I am in an upswing and have started to be able to control my migraines and extreme jaw pain, I need to stop focusing on it. It has [unfortunately] become a part of my life, and I need to get over it - it'll make me a happier person.

4) Find foods that are both sore jaw friendly and healthy OTHER than soup or anything that resembles soup. I am 6 or 7 months away from surgery and I already despise the stuff. I eat it every day for at least one meal, sometimes two. I need to figure out how to get more vegetables and fruits in without causing more pain. (And of course, soup is the best way. UGH!).

5) Become more familiar with the surgery I am about to undertake. I'd like to know exactly what's going to happen inside of my mouth so I can prepare myself as best I can. I especially want to research more about wind instrument playing after surgery.

Here's to a good next six or seven months.

okay, freak out now.

None of the available insurance plans cover orthognathic surgery except for in extreme cases. I can go through a lengthy appeal process with my school district, but even then I'm not sure what my chances are about getting it approved.

So.... a lot of random crying going on. I think I'll just have to have my orthodontist put me back together again, fix my bite as much as possible, and remove the braces - I can't afford this surgery without insurance, and I can't afford to have my bite get any worse. I have shooting pains in my jaws all the time now, and I'm getting migraines every other day or so.

And it's considered "cosmetic." What a bunch of shit.

adjustment today

As I said in my post yesterday, I had a lot of questions going into this appointment. But my orthodontist is so great - he read my mind before I could even ask them!

I will be surgery ready in.... are you ready???? APRIL! However, I can't take time off of school, so surgery will have to wait until June. But what a relief! He also explained what will happen in my next few appointments - the next appointment is a long one, repositioning brackets and getting my first set of stainless steel wires. After that, the focus will be on closing my lower gaps and achieving as much width in my lower arches as possible. He says that while they are working on my upper jaw, it's not as big a priority because it's going to be widened in surgery.

School gets out on June 16th with the 17th-20th being possible snow makeup days. I will probably shoot for the last week in June to give me time to prepare. My mom has a ton of vacaction time, luckily, so she'll be able to come up and take care of me the first week or two (my husband leaves for National Guard training in January, and will be gone for a year to two years in California... with no way to take time off). Thank goodness she'll be able to help - otherwise, things would be scary.

He also gave me a few splints, hoping to curb some of the severe migraines I've been getting lately from my jaw. They're pretty neat - I'll post pictures when I get a chance, and let you know how they work out.

Oh, and the gums? Looking fine. Whatever.