rubber bands

I learned a new lesson. All of that yummy, soft indian food that Nick brought home to comfort me with the major metal mouth was great... but it turned my new rubber bands GREEN. Very bright green. And while normally I wouldn't mind (neither my kids at school nor my husband really cares), I have my annual music education conference in less than a week and just wearing braces is bad enough, let alone wearing braces and stuff that's all nasty looking.

My jaw is intensely sore. I really need to go back into the acupuncturist. It's cramping up like crazy, and sending spasms of pain into my neck. But since it's Friday, I came home early and am able to take my stronger muscle relaxant. Hopefully it'll help.

It's Nicks and my 5th anniversary this weekend, and we're going to a fondue restaurant. It will either be fantastic and easy to eat or terrible and I won't be able to eat anything. Hopefully the former, not the latter.

migraine part 1,000,938,822

I'm beginning to believe that every time I have an orthodontist adjustment, I should just prepare lesson plans for the next day so I don't have to worry about it the morning of. That's right, I'm home with a migraine AGAIN.


The only bright side is that I have an amazing husband who brought home two giant bags of indian food (all slow-cooked and delicious and mushy and doesn't need to be chewed). So I just had an amazing meal that I didn't have to chew once.

I am ready to be done.

metal mouth extreme

I had an hour long orthodontist appointment today. And it wasn't one of those chat for a half hour before the real appointment begins appointment... it was an hour of people with their hands in my mouth and adding pounds of metal onto my teeth. Looky looky: if you look closely, my front 6 or 7 teeth are all connected by a wire that is twisted and criss-crossed around each bracket. Then I've got huge hooks on the top and the bottom. There are two huge springs on the bottom, working on closing those gaps, and there are "tie backs" on the top teeth - rubber bands hooked from the top hook to the back that I don't change. The archwire is a thick stainless steel wire. So. Much. Metal. I'm a tad worried about playing the clarinet with all of these things inside of my face! On the right is a better picture of the spring and the dreaded gap... there is a matching one on the other side. Oh, hey, and there's food stuck under the top hook already. Lovely. Already the extra stuff is rubbing against my lips and making my teeth sing more Wagner arias. Despite taking an extra-large dose of ibuprofen, my teeth are pretending themselves sopranos - singing the high notes!

Other than that, not a ton of change... My orthodontist seems really pleased with the overbite, which is sure a different reaction than my own. This new set of wires, along with closing the dreaded gaps, is trying to spread out my arches. My next appointment is in April, and that should be my last major appointment prior to surgery - perhaps some minor tweaking appointments after that. WHOA! I am more excited than I can possibly tell you that surgery is coming, but all of a sudden it seems like it's rushing at me at 100 miles an hour.

letter number 1!

"To whom it may concern:

Stephanie has been seen to determine the feasibility of surgically correcting the unsatisfactory functional relationship which exists between her upper and lower jaw. Clinical examination and review of records demonstrates the patient to have maxillary hyperplasia and mandibular hypoplasia. I have outlined to the patient a plan of treatment, which will involve surgical realignment of the maxilla and mandible. This will entail a 2-piece Lefort I Maxillary Osteotomy and Bilateral Saggital Osteotomy, with Impressions and Custom Preperation of TWO surgical splints PRIOR to the date of surgery. This form of major surgery is performed in an outpatient 23-hour observation facility using nasoendotracheal anesthesia. It should aslo be stressed that the proposed surgical procedure is a functional correction; it is not cosmetic or dental in nature, nor is it TMJ-related surgery.

The above procedure is medically necessary. The American Association of Oral and Maxillofacial Surgeons defines "medical necessity" as (1) appropriate for the symptoms and diagnosis, care and treatment of the patient's condition, disease or injury; (2) provided for the diagnosis, care and treatment of the patient's condition, disease or injury; and (3) in accordance with standards of good oral and maxiollfacial surgery practice. Stephanie has a facial skeletal deformity. The orthognathic surgery which is recommended would be done to establish normal functional relationships between osseous, muscular and contiguous structures. I feel that medical necessity is established by the diagnosis of a musculoskeletal deformity, which is by itself, pathologic, and constitutes a medical condition which requires surgical correction. I would cite corrective surgeries that are routinely allowable, such as scoliosis of the spine, cleft palate, and club foot, and would request that Stephanie's orthognathic surgery be considered in the same context of medical necessity.

In outlining the details of surgery, hospitalization, and anesthesia to the Sheppards, they raised the question regarding insurance coverage that might be expected. I have mentioned the importance of obtaining a predetermination so that she might better understand her financial obligations. Two points should be stressed. First, the diagnosis mentioned above refers to a skeletal deformity. Second, the singular objective of treatment is to establish and maintain an acceptable functional relationship between the upper and lower jaw. Pending your review and response, we will advise the Sheppards accordingly.

Sincerely,

JL"

Ahhhh!! :)

braceversary

Alright, I tried to be clever after a run and it didn't work. Regardless, my braces anniversary is tomorrow! I think I'll celebrate by eating soup. And more soup. Ooooh... and oatmeal!

A year ago tomorrow morning, I was waking up and late... which ended in only getting half my braces on. While my jaw and teeth were not functional at the time, I never really had a problem with a tight jaw (unless I chewed gum for too long or chewed a big piece of steak), I never got migraines from my jaw, and while it clicked and popped a lot, it didn't really bother me, per se. I decided to get braces because my bottom teeth were so crooked that it affected my clarinet playing (plus, I hated the look of my crooked teeth).

What a year. And what a year ahead of me... Maybe at this time next year we'll be looking at de-bracing dates! Whoa.

Oh... and I decided to do the half-marathon, but I think I'll postpone my surgery into the first full week of July. I'll run, I'll work a bit at Starbucks, I'll chair shop, I'll blend and make soup (blegh) and be nice and prepared. I'm sure that I COULD do it and have surgery two days later, but I want to make sure my body only has to worry about my bones, not the rest of my body, too.

here we go!

I finally called my insurance company to get this show on the road today - and get this. I explained the surgery I needed (had the surgery codes and everything) and wanted to know when was an acceptable time to start my appeals process, as P*remera does not cover orthognathic surgery for teachers in Washington State.

Lots of confusion later, the woman on the other line tells me that I can't appeal something that hasn't happened already. I have to have the surgery and then appeal if they deny covering the bills. I explain that the surgery and hospital stay may be upwards of 10,000 dollars and that wasn't something I was willing to do, and that I needed it pre-authorized. I pretty much get no where.

So I called Tami, my wonderful amazing patient coordinator, who simply asks me for my subscriber ID numbers and group number, and tells me that she'll send a letter off tomorrow explaining that surgery is medically necessary, and they will deny it from there - and then the real appeal process begins.

Here we go!

half marathon + surgery?

I'm not sure what's happening... but I got a doozy of a migraine on Sunday and it hasn't left, missed yet another day of work on Monday. Today I spent the day wearing earplugs which resulted in mildly offended middle schoolers. (Not fun. Not fun).

My jaw is also intensely tired... but I haven't been working it out, I swear! I have stuck to my rigid chew-as-little-as-possible regimen, eating oatmeal and soup and smoothies instead of "real" food. It is spasming left and right, and I can not find a comfortable resting position to save my life.

On another note, I've been considering running a half marathon for a while now and my friend wants to do the Seattle Rock and Roll Half Marathon with me... however, it's June 27th. School is already going to be delayed getting out by at least two days (we've had a bit of snow this December in Western WA) which places us out of school on the 19th. If I had my perfect date, I would choose June 29th for a surgery date.... but I'm wondering about putting my body through the stress of a half marathon only to have major surgery two days later. What do you guys think?

appeals, here we come

It is after January 1st! I have new health insurance. I'm going to call Dr. Lee's office this week to learn about when I should start the appeal process. I will NOT have my surgery delayed because of insurance snafus.

Ooh, am I scared, though. Moment[s] of truth.

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.

tired of braces

I've been really tired of my braces lately. I'm ticked off that I can't eat all of the yummy holiday candy (between the jaw and the braces, I seem to be out of luck for most of my favorites), I am beyond tired of brushing my teeth, I am sick of fishing out food for hours every time I decide to be brave and bite into something head on, and I am for some reason developing more and more little ulcers in my mouth.

For a while the braces didn't bother me - in fact, for a good six months I barely noticed they were there! But suddenly, in the past month they feel huge in my mouth - almost like when I first got them on. No real pain coming from my teeth, but my lips don't seem to fit around them as well as they used to. And combined with all these random sores inside of my mouth, it's really annoying!!

And I'll probably be in braces for the next Christmas season as well. Sucky.

'tis the season

It's the season of performances for musicians and music teachers, so I'll admit to being a blogging slacker - but I have a good reason. I performed or conducted seven times last week PLUS I'm dealing with the car wreck, continued jaw pain, and a huge cold. But now I'm only three and a half days away from winter vacation, so things are looking lovely.

I'm fine from the car wreck, I've just got nasty little whiplash in my neck. My jaw did not take to a car wreck lightly, but the stronger muscle relaxant for my neck has made it manageable.

Odd braces story (which we all love).... I was working at the 'bux last week, helping customers and putting away the order when a lady came up to me and asked for help. She was deaf, but could read lips: however, she could NOT read mine for some reason - after about three solid minutes of trying to explain that she needed a gift receipt for any returns with no luck I got my manager - it took Jen less than 30 seconds and all was well. I can't figure it out except for that I stretch my lips over my braces when I talk, and it must have muddled my "speech."

Weird, huh?

ugh

After all of that "I'm not getting headaches!" and "Hurray for less pain" I go and get myself into a car accident. I have a stinkin' concussion and my neck and back are already stiffening up and I'm frankly pissed.

My fault, too. Ugh.

doctor visit

I had an intake appointment yesterday and had a long conversation about my jaw pain and headaches with my new primary care physician. She has decided to prescribe me the same muscle relaxants for the next 7 months until my jaw surgery. She is worried about my body adjusting to the medication and addiction, but we both decided that those risks were smaller than dealing with the long, intense migraines of the past few months. I guess I'll deal with the addiction bit once I get past the surgery....

I have REALLY noticed a difference now that I'm on muscle relaxants and doing acupuncture... I have less jaw pain than before, especially while playing my clarinet. I have only had three migraines in the two weeks since getting started on them, and each of those migraines lasted less than a day. I am able to get through my 5th period class without being in considerable pain (it is my last period of the day, and usually the most painful).

Good news.

thanksgiving time

I am thankful for many things.

• I am thankful for the lack of migraines since my last one (still! hurray!)
• I am thankful for my rapidly moving teeth, despite the discomfort it causes.
• I am thankful for my wonderful husband that takes the brunt of all of this jaw pain and headache pain and everything else.
• I am thankful for the means to get braces and jaw surgery. There are families at my school that have trouble putting food on the table, but I can afford 10k for braces and probably that much more for surgery.
• I am thankful for heath insurance and dental insurance.
• I am thankful for a steady job.
• I am thankful for all of my friends and family.

Happy Thanksgiving, everyone!

x-rays

I just found out my orthodontist puts our pictures in a database online. Look at the difference in my x-rays from the first initial appointment (prior to braces and extractions) versus the x-rays that he took last week.

I know they're small (can't make them bigger), but look at the difference!

I hate to get ahead of myself....

... but my jaw was not especially sore today, nor did I have a headache! Usually Tuesdays are my worst days for jaw pain and headaches due to my 2 hour rehearsals on my clarinet on Monday nights.

The funny thing now? I don't know what is actually giving me relief. I didn't play as much as usual last night (nightmares of migraines), I am trying acupuncture, I have those new muscle relaxers AND new day-time pain medications (sodium naproxen).

Still, I have a glimmer of hope [again]. Hopefully it's not a fluke this time.

more mirgaine fun!

I ended up in the Urgent Care on Thursday because the migraine had surpassed all migraines before it. It actually ran out of room to inflict pain on my [normal] left side, and began aching and pulling on the right. I couldn't hold food down, I couldn't see straight, I was sleeping for the entire day (we're talking, I'd wake up, moan, turn, cry a little bit, and finally fall asleep because the pain was so bad I couldn't see myself getting out of bed).

At the urgent care, they gave me an anti-nausea shot in the hip and a hardcore painkiller shot in the hip, along with some prescriptions to try for the jaw (a muscle relaxant for at night, a painkiller for the day, and a super-pain-killer for days like the last few). Hopefully something works!

I missed 3 days of school. Unheard of.

Acupuncture today with a crazy needle configuration on my left side (the ouchy migraine jaw pain side).... I again feel less tension already. Hopefully tomorrow I'll be pain free for a while!

He says that a week between visits is optimal. I'm seeing him again next Friday. Hopefully no record-breaking migraines before then.

acupuncture and adjustment

Acupuncture was this past Friday. I had needles. In my FACE (and neck, shoulders, hands, and feet). It was a bit scary. The acupuncturist was very good - he made me feel very relaxed, asked me a lot of questions, told me he thought acupuncture would help (and he can also fix my I'm-suddenly-getting-old-or-something weird stuff going on like my hip being weird). The needles stung a little bit going in on my face, but nothing more than a pinch and a sting and it was over. He left Nick and I in a nice warm room to hang out for maybe 20-25 minutes with the needles in (good picture time). I didn't feel any immediate relief, which was a bummer because I was coming off of a doozy of a migraine, but the next day I woke up to no pain. Not even a little. In fact, I didn't really notice anything was different until I went to yawn and I winced and grabbed for my jaw joints like I usually do and realized it didn't hurt. It didn't last long, maybe an hour, but I now have confidence that it can work. He says that the relief will be more immediate and more long lasting as treatment progresses.

Then the next day I got the worst migraine I've had in a long time. Hopefully not connected... I still have it now and I'm contemplating missing school tomorrow it hurts so bad.

Adjustment was today. They x-rayed my teeth and took off a maybe 7-8 brackets on my lowers and 1 on my uppers for replacement. She put the same wire back in and I was originally disappointed (no pain no gain!) but immediately I felt the results.... and 8 hours later my teeth are singing Wagner. Whoo-eee! I was sad, he made a comment on my teeth getting a little discolored. I drink coffee. I LOVE coffee. I'm not sure how I'm going to give coffee up, but he's right. My teeth aren't as lovely as they once were. Any ideas?

Oh, and progress pictures. The gums keep swelling (the splints make it worse, I think), the overbite keeps growing, and the gaps keep closing. On and on.

great news! (maybe)

Over the past few months Nick (the husband) has been getting lots of conflicting information about his school dates for the Natl Guard. At first it looked like he would leave in January and not really come back until both schools were finished (which would total a bit over a year).

NOW, we have a tentative date from early February to July 2nd! If I scheduled my surgery for the 5th or 6th, I could have Nick take care of me instead of my mom! I hate having to make my mom take time off of work - plus it's a hassle for my brother Jake at home, who'd have to take care of things while Mom is gone. (Did I mention how grateful I am to have people to take care of me?)

I'm REALLY crossing my fingers. The problem is, is it's the army. And the army is full of schedule changes and setbacks. Since I'm not scheduling my surgery until March, we'll know whether or not he is gone and when he'll be back.

benefits

Even though my district is now offering a "basic" plan, it will still be financially wise for me to chose the more expensive plan. This coming year, it is $267.00 a month for health and $20.00 a month for dental.

Now, it's looking like
Health Insurance Total: $3204
Hospital Co-pay: $300
Out-of-Pocket Max: $500-$2000 (depending on in-network status)
Surgery Downpayment: $1000
Genioplasty: $500.00

My husband and I just got out from under 4.5 years of major credit card debt. As of yesterday, we are debt free (well, except for my student loans)! But now, looking at all this money I'm going to spend in the next year, things are looking down. Because this doesn't include co-payments for visits ($20 each), co-payments for prescriptions ($10-$30 each), or the stuff I'll need to buy - blender, zip-n-squeeze bags, etc.

I know I need this surgery (after two more days of migraines while teaching band and orchestra, believe me I know), but at the same time I can't stand that it's so expensive. And I don't know that I'll even be covered when it comes down to it.

This is all so frustrating. I was really hoping the basic plan would help me out.