anxiety

I am having major anxiety about the benefits hearing on the 30th. I can't get it out of my head, and the stress is leading to me clenching my jaw, especially at night... which of course makes the jaw pain worse and worse and I've had a constant migraine headache for the past week.

This whole situation is depressing me more and more. I don't understand how it's legal for an insurance company can simply "exclude" a surgery that could be medically necessary - how is that possible?! Why do I have insurance if it doesn't cover everything I need? Is it because of the cosmetic factor? Because I understand that. But I also understand that with sufficient testing and positive results, it should be covered - no questions asked.

Pity poo party time. This just isn't fair.

update part deux

I completely misunderstood what was happening with my school district vs. insurance company. Since there IS a specific exclusion, it's up to my school district to pay for my surgery or not to pay for my surgery. End of story. I don't know where THAT misconception came from, but it sure was a big one - I had my poor insurance company (ha) on a wild goose chase. Oops.

I feel like I'm completely annoying the school district people. I don't mean to inundate them with information about my situation - but it seems like the more they know, the easier making an informed decision will be for them. And since this doesn't seem to be the most common problem in the world, I want them to understand what my daily life is really like. And I want them to understand that this is a last resort - not just a flyby could-possibly-help surgery - it will change my quality of life considerably. CONSIDERABLY. I've tried so many things to make this better and have had migraines my whole life - to think that I could go for weeks without a migraine? To think that I could eat a steak or chew a piece of gum and not be sick for a week? To chew breakfast, lunch, and dinner? To not have to worry about playing my clarinet or trumpet in class or in rehearsals too much. To be able to play my saxophone. The list goes on and on and on.

Well, all I can do is wish and hope and pray. And leave the insurance and school district benefits people alone.

Oh! I wanted to put out MY appeal letter in case someone is writing their own - it took me FOREVER to write and had it not been for help from Stephanie I'm not sure it would be as decent as it is.

To Whom It May Concern:

I am writing this letter to serve as an appeal to the denial of insurance coverage for the surgery recommended to me by Dr. Bruce Molen, Dr. Rick Molen, and Dr. Jessica Lee. This surgery is medically necessary, and Regence Blue Shield turned me down because the plan specifically excludes orthognathic surgery – not because of medical necessity. I would like to appeal that exclusion.

I have been exploring non-surgical methods to deal with my migraines and chronic jaw discomfort since college with limited success. While I had gotten migraines prior to college, they were solely hormonal in nature and very seldom. In college when they began to occur frequently, I began to seek treatment at the medical center in Ellensburg. My doctor tried topomax to prevent migraines, which had no success. I responded to Imitrex taken early on in a migraine, but after 4 years of taking Imitrex I began having “rebound migraines” every time I took it. I am now on Zomig, which is only minimally successful in treating my current migraines. I also suffer severe side-effects from Zomig.

When I had my first consult with my orthodontist back in November of 2007, I was only interested in straightening my teeth, as they were becoming too crooked to play my clarinet well. After showing me the misalignment in my jaw, he asked me if I suffered from migraine headaches, and then explained that all of the tension in my jaw (from posturing it to a “normal” position) was likely a cause of most of my migraines. I was amazed.

Currently, to prevent migraines and to relieve jaw pain, I wear a splint at night and during the evening hours to help my jaw relax and to prevent me from clenching. I have seen chiropractors, massage therapists, and acupuncturists. I take ibuprofen 3-4 times a day and Amrix, a muscle relaxant usually only used in the short-term, every evening. I have also completely changed my diet to prevent migraines and jaw pain. I do not chew food for more than one meal a day. My diet consists almost solely of oatmeal, yogurt, soup, smoothies, and pasta.

Despite all of these precautions, I have moderate to severe jaw pain almost every day and a migraine headache 3-5 times a week or more. I have already missed 10 days of work this year from migraine headaches so severe I am unable to function. Last year I missed 9 days of school due to migraine headaches. I have also missed countless rehearsals outside of school and days of work at my part-time job. A migraine headache for me consists of blurred vision in my left eye, sensitivity to light and sound, nausea and vomiting, severe pain in the front left side of my head and temple, and dizziness, plus muscle pain in my jaw and the muscles around my jaw.

I am a middle school band and orchestra teacher. I am also a semi-professional musician who plays clarinet for organizations around the south sound area. As my jaw has continued to deteriorate this year and migraines have become more and more frequent, I have been forced to turn down performance gigs. I also find myself not playing examples for my students in class for fear of migraines and jaw pain. I can often be found in my classroom with the lights down low and wearing earplugs to try to keep my pain level manageable.

If my condition is not corrected I have a very high chance of my symptoms continuing to get worse over the years. I have already watched my symptoms get significantly worse over the last two years, and personally and professionally I cannot allow them to continue to deteriorate.

Thank you for the consideration of this appeal. Dr. Molen, Dr. Lee and I would be happy to discuss with you in further detail about this procedure if necessary.

Respectfully,
Stephanie Sheppard

the options, as I see them

For the most part, I am feeling better. Maybe better isn't the right word - I'm feeling numb. In spite of everything, I am trying to think positive about everything. My husband reminded me that I spoke to a customer service representative, not an expert in insurance and in private insurance agencies like my school district. AND... even if that is the case, there may be a way around it. And if there's not, well... I'm researching other options as we speak.

Some findings today: in California it's against the law to deny a patient orthognathic surgery? I looked for laws similar to this in Washington, but there weren't any to be found. It's looking like private insurance really isn't an option for me. I have researched countless plans - Kaiser isn't available outside of southwest Washington, Regence has an exclusion, Assurant has a $500 dollar maximum payout for jaw related surgeries (HA!), Lifewise has an exclusion, Premera Blue Cross has an exclusion.... and those are the major companies in WA.

I am not ready to quit my job for this. Now, the quick of the matter is that I am also not ready to spend the next year with the same jaw pain and migraines. My jaw pain is becoming more and more severe every day, and it's driving me crazy. I mean, I have never been in this much pain in my life - and that includes 6 years with carpal tunnel and tendonitis - so bad that I had to take a quarter off of playing my clarinet in college because I couldn't open doors with doorknobs or put my hair in ponytail - my fingers and wrists were too sore and stiff. So I've been in pain before. This is so. much. worse.

Another option? Having surgery outside of the US. But I'm not even sure of how to go about this - do I call an individual surgeon? Do I have to call a hospital? How do I pick a surgeon without the help of an orthodontist? I would have the surgery in Canada because I'm relatively close living in Washington state. It wouldn't be out of the question to drive up there and spend a few weeks, and I can always fly back for post-op appointments.

Another option could possibly be the army. Nick is currently just in a 9 week school, but his next school places him in active duty for at least 48 weeks, possibly more. Maybe I can somehow be covered by the army insurance? Do I really want an army surgeon doing my surgery? The only time I went to see a doctor at Madigan I had bronchitis. I used to get bronchitis at least once a year, so I knew what it was - no doubt. After I told the doctor this, he listened to my chest, wrote me a prescritption for ibuprofin and told me I had a cold. A week later I was in the emergency room because I couldn't stop coughing - and it had turned into pnemonia. Needless to say, I don't have a lot of faith in the army medical system.

Otherwise... I wait until Nick is done with language school and hopefully gets a job with good health insurance? But that's at LEAST a year from now. Probably more.

And there are my options, as I see them. In the end, I'm just praying that my school district sees me behind the millions of dollars this is probably going to cost. I'm praying that they say yes. Because I don't know how I'm going to handle it if they do say no.

It kind of feels like I've jacked karma somewhere along the line - I spend 5 years at college doing everything I can to make myself a good teacher and a good candidate to hire. I spend my first two years out of college working in random jobs outside of my comfort area - not to mention one was a long term sub job and one was a leave replacement contract. So now I've got a job with wonderful kids in a wonderful location and a continuing contract... but for some reason this district doesn't use the bloody union insurance - the perfect insurance that covers everything I need at 95%.

Alright, I'm done with the depressed musings now.

and the bad news just keeps on coming...

I called to check on my insurance company today - to make sure they weren't forgetting about me and my lovely, confusing case. In doing so, I managed to get the worst information I could have possibly gotten, therefore making me believe there isn't any possibility for my surgery to come through.

I'm sobbing as I type this, wanting for nothing else except for a hug from my husband and for a jaw surgery fairy to come along and grant me my one wish.

Alright, the bad news (in 2 parts). First part - there isn't a way for my school district to grant me an exception for the stupid orthognathic surgery exclusion. They would have to change the policy for ALL members... which I'm sure is really expensive. So, thinking on my feet, I asked what would happen if I paid for the surgery out of my own pocket- the response? I would have to pay for EVERYTHING out of my own pocket - including the overnight hospital stay, operating room, the whole shebang.

Because all this while I kept thinking in the back of my mind that we could manage to pay the almost 14,000 dollars on our own. We have excellent credit and a few empty credit cards with large limits.... But that's stretching it. I can't afford the 100,000 dollar everything else - let alone if something (god forbid) goes wrong - and what? It costs 200,000 dollars? 300,000?

Nope, sorry, no way.

So what do I do? Look for a new job in a state where music programs are being cut in practically every district? And then be stuck at ANOTHER school - a new school 4 years in a row? No! I like my school, I love my kids, I like my district - if it weren't for all this crap about jaw surgery.

I just don't know what to do.

I love my orthodontist

Look at this letter! It was worth waiting for.

Dear Sir or Madam:

Stephanie presented to me for an initial orthodontic consultation on November 30, 2007. Her subjective complaints included migraine headaches, chronic TMJ pain, and chronic oralfacial muscle pain. Stephanie also reported severe pain upon eating hard foods and had therefore contained herself to a diet of soft foods.

Upon clinical examination it was noted that Stephanie exhibited excess gingival display due to excess maxillary vertical growth. The mandible also displays excess vertical growth giving Stephanie a dolichofacial facial type. Popping and clicking was detected in both temporomandibular joints. Class I molar occlusion was noted bilaterally with moderate crowding in the upper arch and severe crowding in the lower arch.

Cephalometric analysis revealed a mandibular plane angle of 53 degrees, where the normal measurement should be 33 degrees. Her SNA was 74.5 degrees (norm: 82 degrees), her SNB was 67.5 degrees (norm 80 degrees), and her resulting ANB was 7 degrees (normal: 2 degrees). The cephalometric analysis demonstrated that despite Stephanie's Class I dental occlusion she has a severe Class II skeletal relationship.

It is my opinion that this discrepancy between the dental and skeletal relationships is a major underlying contributor to her current muscle and joint pain. It is my opinion that Stephanie's TMJ and muscle pain are secondary to her skeletal deformity as previously described. If Stephanie's skeletal deformity is not addressed soon via surgery she will be at very high risk of developing permanent joint changes leading to a lifetime of continued joint and muscle pain.

Respectfully,
RM, DDS

Okay, so to tell you the truth I don't understand what most of this letter says. Anyone? Anyone? What's all that degree stuff mean? And I have excess vertical height on my mandible, also? No wonder my face looks kind of horse-like (growing up, I HATED the "why the long face" comments I used to get).

He also included x-rays and photos from my initial appointment - and sure enough, my TEETH were Class I! Who knew? No wonder I had no idea that I had an overbite - I didn't have one! Now there's no denying it, for goodness sake.

This gets dropped off at my benefit coordinator's office TOMORROW, along with my journal of pain and migraine counts - I'll post that and my personal appeal letter soon.

orthodontist appointment today

Not really an exciting orthodontist appointment today. I have the exact same configuration, just adjusted with a little more tension on my springs and new rubber bands. I was partly excited (hopefully I will avoid one of my killer post-orthodontist-appointment migraines because they didn't really change much)... but mostly disappointed because SHEESH do I want some of this metal out of my mouth! I have NEVER been a wax user, but as of the major metal additions I have been a real addict to the stuff - and I don't play trumpet or clarinet as much for my kids during class because I hate having wax in while I'm teaching.

Yeah, I'm a diva. So what?

More appointments, though. In the last week of May I have a last-minute checkup appointment to make sure everything's going as planned. Then on June 23rd I get my surgery hooks on - a full week before surgery (blegh), but that was the only date they had open as they go on a vacation right around that time. I also will be getting my impressions taken with the hooks in, which ought to be a BLAST!

My husband's leaving tomorrow morning for his training with the national guard. He'll be gone from anywhere from 9 weeks (if he goes to the first school only) to almost 60 weeks (both schools in a row). Ugh. I still have hope that he'll be home for my surgery, but it is quite bleak.

oh good grief!

I stumped my insurance company.

Today I decided to call the insurance and see if I could work out the "problem" of a medical necessity appeal PRIOR to my school hearing on April 30th. It took a long time to explain what I needed and what my situation was (granted, it's probably pretty odd). She put me on hold for almost 10 minutes when she came back just to "check on me." 5 minutes after that, she told me she had emailed out her question/ my request to a bunch of people and would call me back when they got an answer. She had no idea what to tell me.

Good grief. Hopefully they'll let me go through with it, though! I don't see there being enough time if I'm approved on April 30th (for it to be included in my plan) and then denied by insurance - I would have to go through the entire school process again. I might have time, but it would be too close for comfort.

my friend, bizkit

For all of you feeling down out there in ortho-bloggerland, just watch this. The first time I watched it, I laughed so hard I cried. That's right.

I tried to embed the video, but for some reason I am unable to copy the entire link. But really - it's worth the 24 seconds of your life, especially if you need a pick-me-up.

http://www.youtube.com/watch?v=z2BgjH_CtIA

the teefs

The teeth sure are looking good! I thought I'd take some pictures while I was thinking about it (and I'm bored out of my mind stuck at home taking care of the husband in his last week at home - who has the same terrible worst-cold-ever cold that I had last week). So I've been reading some jaw-surgery journals, lurking on the yahoo orthognathic surgery group, and generally freaking myself out about the upcoming surgery. Now that it's almost April, and all of my blog-buddies have surgery dates in the next two months (and I've got one for just 3 months out) I'm getting a little nervous.

Otherwise, my gaps are closing. Now I'm forced to use the small brushes to clean out in there, and soon I will be flossing! I have been thinking a lot about surgery lately, and I don't think I will be needing the lower expansion. I can't believe how much wider my lower palate is now - it's like looking at a different mouth. My top teeth are finally looking straight, though, which is nice - I thought that would never happen!

The overbite is growing at a pretty pace once again. A few days ago I bit down really hard on a piece of bagel and my top teeth came down on my lower braces - whoa! Not only was it painful, I thought that I had bitten off a bracket. But, they are tough as nails and didn't budge a centimeter. Sorry the picture is a bit funky - you can see up my nose and at my glasses! But it shows the overbite in all it's glory. Triple yuck.

And now, my smile! Now, yes, it is marred by a million pounds of steel and titanium and springs and rubber bands, but check out how much wider it is than in the beginning - where there used to be pockets of dark space, now there are TEETH! Yahoo!

oddly enough...

My face is getting thinner. Over the past few months I've wondered about people asking me if I've lost weight. No, not really... But I was checking out my staff photo from the beginning of the year - and while I am relatively the same weight I was then, my face is quite thinner. My cheekbones look different. My face looks... taller, almost?

I'm wondering if maybe my jaw joints are actually moving? This thought scares me and really makes me want to run to the nearest doctor and check out my joints ASAP. Weird. Am I being paranoid? Possibly. More than likely.

No updates on the insurance stuff. I caught the death cold from the Annie production kiddos [I was playing clarinet] and spent the last two weeks barely surviving the combination of migraines, sinus, really high fever, coughing, runny-nosing, et cetera et cetera et cetera (I'm on a musical kick... a gold star to whoever can name THAT musical). And the best part? I have 2 sick days left for the rest of the year, which I am pretty much forced to save for puking migraines. Because while it is possible to teach band and orchestra with a fever and chills and cough and sinus stuff, it is impossible to teach while puking. Lame.

I'm on spring break [can I hear a hallelujah?!] this coming week so I'll get everything taken care of - and at an hour where the customer service people aren't rushing me off the line so they can take care of the next 100 customers on hold.

And speaking of puking migraines, I have an orthodontist adjustment on Thursday (hooray! we can talk about surgery!). I'll post more pictures before then, as my gaps are almost... well, not gaps.

appeal appointment

I went down to our benefits office today to ask some questions about what I was needing to turn into them, and I ended up turning in my packet and getting an appeal review date. On April 30th I will be pleading my case before an appeal committee. About a week later they'll give their recommendation to the board of trustees, and then I'll be notified. I can then appeal their decision, I think, if they deny it. The could decide to pay for it in full, deny it in full, or pay for the surgery in part.

I just realized today, however, that there will be a hitch in the road: Right now I'm just trying to convince them to allow my coverage through Regence to ALLOW orthognathic surgery - just allow the idea of having surgery. In reading through other people's experiences, often insurances deny the patients the first time around, making them prove that the surgery is medically necessary. I asked the coordinator today - what happens if I get approved for the surgery to be considered, but then denied through Regence the first time? His answer? Go through the whole appeal process again.

So tomorrow I'm going to call Regence and see how they determine the surgery is medically necessary and see if I can go through that process PRIOR to April 30th so I can skip that bump in the road.

I feel like a hamster.

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.

insurance update

Every day is exciting when you're dealing with insurance companies, let me tell you. Right after I got home on Thursday I called the insurance company to figure out how to start my first level appeals process. The lady I got ahold of said that there was nothing to appeal, as the procedures and materials for orthognathic surgery are specifically NOT a part of my benefits package - they are specifically excluded.  We talked for quite a while, and she ended up recommending me to write a personal statement about why I thought I needed the surgery despite what my insurance covered, and to label it as a "second level appeal" instead of a first level appeal, which I should be doing. 

I called my school benefits people shortly after, and explained to him that I can't appeal something that hasn't been denied, and that I was worried it would take a long, long (too long) time to get another denial before I can start appealing with THEM.  So he sent me the package and kind of explained what I have to do. 

I have to write a personal statement and get letters from my orthodontist and surgeon about why the surgery is necessary.  I have to get documentation from every person that's seen me for my headaches or jaw pain.  I need to have an estimate of what the surgery will cost.  Then I'll hopefully appear at a hearing with the school benefits people where I'll plead my case prior to them making a decision.  I've also got a "jaw functionality" report that I need to fill out for my surgeon's office (and I'll be using it in my hearing).  

I'm so scared.  If any of you out there has example letters that you've written to appeal your case, can you share them with me?  I'm really confused on how to write my letter/personal statement...  My email is sheppard.stephanie@gmail.com or stephanierae2804@yahoo.com, if you don't want to put them online.  

Our computer has been pretty wonky lately, so if I don't respond to comments quickly it's because I can't get on blogger from my school internet.  I can check both emails, but that's about it.   

I'll keep updating as I get more info. 

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!!

waiting

I hate being such a worrier. I'm calling my surgeon's office on Monday to possibly schedule a date (AHHH!!) and to figure out how we continue with appealing the insurance stuff.

If it were a perfect world, I'll schedule the surgery for June 30. It would be perfect (a good few days after the half marathon, but still in June). It'll be around a week and a half after my last day of school (with kids, anyway... I'll have a few teacher meeting days and clean up my classroom days). But I'll be happy with that first week in July (although, it might mean not scheduling the date until April, argh!). I want a date. I want something to look forward to.

My gaps are closing pretty rapidly. My rear molar has stopped rotating the wrong way. My upper jaw continues to surprise me with how wide it is becoming - my smile is so much nicer already! My next orthodontist appointment isn't until the first week of April during my spring break, and I'm really hoping they take off some of this extra metal on my teeth - I am back to brushing 4 or 5 times a day because no matter what I eat, it sticks in the front teeth in those thin criss-crossed little metal wires - even though I've stopped biting into anything with my front teeth. I'll post pictures soon.

Well, thanks to everyone that voted for my friend Kristin's classroom (if you haven't, see the last entry - voting continues until March 8), and I'm thinking of everyone (especially those of you lucky enough to be getting dates!!).

I know this is a TOOTH blog, but I have to help a friend out.

If you're reading this, orthobloggers, a good friend of mine needs help. She's an elementary music teacher who teaches music in a converted SHOWER room. She's also a finalist in a contest for a $25,000 classroom makeover by Expo... so, if you would be so kind, vote for her here:

http://expoclassroommakeover.com/officedepot/main.taf?p=2 - and vote for #6, Kristin Woodford from Springfield, OR.

Alright, back to our regularly scheduled program....

first rejection is IN!

I got my first rejection letter today.

Dear Dr. Lee,

Thank you for the pre-authorization request for Stephanie R. Sheppard.

Your request has been reviewed, and it has been determined that the Lefort I, mandibular and maxillary osteotomy and related services cannot be approved. The member's health plan specifically excludes treatment for, or any appliances used in connection with, myofascial pain syndrome, malocclusions or other abnormalities of the jaw.

We regret that we are unable to provide you with a more favorable response, however, we are obligated to administer our health plans consistently and according to their terms.

If you disagree with our decision, you have the right to request a review either verbally or in writing. This is the first level of the appeal process. Enclosed is an overview of this process. A complete description of the member appeal process is available upon request, free of charge.

If you have any questions, please contact Provider Customer Service.

Sincerely,
Correspondence Coordinator.

The overview for the regular process first level appeal is that I have 180 days from when the letter was written (January 26th, though I just got this in the mail today) to request a review. They will then send me a description of the entire member appeal process according to my specific plan. The first level review is done by a Grievance Coordinator and a decision will be made within 30 days. After that, there are "Subsequent Levels" where I can further disagree if they deny me again - and request further information about additional referrals.

I'm not exactly sure how my school district fits into this - I know that they can ultimately make a decision and override my insurance if I appeal through them, but I'm not sure how many official insurance appeals I have to go through first. We'll see.

Here we go!

sunshine and straight teeth

It is sunny outside! I went for a nice long run in a t-shirt today with no overjacket, no scarf, no gloves (and didn't get soaked or frozen!)... It was beautiful and very relaxing. Up here in the pacific northwest we tend to lack sunshine, so it's always a great thing to run outside in the spring - tons of other runners are out, people waiting for buses are smiling, and it's a generally positive atmosphere.

My teeth are really moving! My clarinet still feels pretty crooked and just plain off when I play, but it's all worth it -my top braces have been on for almost a year now and my front teeth have continued to be pretty crooked. This is no longer! They are quite straight.

The other amazing braces tidbit this week: My tongue officially fits inside the roof of my mouth. I remember when I first got my initial exam at my orthodontists - he told me that the reason I breathe through my mouth (almost exclusively) is because my tongue has no where to sit up at the top of my mouth, where it's supposed to rest when you breathe through your nose. I have noticed breathing is much easier, and I have started to randomly breathe through my nose! Wahoo! I've spent my entire life trying to stop mouth-breathing - when I was 11, I had my tonsils and adenoids removed, hoping it would help. I got braces as an elementary schooler, a palate expander, headgear, and many sets of complicated rubber bands.

But now it's being fixed! I feel like my mouth has gone from our very first apartment (475 square feet) to our apartment now (950 square feet). I can't wait for after surgery and it moves into a house!!

I am not an orthodontist

A few things on this fine freezing evening.

Fondue was AWESOME! I could eat almost everything (and did). What a nice anniversary (I still can't believe we've been married for 5 years...)

I got my nasty green bands changed for the conference this weekend... and then promptly had the opportunity to eat palak paneer again (the dastardly green spinich/cheese indian dish that did me in to begin with). Well, instead of getting the rubber bands green OR skipping one of my favorite dishes, I just took the rubber bands off. It hurt. I had my doubts that the rubber bands were actually doing something, as I don't have gaps up there... but within 10 minutes of having them out I was scrambling to put them back in. I have to remember, I am not an orthodontist.

I have a back tooth that is quickly tipping on it's side. I have been telling myself to not worry about it (after all, I'm not an orthodontist) and to stop being that patient... but who am I kidding? I AM that patient. I'm calling on Monday when I get back from conference. I'd rather be annoying and lame than have my surgery postponed because of one rotated molar.

All the new metal and rubber inside of my face is intensely annoying. My front teeth have somehow shifted, causing me to spend an entire rehearsal thinking my clarinet was crooked and possibly put together wrong. My gaps are closing with a quickness, but causing me to have the bite from HELL. I have migraines most days. I can no longer eat a meal without brushing directly afterwards (the little metal criss-crosses are A+ grade food traps.

I am ready for surgery, already...

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.