I love the ER, and the ER loves me

The migraines took an unexpected turn for the worse this week. I was at school throwing up on Wednesday on field day (yuck), so right after I went home we went to the ER. Spent 6 hours and could only get my pain down to a 3 or 4 (out of 10). The "big guns" narcotics just aren't working for me - in fact, they seem to be making everything worse.

On Thursday I had the massive migraine all day while bowling and skating with the 8th graders at my school - came home, napped, thought I was feeling better, and then Nick accidently moved my arm that was pressing into my face. Seriously, that's all it takes anymore - I almost puked immediately, I couldn't move, finally fell asleep with my hands pressed to my jaw in complete agony.

This morning, woke up, thought about going to the ER but I don't have any more sick days and since the husband is home but not working we're a little short on cash - but it did me no good. I got to school and the pain was so bad I couldn't form complete sentences so another teacher drove me home and Nick drove me straight to the ER where we spent only 4 hours. With lots of narcotics that don't make it better.

My hand (from the IV on Wednesday) has a giant bruise. My arm is a GIANT bruise because the poor nurse today was new and I have hard veins to find anyway... she had to root around in there a lot to find the vein. OW!

I don't know what I'm going to do, or how I'm going to survive the next two and a half weeks. I went to my regular doctor this afternoon and she just kind of said "well, good luck! Jaw surgery is in 2 and a half weeks!"

Great. Lord, help me. I don't know if I can do this.

time flies...

...when jaw surgery is only 3 weeks away.  3 weeks from now I will be coming out of surgery and I'll join the rest of you on the 'other side.'  I'm becoming terrified!  This is so scary now that it's coming up so fast.  Luckily I'm running a lot (half marathon in 2.5 weeks), I'm working a lot (7 more school days), and I'm playing my clarinet a lot (2 more concerts).  This weekend I'm hanging out with the mother-in-law who is hopefully making me lots of soup for the recovery bit.  

The jaw hurts like CRAZY and I've had what seems like a trillion migraines in the past few weeks but everything seems a little better now that surgery is on the horizon.   

It's all coming so fast :(  I'm scared. 

inquiring minds want to know...

I just had a freak-out moment when I realized that no, jaw surgery is NOT a million light years away anymore. And yes, it really is happening... in 33 days. And wait, I should start thinking about all of that STUFF that jaw surgery patients can't live with out. Because really, when you think about ordering after payday on the 1st of the month and waiting for things to come in the mail (and my UPS and USPS guys refuse to leave stuff on my porch, telling me to come pick it up during business hours - which are 8am to 3pm, when I work 7am to 3:05pm... I've been working on getting a package of music games for 2 weeks now... And since Nick is no longer here to pick stuff up for me I'm a bit outta luck)...

(Did I just rant about my mailmen on my tooth blog? I really have lost my mind. Back to the regular scheduled programming...)

All of you lucky patients on the dubious other side (and anyone else who has an opinion). Answer me these:

1) Zip and Squeeze Bags: Worth it? Not worth it?
2) ZnS Cool Jaw Wrap: Worth it? Not worth it?
3) What are products that I should think about buying NOW (other than a recliner, I'm working on that this weekend)?
4) Do I need a recliner? I am looking into both purchasing one and also possibly leasing one.

I think that's it... for now. In a few weeks, expect another post titled "inquiring minds part II" about questions for the surgeon and foods and other STUFF that I can get at the grocery store. Maybe it's a good thing all of my buddies are beating me to the operating table ;)

Love you guys!

orthodontist today

It was an uneventful orthodontist appointment today. I did lose the springs on bottom, and while I never thought I'd say this - my braces feel so small now! Playing the clarinet will be much more comfortable now (and my insane wax usage ought to level off). I'm in the same wire as I have been for the past few adjustments, and it'll be the wire I have surgery in.

He did mention that when he emailed Dr. Lee she wasn't specific in fixing the height of my bite (ie the gummy smile thing). He told me to make sure to remind her of this in our pre-surgical appointment (although, this seems WAY too close to my actual surgery... yikes). I must remember to ask her about this, though, as it's pretty important to me. I figure if I'm going through all of the dual jaw surgery thing, I might as well come out with a nice smile.

Anyway, pictures finally: Check out the [lack of] gaps on the bottom!

by the numbers

Days until surgery: 40! (tomorrow will be 39!!!)
Days until my half marathon: 37
Days until the husband is home: 25 (ish).
Days until school is out: 18 (actual school days, not including weekends)
Number of migraines in the last two weeks: 8
Miles in my race last weekend: 7.5
Days until my next orthodontist appointment: 5
Performances/Concerts/Field Trips in the past two weeks: 5

I have to say, I am quite jealous of all of the swollen lips, puffed up faces, sawed-apart jawbones, and perfect bites of the past few weeks. I am SO happy for everyone, especially Kate and Aimee and Aimee (ananda devika)... it seems like we all started orthoblogging around the same time, and now they're all "fixed"! But tomorrow that countdown clock rolls on into the 30s, which I can't complain about. I'll follow you guys to the 'other side' soon enough!

I still haven't called my benefits coordinator about what exactly is covered. I'll do it next week. Somehow it's fallen off of the radar with all of the relief still goin' on. :)

officially approved!

May 12, 2009

Dear Mrs. Sheppard:

The Board of Trustees of TSP heard your appeal requesting coverage for orthognathic surgery at their May 7, 2009 meeting.

The board has approved the appeal and I will contact Regence Blue Shield to let them know that the trust will pay for that coverage.

Sincerely,
MP

Still need to call about what exactly is covered, but I think that will be on next Monday. I'm violently vomiting everything I eat, but don't have time to make it to the ER - I performed in a concert on Monday (with my left eye closed because it was too blurry to see out of), conducted a concert last night, had band contest all day today, conducting a concert tomorrow night, and have orchestra concert on Friday. If this is still happening on Friday you can bet your butt I'll be in the ER after school.

Unless my head just explodes on my shoulders before them. Seems like it's about to happen - I'm amazed that one little head (big head?) can hold this much PAIN.

countdown begins

I like to stare at my countdown clock lately. It makes me feel strangely peaceful. It's funny - I can't say that I ever thought I would be joyful looking at a countdown to someone sawing apart and re-arranging bones in my FACE.

The surgery is going to be wretched, the recovery process long and difficult, and I will hate every minute I'm not able to sleep or eat or drink or talk or chew or move. I'll want to cry when I see my swollen face and I'll be scared about my nose changing or whether or not I'll like my face once the swelling goes down.

But at the end of it all, I will be able to chew steak. I will be able to eat a gummy candy and not get a 3 day migraine. I won't have this terrible jaw pain and all of these constant, aching migraines.

The migraine that I am currently getting (will probably be full blown tomorrow, great timing with one performance of my own and 4 for my students) doesn't seem as bad because I know that in 51 days I might not ever have a migraine again. (Probably not, but you never know!).

Hurray!! I'm on cloud 9. STILL.

APPROVED!!!

The short story is... I'M APPROVED!! I'M REALLY APPROVED!!!! AHHHHHH!! I've been sobbing for the past 15 minutes in relief. I hope the husband doesn't freak out - I'm sure my message was a blubbering confusing mess and he'll probably think I was denied.

Now, the long story. I left a few minutes late from school (pep assembly today and the band always plays). I couldn't wait until I got home, so I talked while I drove (I figured I could pull over if the tears got too bad). Well, I got ahold of someone - but he said that "no one was in the office today" and that he would go look for that information. WTF?! I freaked. He came back, and said that while he heard the meeting and the cases presented, he didn't know names and couldn't give out that information. I desperately said "please... Mine was the jaw surgery case? Orthognathic surgery? Scheduled for July 1st? Contract exclusion?" and he hemmed and hawed a bit before telling me he'd call me back in 5 minutes. 11 minutes later (possibly the longest 11 minutes of my life thus far) he called back and apologized for the run around and made small talk before telling me I was APPROVED!! He said he didn't know details and the head honcho (Mike) would contact me next week and talk details.

So I don't know if anything EXCEPT the surgery is covered - that 14,000 dollar bill. I'm not sure about hospital stay and all of that - but even if I have to cover the hospital stay, we can accept that kind of debt.

I'm still crying! Oh, Lord, thank you all. Thank you for your prayers and your kind words and your encouragement when I thought I was going to just fall apart! (Which I did. Many times).

July 1st - we're on!!!!

slowest. week. ever.

This week is crawling by as I count the days down to Friday. I decided I'm not going to call the benefits office until after school - if they decide to deny me and I find out at 8am, right as my first class starts, there's no way I'll be able to teach for the rest of the day. I'll just leave right at 3:05, drive my butt home, and call from the comfort [read: privacy] of my own apartment.

Just 43 hours. Or so.

feeling better already

It all happened so fast today. I arrived with my best friend in tow - she came along for moral support - and I was allowed into the meeting, I met the 6 people (secretary, 4 board members, and the manager guy I've been working with), and they asked me to tell them a little about me. I pretty much summarized my appeal letter. They asked about the surgery procedure, recovery time (would I have to take time off work? No, it's during the summer), sick days, migraines, etc. They asked what I would do if the surgery wasn't approved - I told them I didn't know, and that medical loans or looking for other means would have to happen, as I couldn't wait. They asked about the insurance - and I told them that I qualified as medically necessary - which I DO! They asked about my surgeon being in-network - and she IS. So, to summarize, yes, it is just the contract exclusion barring me from the surgery.

So, it was all anti-climactic. I can call next Friday to find out the results - they can approve me in full, deny me in full, or approve me in part - like they would pay a portion of the costs.

As it always is, I can't imagine them deciding to deny the surgery that I so obviously need. But on the other hand, it's so damned expensive and I already know a handful of people being RIF-ed (reduction-in-force) from music jobs. It's not like they couldn't replace me.

So, if you're the praying type, continue those prayers. At least it's over. Maybe I'll sleep tonight? It feels good to have it done with. I keep wondering if I could have said more, what I should have said - but I was sitting at that table just trying not to cry. They have such a large amount of information that I'm not terribly worried about not saying enough - everything I said was in the packet they received.

Well, to be continued...

almost there...

I'm still waiting for Thursday with no peace. With my skin suddenly breaking out like crazy, this stupid drama with insurance, and the braces, I really fit into the middle school scene this week!

Migraines have been pretty terrible this week - though it still feels so much better than last Friday I feel quite blessed. The ER really did the trick!

The good news? My gaps in my lower arch are pretty much closed now! The right one seems to be permanently closed, but the right one will close tight enough for me to need to actually floss (!!) but then the next night is open and I need the little brush. But it's pretty much there. I still feel like my teeth are tipped on their sides and don't meet at all but I suppose that will be taken care of at my next orthodontist appointment - the end of next month.

Thanks to everyone for their kind words and prayers. They are gratefully accepted as I come closer and closer to the appeal hearing. I'll post afterwards with my opinions about it, but will not have an official decision until after May 7th.

Until then...

another ER visit

What a terrible day. It all started out around 1am puking from a migraine - my splint had fallen out somehow during the night. I tried going back to sleep with a painkiller, puked again, then finally was able to sleep, thinking that once I could get to sleep my migraine would improve. Instead, I woke up and it was worse - so bad that I could barely look at the computer to call in sick, let alone type lesson plans for the day.

After trying to take something for the pain again I started to puke again and I knew it was time for the ER - but I had no clue how to get there without Nick. So I called my mom in Shelton (about an hour drive) at work, and she left work early (7 hours early) and drove up and took me to the ER where I spent a few hours with an IV and shots of painkillers. A 5 hour nap later and I felt pretty good, but what a terrible day. The migraine is still around - never got it below a 2 or 3 out of 10 pain wise, but that's pretty much as good as it gets anymore.

Whoa.

still anxious

I am still achingly anxious over the hearing on the 30th. I get a wave of nausea every time I think about it. And the 30th isn't even the end of it - they don't even meet with the entire board to make a suggestion and vote until May 7th, I believe. Of course I'll request to be notified as soon as possible afterwards, but that might not be until the next day, I imagine.

All I do in my spare time is think and mull and wish I knew how to prepare myself for this hearing. Will they have any questions for me? Should I bring them case studies of other people in similar situations (ie overbite, migraines, duel jaw surgery)? How can I convince them that NOT having the surgery is not an option? And that there's just no way for us to afford the surgery on our own? And if I end up not being covered, how do I go about figuring out how much it will all cost if I pay in cash (er, credit card?).

Argh. I'll try not to complain too much more, but it's just where I am right now. Feeling pretty low, missing the husband like crazy, getting low grade migraines every single day lately and terrible jaw pain, and feeling like this might go on for a long time. A long, long, long, long time.

As a final note, I can't believe that I'm able to teach middle school band and orchestra with migraines. In college, the first 10 minutes of a migraine would have me running for my bedroom, where I'd turn out the lights, put a cold cloth on my head, take my migraine medication and sleep for 12 hours or longer - until it was gone. It would have taken a huge occurrence (a test, juries, performances) to get me out of bed. Now, I have a migraine almost every day - but I'm used to not seeing well out of my left eye. I'm used to feeling nauseous after eating. I'm used to only one set of lights (out of 3) on in my classroom - sometimes none when I can open the windows and let a little light in. I'm used to the reverb that makes me dizzy when my kids play too loudly. I'm used to being short and snappy with my students. I'm used to not being able to speak clearly or think clearly enough to give feedback on performances. It's such a part of my life now, I can't imagine life without migraines.

Ugh.

Ugh.

Ugh.

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.