TMJ Day 6

Everything is going ok today. I haven't had a Hydrocodone since the middle of the night. It's now 2:30pm. I'm scheduled to have my stitches removed on Wed at 3:30. I'm pretty gross looking still, my head is in the shape of an upside down triangle. I haven't had much to eat today just some scrambled eggs and a green juice. I got an official letter in the mail from Cigna approving the surgery so I called them to double check my deductible. I was told that I just have to pay the $1900 deductible and the rest is covered at 100%. So, lets hope that sticks! I went for a walk and when I came back my wedding dress had arrived and was at my front door! It was so exciting because I wasn't expecting it until May. I tried it on very carefully and it was perfect! Hopefully I will be able to get married on time and with my jaws in good shape.

TMJ Day 5

My bite is really weird now. I'm not sure what to do or how to hold it. My bite a week ago was open and the lower jaw was set way back. Now the lower jaw is pushed forward and slightly crooked like a bulldog. I will just continue to move it around as much as I can.

I'm still in pain. I've been taking my antibiotic 3 X a day and Hydrocodone as needed, which is still about every 6 hours. Today I went for a long walk, it was so beautiful and perfect outside. I also tidied up around our place. I changed the sheets, did some laundry, cleaned the bathroom, etc. Nothing too strenuous but I wanted to move my body some. Laying in bed for days is really painful on your neck and back. I rolled on my foam roller to try and get some bed sores out. I still feel foggy and dizzy from the medication and my head feels huge. On a side note for the girls: Dr. Franco said that I wouldn't get my period after Orthognathic Surgery so I assumed that I wouldn't get it for TMJ Surgery but I did and I've been having to deal with that in addition. At least I'm laying around in bed doped on Hydrocodone. Not sure if anyone would care, but just a little side note. Today I ate oatmeal and tea for breakfast, Curry over rice for lunch with carrots (I cooked the carrots really well) and a spinach smoothie with protein and collagen powder. My ears are starting to heal so they're itchy which I hate. I used a q-tip with warm water to clean some of the blood inside and put Neosporin on the stitches to keep them moist. When Dr. Franco takes the stitches out I am anticipating some pain, I've had stitches removed before and it's painful. The more moist they are the easier they'll slide out. One other thing I forgot to mention was that on the day of my surgery my boyfriend went to Walgreens to pickup my prescription and they said they don't take my insurance! HA HA HA HA HA! So, it was $130.

TMJ Day 4

I saw Dr. Franco yesterday and he said my recovery was really good. He said he expected a lot more swelling. We talked about my bite or lack of and he said to keep trying and exercising it. Once we do the breaks they will fit together more naturally. For now, I need to keep the joints moving. He said that he was surprised when he "got in there" because my joints looked like a 60 year old and they were mushy and gross. Ha! So, he rebuilt them and that is the strong tension that I'm feeling. I'm supposed to go back on Wed. and have my stitches removed. Today I napped less and took less pain killers but I'm still tired and there is a lot of tension in my head and pain in my ears. Franco told me to go ahead and eat solid foods. So, today I ate oatmeal, eggs, and blueberry pancakes without a problem. Here are my ears today.

Post TMJ Day 3

My face is much more swollen today. The pain is down a little. I still can't close my bite, my mouth is just hanging open and I'm not sure if I'm supposed to try to force it closed or not. I will go see Franco today and I'll ask. I haven't taken a pain killer since 4:30am. I took my antibiotic at about 8am and 2 Advil at 11. I want to try and space out my pain pills more so I'm not sleeping constantly. Josh and I went for a walk in the park but it was muggy and gross outside so we only did one lap which is .5 mile. I felt dizzy a little. My ears hurt and my hearing is weird. It sounds like I'm underwater. My lips are disgusting. They're so chapped and peeling so much it's gross. I look terrible but here are some of today's photos.

TMJ Surgery Day 2

I'm finished with my TMJ surgery! I showed up to Franco's office at 6:15am and nobody was there. At about 6:30am my anesthesiologist pulled up and a few minutes later the office lights were coming on...So I guess Rachel was right about the time. My boyfriend and I waited in the waiting area for about 30 minutes until they called me back. My boyfriend, Josh took my purse and gave them his number and off I went to the back. They took a panoramic X-Ray. Then they walked me back to the bathroom where they had a gown and booties for me to wear. I was told to remove my shirt and bra and wear the gown and I could keep my yoga pants on. That made me happy! From there I went to the recovery area where I was to get my IV going and talk to my anesthesiologist. He came in and asked me a series of questions like "If you block one nostril which one is more clear to breath out of?" He had me sniff some spray up my nose that shrinks the blood vessels. The first shot he gave me numbed my hand. It was the tiniest prick so it didn't hurt much at all, then he inserted an IV line and explained that we would go into the O.R. and chat for a minute but I wouldn't remember the chat and then I would wake right up and it would be over. After he left he asked me to go to the bathroom and "get everything out" this worried me because I could't go poo that morning because I have to have a drink of water or cup of coffee for it to move. I told the nurse and she said it would be ok. So, I peed and went to the O.R. There were about 5 doctors and nurses there and a chair with a light over it. I told them I felt like I was being executed. There was my X-Ray up on the wall and everyone was pretty quiet and that's the last I remember. I woke up and I think someone walked me to the recovery room. It had been over 5 hours but only a moment to me. It was like time travel. I laid in a recliner and Dr. Franco came in with a fizzy drink and had me drink it. My mom and Josh came in shortly after to sit with me. I felt pain but was still on a drip that was helping some. I could mumble and talk a little. I stayed there for an hour or so. Dr. Franco came in and gave me a shot of medicine and it really took over me! I couldn't keep my eyes open and I was so nauseous. I felt like I was going to throw up and they brought me a cold cloth for my head. My mom said, "She's clammy." Once it passed, I was walked out to the car and we went home. Once I got home, the pain became unbearable and I was vomiting violently. It was really unpleasant. I was supposed to be taking an antibiotic, a pill for swelling, a pain pill and I had a nausea pill. But that wasn't working to cure the vomiting. Eventually I figured out that it was the pill for swelling that made me sick. I stopped taking it and I haven't been sick since! I text Dr. Franco my issues and he said it all sounded normal. Today I had a scrambled egg, a cup of chicken soup, a cup of tomato soup, a cup of apple sauce, a green juice (kale, cucumbers, parsley) and black tea. I took a shower and took my bandages off. My ears are pretty beat up.

Night Before TMJ Surgery

I'm all ready for my TMJ surgery in the morning. I took 2 weeks off work and I just went and got some things from the store. Veggies (for juicing) and fresh squeezed juices from Central Market. I got some oats to put in shakes and some almond and coconut milk since Franco told me not to eat dairy. I had a slow roast for dinner with potatoes and vegetables and 4 gluten free chocolate chip cookies! There was a message on my answering machine from the anesthesiologist who said that I need to be at the office 45 minutes prior to my scheduled surgery at 7am. Funny, because that means Rachel told me wrong. She said be there at 7 and surgery started at 7:30. He also said not to eat or drink after midnight. I will be asleep long before then but I'm trying to drink tons of extra water so that I'm not dying of thirst when I wake up which I usually am. I hate mornings without coffee. Here is the anatomy of TMJ.

My discs are both out of place. Dr. Franco will repair them and sew them back to their spot. I hope this is not too painful...

Not Forever After All

Today's news is that I can get full hospital coverage for being in network with the hospital; partial coverage for Orthognathic surgery for being out of network with Franco; TMJ will be a separate surgery done in Dr. Franco's office and has to happen first. Next Wed., the 26th I will go to Franco's office for TMJ surgery. It starts at 7am and lasts to about 1 or 2pm. I will need about 2 weeks off work for this, I told my bosses and they were cool about it. In fact, they gave me a bonus today. That was really nice. My boyfriend took off work too so he can take care of me. The Orthognathic surgery will take place in the hospital in June. If you are reading this and thinking about getting this surgery, I can tell you that it probably won't be this messed up and complicated for you. I'm happy that the surgeries are now happening but I'm starting to worry because I already booked my wedding for next January 31st. If I don't do jaw surgery until June and it takes 6 months before braces come off and I need to have the implant in there somewhere....you know where I'm going with this. It's shallow I know, but I don't want to be a brace faced bride. I'll leave you with a picture of my cat who will be keeping me company after surgery. She's begging for food at the table.

Waiting

Yesterday Rachel told us that they are waiting on Cigna to send my paperwork over, when that happens she can call Baylor to get me set up again. I have no idea how long that will take....

Awesome.

Nothing has happened since last week. Our phone calls and emails have not been returned yet.

One step forward

Yesterday I was bummed out all morning and I kept going over and over all the details in my head trying to figure out why all this happened. When I think back I can remember some vague remarks that I think were intended for me to get a general idea of some costs, but not really. I think if we're dealing with big numbers there should be some kind of financial plan on paper saying what will be due on what date and what it's for, etc. We were just throwing out numbers here and there and it was all uncertain and incorrect anyway. THE GOOD NEWS IS: I got a call from Rachel yesterday and she said that Dr. Franco finally did get a call from Cigna for the Peer to Peer and they were able to approve me! Yay! THE BAD NEWS IS: Cigna doesn't cover TMJ which means they will not cover ANY of the hospital costs if he works on my TMJ durning the Orthognathic surgery which was approved. THE SOLUTION: Dr. Franco suggested that we do the Orthognathic surgery only at the hospital. Surgery and hospital is covered. After a month or so, do the TMJ surgery out of pocket in his office which would be much cheaper. It saves over $20,000 if we do it that way. The downside is that I have to have 2 surgeries, which means more pain, more time off from work, etc. But, it's probably the best way. We were able to get me rescheduled for March 26. Lets see if it sticks this time!

Surgery Postponed!

Today is my surgery day. As you are reading this you can correctly assume that I am not on the operating table. Yesterday morning Rachel calls and tells my mom that Cigna stood up two appointments with them for the peer to peer review. She claimed that they called and called and no one would talk to them. In my opinion, this should have been done weeks ago, not the 24 hours before surgery. There was an exchange of about 40 calls between me, my mom, Rachel, Cigna and Baylor Hospital with every roadblock you could imagine. In the end the result was that with or without Cigna's help I would still owe $19K and change on the day of surgery. This is because of TMJ fees being charged out of pocket. I paid for the TMJ surgery but there are separate fees the hospital gives you. This was never told to me. Rachel claims that she discussed it with me. She didn't. I think I would remember if she had said, "You will owe 19K on the day of surgery." In one of the conversations we had yesterday, she said "I'm confused because it's the same with all our patients that a down payment is due and I thought we discussed the 28K?" I said, "Yes, we discussed the $28K (which was wrong by the way) and you said I could work out a payment plan with them. 19K was never a number in the mix. A huge deposit was never discussed." I've never had surgery before and I relied a 100% on her to give me all the info that I need. After I learned that it was 19K down, I sent her an email and she acted shocked. She said that "She'd received my scary email." She acknowledged that the price wasn't right. She called Baylor after we talked and said they coded the surgery wrong. So...why is she mad that this was a surprise? She's acting like it was a surprise to her too? We need another week at least to borrow the money. I hung up with her and she called my mom. She told my mom, "This is kind of a big deal that you're canceling the day before." But there is nothing we can do. This deposit was sprung on us at the last minute and she didn't work out the peer to peer. We asked to reschedule and she said Dr. Franco doesn't have another opening until May. She said that she won't book another OR at Baylor until we pay everything up front. Too bad she wasn't that clear and forward a month ago! I called Cigna this morning at 6am and wanted to get my mom, dad and lawyers names on the approval list to talk to them and they said I had to fill out a form and send a fax that would take 3-4 weeks to process. There is no way to verify that they received the fax. So nothing is rescheduled, I didn't have the surgery, I lost 2 months of supplemental income for an ESL class I teach and I had to fire that girl that was covering me for the next month.

These people are causing me to overeat

This morning at 9am I showed up to Baylor for Pre-Admitting. My boyfriend and I walked there from our apartment. It was such a beautiful day, pretty much perfect weather. We signed in and waited only about 10 or 15 minutes. When they called me back we sat with a billing woman named Natasha. She entered all my information into her system and then looked confused and said, "What did your insurance tell you?" I told her the story and she said that we have to pay the $19K. Now it's $19K. Two days ago it was $15K and tomorrow it will be something else. She said that if the insurance didn't accept the surgery then we could post date the payment and have 2 weeks until it withdraws. But still...that's not much help. We didn't even do the physical, we just left. I called Rachel at Dr. Franco's office and she said that they were trying to get that peer to peer review but Cigna wouldn't call them back. Then she said that they'd finally called and said that the guy that he needs to talk to only works on Wednesdays. But, the surgery is on Wednesday. So, she said that they will have him call in before 5pm. So, I went on about my day. I went to the dentist and got a cleaning. I also renewed my driver's license which will expire next week and got my car cleaned. We ate brunch in a really cute courtyard and dinner at a really yummy Asian restaurant.

The Most Annoying People Ever

Cigna has not approved my surgery fees yet. With that being said, I've paid out of pocket in the hopes of them covering it at the last minute. Last week the woman who works at Dr. Franco's office in the business office tells me that the estimate for out of pocket without insurance paying is $28,000. It's a hospital so I can set up a payment plan, etc. I've already paid for the surgery separately. It's kind of generally understood that hospitals will work with you on payment plans and negotiating the bills. Yesterday I got a call from the woman at Baylor Hospital in their business office. She tells me that the estimate is $61,000! And that I owe 60% at the time of services. That's kind of a huge bomb to drop on someone a few days before their surgery!

It was late so I wrote an email to the woman (Rachel) at Dr. Franco's office who is his business manager, she tells me that when she got the estimate from Baylor they told her if insurance doesn't pay, it's $28,000. She calls them and they tell her "whoops, we coded the surgery wrong". Now, I am really in a bind because I'm expected to show up on Wed. with about $15,000 cash. $61,000 - 35% (no insurance discount)= 39,000 they want 20,000 but will take no less than 15,000. Rachel also tells me that Cigna doesn't even have my X-Rays yet! She faxed them and they received them solid black so she mailed them and they haven't seen them. She set up a peer to peer review with Dr. Franco for Tuesday. Ha! So, I guess I won't know until Tuesday afternoon whether or not I'm having surgery Wed. morning. On a side note I'm finished with work. They brought in another person to fill my position for the next month. This is ridiculous.

Stocking Up

On my last post I titled it "Post Op Rush" but I meant Pre-Op. I was really tired, sorry. I haven't had my surgery yet, just to make that clear. Dr. Franco told me to start taking Arnica pills today. You can buy them at whole foods. They are for muscle pain, bruising and swelling. He also told me to buy Calendula cream. I suppose I'll use that on my face after surgery instead of my regular face cream. I also bought about $80 worth of pureed soups by Pacific. I like that brand because they're low in sugar. I don't want to be lying around in bed for a month drinking sugar. They also have low sodium options for a lot of their soups. Sodium is bad for swelling so we don't want that. Finally, I ordered a bag of collagen in powder form--it's good for healing bones and hair. Dr. Franco said some of my hair might fall out! I'll put that in my drinks. Whey Protein is good for shakes but is has a vanilla flavor so it's not good for everything. That's it for today! Have a great day!

Pre-Op Rush

I was supposed to visit Dr. Franco tomorrow but they called and had me come today. I had to pay 1/2 down. By "I" I mean my mom. I signed some waivers. Do I agree to have blood given to me if I need it? Yes, but asked if the blood could come from my dad if I need it. He's my blood type and he's my dad so I felt like it was less gross. Dr. Franco said that it's not likely that I'll need any anyway. Do I agree to let Baylor take the body parts or fluids that they take out? Yes. Do I agree to allow video or photos to be used by Dr. Franco or Baylor? Yes. He said they're not taking a video but some students want to watch behind a glass. Yes, that's fine. Some of the side effects page scared me. It mentioned dead lips forever, pain forever, wonky bite, etc. Oh, and of course paralyzation and death. But I think those are all worse case scenarios. Dr. Franco assured me that none of his patients have had those things.

Dr. Franco said, "Please Please Please don't blow your nose." He's told me this before, so I know something bad could happen if I do. He said no breathe right strips. He said not to eat dairy if I can help it. He went into some detail about the procedure. The TMJ part is first - through the ear he'll rebuild and basically nail in the disc to each side. Then he cuts the tissue above the gum line and pulls upward to make the incision from molar to molar. The entire top jaw comes out and forward, and he'll expand through the center (palate) to make it wider. Then the lower jaw will be cut behind the wisdom teeth and pulled forward. He said that here, he will make tiny incisions through the outside skin itself. So, I will have a small blue stitch on both sides of my jaw. But there won't be a scar. That's the gist of it! Finally, we talked about some after surgery side effects such as depression, insomnia and stomach problems. I'm supposed to keep him in the loop about any emotional problems I have.

A Week To Go!

My Surgery will be March 12th. On the 10th I have pre-admitting at the hospital at 9am. This appointment is a physical. I'm doing it at Baylor Hospital in Downtown Dallas. I live in walking distance from this hospital so I think I'll walk to my appointment. I'll go see Dr. Franco at 11:30. At 2:30 I'll go to the dentist and get a good cleaning. I figured I may as well try to get them as clean as possible beforehand. This Tuesday the 4th I'll also go see Dr. Franco to make a payment. As of now, I'm denied from CIGNA and they're asking for a 'peer to peer' review from the physician. This is where my doctor calls them and tells them why it's medically necessary. The politics of medical insurance are such a bore. I'll be posting more from now on. There wasn't much to say prior to this but now things are rolling.