Hooks On and No Turning Back

I went to see Dr. Simon this morning and she said, "Oh no!" when she saw my teeth. My incisor had moved behind the front tooth. I'd already taken my molds so she worried that if Dr. Franco used the mold to make the splint then it would be wrong on surgery day. She spent an hour trying to get the doors open (I've had problems with the bracket doors opening the entire treatment) and pulling that tooth back into place. It was really painful but she got it right and got my surgical hooks on. After my visit to Dr. Simon's office I went to Dr. Franco's office. They took molds (so no problem about the tooth after all) and wax bites. Whenever I take a wax bite I always mess it up. I tend to do my best to bite the wax when I shouldn't. If I bite naturally, there is no bite mark because I have an open bite. I had to tell him that the bite didn't feel natural, so we did it again. After the impressions we did some X-Rays. Dr. Franco came in to visit with me a while and take pictures and measurements. It's embarrassing when people get up close to my face and examine it. I don't know where to look. At their shirt? It's weird to stare back into their eyes. I had some questions: Q: What are the chances I'll get staff infection? A: Practically none. One patient before had an infection and it was because she had bad hygiene. Q: My tongue presses against my teeth now, if I continue that, will it affect my teeth in their new position? A: There will be plenty of room in my mouth after for my tongue, it's too crowded now. Q: Can I use my waterpik or a humidifier after surgery? A: No. Use a baby toothbrush and NEVER blow your nose or force drainage. Just let it run and dab it with a tissue. Q: Will I pee on the operating table? A: You will be asleep so it won't matter. After my talk with Dr. Franco, I met the financial advisor to talk money. She said that they are In-Network with all Cigna plans except mine. She said that Cigna covers my surgery but she doesn't know my plan well and is not sure if/what they will pay. As of today, a surgical molding process begins and it is very expensive for the office therefore I cannot back out of it for financial reasons. (I wouldn't anyway.) Worst Case Scenario: Cigna pays nothing and I pay everything out of pocket. This wouldn't be a shocker, I've paid everything out of pocket so far anyway. Best Case Scenario: I get 50% paid since my plan is out of network. I'll leave you with some photos of my hooks. I may have to swing by Dr. Simon's office tomorrow and get a wire clipped. I can feel it poking me in the back of my cheek.

Date Set

I saw Dr. Franco yesterday. We set a surgery date for March 12th. I'm still waiting to hear back from Insurance. I'm guessing they'll want to keep playing games, but we'll see. Dr. Franco went over the details of the surgery with me again. The surgery will be 5-6 hours and he'll break my top and bottom jaws, split my palate, move the jaws forward and rotate them slightly, rebuild both TMJ joints and reduce some cartilage in my nose. Crazy. Well today was a snowy day in Dallas. It snowed so much that we got to leave work at 3pm. I'll leave you with a photo of how yellow my teeth have become. They used to be clean and white and now they're not even in the white family. They are in the pastel orange family.

Getting Closer!

I saw my Orthodontist this week. She took molds of my teeth and made a small adjustment to my wires. We made an appointment to get surgical hooks on March 3rd. They told me that surgery usually comes 2-3 weeks after this appointment. My orthodontist and surgeon will look at my molds and if he thinks I'm ready then we can move the hook appointment to an earlier date. So, now I'm just waiting. My Orthodontist is Dr. Simon and my Surgeon is Dr. Franco. Dr. Simon gave me my patient photos so I could post them on my blog.

ObamaCare isn't Working Out.

The company I work for offers healthcare to everyone but me. I got the job through a placement agency. I told the agency my salary requirements and asked them to send me on interviews that offered at least that salary. I met the hiring manager and she offered the salary I wanted with benefits. The agency places you in the company and basically you work 90 days at a "discount" which goes to the agency. After 90 days you become a permanent employee. If you have not already guessed what happened, the hiring manager asked for their "best" and she got it...me. She never bothered to ask the owners what the position paid. I worked the 90 days and then spent an additional 30 bartering for my position which I'd already been offered under false circumstances. I was kind of backed in a corner because I'd spent the 90 days working for cheap, so I'd planned on that financially. I could leave and get placed somewhere else (and the same thing could happen again)or I could take a lower salary with benefits or I could take the salary I requested and not get benefits. At the time, we were only a few months away from Obamacare and I assumed that I could get insurance cheaply through that source. By the end of next year, I will marry my boyfriend and I can go on his plan through his company. No problem right? Wrong. October 1st, 2013 I go on the ObamaCare website and try to enter my information and setup my health plan. It took me around 35 days to get everything entered. Once I was able to get everything entered I could see the plans I could chose from. They ranged in price from $130-$400. I chose a Cigna plan that was very expensive but supposedly paid for Orthognathic surgery and hospital bills. I applied and there was no information on how to pay the premium. I called the customer service number and was on hold for 45 minutes. They told me Cigna would send me info in 48 hours on how to pay. They said if Cigna didn't contact me in that time to call them. So 48 hours came and went. A full week passed and I received nothing. I called Cigna and was on hold 1 hour and 34 minutes until someone picked up. I told him I needed my paperwork and needed to make a payment. He asked me what state I was calling from and said he needed to transfer me to that department. He disconnected me. I didn't call back that day. A day or two later I called again. Another hour an a half hold time and my call was taken and I was transferred 6 times! Finally they transferred me out of the company completely and back to Marketplace! Of course they said they had my application and told me to call Cigna. Ha! It was so stupid I couldn't believe how much time I'd wasted. A full month passed where I was trying to pay my premium until finally I just thought well screw it, if it is this hard to pay them I would never be able to get them to pay for anything that I needed. What a waste of money. So I went back on Marketplace and cancelled my Cigna application. The website doesn't let you cancel. It's really stupid because there is a place where you can change or edit your plan and takes you through the whole process, but then when you finish and press enter it has an error message that pops up and tells you you're not supposed to do that. So I'm not sure why they have that on the website if you're not allowed to change. It was another huge waste of time. Anyway, the next day Cigna sent my paperwork. I am not going to give them any money. I'm thinking that it will be easier for me to just pay the entire surgery out of pocket. The payments will be about the same as my insurance premium! It would be like buying a car. I feel like the stress and worry of the surgery itself is enough. There is nothing I can do to make it better, so I should just forget about it. This has all been very annoying but I'm still staying positive.

Spinwheels

It's been a couple weeks since the last post I did about switching out my brackets. I wanted to note that on that visit they put these spinwheels on the wire. Spinwheels is a word I made up. I know this because I looked it up in the dictionary and it wasn't there. In between the lateral incisor and the canine they put these circular wires. They are like those slinkys from my childhood that I would drop on the first step of the stairwell as a kid and watch it slink down. Anyway when I lick my teeth it cuts me every time because they are tongue pinching jerks. I would also like to mention that in the two weeks since that visit my bite has drastically changed. Nobody has said anything about my appearance but I can see a huge difference. The bite is really open now, my cheeks are very round--they were round before but now I look like an apple head. I am having an even harder time chewing than before. Also, my lips don't touch when my jaw and bite are at rest.

Brackets Changed

Today I changed out my bottom brackets. They have these doors that open to fit the wire through and the ones I had were faulty. The doors would stick and they would have to really struggle to change my wires each month. My Orthodontist said that she'd tried that brand for the first time and they were sticking on everyone. They mentioned at first that the adults were having more trouble than the teens because they drank less soda. The soda erodes the doors enough that they are more easy to open. I don't drink any soda, so they were the same bad fit each time. I bought a toothpaste with baking soda to try to help but it didn't work. Taking the brackets off are really uncomfortable if you've got braces for the first time (This is my second time to have braces). It's sore on the tooth but for me the most awful thing is the cold air and cold water on my teeth and against my gum line. I hate it. My Orthodontist said that next visit we will do surgical impressions and she will meet with my surgeon about them. If he says they look good then I can book a surgery in March. Exciting! And scary. I asked the receptionist if she'd send photos they took of my teeth, for this blog and she said she'd do it tomorrow. In the meantime here are some of my own.

Insurance and Out-of-Pocket Time Line

This is Long! Sorry! 2011: The dentist I had seen my entire life had recommended I fix my jaws. I wore braces when I was a teenager and for whatever reason I ended up not doing the surgery. My parents and I have conflicting recollection of why I didn't have it. I remember that the insurance was denying us and I'd been in braces 5 years when I finally said forget it. They remember that I wanted my braces off to look pretty at the Prom. Either way, it wasn't done. 18 years later... The life long dentist retired and I went to a new dentist in Dallas. On my first visit he said the 2 teeth I was using looked terrible. I told him about the headaches and he referred me to a Maxillofacial Surgeon. At the time I had United Healthcare. The doctor he referred me to was not in Network. I chose another doctor I found online. I went to a consultation and he reconfirmed I need double jaw surgery. They requested payment from my insurance. I was denied. No payment plans. 2012: My good friend referred me to a doctor who treated her sister. I went to a consultation and he suggested I get a sleep study. I went to the sleep study. The results were that I do not have sleep apnea, but I do have a restricted airway. This restriction was causing 8 arousals per hour. In sleep apnea, the person stops breathing and in an arousal the muscles jerk the person awake prior to losing their breath. Basically, I wake up 60 times a night. The Sleep Doctor told me that a person can ‘get’ sleep apnea. We took this information and combined with the Acid Reflux, headaches and chewing problems wrote a second request for coverage. Denied. No payment plans. 2013: I changed jobs and the new job did not offer insurance. I applied for BCBS and was denied due to pre-existing conditions. I applied for Cigna and was denied for the same reason. I applied for BCBS Texas Health Pool for people with pre-existing conditions and they accepted me. My monthly premium was $400 and they covered nothing. I met a dental nurse and told her my situation. She referred me to a Doctor in Dallas who she believed could get me a cheap surgery. He was a teacher at Baylor specializing in Jaw surgery. Baylor had a teaching program where the program covers the surgery. I booked a consultation. When I met the doctor he told me that Baylor no longer sponsored those surgeries but I would have been a good candidate. He now runs a private practice and still maintains privileges at Baylor. He reviewed my case and asked if I’d had an MRI. After I told him no, he said, “How did these other doctors diagnose you if they hadn’t seen an MRI?” He told me that the clicking was a TMJ issue. If I had something wrong with my TMJ then that would have to be fixed. He said that if you do orthognathic surgery to correct an open bite and there is a problem with the TMJ, then the bite could return to its previous state after surgery! I booked an MRI. It was $500 since my insurance covered nothing. The MRI results showed that I have dislocated both discs in my TMJ which helps the jaws rotate smoothly. Instead they are scraping against my skull. This doctor told me that I should do the surgery and that it would be a long process and to be prepared. His staff said I could do a payment plan. He laughed when I showed him what the other doctors wanted to charge me for the surgery. He said he would do the top & bottom jaw, the palate and both TMJ replacements for $20,000 less then the others charged for just the double Jaw Surgery. He also offered me a payment plan since I was going to battle this out-of-pocket. April 2013: My Orthodontist reviewed my case and spoke with my surgeon. I had enough recession on my top gums that it could intervene with a surgical cut. They sent me to a Periodontist for gum surgery. I booked the surgery. I first went to my Dentist to remove a bridge I’ve had since childhood. There was a deciduous tooth but not a permanent tooth. They removed it and placed a bridge there. My Dentist broke it off and sent me back to the orthodontist to get my bottom braces put on. May 2013: I went in for gum surgery. It was painful. I was awake during the surgery but didn’t feel anything. I felt it the next day and the 10 days that followed. It was $2500 out-of-pocket since Health Pool doesn’t pay for anything. June 2013: I drop Health Pool. It’s worthless. July 2013: I get my top braces. October 1 2013: Open enrollment begins and the website is non-functional. After 30 days of repetitive efforts I am able to get into the site and fill out the enrollment application. I am given 11 options of Insurance to chose from and the prices range from $265-400. So much for affordable care. My boyfriend and I discuss a quickie courthouse marriage so I can join his insurance policy. That conversation quickly diminished and I have now narrowed my choices down to 2 Cigna policies. I am quite certain that I will not get any help for the surgery. At this point I am trying to save myself from a $30,000 hospital bill. The surgery and hospital stay are separate and I’ve heard that hospital bills can bankrupt people and really drag them through the financial mud for years. I also went to visit my Dentist for a cleaning and was surprised to find he retired! All the staff was gone too, it was kind of weird. I didn't get a note or anything. Ha! This ordeal is taking so long that I've seen two Dentists retire! I hope my Surgeon doesn't retire too. He's pretty young though, so I don't think I have to worry.