Deviated septum surgery is tomorrow!

Well, tomorrow's my big day... again. Deviated septum surgery is tomorrow and I actually feel okay about it. My last surgery, well, I was definitely freaked out and way more stressed. This time around, I'm completely cool. Tomorrow's surgery is way less complicated than the last one so I'm not worried at all.

For those wondering, my surgery is tomorrow April 28th at 9:30am at Mass Eye & Ear. I've only ever remembered going to MGH so this will be different for me. The procedure is a day procedure so I'll get to go home the same day. The surgery itself should take about an hour, maybe less. I'm usually a hard person to wake up after general anesthesia so it may take a few hours before I come to. If I'm lucky and the surgery starts on time and I have no issues waking up, I may get home around 2pm or 3pm. If I'm unlucky, maybe closer to 4pm or 5pm.

I'll be out of work for about 10 days so expect me to be watching tv, doing stuff on the interwebs and sleeping. This will be the 2nd time that I won't be able to sleep lying down for a little while. It took me about 2 weeks after my last surgery before I could sleep lying flat again. Not sure how long it'll take me this time around but I can't imagine it being longer than a week.

I'm really looking forward to being able to eat food normally this time around. These past 3 surgeries required a modified diet of some kind so I'm thankful that I don't need to eat pudding or use a syringe this time. I'm also looking forward to popsicles for some strange reason.

My upper teeth may be numb again (le sigh) so not sure how successful I'll be at eating but we'll see. I've also been told I might have some bruising and/or swelling around my nose. I didn't bruise much at all after my last jaw surgery so hopefully it'll be the same this time too.

I'm terrible at trying to explain what's happening to me tomorrow. If you are curious and don't know what a deviated septum is or what the process is to fix on, check out this link here: http://www.healthline.com/health/septoplasty#Overview1

I've read a couple of articles and blogs about septoplasty. One article said to avoid driving for 6 months. I drove 3 weeks after my jaw advancement surgery, I'm pretty sure not driving for 6 months after this surgery is a bit of overkill. Sometimes you just have to laugh cause it's obviously ridiculous.

I'll try to post something when I come home tomorrow but it may have to wait until Friday. For now, wish me good luck!

It's Official! Really official!

So there's good news and there's bad news.

The good news! Today I got confirmation that my surgery will be 100% covered by my insurance. I was told previously that it would be covered but having the proof is just a great relief. I definitely couldn't afford this surgery if my insurance wouldn't cover most of it.

For all you medically inclined folks out there reading this blog (aka nurses, doctors, medical staff), I have been approved for a Le Fort 1 and Saggital Split operation.

For those not medically inclined, it means that I am having both my upper and lower jaws moved into the optimal position (aka double jaw surgery).

Now, for the bad news. BCBS won't cover any type of genioplasty because it's considered "cosmetic." Gosh darn, I really wanted a new chin! Hahahaha! I've been told that after my surgery, my chin might not be as pronounced as it is now. I saw some digital mock ups of what I could look like with a chin implant and I decided that it just wasn't for me. LOL.

Time to make some appointments! But first, a photo!

Me and my approval letter!
Also, this is what I will look like in the future with no chin. HAHAHA. Nailed it.

It's Official! What I've been waiting to hear...

These last couple days have been quite hectic for me! Lots of annual doctors appointments, dentist visits and orthodontist check ups.
Yesterday, I went to my regular dental visit for a cleaning. Came back 100% clean and with no cavities! This had been like 3 years with no cavities so I'm pretty happy. 
Next, I went to the orthodontist in the city. Got there a little early only to discover an ice cream festival at City Hall Plaza here in Boston. I'm a lover of ice cream so I couldn't say no to that! Only regret is that I wish I could have stayed longer!

Finally saw Dr Klein and she finally uttered the magic words I've been waiting to hear : 

"You are officially ready for surgery."

Ahhhhh! 

There's a part of me that is ecstatic, over the moon, happy to get this over and done with. And there's another part of me that is scared, I'm comfortable where I am right now, and Jesus they are going to do what to my face?! So yea yesterday I had every kind of emotion that a person could have rolling around in their body.
I decided that denial would ultimately win out until I got a phone call from Dr.  Keith's insurance coordinator, Mary. It doesn't exist until things actually start happening, right?! Haha. Last time I had to deal with her, I had all sorts of issues with getting in contact with her. My messages weren't returned and it took forever to get a surgery date scheduled once the insurance approved it. However, I was pleasantly surprised when she phoned me this morning! I've got a pre-op appointment already scheduled for next week! Definitely impressed, that's for sure.

Aaaaaaah! Pre-op already?!?!?!

So many things happening all at once; my brain can't process it! I'm sure my schedule will fill very quickly with all sorts of appointments. Very exciting! And scary too.

I have another orthodontist appointment with Dr Klein just to double check that the wires are all good. They will also be prepping all my brackets for surgery at that appointment. Which kinda sucks but oh well. The surgical wire isn't as bad as I originally thought but we will see.

For now, I'm in a holding pattern. Which I guess means no more adjustments! YAAAAAY! 

My teeth have looked pretty straight for awhile now but here are some photos anyway!

Me looking fine in my hospital bling. hahahaha

Teeth - Straight!! Ta da!

A more natural smile. 

Braces adjustment and some news!

I had my most recent orthodontist appointment on Friday. The visit went very well! Dr. Klein still can't get over how fast my teeth are coming together. She was extremely pleased. I showed her a few pictures that I had taken. She was astounded, and again, very happy with the progress.

My teeth have been moving so fast that she told me that I would need to come back in 4 weeks and redo my impressions. The models that she had are no longer valid. Impressions are really such a pain but I don't have to pay to redo them so I'm fine with it. They are just a diagnostic tool for the doctor. And getting impressions doesn't really hinder my progress in any way so it's really not a problem. It just sucks that I'll have to redo them again.  

When I went she told me that I'm very close to being ready for surgery. (!!!!!!!!) At my next visit, she's going to put on a surgical wire on my bottom teeth and then reevaluate and decide when to put a surgical wire on the top teeth. I'm not sure what a surgical wire is exactly but I'll find out in 4 weeks. I'm thinking it's a thicker/stronger wire to keep the teeth together during and after surgery. Oh how wrong I was! See this post to find out what an orthognathic surgical wire actually is. 

The only issue she had is that one of my back molars isn't moving in the direction she'd want so now I have to wear an elastic to help encourage it to move in the right way. I only have to wear 1 elastic at night on the left side. It's very weird, it hooks onto the front of the back tooth but then the other side hooks to the back of my bottom tooth. It seems very strange but that's what I'm doing. The past 2 nights have been a little rough. The elastic puts a lot of pressure on that tooth (doing what it's supposed to) so I've been waking up a lot during the night. Last night I took some tylenol before bed and it didn't seem to bother me as much as it did the night before. I've been very good about not taking ibuprofen so maybe that's why my teeth are moving so quickly? Who knows!

After getting both top and bottom A chains replaced along with the bottom wire, Dr. Klein and I talked about surgery. It's now looking like I'll have the surgery sometime around August or early September. It seems sorta like a perfect time to get it done I think. If it's in August, I'll still be able to enjoy the summer (my college bestie is visiting again in July so that's exciting!). And then another friend is having her bachelorette party in October that I'm hosting. If I have surgery in August, that'll give me more than enough time to recover fully. I may not be able to eat much but I'll still have a good time I think. If the date gets moved back to anytime after September though, I'm planning on waiting until the end of October. That will allow me to enjoy the bachelorette party and my own wedding anniversary. Plus, If I get the surgery in October, my recovery will include Thanksgiving and that's all soft foods. It'll probably be one of the first meals I'll be able to enjoy that's not a liquid.

I can't believe that I'm so close to getting this surgery date. I know that August seems so far away but I've been waiting for this surgery since May 2013. I can sorta see the light at the end of this tunnel! 

Sarpe Recovery - Day 5

Today was the big day! I had my post-op appointment this morning at 10:30am. My surgeon was happily surprised at how good I looked. My jaw has started to bruise and I was a lovely shade of yellow/green when I had my appointment. However, according to my surgeon, most of his patients who go through the same procedure bruise more heavily than me. He said the bruises will probably become more pronounced within the next couple of days but to just keep using the heat pad to help promote blood circulation. They should slowly start to diminish as I heal.

He told me that I can start to amp up my diet (which makes me very happy). This means I can eat more than ice cream, yogurt and mashed potatoes. My local grocery store had a sale on some really nice looking salmon and wild cod so I think I'll make that tonight to celebrate. Oh man, just thinking about it makes me so hungry!

I was also told that I can now take ibuprofen again. You have no idea how happy I was when he told me that I could start taking the ibuprofen again. Tylenol helps to take the edge off but doesn't even come close to what ibuprofen does. If I want to take the ibuprofen I will have to amp up my diet though because my stomach will be very upset if I take the ibuprofen without eating first.

I am still not allowed to blow my nose or use a straw. I can do both starting next week which is good cause I've been dying for an iced coffee and to be able to blow my nose. I think I can wait a little longer though.

And lastly, the best part, he gave me the ok to go back to work! He told me that it was up to me and how I felt but that if I wanted to go back, he said he was fine with it. He was a little concerned with me over-doing it though so he suggested a modified lite duty. For the first week I'm back, he doesn't want me to do any heavy lifting and to limit my talking on the phone which I'm totally fine with. I work in a pharmacy and there's a bunch of stuff I can do without answering the phone or lifting heavy stuff so I'm not concerned. I have another appointment tomorrow morning at the hospital where I will get cleared to go back to work. I can't officially work until occupational health clears me. It's a little bit of over-kill but I understand why they do it. Patient safety comes first and they need to make sure that I'm well enough to work so that my patients leave happy and healthy. I'll just have to talk to my boss about coming back early and hopefully she'll have something for me to do.

There was a slight hiccup with the orthodontist though. Apparently, I was supposed to also have a post-op appointment with my orthodontist. When I was last there, I asked about when I should see her again, and was told 6 weeks after my surgery. So that's what I scheduled. When I told Dr. Keith that, he said that there must have been some kind of mistake because I should have had an appointment to see her 1-2 weeks after my surgery. It doesn't really surprise me, the people at the front office can be super spacey. And they have a lot of new staff that aren't that familiar with schedules. But he called my orthodontist and fixed everything. Now I have an orthodontist appointment Friday morning at 8am. I'm not looking forward to driving into Boston on a Friday morning but I will do it.

Anyway, I feel a lot better and am looking forward to getting back to work.

The big day is here!

Today is the big day! Surgery number 2 is here! I'm currently sitting in the waiting area waiting for my name to be called. I'm already really hungry (haha no surprise there) and would really like a large coffee. Lol.
Don't know if I'll be up to writing a whole blog entry after surgery but I will try. If not, I will shoot for tomorrow.
I've already got a stash of movies to watch while I recover including the first season of game of thrones. See everyone on the other side!

Next Steps...

Hope everyone had some happy holidays! I got The Little Mermaid on blue ray so of course was Christmas was great.

But, back to reality! Right before the holidays, I had my 2nd appointment with the orthodontist. It included getting some more x-rays, pictures, and the dreaded impressions. After Dr. Klein and I spoke, she told me that I would have to schedule an Orthognathic Work-Up with my oral surgeon. I'm still a little unsure of what exactly will happen at that appointment, but I was told that my surgery team will form and they will decide exactly what type of surgery I need. They told me that I can expect anything from blood work to x-rays to an EKG. Unfortunately, it is not covered by my insurance (GRRRR) so this will have to come out of my own pocket. And it's not a cheap appointment. $1500 for a single appointment! Ridiculous! Thankfully, it's a new year and my FSA has just started. I opted to get the max my company offers. With the $1500 work-up and braces, we will definitely use it up no problem.

Speaking of braces, I have my appointment to get them on. Wednesday, February 12th is the big day. Now all I need to do is decide on a sweet color. Hmmm, decisions, decisions! I'll have to search online and see what all the cool kids are doing.

Well, hopefully I'll update again in a few weeks after my work-up!

Bilateral TMJ (Arthroscopic) Procedure

On December 2nd I had a bilateral TMJ Procedure. A lot of people are curious about the procedure, what happened and how it helped me. I'll try to be as simple as possible!

The procedure I had was done on both sides (bilateral) and dealt with the TMJ area, specifically the joints connecting the top and bottom jaws. My oral surgeon made two cuts, one cut on each side of my face in front of my ear. From there, he used a very tiny camera to see the joint. The camera was no bigger than the tip of a regular pen (totally cool how advanced technology is). Then, he injected steroids into the joint to reduce the inflammation I had. After that, he stitched me up, wrapped my head in an ice pack (known in the TMJ Surgery world as a face bra, lol), and sent me off to PACU to wake up. The procedure was about 30 minutes (15 minutes per side). I was probably out for a total of 2 hours though. The PACU nurse taking care of me was very surprised that I woke up so quickly. Most of the time, patients have a hard time shaking off the general anesthesia. I saw Dr. Keith before and after my surgery. He even gave me some pictures of my jaw joint after I woke up. It was great to actually see what he saw. After I was awake and had my IV line removed, I was given my prescriptions and sent on my way.

My experience was pretty easy seeing as how I work in a hospital and most hospital OR/Surgical Suites function in the same ways. Here are some tips for people having surgery that I found helpful to myself:

• If you are having any surgery that involves general anesthesia, make sure you have a reliable person to give you a ride home. If you don't give a contact name with phone number when you register, they'll 100% cancel your surgery. My hospital was liable for my care 24 hours after I left. And if I decided to operate a car and drive myself home and then got in an accident, it would be their fault. I'm married so it was a no brainer to me. My husband just drove me home.
• Since I had stitches on my face, I needed to keep my head straight. I bought one of those travel pillows and put it in the car for my ride home after the procedure. It really helped to keep my head from bouncing around and banging my stitches. I also had a light blanket (I'm always cold so the blanket was for added comfort). 
• Wear comfy clothes to your surgery. You'll have to change into one of those uncomfortable and revealing blue hospital gowns but the clothes are for when you go home. I had pajama pants and a loose t shirt and a sweatshirt. There were some people there wearing tight sweaters and jeans and boots. I just can't imagine how they woke up from the anesthesia and put their clothes back on. I know I was barely able to pull my pants up, nevermind figure out boots. 
• Make sure you have everything before you leave. Refer back to the reliable person for your ride home. They can be your second set of eyes. This includes any prescriptions from your surgeon. I left with a whole folder full information along with my two scripts. But don't worry, the OR staff won't kick you out before you are ready. 
• The night before your surgery, have some soft food left overs on hand so you don't have to cook while you recover. Mashed potatoes, squash, apple sauce, jello, ice cream. My husband even made me a smoothie which was nice. 

I'll talk more about my recovery in the next post!

Next Steps, Surgery, and my doctors

It's been quite awhile since I've last posted. Within the last 2-3 months, my range of motion in my jaw decreased quite a bit. I was able to eat small pieces of chicken and a bagel (if i ate it one quarter at a time). But about a month an a half ago, it just became too hard and painful to open my mouth as wide as most foods require.

I was told by my oral surgeon that an arthroscopic procedure would really help with my range of motion and would help dub my pain down a bit. I was not sure I wanted to do it at first but once my condition got worse and I was told the exact same thing by a second opinion, my mind was made up.

I had a little hard time finding other blogs out there talking about the same procedure I was going through. I knew there must be a different name people were calling it cause there was no way that I was the only person going through this. Well, yesterday, all the nurses kept calling it a bilateral tmj procedure. Guess I know what the other name was!

Since I had such a hard time finding blogs about this procedure, I knew I had to write about it. Cause if I had issues finding stuff, then I knew other people must have as well. I'll go over all the things that I went through, the questions I had, the answers I got, and my recovery. In my next post I'll go over all that good stuff so that this post/disclaimer isn't super long.

It also occurred to me that people might want the names of the doctors/dentists/oral surgeon I dealt with. I'm from Massachusetts right outside Boston so I'm spoiled with the amount and quality of healthcare. I'll put their information here to not clutter up the next couple posts.

Primary Care: Wellesley Primary Care (781-431-2345) : I see Dr. Alan Glaser MD and Elizabeth Dewire NP. They are both wonderful and really care for their patients. Dr. Glaser actually called my phone one evening when I was really sick to check up on me. I really appreciated that he took the time out of his busy schedule to call me after my visit to see how I was doing. Really wonderful service. And Liz is just wonderful. She's so sympathetic and a great listener. I feel that some doctors hear their patients but don't necessarily listen. Liz does both which is great. 

Dentist: Wellesley Dental Group (781-237-9071) : Dr. Femina Ali and Dr. Ejaz Ali are a husband and wife team of community dentists. They are wonderful and are the people who realized that I had all these problems. They're committed to going on this journey with me and get my jaw working like normal. 

TMJ Specialist : Dr. Emad Abdallah : He is a part of the team at the Wellesley Dental Group and he has been helping me with my TMJ problems. He's actually one of the only dentists in the country that is also an orthodontist. He's great and will really tell me like it is. Doesn't sugar coat anything which I like. He's also very supportive of my decisions and is on board with my long term medical plan. 

Oral Surgeon: MGH Dental Group Danvers/Boston (978-882-6600) : I visit Dr. David Keith at the Danvers office. He is a world renowned oral surgeon specializing in TMJ and Orthognatic Surgery. He's super nice and again is a great listener. 

Orthodontist: MGH Dental Group Danvers/Boston : I've recently been referred to Dr. Katherine Klein by Dr. Keith. I've only visited with her once but she was extremely nice and knowledgeable. She also made a medical plan for me on my first visit which I liked. 

Ok, so that's it! If anyone out there wants to call any of these doctors and set up an appointment, I highly recommend any of these professionals.