Saturday, November 10, 2012

I finally have a surgery date!!

There are a few key dates during a jaw surgery journey that we can't wait to know and yesterday was one of those days for me. I called my surgeon's office to see if I could schedule and after a couple bumps I was able to schedule my surgery! I will be having my surgery on Monday, March 4th, 2013. Even though is it still almost four months away I'm glad to have an actually date and not have to tell people that I don't know or sometime next year. I have my pre-op appointment on February 13th to have my records taken and sign all the forms. Now I'll have to do is wait until February to really start prepping for surgery!!

Tuesday, October 30, 2012

Almost there....sort of.

Sorry guys, long time no blog. Just wanted to do a quick little update on the status of my surgery. I still do not have a date for my surgery, but I am getting closer. Today I received a letter from my new insurance saying that they have approved my double jaw surgery! I wasn't worried that they won't approved it, but it's nice to see it in writing that they did approve it. Now I just have to wait for my surgeon's office to update my financial estimate, mail it to me, sign it, mail it back and finally schedule my surgeon!

I'm thinking that I will probably schedule early March even though I'm technically ready for surgery now. Part of the reason being my surgeon's schedule is already filled for December, the winter weather and I am finally transitioning into a new position at work. My new job is going to be working with families and I don't want to be there for a little bit and then be out for a month. Only time will tell what the actually date will is going to be, but I'm excited to get to that point in my pre-op journey.

To all my fellow bloggers, are there any other bloggers that are still in the pre-op stage or know of anyone who is? I know that there were a few that had their surgeries not that long ago and some that will be happening in the winter time.

Until next time folks, hopefully with a surgery date!

Monday, September 24, 2012

I need my teeth!

I had an appointment with my orthodontist today. They took impressions of my upper jaw to make my new pontics and adjusted my wires. Right after I left my orthodontist's office I received a call/message telling me that my orthodontist says that I'm ready for surgery and to call my surgeon to schedule my appointment!! Umm, what?! The message told me to aim for an appointment in December and that I will need to go see my surgeon for my pre-op so that they can take all the surgical records! After all the drama with UCSF, this was the best news ever!

As far as scheduling my appointment, they are two parts my surgeon's office needs before they will let me schedule, first being approval from my orthodontist that I'm ready for surgery and second being a signed financial arrangement. First part down part down and they mailed my financial arrangement last Friday, should be getting it any day now. I'm planning on calling them tomorrow and seeing what I need to do next.

There is still the little fact that my primary insurance switches as of October 1st. Part of me doesn't want to tell them until I have scheduled my surgery, but I don't want that to result into more problems. The good news about my new insurance is that they only take 5 days (I'm assuming business days) to process a pre-authorization request. More details to come!

Side note: When they were going to take the impressions for my pontics, they removed my current ones and I was able to see what I truly look like with my gaps. Here's a picture. It took me a little bit to get used to them, but thankfully they put my pontics back in so I won't have gaps in my teeth while they make my new ones.

Tuesday, September 4, 2012

Ring, Ring......Hello?

I got an unexpected call from my surgeon's office, well not completely unexpected, but didn't think they would be calling me back so soon. I had sent an email requesting to have my surgeon look over my current x-rays and confirm the treatment that had been set and go over it a little more in detail with me. I got a call this afternoon saying that they got my email and Dr. Bloomquist would like to talk to me and if right that minute worked for me?! Yikes, I hadn't even really thought about what I wanted to ask him, no list, so unprepared, but I wasn't going to let this opportunity slip away. I was expecting them to give me an "appointment" when I could expect a phone call.

I did learn a few very valuable aspects of the surgery from the phone, which I am very thankful! The most amazing thing he could have said and did was that I will not be rubber banded shut!! A miracle if I've ever heard one. How is that possible you ask? Technology. He said that from all his experience he hasn't seen the rubbers to make a difference and in some cases to make things worse. Thank you Dr. Bloomquist! He did say that they do rubber band you shut for the first night due to the swelling, but they normally don't send you home with rubber bands!

As far as needing a splint or not depends on if he will need to widen my upper jaw or not and he wouldn't know that until he takes the molds one month before the surgery. With not being rubber banded shut and the possibility of not needing a split is making the food after surgery not look so bad. He said he would want me to start eating very soft foods after about a week post op since I'll have to learn how to chew all over again. It would be 8 weeks though until I can chew hard food and 10 weeks for contact sports, but I'm not worried about that part. He did say that I can exercise as soon as I feel up to after surgery as long as my face is in no danger of getting hurt.

All in all pretty good new from Seattle for me today. I have an appointment with my orthodontist on the 21st, after that appointment he will send a letter up to Seattle to let them know when I'll be ready for surgery. Once that's on file and I've signed my financial agreement I can schedule my surgery!

There was one hiccup that I'm trying not to get in the way, my work is switching insurance providers, which means that I'll need to get a new authorization on file from them. If the two insurances that I have currently have approved my double jaw surgery, I feel pretty confident that my new one will as well.

Monday, August 20, 2012

Feeling optimist!

I am definitely feeling more optimist about my jaw situation than I was during my last post. I've had the weekend to process everything and this morning I talked to both my insurance companies, the office in Seattle and my orthodontist about changing my surgeon back to the surgeon (Dr. Bloomquist) in Seattle instead of the inconsiderate butt-head at UCSF. I just went to Google Maps to see the exact distance from my house to my surgeon's office in Seattle and it is 604 miles, 10 hours 54  mins. Definitely not ideal, but doable.

The first people I called where my insurance companies, Blue Shield of CA and Delta Healthy Systems, to make sure that Dr. Bloomquist did indeed submit and got approved to do both jaws and that was a YES!!!! A huge weight off my shoulders. I talked with the surgeon's office in Seattle, they were extremely helpful, understanding and empathetic to my situation which made me feel at ease. I talked to my orthodontist and to my surprise he wasn't surprise by the surgeon's behavior. My orthodontist thought he had told me that he was like that, but I never knew. I did sense that he wasn't completely comfortable with me going to UCSF, but he never said why.

Like I said earlier I am feeling way better about changing my surgeon after all that drama with the UCSF surgeon. I am planning on having a conversation over the phone with Dr. Bloomquist to talk about my surgery more in depth. I did an update video on YouTube about my appointment and will put it below. 

All in all I'm feeling good about where things are. My jaw surgery probably won't be until Mid-January to February, which is ok because I might me be transiting to a new job with my agency and it will give me more time to be comfortable with my job and the families that I'll work with before my surgery and coming back with a split to work. :)


Friday, August 17, 2012

Wasn't expecting that curve ball!

I had my appointment with my surgeon to find out what the treatment plan was, but it didn't go the thought it would and unfortunately more disappointment came today with regards to my surgery. My mom and I left at 6:30 this morning to drive down to SF for my appointment, really excited to find out what the plan was and to know that surgery was that much closer! At my previous appointment I mostly saw the residents/interns and not the surgeon, but to my surprise it was just the surgeon who came to speak to us. That really made me excited, hoping for good news!

As he started to talk about my "situation" he starting to say that they were going to submit for lower jaw surgery to the insurance because he didn't think that they would approve double jaw surgery, saying that they would consider upper jaw surgery cosmetic due to my semi gummy smile and not cover it. What the hell is he talking about! I told him about the previous surgeon requesting a LeFort I and BSSO from the insurance and to my knowledge they approved it and he basically told me to go to the other surgeon. Just like that! Like he could care less, he was actually being really insensitive about the whole situation which I did not appreciate. We drove down 5 hours from this appointment, my mom and I both had to take the day off and we were with him for less than 10 minutes!

His reasoning for not wanting to request the upper jaw & lower jaw was because he didn't want to deal with the insurance since he already knew that they wouldn't cover it. It was a bunch of crap, excuse my language, but this was really unacceptable behavior for a professional such as himself to have. Let me back track a little, when he did tell me the plan of just doing the lower jaw I asked how that would work with my deep bite. If I remember correctly he said something about bring my lower jaw out and then tilting it and that there would be a lot of work for my orthodontist to do before and after the surgery.

I've had my braces on for 15 months already and according to my orthodontist I would be ready for surgery hopefully by Christmas time, but with all this lower jaw stuff it would be a lot longer. I really didn't appreciate the manner in which he deliver the news. Needless to say I was and still am really bummed out from the outcome of this appointment, but what I have learned from reading others blogs is that with jaw surgery you will learn to have patience weather you like it or not.

Time for Plan B. Right after my "appointment" I called the surgeon in Seattle to see if I would still be able to have Dr. Bloomquist do my surgery and luckily they said, "yes". I asked the receptionist about my insurance authorizations and I needed to talk to another lady that has been dealing with my case about it because she was reading conflicting information. The lady is suppose to call me on Monday. I guess there really isn't much I can do about it until then, but this patience thing is really hard. The receptionist said that my surgeon would need to talk to my orthodontist to see when I would be ready for surgery, when that time was closer I would need to get new records taken and get them sent to Seattle. My plan is to call both my insurances first thing Monday morning to see what was exactly authorized and also to call and talk to my orthodontist and see if it's really possible to get me ready for surgery by Christmas time. I would also like to talk to the surgeon more in detail about my possible surgery since the last/only time I talk to him was over a year ago.

I wish I had better news, exciting news or even everything is still in the process news, but I guess this isn't going to be as simply as I thought it would be. We are talking about having surgery in Seattle, which is 12 hours away and possibly in December, not the best time to travel. One step at a time. I'm going to not let myself get so head of myself this go around, but only time will tell. Hopefully I have more news on Monday.    

Friday, August 10, 2012

One step forward, two steps back

I had an appointment with my orthodontist bright and early this morning and it left me more than a little disappointed about the timeline I had set in my mind for my surgery. My orthodontist had never really talked to me about when he projected that I would be ready for surgery, so this morning at my appointment I asked him when he thought that and told me around Christmas time-February!! That was definitely not the answer I was expecting! After he told me that I definitely felt defeated. First I had to switch surgeons, then it took me three months to even get it for an appointment and now it probably won't happen for at least another 5-7 months!

The way that I am paying for my surgery is with insurance and with a new calendar year comes a new deductible, which means more money that I will have to pay out-of-pocket and I can't do that. Currently I have insurance through my work and insurance through my mom. The plan was to have two so that I don't really have to pay very much out-of-pocket from the start. As long as I am able to get my surgery by December 31, 2012 I think it will be ok, but I don't want to risk it being so close to the wire. The earlier the better, just in case there are problems.

Another worry with having my surgery in late December is that many people get their surgeries during that time because of being on a break from school, but also what if my surgery is going to be on vacation? There are so many uncertainties right now and I'm feeling very unsettled by them. There was a good thing that came from my appointment, I should be able to get new pontics made soon. Those are the plastic teeth that I have to maintain the spaces for my upper laterals and fill the gap. They put a power chain from each K-9 to the back molars so that they can get to their final place and then take the impressions to make my new pontics. I guess that can be my silver lining for the day. The also put a power chain on my bottom jaw to close all the gaps and he did say that my bottom jaw is almost there.


I still have my appointment with my oral surgeon in San Francisco NEXT FRIDAY, I'm hoping that he will have good news! At my first appointment I didn't really ask many question because they were just doing a work-up, but now that they have had time to look over my x-rays, molds and come up with a treatment plan/diagnosis I definitely will be getting some more concrete answers about my surgery, at least that. I will also ask them about their availability in December. I'm crossing my fingers for good news! 

I got this from a Dove chocolate that I ate yesterday and the first thing that I thought was, "No..." But then I thought about it and I guess it's true, but for all of us jaw surgery/braces folks we know better. : )

Sunday, July 29, 2012

They say patience is a vertue.

My next appointment with my oral surgeon is in three weeks and time just feels like it is dragging along! During this next appointment I will get to find out what exactly they will be doing during my surgery, but most importantly they are going to be sending off my insurance pre-authorizations. My surgery can't get scheduled until the authorizations are approved, even though my surgery was already approved for the surgeon in Seattle, the process has to start all over with my new surgeon. I'm starting to get really antsy about the whole thing; I just want more answers! It could also be because all I think about now is my surgery or because it seems like a lot of people have had a lot of hang-ups due to their insurance, probably both.

In the mean time I have just did my first video for my YouTube channel. I need to occupy myself somehow, even if it is still surgery related. Tell me what you think. :)

Monday, July 23, 2012

Who wants to break my jaw?!

Just a warning, this is going to be a long post!

Where I live there is only one oral surgeon and he doesn't do these types of procedures on a regular basis my orthodontist referred me to an oral surgeon in Seattle, Washington that he works with a lot. Seattle is about 12 hours north from me. I had a consultation with the oral surgeon last July, only a couple months after I got my braces, since I was going to be in the area anyways visiting family. The consultation with him was pretty straight forward, but not very informative.

I don't know if it was because I didn't really know a lot about the surgery which caused me not to have a lot of questions or he didn't really offer much information, but as I started to do more of my own research I felt less comfortable with the idea of going all the way to Seattle to have such a major surgery. I asked him about how many total visits I would need to make to see him and he said it was either 2 or 3 depending on if I was going to have just my lower jaw done or both.

That isn't very many visits and that was including the visit to have the surgery! I have seen people's videos on YouTube and they go to their surgeon at least once a week for the first few weeks after their surgery. That, on top of the distance, changed my mind about having him do my surgery. Luckily, I did receive the letter he had sent to the insurance company to request authorization and a letter he had sent to my orthodontist about my consultation, those two letters were very informative and I'm going to share a couple parts with you.

The letter that was sent to my insurance company stated the diagnosis of maxillary vertical excess with mandibular retrognathia. It also said that the surgical plan included maxillary LeFort I osteotomy with mandibular bilateral sagittal osteotomy, with oral surgical splints.The letter that was sent to my orthodontist contained the much wanted measurements I was curious about and also raised a couple questions. As of July 27, 2011 I had a Class II with an anterior overjet of 7.0 mm and an overbite of 8.0 mm. While preparing for my blog I re-read the letter and found a couple statements that I have no idea what they mean, for example, she does have a moderate to significant amount of lip incompetence with a resting lip to incisal edge distance of 7.0 mm. What does that mean? Is that good or bad? The other one was, there is a mild mandibular curve of Spee. Umm, ok...what's that? I'm planning on asking my orthodontist at my next adjustment.

Since then I have found a new surgeon, one that is in state and is covered by my insurance! The surgeon is in San Francisco, which is five hours south from me. Definitely not as far away as Seattle, but still a pretty far. My surgeon is at the University of California, San Francisco (UCSF) and I had my first appointment with them last month on June 8th. The appointment consisted of lots of measurements, lots of pictures, lots of questions, getting a mold of both my jaws and I had to have x-rays taken, but there machine was down, so when I got back home I made an appointment with my orthodontist and had them take the x-rays and send them to UCSF. I was so surprised at how much detail they were wanting because the previous surgeon didn't spend much time looking at my mouth, a very good thing and it helped me feel more at ease with the new surgeon. I guess they considered it more of a work-up appointment than a consultation. Anyways, the plan now is that they are going to present my case at some monthly conference they have called Orthodontic Treatment Planning (OTP), I think, which is actually this Friday, July 27th.

My next appointment at UCSF is on Friday, August 17th and that's when they will present me with the treatment plan. Luckily since I have already met with a surgeon I have a good idea of what they are going to want to do. The step after that is to submit the per-authorization to my insurance and once I have the ok, I get to schedule my surgery! With the surgeon from Seattle I did have the surgery already per-authorized, so I'm hoping that there won't be a problem with the new authorization. I'm hoping that I am able to have my surgery sometime in October because I want to be able to chew by Christmas, I was some tamales! I can't miss out on that. Thankfully my work is very flexible and have told me that I can have time off, just to tell them the dates when I know them.

I guess that's it for now. My next orthodontist appointment is on Friday, August 10th and then a week after that I have my appointment at UCSF. I will keep you guys posted once I get more information.   

Sunday, July 22, 2012

Hello there!

My name is Esmeralda and I will be going through corrective jaw surgery later this year (date is still to be determined) to fix my overbite/over jet. Originally I was planning on just documenting my journey on YouTube, but once I started to read the blogs that people have written on their experience with the surgery, I realized that you get more day-to-day details and personal experiences then one do on YouTube, so here I am!

My story:
Before I even went in for the consultation for my braces I was blissfully unaware of the true status of my mouth. I knew I didn't like the way my teeth looked and that I was missing a couple teeth, but I had come to accept it for what it was and didn't think much of it. I guess it was because I didn't really know many people that had gotten braces, let alone have jaw surgery to fix their bad bite, it also never occurred to me that my parents would pay for braces, not because they won't want to , but because I come from a family with seven children, so I just adapted and started smiling with my mouth close and forgot all about it. That is until I saw the picture below where my mom caught me laughing and showing my teeth. Prior to braces I smiled with my mouth closed, picture below. 

22nd birthday, October 2010

Halloween 2010

I still remember the day I had my consultation for my braces, my orthodontist looked at my mouth for what seemed like forever and then asked if it was okay if he had another patient (who was a dentist) take a look at my mouth. I kept wondering what he was seeing because I didn't really see anything wrong other than missing my upper laterals and having my K-9's drifted into their place, which is why I decided to look into getting braces. He asked me what my chief compliant was and I told him that my gaps where what bother me. He told me that he could fix that with braces, but that wasn't going to fix my problem and that I would need jaw surgery to fix everything. I had never noticed that my lower jaw didn't grow all the way and I later I found out that my two front teeth tilted back so that my teeth could meet and be able bite into things.

So there I was, 22 years old, being told that I am going to need to have surgery if I wanted to fix my bite/mouth when I've never even broken a bone! I thought about it for a moment and decided why not! I'm not going to spend money on braces and not have my teeth look perfect! That's how my journey got started. The following money I went in to have my records taken.
Pictures taken before braces.

Mold before braces

Pano before braces
Lateral ceph before braces

 I got my braces put on in May 2011. Below is a picture of my teeth the day I got my braces put on. A side effect, I guess, of getting my braces was that I could no longer smile with my mouth closed like I used to, it didn't feel natural anymore. As time went on I adjust and now after a year of braces when I try and smile with my mouth closed I feel like it is fake. Also, as part of my treatment, my K-9's were going to be moved to where they should be which meant that I had gaps on either side of my front teeth.

First day with braces
February 2012
Current photos/xrays below:

Resting side profile. When I close my lips my teeth don't touch.
Side profile while biting down.

Pano from 6/14/12

Lateral ceph from 6/14/12
I'm going to do a separate post to talk about the surgery and the oral surgeons.