One Year later...My Re-Arranged Face

Hi friends and family. I hope you all are well. Wanted to update everyone on my recovery from my double jaw surgery. Can you believe it's over a year already? November 2nd marked one year since my jaw surgery...time flies.

Overall things went very well. Earlier this week, I had my one year follow up appointment with my surgeon, and he said everything looks great.

The only issue is I still have is a some numbness. My bottom lip and my chin are numb on the right side. The amount of numbness seems to very slowly decline, and it tingles to the touch. It feels kind of like when your foot falls asleep and it is waking up. I also still have some numbness in my teeth, gums, and the roof of my mouth. This all makes things like brushing my teeth fun, and of course, sometimes I drool a little out of the right side of my mouth. Neat! The doctor said this could all last up to two years from the surgery and what ever is still numb by then is probably permanent.

The two most common questions I get asked are,

"Are you glad you did it?"

"Would you do it again?"

The answer to both those questions is without a doubt, YES!

My overall all jaw health is way better now. I can chew normally, and as a bonus I can breathe better. Why? Great question. It's because the surgery expanded my airway. I have noticed this the most when playing indoor soccer. I can breathe easier and have better stamina. Losing some weight due to the liquid diet after the surgery probably helps with that as well.

Fun fact, since today is Thanksgiving, and as I reflect back on my recovery from surgery, I remember having to blend and drink my Thanksgiving meal last year. Here is a picture of what that looked like.

I bet looking at that makes you jealous. I'm joking of course. It was very...strange. This year I am very grateful I got to enjoy my meal the normal way. Here is what my first plate of food looked like, yes I said first, I had two plates. I really enjoy food!  

It was a long journey and I'm glad I went through it. They say a picture is worth a thousand words, and since I don't feel that I am very good at writing, blogging, etc, here are some pictures showing the day before the surgery and some we took on the one year anniversary of the surgery. Enjoy!

Before

After

Before

After

Before

After

Before

After

Before: March 2013, when I first got my braces on.

Before: October 2015, right before surgery.

After surgery: November 2015.

After: August 2016, the day the braces came off.

After: November 2, 2016.

What a difference a year makes! Thanks to everyone who supported me through this journey, for your thoughts, prayers, kind words, & help! As always, thanks for reading my blog. I pray that God would bless you and your family greatly!

Time To Rearrange My Face

November 2, 2015 will probably be a day I never forget, because I am having my jaw surgery to fix my under-bite. It's been a long journey to get here. If you need to catch up, you can read these other posts:

Post 1: My New Metal Mouth.

Post 2: My First Surgery.

Post 3: 2nd Level Appeal Approved.

Back to today. Today will be one of the most significant days in this journey. Surgery day has arrived.

The question I seem to get most is, "Are you nervous?"

The answer is, "Yes, I am little nervous."

I have never had a major surgery. I have never been under anesthesia. However, I am as prepared and ready as I can be. I also feel like I have an army of people praying for me, and I take great peace in that. I know God is in control and I am confident everything will go fine.

I am most nervous about the recovery. My jaw will be wired shut for six weeks. I will be on a liquid diet during that time, and on leave from work. I am not exited to have to drink all my meals, but on the plus side, I should have some much needed weight loss.

The next most asked question I get is, "What exactly are they doing to your jaw?" I will spare you the gory details, but the simple answer is they are cutting my top jaw and moving it forward, and adding bone from my hip/ pelvis area (via bone graft), and they will be cutting my bottom jaw and moving it backwards. Then they will use some screws and brackets to put it all back together and wire it shut so it can heal and I can have a proper bite.

I would really appreciate your prayers for my surgery and recovery and for my wife as she takes care of me.

I will post some updates and some pictures after surgery.

As always, if you take the time to read this blog, may God bless you greatly!

2nd Level Appeal Approval.

Today was a good day in my journey towards getting my underbite fixed. 

Many of you know that I started this process in October of 2012 when my then new dentist encouraged me to start the journey of looking into getting my underbite fixed with orthognathic surgery.

Here are some links to my previous posts detailing this if you're interested:

Post 1: My New Metal Mouth

Post 2: My First Surgery

We originally started to plan the surgery for December of 2014, but that didn't work our for several reasons.

Long story short...Sarah changed jobs in January. Leaving her last job in December meant our health insurance left too. We had pre-approvals for everything with the surgery with the old insurance company and we were hopeful things would be good with the new insurance company, that we got through my work.

In January, my surgeon's office called the insurance company to check if all the surgery stuff (including pre and post op) were covered billing codes. They said yes those are covered codes, but you will need to get a pre-authorization. So, we planned to have the surgery the first week of May 2015.

We were all systems go at this point, or so we thought...

In February, the surgeon's office put in the authorization request, I got FMLA and short term disability approval from work, and we had everything scheduled.

Then one March afternoon, about a month after we requested the authorization, I got the mail on my way home like I do most days. I don't remember the exact day, but on this day there was an envelope from my insurance company. I opened the envelope to find a letter from my insurance company saying the authorization for a pre-surgery CT scan and any surgery was denied due to an exclusion for dental procedures in my insurance policy.

We were in shock. It seemed very odd after being told the billing codes were covered, and having many medical professionals tell me this surgery was "medically necessary" for me, to get a denial of benefits.

The bad news: a denial; the good news: you can appeal the decision.

So we appealed. My surgeon's office put together documentation proving the medical necessity, including letters from the surgeon and my orthodontists. We felt good about this appeal and thought we had a good chance based on all the evidence we provided. The appeal paper work was faxed the first week of April 2015.

Due to some weird appeal authorization (we were told we did not need) required for the surgeon's office to appeal on my behalf, the appeal did not get looked at until May 27th.

The first level appeal panel, upheld the initial decision citing the same vague dental exclusion, which in my opinion likened my jaw surgery to getting a tooth pulled or getting x-rays.

At this point we were unsure what to do, but the paper work said we could do a 2nd Level Appeal. So that's what we did. My surgeon's office gathered more information and evidence and sent off the 2nd level appeal, the last week of June.

After a lot of waiting, considering, and praying, we started looking into options to have the surgery without using the insurance. Sarah and I looked at loans, borrowing against her 401K, starting a Go Fund Me Page, etc.

On August 14, I received an email from a Grievances and Appeals Analyst named John from my insurance company, inviting me to attend a meeting on September 2 to state my case for why I believe the surgery should be covered. I did not get such an invitation for the 1st level appeal.

This bring us to today. This morning September 2, 2015, Sarah & I attended this 2nd level appeal panel meeting. We were almost late due to the wonderful Denver traffic. Thanks Denver!

When we got to the insurance building we were met by John. He gave us an overview of what would happen in the meeting and told us that they would make a decision on the appeal today after our meeting.

The meeting lasted about 20 minutes for us. The meeting facilitator introduced the three panel members who would be voting and explained the agenda to Sarah and I. Then they had the Analyst John, give a summary of what we were asking in the appeal to the panel.

At this point the facilitator gave me the floor and allowed me to present my case for why I believed the surgery was medically necessary. Sarah added a few points as well!

Next, the facilitator asked the panel if they had any questions for us. They asked a few questions. Then our part was done.

We thanked them for allowing us to be there and for listening to our case. John walked us out, and now it was time for them to review all the info, deliberate, and most importantly, vote.

We were really unsure what to expect from this appeal meeting, but it was all rather cordial and pleasant. When we were leaving John said to me, "You did a really good job!" Sarah and I took that as a sign to be cautiously optimistic.

As we were leaving, John told us he would send out paperwork later this week with the panel's decision, but I asked if he would email me today, so I would know and not have to wait for days for an answer.

Sarah and I got back to our house in Colorado Springs from Denver and there was an email waiting from John.

The verdict was in...we checked nervously...APPROVED!

We were ecstatic! I jumped around the house like a little kid at the excitement of Christmas shouting, "Praise the LORD!" 

So, now we will start the process of getting the surgery planned again, this time with insurance approval!

I am so thankful for the many family members and friends that have been praying for this. The past eights months have been hard dealing with this. Today was a huge relief and blessing!

I'll will keep this blog updated with surgery details, so be looking for that.

As always, thanks for taking the time to read my blog. May God richly bless you and your family!

My First Surgery

You might already know that back in March I got braces (if not, read about it here) to start a long journey to get my underbite fixed. Today was another major step towards that.

I had a periodontal surgery today called, "Osseous Ridge Graft/ Augmentation." Basically, what that means is, I had bone added to my top jaw above my front six teeth.

They way it works is: they recess you gum, drill holes in your jaw and pack ground up bone into the holes and into the ridges between your teeth, then put a membrane down, put your gum tissue back in place, and suture it all back together. Sounds fun right? Oh and I had it all done with just local anesthetic. The surgery took just over an hour and believe or not, I drove myself home afterwards.

So you might be thinking, why did Tony need this surgery? Great question! After the surgery your own bone and gum tissue grows back in the graft area, and this gives you better bone and gum tissue and better foundation for the roots of your teeth.

I had to have this surgery because they need to move my teeth on my top jaw a lot to get them to where they are supposed to be and make my jaw fit right after I have the surgery to fix my underbite some time in the future.

My Orthodontist was worried that I might not have enough jaw bone and gum tissue to support all the movement. So he sent me to a Periodontist to have an evaluation, to see if he thought I might need this surgery. After my Orthodontist and Periodontist consulted they decided it would be best and prevent future problems like the roots of my teeth popping out of my gums. Ouch!

The recovery is fairly simple antibiotics and a mouth wash to help the healing, along with ice for the swelling. Oh and I get narcotics for the pain. I can resume normal activity after a few days, and in a week or so they will take out the stitches.

Anyways, my first surgery of my life is in the books, and although it was minor, it was a pretty strange experience, not to mention I have ground up cadaver bone in my jaw and gums. Weird Right?

For those of you that prayed for me, thanks so much, I appreciate it!

And as always thanks for reading my blog, may God bless you and your family!

PS Here are a couple pictures, just a note they are a little graphic:

You can see some of the stitches, and the swelling where the bone was added behind my gums.

Here is a closer look than above, Sarah gaged while taking this pic, lol. 

My New Metal Mouth...

So...today I got braces. Well, actually I got some of the brackets to hold the wires and some separators to make space for some bands to hold brackets on my molars last week. But today, I got the rest of the brackets and the wires in the brackets.

So, now I'm officially on a several year journey to get my jaw fixed. In a year or so, I will need an oral surgery in which they cut and rearrange my jaw to a proper bite. My top jaw will be moved forward, and my bottom jaw back, and my jaw will be wired shut for six weeks after the surgery. Sounds like fun doesn't it?

But before we go on we need to go back in time...

As a kid, most of my adult teeth grew in crooked. In fact, one grew in almost sideways. My bottom jaw began to grow faster than my top jaw, so I developed an under-bite. At the advice of the dentist, my parents got me braces. Thanks Mom and Dad!

I wore braces for about seven years of my childhood, spanning from elementary to high school. They tried to fix my under-bite with some appliances and the braces, but it didn't really work. We were told that surgery would be the only way to fix it, but I didn't have to do that.

My under-bite was pretty minor at that point. But what we didn't know, was that not getting surgery assumed I was done growing, and that my under-bite didn't get worse. As you can probably guess, I continued to grow through college, and so did my under-bite. My top jaw didn't grow enough and my bottom jaw grew too much.

From then until now I had dentists ask if I had ever seen an orthodontist, and ask if my jaw hurt and such. My last dentist asked me to consult with an orthodontist in his office, so I did. He told me what I had heard since getting my braces off as a kid, that it would take surgery to fix my bite, but if I don't have pain and I can chew, it's not a big deal.

So, I planned to go through life with my under-bite. Besides, I survived the teasing of kids in junior high, high school, and college without becoming a mass murderer, and I learned how to deal with eating problems. You can imagine how fun eating an apple or corn on the cob is for me.

On October 10, 2012 I got new dentist, and seeing him for the first time changed everything.

For the first time in my life, this new dentist explained that I needed to get my bite fixed, or I might not have any teeth in 10 years, and they can't make dentures for my bite. He also informed me that my bite was destroying my teeth and that's why I had so many crowns, fillings, and root canals, despite my good oral hygiene. At least my gums are really healthy! 

On top of that, he told me the stress from my bite can cause all kinds of bone problems in my jaw that could lead to all kinds of problems and surgeries. I was shocked. I told him how I had been on other consults, and they always acted like it was no big deal. To which he said they probably didn't want to deal with an under-bite as severe as mine, because it's hard work. I had never had a dentist be so candid with me before, and more than that, he seemed to actually care.

So my new dentist asked me to go see another orthodontist in town who was one of the best in the country with helping people fix their under-bites. So I did.

The orthodontist said I definitely need to have this surgery, and confirmed everything my dentist said. So, after some fancy x-rays, bite impressions/ models, oral examinations, a treatment plan, a consult with a periodontist, a consult with an oral surgeon, a revised treatment plan, and two more office visits to the orthodontist, we are back to today. Me with a mouth full of metal and sore teeth.

I'm not sure what the point of this blog is other than to inform people who might care. Well, and to say that braces suck, but being an adult with braces really sucks! I would really covet your prayers as I continue on this adventure, because as you might guess it's not cheap and we are not sure where we will get the money for the oral surgery yet (that's the most expensive part and only partially covered by our medical insurance).

If you took the time to read this blog, thanks for caring about me! I pray that God blesses you and your family greatly!

Oh, and just for fun here's a picture of my new metal mouth:

Hey homies, check out my new grillz!!