Recovery Week 2: November 9-15, 2015

Recovery week two was better than week one. Swelling came down a lot in my face, and pain levels came down a lot as well. I have also been sleeping better this week. I was able to change out my rubber bands that hold my jaw shut a couple times on my own. It nice to be able to take those out and brush my teeth and drink a meal with out them in. I was also able to drink out of a cup some. My chin and bottom lip are still mostly numb, but I am figuring things out.

Monday was a pretty uneventful day. On Tuesday, my Mom took me to a follow up appointment with my Surgeon. It was a good appointment. The Surgeon said things were looking good and healing well.

Wednesday, I was home with my son Uriah. We had a fun day playing games, watching TV, and just hanging out together. In the evening my friend Grant came to hang out. He stayed for dinner and we watched some UFC Ultimate Fighter together. It was great day as it brought some normalcy for me.

Thursday was the roughest day of the week. I was in a bit more pain than the previous few days. I might have did a little too much the day before. I also had some stomach/ constipation issues. Once those resolved I felt much better.

Friday, I had an Orthodontist appointment as they wanted to see how things looked. Thanks again to my Mom for driving me. I was also able to attend my church Life Group on Friday night and that was fun. That was probably the most I have talked since the surgery.  

Saturday, I went to some stores with Sarah and the kids and in the evening watched a UFC PPV at friends house. Saturday was probably the most active I have been since the surgery. It left me pretty tired on Sunday.

Sunday, I went to church and then stayed home and relaxed the rest of the day. One weird thing. The bandage covering the bone graft incision spot came off. This is the first time I have seen that. Here is a picture.

Incision area in my right hip from where the bone graft for my top jaw was taken.

Overall it was a good week. I am feeling better as each days passes. I want to thank all of you who have been praying for me, texting, emailing me, commenting on my facebook page. I appreciate the love, support, and encouragement.

I also want to say thanks to all those who have brought meals for Sarah and the kids. That has really helped out, and Sarah and I are very appreciative of that.

Below are some pictures showing how much the swelling has gone down since last Monday. The pictures on the left are from Monday, November 9, and the pictures on the right are from this morning, Monday November 16.

 

 

 

       

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

Recovery Week 1: November 2-8, 2015

So for those of you interested in following along with the journey of recovery after my double jaw surgery and bone graft I will post weekly updates on Mondays. Obviously, I am a little behind on this first one, but it was a long week.

Monday was surgery day, Please click to read my previous blog post about that.

As Tuesday came, I was still in the hospital, but I was lot more in tune with what was going on around me. I was still fairly tired and medicated, but they were planning on sending me home late afternoon/ early evening. I was able to get out of the bed and sit in a chair. I was able to eat, well drink smoothies for breakfast and lunch along with some water and Gatorade. Here are some pictures of how the swelling was Tuesday morning:

During breakfast and lunch Sarah and I learned the process of eating from a syringe for the next few weeks would not be fun. Syringes sometimes glide very smoothly and sometimes they don't. When they don't glide smoothly and you force them a little, the contents inside explode, everywhere. As Sarah and I were figuring out this whole eating from the syringes thing, we both took a food shower or two.

My surgeon came to visit me again on Tuesday, and said that he would start the discharge process for us and wanted us to stop by his office in South Denver (Lone Tree) before we headed home to Colorado Springs.

The nurse came shortly after that and pulled all the tubes out of me (IV & Catheter) except they left a port (actually just an IV) that they put in my hip in the area where they took the bone graft. My Surgeon said he would give us medicine at his office that we could put through that port which in turn would help with soreness/ pain in the bone graft area.

Now it was the very fun process of waiting for your evacuation system to start working again on it's own before you can leave the hospital. Yes this means I had to pee a certain amount before I could leave. It took a bit, but I got it done and then it was off to my Surgeon's office. Below is a picture of me ready to leave the hospital. We were finally able to leave the hospital around 4:45 PM.

Still rocking that fashionable Jaw Bra!

At the Surgeon's office he looked things over, gave us some stuff, showed Sarah and I how to administer the medicine through the port in the bone graft area, and he gave me a portable suction device to use. Then it was off to home. We got home around 6:45 PM.

Wednesday, I just took it easy at home and Sarah I tried to figure out a routine for eating/ medicine etc. My Surgeon told me that today would be the peak of the swelling in my face. Here are a few pictures we took on Wednesday of the swelling.

On Thursday, we had a follow up with the Surgeon. During this visit he pulled the port from my bone graft area, which I thought would hurt, but did not. He took the rubber bands out that hold my jaw shut and let me brush my teeth with out them in, that was glorious. Then came the not fun part. He decided to put a pallet expander in my mouth. This is a metal bar that runs across the roof of your mouth and attached at the second to last molars. He also informed Sarah and I that he wanted me to get a reverse pull mask from my Orthodontist. Joy!

After the bad news, He taught Sarah and I how to change the rubber bands and let us know that we can do that once a day. He also told me I can eat (well drink) and brush my teeth while the bands are out. We did not know this would be the case, so that was nice to know. He also said I can shower as normal which was great news.

On Friday, I went to visit my Orthodontist to get the reverse pull face mask. This thing sucks. It's purpose is to help make sure that my jaw muscles don't try to pull my top jaw backwards, and help everything stay right where the Surgeon and Orthodontist want it.  Here are some pictures.

Saturday & Sunday were pretty uneventful days. My Mom, Dad, Brother, Sister-in-law and few friends stopped by for a visit on Saturday, and that was nice. My parents had been watching our dogs and brought them back to us as well. Mostly, I watched a lot of football and napped on Saturday and Sunday.

All in all, the first week of recovery went fairly well. There were a couple of times where the pain got pretty bad, but the medicine was able to help bring it back to a tolerable level. I am still adjusting to all the numbness in my face. My nose, lips, and chin are still very numb. The first time Sarah and I tried to change out the rubber bands that hold my jaw shut was an adventure as well.

If you took the time to read this whole blog, thanks! I pray that God blesses you and your family.

Surgery Day: November 2, 2015

My first major surgery is in the books. The day started very early. Sarah and I got up about 3:45 AM as we needed to be to the hospital by 5:30 AM to register and check in. We took the picture below to capture the moment right before we backed out of the garage. 

4:15AM in the car about to drive to the hospital.

We got to the hospital, got through registration, and got checked into the pre-surgery room. My surgery was scheduled to begin at 7:30 AM. Probably the best part of getting ready for surgery is the awesome hospital gowns. They don't really make those for people my size and build. Of course you also have to get your IV. Here's a picture of me in my luxurious hospital gown waiting to be taken to the surgery room. 

Love the pink trim on the hospital gown.

About 15 minutes after the above picture was taken they wheeled me to the surgery room. Once they got me in the room my surgeon & anesthesiologist talked me through some of the details of the surgery, and then it was lights out. The surgery took around 7 hours total.

I have almost no memory of being in recovery after surgery, or being moved to my hospital room. Obviously, I was in and out of sleep a lot. The one thing I do remember is that while in recovery I found out I had been given a catheter before surgery, but after the anesthesia (Surprise!). I remember a nurse in recovery telling me not to pull it out, ha ha. Anyways, here is a picture Sarah took when she was allowed to see me in the recovery room before I was moved to my hospital room.

In recovery, notice my luxurious gown and jaw bra/ oxygen mask accessories completing the look!

In the picture above, the white and blue fabric holds ice packs on my jaw. It's velcroed on my head, and fun fact, is called a, "Jaw Bra." Most of the rest of Monday is a blur. I was in and out of sleep a lot. I remember the nurses taking my vitals and giving me medicine, the Surgeon checking in on me, and trying to to talk to Sarah. Here is a picture I took around 11:30 PM. That is one swollen face!

Swollen face, head bandage, jaw bra, oxygen mask, gown falling off...very attractive!

That pretty much sums up my surgery day. Thanks for following along with the journey. I will be posting weekly updates from here on out on how I am healing. I would greatly appreciate your prayers during the recovery. I will have my jaw wired shut (its actually rubber bands), and on a liquid diet for at least the next six weeks. 

As always if you took the time to read my blog, I pray that God blesses you and your family.

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!

A New Chapter

So let's go back ten years in my life...

In March of 2003, I was diagnosed with a chronic condition called Crohn's Disease. After the diagnosis I started to do well with medicine to control it. The few years before that diagnosis were hard. I was sick, anemic, weak, in pain, and most days I had to be near a bathroom at all times. There were a lot of sleepless nights, pain, and weight loss. I have a mild case of this horrible disease.

I started getting tested for things in January of 2003, but after lots of blood draws, urine and stool samples, and other tests, my primary care doctor sent me for a colonoscopy. That's were I got the diagnosis of Crohn's. I was placed on a medicine that seemed to control my Crohn's.

After my one and two year check ups things seemed to be going fine and my gastroenterologist declared my Crohn's in remission. He said to just keep taking the medicine until something changes. If I start to have symptoms again we will take another look at treatment. The upside to this, no Crohn's symptoms; the down side, six pills a day for the rest of my life. Taking pills is much better than being sick all the time. Overall, things have gone well.

Fast forward to April of 2013...

I am sitting in training for a new job and I get a voicemail from the pharmacy that said to call about my prescription. On a break, I call and they inform me that the medicine I have been taking for the past ten years is no longer being manufactured, due to some non-active ingredient in the coating of the pill that is known to cause cancer in rare cases.

Needless to say, that was not a fun phone call. It left me with a lot of questions. So I called my doctor to see what we could do.

Long story short, we found out they made an HD version of the medicine I was taking that was still being manufactured. It was 3 pills a day instead of 6, but that same amount of the medicine. So my doctor prescribed that and referred me to a Gastroenterologist for a long term solution.

I met with the Doctor and he recommended we do a colonoscopy to take a look at things, and that way we would could make a better informed decision as to what to do moving forward. He was optimistic that since the medicine I had been taking was not really designed for my problem area, and was keeping my Crohn's mostly symptom free, that I might be able to stop taking the medicine all together.

That brings us to today, the day of my second colonoscopy. Most adults have no need for one of these procedures until they are in their 50's or so, and I have had two before age 35, joy.

Side Note: If you have never had a colonoscopy they are not fun. The day before, you have to fast (not eat), drink lots of water, and take super laxatives. This is a terrible combination that leaves you feeling awful. The procedure itself is not too bad (because they give you drugs that make you sleep), but the preparing is horrible. I digress...

So after my colonoscopy today, I got great news from the doctor that there were no signs of active Crohn's Disease! He said he is "cautiously optimistic that my Crohn's is completely in remission." He also said that I could stop taking my pills. YES!!!

After 10 years of taking pills everyday I get to stop! God is good and he kicked my Crohn's Disease butt (pun intended). After a 10 year journey with Crohn's Disease, I get to start a new chapter, one with without pills to take.  :-)  Please pray that my Crohn's stays in remission. Sarah and I have been praying for this ever since we found out that they stopped manufacturing the pills I was taking.

If you took the time to read this, thanks for reading my blog, and I pray that God will 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.