Brandy's Braces, SARPE, Jaw Surgery Journal

This is my daily journal to my eventual perfect smile and Apnea free life. It logs my surgeries, and daily progress.

Thursday, February 22, 2007

Beauty and Elimination of the Beast!

Well I got a lot of information today. My oral surgeon called me and we talked about his plans for my upcoming surgery. He mentioned how some of the big doctors like at Stanford who do this surgery everyday move the maxilla out a lot. I told him I had done a lot of research on it and that the average was around 10mm for apnea. He said "yes that is correct, they are pretty large advancments." He said that he had reviewed my cephs and that he feels that if he moves my maxilla out 3 mm and then brings my lower jaw to meet it (which will be 6-7 mm on the bottom), followed by a small genio that we will be able to effectively eliminate my apnea. He says the 6 mm on the bottom will actually give us about an additional 3mm in space as it changes the pull on the tongue. He said that he wants to make sure he eliminates my apnea but that he also wants me to look good too. He said he is encouraged by the fact that I was able to correct my apnea with the sleep appliance by just moving my teeth out to line up with my uppers, and that this surgery will actually move them a bit farther then that, so he is confident this will work for me. He also said that in addition to fixing my apnea, these measurements will give me perfectly balanced facial assymetry. He said that it will not change my appearance so much that people will not recognize me, but that it will improve my looks but also help me sleep like a baby.

He said he plans to do a one piece Lefort 1, as it doesn't appear that he will need to make any other movements then just straight out. He said that he will know more the closer we get to my surgery date though, when he does the actual practice surgeries on my models, and that if we need to change it then he will let me know ahead of time.

We will be submitting my pre-auth tomorrow. I have a wonderful women who works at my insurance company who hand processes all of my claims so that I don't have any issues. She has truly been a godsend, and I should know something definitively within about 2-3 days. I'm pretty sure it all will be covered as they had already approved the lower jaw advancement. It was in the original treatment plan with my SARPE. So this is really just a modified treatment plan and my doctor has written a note of medical necessity for it so it should all be good. I got the actual health insurance claim form with all the billing codes etc on it today. The total cost, just for the surgeon is $23,425.000. This does not include the hospitalization etc. I figure by the time we are done it will be upwards of $50,000. That scares me as even with a pre-auth there is no guarantee of payment. I have read that others have had this done, gotten pre-auth, and then had insurance refuse to pay. I don't think that would happen as I'm pretty sure I have covered all my bases, but it is just stressful since its so much money!

Anyway....I'm just happy to have a diagnosis and actual specifics on my treatment plan. The doctor said that he will have the schedule for May and June ready by next week and I can call and schedule out my surgery date. I will also make my pre-op surgery appointment at that time. So really short of getting the dates scheduled and my surgery hooks put on in the next couple of months there is not much else to do but wait.


  • At 11:27 PM, Blogger Shontell said…

    Hi Brandy!
    Thank you for the wonderful compliments about Lydia. I just read through all of your blogs. LOTS of useful stuff in there and awesome links!! Prob one of the most useful sites I've been to so far. Thank you for all of it. ;)
    You sure went through a lot huh?! And it's not over either. WOW. Your smile has come a long way and is looking fabulous! I still have one more surgery on my bottom jaw. NOT looking forward to it AT ALL. I have a question for ya. I'm getting this tight feeling where the stitches are - really tight actually and my lips are tingling. Did u experience this?


  • At 2:56 AM, Anonymous Anonymous said…


    I got your blog URL from your message on the site. I have OSA and am going through consults at Stanford with possible MMA down the road. 2nd sleep study going on later this week.

    As I am writing this at 3:30 am after waking up from OSA with pounidng heart, etc. (every night), I was interested to read an older part of your blog where you said your doctor gave you a supplemment that reduced the impact of cortisol in the bloodstram.

    Can you tell me what the supplement is?

    I think that would help me as I sort out what to do re next steps and surgery. With the apnea every night, my cortisol level has got to be fairly high, as it usually takes me at least 45 minutes to go back to sleep after I initially wake up. I wear a dental device, which helps, but does not solve the apnea issue by a long shot. CPAP doesn't work, even though I tolerate it well.

    I'll keep looking for your progress on sleepnet.



  • At 8:45 AM, Blogger Brandyleigh35 said…

    Hey Shontell,
    Yes I did, the stitches get tight because you are still swollen. Honestly that area was the one that bugged me more than anything. It was really uncomfortable for a few days. Try putting some white rice (uncooked) into a soft sock. Tie it off then zap it in the microwave for a minute or two. You can put a warm washcloth over it for moist heat, or use it just the way it is. The heat will help get the fluids in your face moving and work out the swelling faster.

    As for the tingling, that too, it was so annoying! The only good thing is that tingling/burning means that the nerves are repairing and that you will probably be getting full feeling back in that are very soon! Hang in there, I personally thing the nerve burning is the worst of all of this, it doesn't hurt, but is sooo irritating and nothing really helps get rid of it.

    Do try the heat(rice socks)it really made a difference for me, and helped reduce the swelling, especially the stuff up under my eyes a lot.



  • At 8:21 PM, Blogger Kristen said…

    Brandy, this is really good news. Have you heard back from your insurance lady yet? Fingers crossed!

  • At 9:12 PM, Blogger Brandyleigh35 said…

    NOt yet....she said early this week, so if I haven't heard anything by Thursday I will give her a call.

  • At 10:09 PM, Blogger Shontell said…

    Thank's Brandy! I will do the rice thing tonight ASAP! ;)

  • At 8:49 AM, Anonymous shelby said…

    Hey brandy. I just got my final bill from the doc. Keep in mind this does not include the hospital or the anesthesiologist (I think they gave the job that name so they could make fun of you when you were going under and you tried to say it). I paid $11,000 upfront down payment before the surgery (made me fee like a car or something) and I just got another bill for $12,000 after all was said and done with my insurance. I think Dr. Li must have given me some sort of break because my insurance sucks (but better than not having it at all!!!).
    Good luck!!!!


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