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.

Sunday, April 29, 2007

Answers Coming My Way....Tomorrow!

So tomorrow I'm going to be checking on my EKG results. I contacted the doctor last week and there was a bit of confusion regarding having my EKG read. They said that it should be done by Tuesday so I figure by tomorrow it should be back at the clinic and read. My doctor is out of town til the 9th and said that I could just have them fax me a copy of my EKG. She said that the Cardiologist writes on it and that while I probably won't understand her notes, what I'm looking for is the word "normal" on it. So...hopefully tomorrow I will know. When I called the other day about my EKG they also said the results of my adrenal ultra sound had come back. The lead doctor called me and said that he did not see anything unusual but that I would want to meet with my doctor to go over the results. So...that was rather discouraging as I was hoping we would find some answers as to why my DHEA is so high.

I have been really exercising lately. Walking, biking, cheering,stretching, and last night I took my cheerleaders to an awesome gymnastics/stunting clinic. It was a blast and was pretty cool to see that after 43 years I can still do a really straight cartwheel, a round off, and several other gymnastics moves. My girls about died laughing when we were doing pike jumps and I landed flat on my bottom with the first one! was hilarious I admit but I wasn't embarrased, I mean the last time I did a pike jump was a least 30 years ago. I was quite impressed that I was able to even do one, and things got better after that so it wasn't all bad. was fun to really be able to participate with the girls. I always workout and stretch with them, I figure if I'm asking them to do it, then I should be doing it to, but this was different. Gynnastics is definitely more of my thing and I was defintely in my element last night. It was like I was back in high school and it was nice to have them see me a different way rather then just their coach.
As wonderful as the whole workshop was though it was a bit depressing too. I have a great group of girls. A couple though are just the sweetest little things and they have so much potential! I really think that one of them could go really far. The trouble is money.....most of my girls come from very low income families, and this girl is no exception. We've done some fundraisers and she was able to come up with 35.00 for her uniform, but I bought her some workout shorts the other day because she didn't have any to wear to the clinic. I managed to work out two great clinics this quarter for them, one was dance/cheers/jumps/and basic stunting. The second one was last night and was all gymnastics and stunting at this really nice local gymnastics training facility. They are going to be having tryouts for the All Star Cheerleading Team on May 19th. I know this one girl could totally make the team, and that her gymnastics could be amazing with the concentrated practice, but the cost is $120.00 a month. No way that is happening. I swear if I had the money I would pay it myself just so she could have the chance. That is probably the hardest part of all this. I mean I know they love the clinics, and I'm glad they get the opportunity to experiences it, but then they also see what they are missing and what they cannot have. It just breaks my heart.

Anyway! I will keep you all posted on my ECG findings tomorrow. Only 9 more days til I get my surgical hooks! Woo hoo!

Monday, April 23, 2007

1 month til Surgery... The Countdown Begins

So today is exactly 1 month (30 days) til my surgery. I must say that I'm eerily calm about things at this point. I'm sure the nerves will start to kick in as the day gets closer but for now I'm enjoying not being stressed out about it all. I took another picture today so that I would have some to remember my old face by.

Not much going on in my mouth lately. I am excited though as my left canine finally appears to be rotating a bit like it should. I'm really hoping that after the surgery my braces drama will be short.
Honestly it would be totally cool to get the surgery done, and get my braces off before going back to work (3 months afer) I seriously doubt that it will happen but hey...a girl can dream right?

No word on my ECG or Ultra sound yet. I'm going to call tomorrow again though. I also need to find out whats happening with the denied Genio. The doctor was supposed to come up with some new documentation to support the benefits of genio on sleep apnea. So far I have not heard a word from tomorrow I will be calling again. Staying on top of all this insurance stuff is a royal pain, I can't wait til its all over and done, and paid for!!

Saturday, April 21, 2007

Ultra Sound Complete

Went for my Ultra Sound yesterday morning. It was rather uneventful. Had to lay on my back and then on both sides for her to find my kidneys and adrenal glands and snap some pics. It was over in like 10 minutes, and short of wiping off the nasty goo they use it was quick and painless.
I then headed over to the lab, as it seems the doctor was not specific enough with her perscription last time and the vitamin D test they ran was not the right one. So....this time I had to give 5 tubes of blood. Now I'm assuming that for most people this wouldn't be an issue, but finding my veins is always a challenge and unless they use those tiny butterfly needles (which are very slow) my veins usually collapse. So....the lady of course didn't listen to me. She thought things looked good so she used a big needle. We got 2 tubes, before my vein collaped, and today I have a nice big, brightly colored bruise to show for it. She then switched arms, used the butterfly needle and got two more tubes (at a much slower rate I might add) but I have only a tini tiny needle mark to show for it today. I hope I'm done with lab work for little while. I'm sure I will have to have more blood drawn the week of my surgery, but I swear I'm really starting to feel like a pin cushion lately!

Not much else going on. Still super busy! We had a staff meeting yesterday and blocked out the end of the year calendar. Starting next week, I have something going on every single day (sometimes 2 or 3 things) until the day of my surgery! Normally that would really stink, but right now, I'm rather happy to be distracted from thoughts of my surgery and rather welcoming all the scheduling gymnastics.

I'm going to call about my ECG results on Monday, hopefully they will have them back by then.

Tuesday, April 17, 2007

Time Whizzing By!

Man I have been busy lately! I'm thinking that perhaps it has been a Godsend though! I coach afterschool cheerleading twice a week, and I have been putting together our program for the school talent show. Between teaching cheers, learning dances, mixing music, organizing cheer clinics, poster making, bake sales, candle fundraisers, ordering uniforms, practices, and then my normal everyday job requirements I barely have time to pay attention! It's exhausting, but enjoyable too, and the best benefit has been that I haven't had a second to even think about my surgery! In fact I had to reschedule my appointment for the surgical hooks, as it conflicted with the talent show presention. I mean come on....I can't abandon my girls because I have an ortho appointment! PRIORITIES PEOPLE!! new date is May 9th for impressions and surgical hooks. I will still be seeing the OS on the 15th for my pre-surgical consult, but it is in the morning so I will be back at work by 12:00. I haven't heard anything back on my ECG yet. I go in on Friday for my Adrenal ultra sound to see why I'm making so much DHEA. Hopefully that will be productive.

My heart has been acting fine lately, I honestly think it was anxiety from my pre-surgical panic week. You know, the one I had a few weeks back where I was freaking out! Anyway...I'm glad that things are feeling back to normal.

That's it for now!

Thursday, April 12, 2007

1 Month, 1 Week, and 4 Day's til my Surgery!

So today was officially day two without any caffeine, and I have to say that I feel pretty great! No more exhaustion, or grogginess. I never realized how hard it is to truly avoid Caffeine though. I swear it is in everything that tastes good! I have been drinking hot Tang lately, and actually I rather like it! I have been walking briskly with my mom at night for an hour. We live in a very hilly subdivision so we are getting lots of good muscle work. The weather is getting really nice now too so it is soooo GREAT! to be able to see the sun and actually feel it on my skin. That part is the best!

So, I checked my ticker today to see how close I am to surgery. I have been staying busy and trying really hard not to worry about it. I hadn't realized that it was only about 5 weeks away now! Coming up soon! I still feel very scared if I allow myself to really dwell on it for any prolonged period of time. Mostly though I have just not been thinking about it, and that seems to be better for me. Honestly I'm just trying to really enjoy the time I have in my current mouth, and while I'm still a bit unnerved, I'm confident now that it will all be fine, and turn out well, I trust my doctor and he did such a good job on my SARPE that I'm actually sorta excited! I know it will be here before I know it though.

My PCP sent my ECG into the cardiologist to be read. Just so happens that I have connectons with this cardiologist. My mom used to be her nanny for a few years. So she called me and said she needed the original ECG to look at (my doctor only had a copy), and she would let me know by about Monday how everything looks. I'm sure it will be fine though so I'm not stressing about that either.

Wednesday, April 11, 2007

So Why AM I Torturing Myself?

This question has popped into my mind several times today as I have been actively abstaining from Coffee. I can tell you for sure that I will not be off coffee forever, why? because quite frankly I love the stuff! The last time I quit it was about 15 years ago, about three months before I became pregnant with my son. I did not have any caffeine period the whole time I was pregnant, to include chocolate. Coffee was however, the only thing I craved, dreamed of, and couldn't wait to have again once I was finished with the whole birthing/nursing experience. I stayed off it for 2 years until I stopped nursing, then the first thing I did was go out and buy a Mocha at my favorite local coffee shop.

I mostly want to stop because I have been down to one cup a day for awhile now and wanted to just take a break while it would be relatively easy to do so. I know from stopping before just how powerful caffeine addiction is, it really is a drug. One you don't realize the potency of until you get off it. I figure that this is as good a time as ever to stop, especially since my surgery is coming up. I mean truly, if I want to be as healthy as I can be, then this is the way to do it. It's not because of my ECG. I'm convinced it is fine now afer talking with my doctor. I'm just taking a break from Coffee and caffeine, until after my surgery because I want to see if doing things right with this surgery makes a difference in my healing. It is actually more of a scientific experiment then anything else. :)

I had to go to the dentist this afternoon to have a cavity filled. I have found that as I get older I have less and less tolerance for the sound of the drill. I mean it really freaks me out! So much so in fact that I worry one day I might go postal in the dentist chair. I don't know what it is about it but the sounds just makes me psycho. I'm thinking I'm going to start asking for nitrous and some headphones so I don't have to hear that terrible noise! I sit in the chair, stiff as a board, talking in my head like the little engine that could...."you can do this, don't freak out, its only a drill, you can do this, its almost over, breathe, breathe breathe"
By the time I'm finished I feel like I was run over by a truck! I'm exhausted! It's the weirdest thing! I have never been like this!

Doctor Says Not to's probably fine. Serious Coffee Withdrawls!

Doctor called me last night. Said that even though my ECG says it is abnormal it also says "uncomfirmed" which means it hasn't been read by a doctor yet. She said it looks fine to her, and she suspects that there aren't any problems with it. She is going to send it to the cardiologist for review just to be sure, and will let me know next week what they say. She said that I don't need to stress, that most likey everything will be just fine. So....that was a relief.

I have decided to give up coffee, and caffeine too! OMG...what a difficult endeavor that has been. Now mind you I don't drink a lot of coffee. I have one really good cup in the morning, made in an single serve machine, with gourment french roast pods. It is truly the only vice I have as I don't drink or smoke. So, I thought it was going to be a relatively painless thing to give it up and stop. BOY WAS I WRONG! So yesterday was my first day without coffee. I had a cup of ovaltine instead. Was good, but not like coffee. So, I get in the car and I'm driving my son to his dads (which is only 5 minutes away from my house) I'm thinking as I'm driving how people with sleep apnea often fall asleep at the wheel. Now mind you this has never happened to me, but so could have! I could hardly hold my eyes open. I felt like I was in the twilight zone or something. The whole ride from dropping my son off to work was like that, I was thinking, this cannot be very safe, no wonder it is such an issue. So, I get to work. I kid you not, I seriously could barely stay awake. I could've laid my head down on my desk and gone instantly to sleep. I was like OMG! how could one little cup of coffee make such a difference in my ability to stay awake. I suffered until about 1:00 at which point I could no longer endure and hit the chocolate easter eggs to carry me over for the rest of the day. I know, its sorta cheating....but I think I might have lapsed into a coma if I hadn't had them. Instantly I was my perky self again!

So today is the first official day with no coffee. Had ovaltine again, a cup of organic yogurt with some organic granola, a glass of EmergenC, my multi-vitamin and a calcium supplement, and so far I'm doing ok. I'm a little tired/groggy but no where near like I was yesterday. I must admit that I do feel a bit better, but I'm really missing my coffee. I don't really drink coffee for the buzz, I drink it because I love the taste of a good cup of coffee. This is a big sacrifice for me, since I really don't have anything else that I indulge in. I mean I really don't even eat chocolate (other then about 2 days a month, right before my monthly friend comes to visit) no smoking, no alcohol, and I try to exercise regularly. Probably the worst think I eat is non organic baked potato chips for goodness sakes!! I'm sure it has got to be better for me to be off caffeine though especially before surgery so I'm doing it for my health. WISH ME LUCK!
If anyone has any suggestions for something else hot I can drink (preferably low cal too) I would be grateful. I absolutely hate herbal tea though, think it tastes like mop water! So that is out for sure!

Monday, April 09, 2007

ABNORMAL EKG! I Swear It Just Keeps Getting Better...NOT!

Went and had my EKG done this morning. I spaced out and drank about 1/2 a cup of coffee before going. Then when I got there I had to run up two long flights of stairs and sprint down a long hall to get to the cardio-pulmonary unit. As soon as I walked in the door the girl at the desk whisked me into an EKG room, slapped some stickers on me and before I could blink we were all done. I barely had time to catch my breath as I was laying down on the table. I'm hoping that this is what the problem it came back ABNORMAl. I was so upset! I have never had an ABNORMAL EKG.
This is what my results said just in case anyone knows anything about this. My doctor is out of the office today so I won't hear back from her til tomorrow. I'm so frustrated as now I have to worry about getting this figured out so I can have my surgery in May! UGHHHH!!! I'm so not having fun anymore!!!

Vent Rate 73 bpm
PR interval 140 ms
QRS duration 92 ms
QT/QTc 398/438 ms
P-R-T axes 63 47 10

Normal sinus rhythm
Nonspecific ST and T wave abnormality
Abnormal ECG

Saturday, April 07, 2007

Insurance Aggravation! Why Do they Make Things So Difficult???"

My insurance lady emailed me back today. Seems the insurance company doesn't think my genioplasty is "medically necessary" This is what they said.

"Based on what has been provided, this is not considered to be medically necessary. If the provider can give us something more to substantiate how this will help treat sleep apnea, we can review again."

So I said:

"I guess I'm confused as to what he would need to provide. It states right in the medical neccessity letter that it is medically neccessary to move the hyoid bone forward which has been shown in the research, when done in conjunction with Upper and lower surgery to increase the airway.

This quote was taken right of of a website I found:


An operation performed to reshape the chin. Genioplasties are often done to treat OSA because the procedure changes the structure of the patient's upper airway.

When MMA is done the surgery usually takes 3 main forms done together. It's referenced on this Mayo Clinic website.

What else would he need to include?"

This is what she said back to me:

"They are probably looking for proven statistical medical efficacies that would substantiate the claim. You provider should be able to easily provide this information."

So now on Monday I need to call my doctor and ask him if he can provide documented proof that sliding genioplasty is actually beneficial and does in fact help with correction of sleep apnea. EVEN though, I can find info about it all over the web. How messed up is that? Guess....the fight is on! :(

Tuesday, April 03, 2007

Medically Necessary Genioplasty & Smile Changes

My doctor faxed me another separate pre-auth today. This one is for my genioplasty with a letter of medical neccessity. He states that after being approved for maxillary and mandibular advancements, he has done further profile sketches and review and that he wants to also do a genioplasty to advance my hyoid bone. He said that since this would be done as an additional corrective measure to eliminate my sleep apnea and not for cosmetic reasons that he feels it should be covered. The cost up for approval is $3650.00.
I gave it to my insurance lady to hand process and she says she will get back with me ASAP regarding the determination. I hope they cover it, then I would only have to pay my $3500.00 and could call it good. So....I guess that means that genio is now part of the plan. I mean I had thought it was already, but it wasn't for sure. Now it appears that he feels it to be "medically necessary" so that means it will probably happen fo sure!

February 13, 2007...........................................April 3, 2007

February 13, 2006 - the beginning of all this oral drama.

Here are the changes that have taken place on my upper and lower arches in the past two months. Looks as if my orthodontist has opened things up quite a bit on top don't cha think? I threw in the beginning pic just for reference.

February 13, 2007............................................April 3, 2007