November Surgery Buddies!

This forum is for discussions relating to oral surgery for orthodontics.

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EWUgal15
Posts: 655
Joined: Fri Apr 03, 2015 8:18 am
Location: Spokane, WA

Re: November Surgery Buddies!

#136 Post by EWUgal15 »

More adventures in insurance land. The geniuses at my surgeons office submitted the claim as out of network. Now, I knew he facility was out of network but the provider is not. So something is not right here. I'm so sick of dealing with this crap. Lord knows I'm not going down without a fight though. I've paid my share, the rest is up to the idiots at the doctors office. And rest assured, they'll get it done right or they're not getting paid.

sherrifrob
Posts: 46
Joined: Mon Nov 23, 2015 7:23 pm

Re: November Surgery Buddies!

#137 Post by sherrifrob »

I had the big move today, I say 'had' I'm still waiting on the movers. They're 3 hours late so I'm sat on the floor next to an overflowing suitcase clock watching. I was considerate so I moved all the furniture into a handy pile for them so I don't have anywhere to sit while I wait. All my boxes & stuff went into storage earlier today, I rushed doing that so I could get back for the movers, I apparently needn't have bothered.

I saw the orthodontist yesterday, she took off the archwire but she left those damn surgical hooks on just so she has options even though my elastics are in the same place & will stay there until she changes the wire on the next visit. She's lovely but I could feel myself getting annoyed with her. A bracket came loose so she replaced that, the buffer she use to get the cement off was not pleasant. I'm getting so bored of the constant visits. It's nice kinda being able to chew but the slow progress is so frustrating.

I work in medical insurance, in the US if the provider is out of network & they charge above the network rate which is understandable cos it's nothing, the claim goes to arbitration where they negotiate the payment. Facilities are more likely to negotiate than individual doctors but as you say he's in network. If your surgeon is in network he should be claiming as such, the hospital does their own paperwork.

Arbitration is basically where they find a figure that the provider will accept that the insurance will pay leaving nothing for you to pay. Sometimes the provider does a self pay discount that's even less than what they get in arbitration. I've seen as much as 40% so there are ways around getting the shortfall between the insurance rate & the out of network rate.

Do you know who authorised the procedure the doctors office or the provider? If it's the doctors office they often request a day surgery just to get the doctors fees covered even though your stay is longer. I've literally been told by doctors offices in the US that someone is having a hysterectomy as a day surgery, like you'll pop off home that day. If they didn't get the proper approval & filed the claim wrong it's on them.

Did you sign anything in regard to being responsible for any unpaid amounts? They usually do it as standard but that assumes they're semi-competent. If you're firm they usually sort it out themselves, first line is always try to get the patient to cough up instead of correcting the paperwork. Don't worry, it'll get sorted. You're right their paperwork, their problem.

I know what you mean about the broken record. I'm staying with people for the next 7 days & I feel like a fussy child. I know they understand but I do feel like I'm being awkward. My sister sent me a picture of some pasta she's making for me.

I think today is the first day I've been able to speak well enough that I don't have to start every phone conversation with a brief explainer.

EWUgal15
Posts: 655
Joined: Fri Apr 03, 2015 8:18 am
Location: Spokane, WA

Re: November Surgery Buddies!

#138 Post by EWUgal15 »

How was the wire changing process for you? You said you haven't had much numbness so was it like a normal wire change or was it painful and different? I read a story a while back from someone who had lower only and she said changing the wire the first time after surgery was a nightmare. A lot of tugging and pulling that was really uncomfortable at the time and then really terrible soreness set in later. I'm sorry to hear that you still have your surgical hooks. Mine are on my arch wires and if my orthodontist decides to change my wires, I lose all the surgical hooks. I've discovered that my lower teeth are more numb than I thought, especially the front ones. So I'm curious to know what the wire change is going to feel like.

The worst part about the insurance situation is that I made a payment to the surgeon before I had surgery. They gave me an estimate of what would be leftover after insurance paid out and asked that I pay it up front. I did have a day surgery...100% outpatient. My mom is a coder and biller for a set of plastic surgeons back home and said that my surgeon's office dropped the ball big time.

sherrifrob
Posts: 46
Joined: Mon Nov 23, 2015 7:23 pm

Re: November Surgery Buddies!

#139 Post by sherrifrob »

It wasn't too bad. On one hand I was dying to get the hooks off but on the other I wasn't sure how it would go without being able to open much. It was fine, tugging & that snapping that happens when they take the elastics on & off wasn't great but tolerable. They used the same wire again so they didn't have to snip the back behind there the bands are like they normally do. I think if they did have to do that it would not have felt great, but overall it was much like a normal adjustment. I was in a bit of a mood afterwards but I think that was more to do with just being sick of going there.

Insurance is a nightmare, mine is provided by my work & I remember a doctor telling me something about billing & thinking, I work for the same company & even I find that difficult to follow. Not everyone is familiar with the coding system. The UK has it's own which I'm sure is fine for providers but unlike the US system you can't just easily good the ICD 9/10/procedure codes. How they expect people to confidently arrange their treatment I don't know.

I don't have a co-pay, co-insurance or deductible & my doctor is in network so I didn't have to pay anything. My braces are on the NHS so they're free. When it came to the length of stay because I had the surgery Friday evening they didn't push me to leave Saturday, I went home on Sunday which technically is 2 nights. I think I could have probably managed to go home late Saturday but seen as it was the weekend they weren't too fussed either way.

I'm heading to the airport in hour. Other than taking out a few bags of rubbish I'm all good to go. My case weighs 19.9kg of the 20kg I'm allowed so now shuffling things about due to the weight Berlin is really mild at the moment just like here so fingers crossed there should be no travel related disasters, touch wood etc.

EWUgal15
Posts: 655
Joined: Fri Apr 03, 2015 8:18 am
Location: Spokane, WA

Re: November Surgery Buddies!

#140 Post by EWUgal15 »

It continues to snow in Spokane. I'm worried I might not be able to make my trip out of town. I know my family will understand if that happens.

I think I can open my mouth wide enough for a wire change. I've been doing a lot of talking and stretching without my ridiculous elastics and I'm almost up to two fingers width.

The weather up here and the attempts at snoring have left me with severely dry lips...do you know how hard it is to put on chapstick when you can't feel one of your lips?

sherrifrob
Posts: 46
Joined: Mon Nov 23, 2015 7:23 pm

Re: November Surgery Buddies!

#141 Post by sherrifrob »

Two fingers width? You're doing better than I am. I can get one finger in. I find the not being able to press your lips together for the lip balm an issue. I use really gloopy gloss because I know it stays on & doesn't end up making your skin greasy. I usually have to use my finger to spread it around, super dignified in public.

Travelling with the eating restrictions is hard going. I left my flat around 3 & arrived at the hotel at 11. Normally I grab something in the airport but that was out. My train to the airport was delayed so I couldn't find somewhere that did a sundae or anything easily eaten in public view due to time. I did grab some stuff that I knew I could eat slowly, by the time I got in I was ravenous so it seemed sooooo slooooow.

I did nod off on the plane, I've pretty much trained my body to fall asleep the second the plane takes off. The lady next to me woke me up mid flight (it's only an hour & a half) to go to the bathroom. I didn't really appreciate that. My case weights 20kg & my other bag is 10kg, normally not an issue but I did struggle this eve. I feel a bit burned out.

Have you got a Xmas plan B? Like friends locally you can see? Will your warden be there to? This is an ideal excuse if you want to avoid in laws.

EWUgal15
Posts: 655
Joined: Fri Apr 03, 2015 8:18 am
Location: Spokane, WA

Re: November Surgery Buddies!

#142 Post by EWUgal15 »

Plan B is to just stay home. Which is no big deal. The warden will be here. Thankfully his parents live on the other side of the country...2376 miles away. He's flying home for the first week of January without me because of our animals.

Almost 2 fingers. I've been really trying to stretch the muscles. It's pretty tough and it's a lot of two steps forward, one step back. I avoid eating in public all together because I can't feel my lower lip. People stare enough as it is with all my elastics, I don't need them staring because I have food on my face I can't feel. Not to mention I'm still chewing on doctors orders. My plan for this short trip is to bring a couple protein shakes and some yogurt. Even though I'm visiting my parents, I'm staying in a hotel. My boyfriend doesn't fit in their guest bed and they're kind of old fashioned and don't approve of us sharing a bed at their house. So we get a hotel not far from their house. That is if we still go...

An hour and a half flight and she needed a pee break? That's a weak bladder.

sherrifrob
Posts: 46
Joined: Mon Nov 23, 2015 7:23 pm

Re: November Surgery Buddies!

#143 Post by sherrifrob »

I have officially reached my limit for incessantly being offered foods I can't eat. Travelling while not being able to eat is no fun. I was ravenous by the time I arrived at 11pm. My sister basically had me cook the entire Christmas dinner including all the stuff I REALLY wanted to eat but couldn't. She had friends over for Xmas dinner, it was hard to talk for hours & not be self conscious about eating.

I have to say I was wiped out most of the time. On my way back I didn't sleep at all the night before & didn't eat while I was travelling, by the time I picked up my mums car I was probably in no shape to drive. The upside is that when I arrived I got to have some poached eggs to celebrate not destroying my mums car in a hangry/sleep deprived state.

How did your Christmas go? Did you get snowed in?

EWUgal15
Posts: 655
Joined: Fri Apr 03, 2015 8:18 am
Location: Spokane, WA

Re: November Surgery Buddies!

#144 Post by EWUgal15 »

While it did snow more, the roads were clear so we made the trip. It was an overnight stay and things were fine coming back. I took food that I could eat with me on the off chance that I wouldn't be able to eat anything that was cooked. That wasn't an issue. I'm not supposed to chew but I did use my teeth here and there with no issues. The worst part was finding myself drooling and nobody telling me. It was because they hadn't noticed but it was still weird.

My boyfriend did all the driving so I didn't have to worry about being tired. Now I have to do all the normal stuff before work (laundry, cleaning, etc). At least it's a short week.

I'm officially up to two fingers width opening. I'm hoping to start flossing more while still using my WaterPik. It seems to be getting the job done but I'm paranoid. My next cleaning is in February and I'm worried that I won't be able to open wide enough. I'm also worried about how the cleaning process is going to feel with my nerve being out of whack. Brushing my lower arch is a nightmare. Certain teeth send weird shocks through my mouth when I brush them and all I can figure is that the nerve is just being weird.

Sorry you had such a rough Christmas with your sister. I've found that a lot of people just don't seem to get it if they haven't been through it. It will get easier though.

sherrifrob
Posts: 46
Joined: Mon Nov 23, 2015 7:23 pm

Re: November Surgery Buddies!

#145 Post by sherrifrob »

Yeh, the nerves in my knees do something like that. Nothing & then zap, nerves heal at something like 1mm a month I read I think. So they do heal just slowly. Plus swelling goes a long way. I'm at my mother's house doing all the mundane stuff until she gets back. It's actually quite nice.

By February you should be able to do a full clean, if you think where you were a month ago it'll just increase exponentially. I think weeks 6-8 is when the break is officially healed. I have my bands off most of the day & they don't hurt that much when I put them back on again. I think things are settling down.

Christmas wasn't too bad considering, lots of stuff could have gone wrong with the move or travelling & they didn't. Also my dad died new years day last year & this was the first christmas without him, no one got upset over dinner or anything, being in Berlin instead of home in Ireland helped. The worst of it was the jaw stuff, all things considered a total win.

I'm in this bustling metropolis for the next few weeks: http://tinyurl.com/jngtalf

EWUgal15
Posts: 655
Joined: Fri Apr 03, 2015 8:18 am
Location: Spokane, WA

Re: November Surgery Buddies!

#146 Post by EWUgal15 »

I've noticed that I have a nasty habit of clenching my teeth when I wear all of my rubber bands. Over the weekend, I left them off for quite a bit of time throughout the day and they were a little tight going back in before bed but nothing upsetting. Being in the office today, I have all of them in and haven't caught myself clenching. I also tried to open my mouth with them in an was reminded that I can't do that. I'm thankful that this is a quieter Monday...not a lot of meetings as a lot of people are still on vacation for the holidays.

A friend of mine growing up lost his dad to cancer around New Years a while back...because of that, his family tends to celebrate Christmas in July. His mother has since remarried, but his father's side of the family seems to always be reminded of the loss this time of year.

There are some pictures here that show the nicer side of where I live in the winter time: http://www.travel-spokane.com/winter-fu ... pokane-wa/
We got more snow last night and this morning. The commute to work was a little slick but I wasn't driving, so that helped.

Tomorrow is my 6 week post-op appointment. I'm curious to know what the surgeon will have to say. I don't look forward to these because I tend to spend more time driving and waiting for the appointment to start than I do in the exam room. But I have a list of questions for him that will extend things out a bit and hopefully make me feel a bit better about things. I will be so excited if he says the orthodontist can take off my surgical wires. I was chewing soft foods most of the weekend even though I'm still not supposed to. If I felt myself struggling or had any pain, I backed off...I feel a little bad for breaking the rules, but at the same time, I've gone 6 weeks without solid food. Nobody thought I would make it that long, so I'm pretty proud of myself.

EWUgal15
Posts: 655
Joined: Fri Apr 03, 2015 8:18 am
Location: Spokane, WA

Re: November Surgery Buddies!

#147 Post by EWUgal15 »

Today marks 6 weeks post op.

Had a check up with the surgeon. He's kind of a putz and I'm getting tired of dealing with him. He looked at my teeth again, said my bite is perfect. Asked when I see my orthodontist next, so I told him next week and he said it was fine to remove the surgical wires. So 8 more days of crazy elastics for me. I get to go back to regular orthodontist appointments now. YAY! The surgeon also said I'm still restricted to 25lbs or less for lifting. I'm not taking that seriously at all. I went to the gym yesterday and did plenty of arm lifting that didn't cause any problems. I went easy and everything, but I'm really over this damsel in distress garbage. So I'm throwing that rule away. Then I asked about chewing. The surgeon tells me "Chewing is after 6-8 weeks. You're still not allowed." To which I very promptly replied "My surgery was 6 weeks ago today." He very quickly tried to tell me that it has only been 4 weeks. I told him "My surgery was on November 17th. Today is exactly 6 weeks post op." He stood there, counting in his head, and finally said, "I guess you're right. You can go back to soft chew foods. No Big Macs, but soft sandwiches and things that don't require much effort to chew." Then said "I'll see you in six weeks." and rushed out of the room muttering that he could have sworn it had only been 4 weeks. The nerve of him to not even look at my chart before coming into my appointment 25 minutes late!

So there's some New Years good news for me! My next appointment is the same day as my cleaning with the dentist, so it will be a full day for me. I'm going to make it a sick day from work so I don't have to worry about doing much of anything, what with 2 orthodontist visits, the hygienist, and the surgeon.

sherrifrob
Posts: 46
Joined: Mon Nov 23, 2015 7:23 pm

Re: November Surgery Buddies!

#148 Post by sherrifrob »

He does sound like kind of an a$$. The egotistical surgeon stereotype comes from somewhere. Personally I have behaved myself & done exactly as I was told for the most part but at the same time I have cheated here or there. I rationalise it with having impeccably clean teeth so it's okay if I incredibly slowly eat a cookie. It's like dieting, the goal is balance & continuous progress, if you're too rigid you'll fall off the wagon.

My doctor & orthodontist do that too, always asking how long post op you are. I dunno if it's maybe that it's such a grind as the patient you assume that they might recall when it began cos you certainly do. I saw my surgeon on a Thursday & was exactly 3 weeks on the Friday, he thought about it for a bit & then said I was okay to start chewing a day early but 'no nuts!'. Firstly, I don't know anyone who after not eating for weeks their go to would be nuts & secondly who is that stupid. Sometimes there just isnt' enough sarcasm to address the stupidity of a statement.

I think the first thing I ate was a goats cheese omelette, it's very much a walk before you can run situation. You don't really feel like you're eating more like you're playing pinball in your mouth. Poached eggs & avocado were great, I really missed fresh unprocessed food. Even though I only ate soups I made myself from scratch & yoghurts I zapped with fresh fruit I still felt like fresh fruit & veg was missing from my diet. Burrito bowls were good in week two of chewing, lots of fresh stuff in small pieces & also readily available from fast food places so you don't have to cook.

I avoided pasta & noodles because they're empty calories. I love vietnamese but the best part is the crunchy fresh vegetables so I just vetoed noodles in case I got lazy & started to live on ramen. One piece of advice, figure out what you can actually fit in your mouth including a spoon/fork & then work out from there. When you're chopping things up it helps to know what's actually going to fit so you don't find out when you sit down to eat that you'll have to cut everything in half again. That is a downer when it takes half an hour to eat a small bowl of anything.

Good news about the bumper day of appointments, I bet you'll feel so much freer when the elastics come off. The gym obviously helps keep you sane, I normally swim but I think that would be a bad combo with the mouth issues & also it's mid winter, it's a lottery whether you come out of the pool without a cold or not. Spokane looks beautiful, do you do any winter sports? I bet you can do some pretty fun stuff on the river too. I'm at that mid winter point where I'm fantasising about swimming in the sea every day. Mid summer I'll be fantasising about mid winter where you don't feel guilty for not going outside. Damsels in distress are always garbage, they never do anything fun.

My mums dogs are driving me crazy, the two rottweilers are good as gold. They're well behaved & quiet, the younger one is a collie & I think he has dog ADHD. The breed are used to herd sheep, so they're high energy which is to say he behaves like he's on crack. CRACK I SAY! No wonder my mums always yelling.

EWUgal15
Posts: 655
Joined: Fri Apr 03, 2015 8:18 am
Location: Spokane, WA

Re: November Surgery Buddies!

#149 Post by EWUgal15 »

I don't do any winter sports. I'm not a fan of the cold...and I mean bitter cold. It hasn't gotten above 32 degrees Farenheit in weeks. There's lots of snowboarding and skiing around though. We even have an outdoor ice rink behind the big clock tower in the photo on that website. The river has a pretty strong current and I don't see many boats on it. They mostly stick to the lakes. We have probably 2 dozen lakes in the rural area around the city. It really is a gorgeous area.

I would love to travel to the UK to see everything. I've never seen a picture of Ireland, Scotland, or London that I didn't like. I just need to travel. That's all there is to it.

As far as chewing goes, I started with the cooked bits in soups, some very thinly sliced and tender prime rib (courtesy of my dad) and egg salad. I had pasta today but I'm still eating very small portions so I don't feel too guilty about all the carbs. I'm definitely in no rush to overdo it on chewing. I feel like after 6 weeks of muscle atrophy (in my jaw and everywhere else), getting back into a weight lifting routine will take work to actually get back up to my normal weights. I have been lifting more than 25 pounds but not enough to grind or clench my teeth.

I am so excited for the elastics to come off next week. I've been resisting the urge to call and ask if I can stop wearing them early since I'm already taking them off to eat and clean and we're taking off the extra books next week. But I'm trying to behave. It's just 7 more days. I think I can make it. I definitely don't mind being asked how long post op I am but I was not very happy when the surgeon tried to tell me it had only been 4 weeks. I still think he could have taken a minute to look at my chart and get his facts straight before seeing me.

I miss having dogs around. My family had a Dalmatian when I was growing up. He passed away a year after I moved out of my parents house. That was when my mom started adopting cats. She has 9 of them. And they can be a handful. I have 2 at my apartment but they don't get along too well. They live in separate rooms so I don't have to break up fights

EWUgal15
Posts: 655
Joined: Fri Apr 03, 2015 8:18 am
Location: Spokane, WA

Re: November Surgery Buddies!

#150 Post by EWUgal15 »

Oh goodness. I managed to floss tonight. With actual floss, not just my WaterPik. I'm amazed. I didn't think I could open wide enough. It felt heavenly. I'm so happy!

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