Tuesday, December 12, 2006


What a disaster today has been. It's only been in the last few minutes that I've managed to pull myself together.

The pre-op workup didn't happen. I've never had a good feeling about this surgeon from Day One, but he IS the chair of the Oral/Maxillofacial Surgery department, and my sleep doc highly recommended him, so I figured, What the heck.

I've never met a surgeon who has dragged his feet when it came to operating, especially on a really cool operation like this one. But for the last six months I've met a brick wall. Every time I went to clinic, the studies were never good enough. It was always Just one more sleep study and then we'll operate. The first time he said this, I already had 3 studies in the span of 5 months under my belt. Because of this man, I've been to the Mayo Clinic and Stanford, and had to fight my insurance company tooth-and-nail for coverage, and am still fighting. Shoot, I've had to fight my surgeon, too. He wants to do some lame-a$$ one-jaw procedure that involves extracting some teeth, having me in braces for a YEAR, and then coming around to operating. He knows that is unacceptable given my timeline for returning to residency, and besides, it's not even the standard of care for my problem.

The pre-op workup can't happen until I see the orthodontist. Braces must be mounted to get a proper mold for a proper fitting splint for post-op. I made appointments for early January, and then found out my dental insurance doesn't cover any adult orthodontia, not even when it's needed for surgical reasons. So I'm eating it all. And never mind that the surgeon waited six months before giving me the name of the ortho guy. I could be all prepped by now.

Then, I get a call from OMFS that after Dec. 31, my insurance company no longer covers the surgery! This surgeon stalled for too long! That means that within 2 weeks, I have to meet the ortho, have braces placed, have molds made and a plan ready for splaying open my face, and the surgeon who has a 6-month track record of stonewalling me has to operate. Yeah, right.

I'm hell-bent to have this surgery. I've got a plan up my sleeves. It involves my mentor from medical school. He hooded me at graduation:
He's a plastic surgeon. Not exactly on-target, but it's a starting point. Because it's not WHAT you know, it's WHO you know.


At 12:04 AM, Anonymous Anonymous said...

Hummmm........You know, even if it involves a "new fight" with the insurance company. Do what is right. You need the surgery that is standard of care.....even though with something like that I doubt that there is a standard. You know what I mean, low incidence, who has the last word on the "standard"? This is a long standing condition and the insurance company can not press for a two week timeline just because they say so. There is room for argument with them. Do what is thought to be the best treatment, even if. It is your face/body/health/peace of mind/etc/etc.
I will keep my fingers crossed out here for you.

At 6:26 AM, Blogger Jaws said...

Well, I think I really am screwed as far as the insurance company goes. The open enrollment deadline just passed about a month ago, and I never made it to the meetings, where they apparently informed people of this new drop in coverage. Why they couldn't put a blurb in the packet we all received is beyond me.

Fortunately, my mother (my sugarmama) has agreed to help me out in the worst-case scenario, but I was hoping to avoid this, mainly for pride reasons, and because she's already spotted me on the Mayo bill.

As for "standard of care," it may be more of an unofficial standard. But everyone I meet says that if you ARE retrognathic and you DO have a sleep issue such as mine, then MMA is the surg with the highest rate of success (even better than CPAP, what a heinous contraption that is. One night was all it took for me there). The literature has reached that consensus as well. I guess standard of care implies some legal duty, and I don't think that's the case, but it shows how informed/UNinformed the surgeon is on this, which is another reason I've never had good vibes.

My plastic surgeon mentor recommended an OMFS guy from the city where I grew up and my mother still lives. I'm contacting him today. If I'm going to eat the cost, it's going to be a surgeon I'm confidant about.

OK, now I have to get to a super-early, unofficial appointment with the ortho to see exactly what we are dealing with from his point of view, because it may be more than braces and mold making pre-op, there may be some widening needed. As you know, L, oftentimes these anatomical anomalies come in pairs/groups, and usually people with retrognathia also have an underdeveloped and narrow maxilla (I have an incredibly high-arched palate) so I may need to be widened in order to get the bite right post-op. This will throw a loop in things as far as the timeline goes.

Thanks for all your support, dear readers!


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