Hey, Mom! What up?
Last weekend was lovely in SF! Wish you were here. D, M & C were here for C's music festival, and it was great seeing them. They said you got snow that (Saturday) morning, so I'm sure they were glad to be here and not there! BTW, C's choir sounded great (they got first place) and the venue (St. Ignasius church...a place I'd never been to), was beautiful. The final concert was at Davies Symphony Hall, and Paul and I were able to go.
So, as I mentioned, I was going to make some lists and read up a bunch on the sleepnet.com site, which I did.
In looking at my big list (which I'm sure is bound to have more additions in the future), I'm thinkin' no matter how prepared I am with all the stuff I need to get, the things I need to do, the questions I need to ask, the things I should expect to happen, in addition to preparing myself mentally, I may be better-prepared, but I'm never *really* going to be fully prepared. Gulk!
(dang! There were a lot of commas in that last sentence!)
So far, the big list is comprised of little lists broken down as:
a) Things I need to to get/have.
b) Things to do in order to be ready for the big day.
c) Questions to ask the doctor at the pre-op appointment.
c) Things to expect at the hospital and during recovery.
- Paul and I went "sailing" last weekend(*garage* sailing, that is) and I found a very nice "used only once" humidifier for only 5 bucks! Someone from the sleepnet.com forum had recommended I get one, so it was on my list. Like you, I love a bargain!
Sure, having lip balm, stool softener, a humidifier, lots of Ensure, instant breakfast, Odwalla's, 7 kinds of food choppers/blenders ;-) , mini toothbrushes, and stuff to help keep me from being bored will be really helpful, but I don't think I'm going to fully comprehend the magnitude of MMA surgery until I wake up in the ICU after it's over. HIGH ANXIETY!!!! ;-)
In all my reading, as similar as many people's experiences have been, there's still as many (if not more) differences. Some people have experienced little if any pain, and others have said it was the most painful thing they've ever experienced. ...and there's no way to know where in that range I'll fall until I experience it for myself. I'm visualizing being on the "not very much pain" side, of course!
- I also took care of some "to-do" stuff. Even though I had my regularly-scheduled teeth cleaning a couple months ago, I scheduled another one for right before the surgery. I figure it "couldn't hoit" since I won't be able to brush like I regularly do for a good while, and there’d be no way to open my mouth far enough and long enough for the regularly scheduled cleaning in September.
Also, I filled out the online medical disability form from work. Can you say convoluted? My HR rep told me that I will be eligible for full pay for up to 63 calendar days, which is good news. Since I’m taking a little more than 6 weeks off, I’ll be covered. Unfortunately, I won't be paid the same way. Instead, the state will be paying a certain amount every week, and work will make up the rest. I just hope it all works out like they say it's going to!
So, what's left? I still have to get a full blood work-up and EKG before the surgery, but that should be pretty easy to do. Even though I still have 5 weeks to get that done, I'll probably do it this week. That’s one less thing to worry about.
As far as the pre-op appointment with Dr. KL goes, I have a (yet another:-) list of questions to ask him (which I'm sure will get bigger)....such as: what *exactly* are you going to do? How far (in millimeters) will my jaw be moved? What about my slightly deviated septum? What about that weird stone in my salivary gland that showed up in my x-ray? Does vicadin come in 1/2 gallon containers? (only kidding!!!)
When it comes to things to expect at the hospital and during my recovery, I'm not that sure what to do yet. I'm thinking about making "ICU cue-cards" since talking might be a challenge. For instance, the cards might say:
* Could you please quiet down?
* May I please have some water?
* Okay, I admit it. This hurts.
* This catheter is not enjoyable. Please remove it as soon as humanly possible.
* Could somebody please suction the “boogs” out of my doze?
* Does this head-rap make my ass look big?
…you know! Stuff like that! :-)
Since I'm still 5 weeks away, there's still plenty of time to add to the lists, and hopefully finish what I need to do. As far as work goes (yet ANOTHER list!) I am going to have to pack everything up in my office, because we’ll be moving from our temporary digs back to our regular offices after they are finished being remodeled. Unfortunately, I won’t be here for the move back, so I want to make it as easy as possible on my co-workers, who will have to move all my stuff/crap. Poor them!
Lists, lists, lists!!
All I can say is I'm glad I'm writin' all of this down, yahearwhatI'msayin'?
xoxox:
Pinski
P.S. I’ll be posting some “before pix” soon, but not until the gi-normous “blemish” ;-) on my temple leaves me.
Monday, April 28, 2008
Friday, April 25, 2008
The "Committee Sessions" and things to consider...
Ola Mama!
I hope my first letter about my MMA “issues” wasn’t too overwhelming!
It was for me!!
…and too bad for you it if was, because there's more where that came from!!
Now that the surgery is scheduled and it is an inevitability, I’ve been having periodic “committee sessions” in my head about a bunch of different things. So much to consider. So many things to plan for ….and so many things to worry about!! Oy!
Don’t get me wrong. For as big as this whole process seems, roughly 90% of me is really looking forward to it, and “getting on with my life”. (a quote used in every soap opera since the beginning of time)
From what I know and what I’ve read, being adequately prepared and having a positive mental attitude is key to a timely and easier recovery, so that’s what I’m out to do, first and foremost. Since I am no stranger to surgical procedures, I am lucky to have had those experiences under my belt. Those operations weren’t quite as major as this one will be, although that gnarly abdominal surgery I had when I was 12 probably runs a "close second". BTW, thanks for taking such good care of me through all of that.
So, I’m trying to be as positive as possible, but there’s still a part of me that thinks “poor me for having to go through this”.
Pity Party for Pinski!!! I guess that's to be expected (some what).
*Some* of the things to consider would be: a) The potential pain involved b) The possibility of unforeseen complications c) Not being able to eat regular food for a long time, d) The boredom that I’ll probably experience during my recovery period. e) How much this is all going to cost …and that’s what just comes to mind right now. I'm sure f, g and h, are soon to follow.
Do you suppose being part Italian and being raised catholic has anything to do with
all this worrying??? Ya, I thought so too! But that’s okay. I’m going to try to look at these challenges in small increments so they won’t overwhelm me, and I’m going to make a counter-plan for each of these “concerns”.
- For the pain, I plan on keeping a close eye on the amount of pain meds I take (and Paul will be a great help with this), and communicating with the doctor if it gets to be too much, instead of over-medicating.
- Un-foreseen complications? Don’t cross that bridge till you get to it, right? After all, I may never have to!
- Food? Okay, I could moan all day about not being able to eat steak, nachos, granola and all that, but it won’t be forever. I *will* eat that stuff again...Maybe not soon, but some day.
- Boredom? Well, “learian” said she slept a lot, so I’m hoping to do a lot of that, but I’m also going to have to find other things to keep me occupied. I’m thinkin’ People magazine….tmz.com...the Boob-tube….blogging;-)....practicing my Break-Dancing (only kidding!) …and I suppose I could also “make-like-a-teenager” and learn to “text-really-fast”!! Oh, the possibilities ….
- The co$t of it all? Well, sure. It’s going to take several years to pay this off, but it’s sure better than the alternative. I’m tired of being so tired!!
Some of the exciting unforeseen things I'm looking forward to are:
How my looks will change. As frightening as that may seem, I’m actually quite looking forward to that. (At the risk of ending up looking like Jay Leno, which I doubt will happen;-), I’m hoping that I have a stronger looking chin. I know, first and foremost, it’s about my health, and not about asthetics, but a stronger chin *would* be a nice "secondary benefit". Does that mean I’m a little vain or perhaps a bit shallow?? Maybe! ;-)
But mostly, I’m looking forward to getting a good, full nights sleep, waking up rested, and having the choice of sleeping on my side *or* my back. It’s tough to tell how much the apnea has been affecting me, really. I guess I’ll know after I experience what's different after it’s over. Will my daily dull headaches go away? Will I feel less fatigued? Will I not feel tired after I wake up? I won’t know until I’m on the other side of the MMA surgery, but I remain optimistic that many things will change for the better. Of all the blogs and forum postings I've read, most of the people don't regret having had the MMA surgery, and I don't plan on regretting it either.
So, this weekend I’m going back to the sleepnet.com site to do more reading. There’s still a lot to learn, and I am fer-shure going to start making some lists and checklists. I know I still have five weeks before the big surgery, but it will probably whiz by before you know it. I want to be prepared and ready for anything.
Now, if I could only convince "Mr. Caregiver" (a.k.a. Paul) that it’s all going to be okay. He can be a pretty big worrier too. I’m going to try like hell to get him to also read-up on the sleepnet.com site, and possibly some blogs to-boot. Just to get an idea of what to expect.
Well, that’s all for now. It was great talking to you the other night and I just want to tell you *again* how proud I am of you for quitting smoking after 50+ years. How long has it been now? Like 3 months? Absolutely FABU, dudette’!
Loads of love;
Pinski xoxoxo
I hope my first letter about my MMA “issues” wasn’t too overwhelming!
It was for me!!
…and too bad for you it if was, because there's more where that came from!!
Now that the surgery is scheduled and it is an inevitability, I’ve been having periodic “committee sessions” in my head about a bunch of different things. So much to consider. So many things to plan for ….and so many things to worry about!! Oy!
Don’t get me wrong. For as big as this whole process seems, roughly 90% of me is really looking forward to it, and “getting on with my life”. (a quote used in every soap opera since the beginning of time)
From what I know and what I’ve read, being adequately prepared and having a positive mental attitude is key to a timely and easier recovery, so that’s what I’m out to do, first and foremost. Since I am no stranger to surgical procedures, I am lucky to have had those experiences under my belt. Those operations weren’t quite as major as this one will be, although that gnarly abdominal surgery I had when I was 12 probably runs a "close second". BTW, thanks for taking such good care of me through all of that.
So, I’m trying to be as positive as possible, but there’s still a part of me that thinks “poor me for having to go through this”.
Pity Party for Pinski!!! I guess that's to be expected (some what).
*Some* of the things to consider would be: a) The potential pain involved b) The possibility of unforeseen complications c) Not being able to eat regular food for a long time, d) The boredom that I’ll probably experience during my recovery period. e) How much this is all going to cost …and that’s what just comes to mind right now. I'm sure f, g and h, are soon to follow.
Do you suppose being part Italian and being raised catholic has anything to do with
all this worrying??? Ya, I thought so too! But that’s okay. I’m going to try to look at these challenges in small increments so they won’t overwhelm me, and I’m going to make a counter-plan for each of these “concerns”.
- For the pain, I plan on keeping a close eye on the amount of pain meds I take (and Paul will be a great help with this), and communicating with the doctor if it gets to be too much, instead of over-medicating.
- Un-foreseen complications? Don’t cross that bridge till you get to it, right? After all, I may never have to!
- Food? Okay, I could moan all day about not being able to eat steak, nachos, granola and all that, but it won’t be forever. I *will* eat that stuff again...Maybe not soon, but some day.
- Boredom? Well, “learian” said she slept a lot, so I’m hoping to do a lot of that, but I’m also going to have to find other things to keep me occupied. I’m thinkin’ People magazine….tmz.com...the Boob-tube….blogging;-)....practicing my Break-Dancing (only kidding!) …and I suppose I could also “make-like-a-teenager” and learn to “text-really-fast”!! Oh, the possibilities ….
- The co$t of it all? Well, sure. It’s going to take several years to pay this off, but it’s sure better than the alternative. I’m tired of being so tired!!
Some of the exciting unforeseen things I'm looking forward to are:
How my looks will change. As frightening as that may seem, I’m actually quite looking forward to that. (At the risk of ending up looking like Jay Leno, which I doubt will happen;-), I’m hoping that I have a stronger looking chin. I know, first and foremost, it’s about my health, and not about asthetics, but a stronger chin *would* be a nice "secondary benefit". Does that mean I’m a little vain or perhaps a bit shallow?? Maybe! ;-)
But mostly, I’m looking forward to getting a good, full nights sleep, waking up rested, and having the choice of sleeping on my side *or* my back. It’s tough to tell how much the apnea has been affecting me, really. I guess I’ll know after I experience what's different after it’s over. Will my daily dull headaches go away? Will I feel less fatigued? Will I not feel tired after I wake up? I won’t know until I’m on the other side of the MMA surgery, but I remain optimistic that many things will change for the better. Of all the blogs and forum postings I've read, most of the people don't regret having had the MMA surgery, and I don't plan on regretting it either.
So, this weekend I’m going back to the sleepnet.com site to do more reading. There’s still a lot to learn, and I am fer-shure going to start making some lists and checklists. I know I still have five weeks before the big surgery, but it will probably whiz by before you know it. I want to be prepared and ready for anything.
Now, if I could only convince "Mr. Caregiver" (a.k.a. Paul) that it’s all going to be okay. He can be a pretty big worrier too. I’m going to try like hell to get him to also read-up on the sleepnet.com site, and possibly some blogs to-boot. Just to get an idea of what to expect.
Well, that’s all for now. It was great talking to you the other night and I just want to tell you *again* how proud I am of you for quitting smoking after 50+ years. How long has it been now? Like 3 months? Absolutely FABU, dudette’!
Loads of love;
Pinski xoxoxo
Sunday, April 20, 2008
Dear Mom: (The Intro)
Hey, Mom;
Remember that sleep-study I had a couple of years ago that said I still had "moderate sleep apnea" --- even after that (UPPP) surgery I had back in 94 (where they took out my tonsils, soft pallet and uvula) ? Well, I went to my ear-nose-and throat specialist recently and he told me that it looked like my apnea had returned (that is, if it indeed ever left:-), and since I never did anything more after that, I really should see someone who specializes in sleeping disorders.
So, it was off to "Dr K" at UCSF, who checked me out, stuck a scope down my nose (good times!) and told me that even though I have a deviated septum, I also have a very narrow airway in which to breathe. He then referred me to yet ANOTHER oral surgeon....someone who does surgeries that are more extensive. I'm thinking to myself: "Ummm, this can't be good".
He explained that in the more severe cases of sleep apnea, there's a surgical procedure called "maxillomandibular advancement" (a.k.a. MMA)" and I might very well be a candidate for it. Then, he explained exactly what that was. Literally, *moving* my jaw? Holy Crap!!
I immediately went home to "Google" this afformentioned procedure, and started reading blogs. The first one I read was "Rogers MMA Sleep Apnea Surgery at Stanford" blog. He's my age, great writer, and a helluva nice guy. Very detail-oriented too. I knew after reading all of his blog, how "heavy-duty" MMA surgery really is, but even after all he'd been through, he had no regrets about having the surgery done. I e-mailed him and his reply was really encouraging. He also told me about the sleepnet.com forum site where peeps such as myself discuss (in great detail!:-) everything one could imagine discussing, around MMA and more!
Fast-forward to a couple of weeks later: I went to the appointment with the other oral surgeon, "Dr C" at UCSF, who took X-Rays, lots of front and side-profile pictures, and made molds of my teeth. Since UCSF is a teaching school, they all have to collectively decide what their plan of action will be. This took another month (yawn!) to finally find out what they wanted to do.
As I suspected, it was recommended I have MMA surgery. I was given a release form for jaw reconstruction surgery and all that. In asking a few questions, I discovered that although this doctor had done "3 or 4 hundred" jaw surgeries, they had actually only done about 10 MMA ops. B-z-z-z-z-T!! Not *nearly* enough experience for my comfort level thankyouverymuch.
So, I remembered how highly Roger spoke of his surgeon, "Dr. P" (who is a pioneer in MMA surgeries), so I went home, and called up Dr P's office to make an appointment. Turns out, he's not in my insurance network, but I didn't care because I decided I needed the best.
It took several weeks before I could get in to see him. Since the sleep study I had brought with me was a little over 2 years old, he ordered another one for me that night. He also took x-rays and a lot of front and profile of pictures.
That night I went to the sleep study in Menlo Park (just north of Palo Alto). They are never that much fun, and I'm surprised I got such a good nights sleep with 436 wires and sensors (okay, I'm exaggerating a bit) hooked up to me from head to toe.
The next week I was back at Dr P's office. Turns out, in the last 2 years, my RDI (Respiratory Disturbance Index) rose from 19.6 to 24.5, and my oxygen saturation had gone from bad to worse. Then, (this sounds *so* hard to believe, that now I'm not sure if I heard him correctly, but) I *think* he said each of the 24.5 episodes (when I'm not breathing) lasted an average of 49 seconds. If that is true, I'm not breathing for about 1/3 of the time I am sleeping.
Holy Crap again!! No wonder I'm always tired!! Maybe that's why I get headaches so easily too.
So, he tells me I'm not only in for an Upper and Lower Bi-Max (MMA) surgery, but also a Genioglossus Advancement (GA) as well. The MMA would be done to move the jaw forward, and the GA will help move my big-fat-stupid-tongue forward. It's the primary offender - because it falls back and cuts off my air when I'm sleeping. Also the reason why I haven't been allowed to sleep on my back for several years.
The office staff At Dr P's was really nice. The lady who handles the insurance informed me what to expect regarding matters of my insurance. Turns out my insurance company pays 80% of out-of network stuff, and 100% after I pay the $1,600 max (of the 20% part). Easy enough. Or so I thought!! There's this little thing called "reasonable and customary", which basically means if the doctor charges more than what the insurance deems as "resonable and customary", guess who gets to pay the difference?? Yeppers! That would be yours truly! (moi')
In this case (hold on to your chair) around 20K. ...and that's not including the anesthesiologist (sp) and some other random stuff.
Remember that advice you always gave me? "You'd better shop-around, uh-huh....you'd better shop around". Well, that's what I figured I'd better do.
Long story short (too late!!) : I went to see Dr KL, another highly-recommended doctor (also in Palo Alto) who has a LOT of experience with MMA surgeries. I immediately knew he was the doc for me. Also, he was willing to negotiate his fees down a little bit, but it's still going to be a hefty 5-figure cost. That's okay. This is my health we're talking about and I want the best. I mean, I bought the Kenmore Elite washer/dryer, the temprapedic bed, and the Samsung flat-panel boob-tube, so why not get the best in my health care as well, right?
By the way, would you care to float me a little loan?? ;-)
So, the big day is June 4th. I'm scheduled for the MMA and the GA, and it should take about 5 hours. It'll be done at Stanford and I'll be in the ICU the first night, and in a regular room for 1 or 2 more nights, depending on how I'm feeling.
I should be back to work the following Monday! ONLY KIDDING!!!!! Apparently, it's a long recovery. I'm so glad I have a decent employer! They have no problemo with me taking 6 weeks off, and I'll still collect a full paycheck since I will be on medical leave.
Don't worry about a thing. Even though he's a little freaked out about all of this, I'm sure Paul will step up and be a fantanstic care-giver as usual. I told him he should run-for-the-hills, but I'm sure he's going to be there for whatever I need. He's a great boyf and I am so lucky to have him. HOWEVER, he (jokingly) said I should call *you* to come out and take care of me, while he goes to Los Angeles to see his family for a few weeks. Big chicken!
I've been in touch with a couple of people from the sleepnet.com forum and was even fortunate enough to meet (in person) this super-nice lady who goes by the name "learian". Dr KL also did her MMA surgery, and it turns out we live in the same town!! It's a small world, idn't-it? She offered to meet me for coffee and show me her before and after pix, so we had coffee at Starbucks and she and her S.O. offered-up a lot of really good information to me and Paulie. Actually, I'm hoping my recovery and attitude is half as "model" as hers was/is. I consider her my MMA inspiration! Thanks, "L"!
I'm a little concerned about the pain-management part, though. As you probably recall, I'm allregic to codene so I have to take vicadin instead. ...and lets just say, from previous surgeries (abdominal and my elbow scopings), I like the vicadin a leeeetle too much. That in itself is going to be a challenge because I'd imagine there's going to be a certain amount of pain involved. When I take more vicadin than is prescribed, I tend to get really itchy and kind of queezy, I don't poo for days at a time, and it really messes up my sleep. (i.e. I sleep lightly and wake up even more frequently than I already do) In fact, remember the morning shortly after my UPPP surgery, when I hurled up that banana yogurt? Well, lets just say, it actually *wasn't* the yogurt that made me gak. Nuff said! Paul knows all about this, so he's going to be in charge of the pain management department this time.
BTW, have I ever told you how much I love jicama? Sweet, crunchy, weird jicama! Gawd! Which, brings me to the food part: You remember how I told you about my intolerance to all sorts of foods these days, right? Marinara, citrus, coffee, and (my life-long favorite) fried foods? Well, I read that there's a possibility that MMA surgery can help...sometimes even cure this. I'm not expecting it, because I can't imagine how one has to do with the other, but we'll see. Oh, to be re-united with one of the true loves of my life, onion rings!!
So, in the next several weeks before the surgery, I'm on a mission to eat as much chewy and crunchy food as I can, because after that, it's liquids and puree'd food for a long-*ss time!
I can only imagine how creative I will become. Anybody for a steak-shake? ;-)
I bet your wondering: Why such a long-winded letter, sonny?? Well, it's because I've decided to kill 2 birds with one stone (figuratively, of course) and combine a blog and letters to you.
There are so many great and informative blogs out there, but I decided I'd take a different approach, and write in a style that more reflects my personality. Of course, I'm sure some people will find it unbearable to read, so they can skip it. After all, that's what blogs are all about. I hope by documenting my personal experience that others facing a similar surgery might benefit in one way or another.
....and since you KNOW what a "talker" I am, (and there'll not be much of that for a good bit of time after my surgery) what a better way to "talk about" my MMA experience, eh'?
So, bookmark this page and hopefully I'll update it every week or so with my progress....and if after the surgery, you get a phone call, and the person on the other end says "Ayyye moorrsh mauya owya ooin' shaya?" You'll know it's me!!
Well, enough about me. Hope you and dad are doing well, and I *really* hope it's stopped snowing there by now. You know, you really *should* move to where it's warmer!! ;-)
I'll write more later:
love;
Pinski
P.S. You should see my new office at work! As soon as I get the disco ball put back up, it should feel like home!
Remember that sleep-study I had a couple of years ago that said I still had "moderate sleep apnea" --- even after that (UPPP) surgery I had back in 94 (where they took out my tonsils, soft pallet and uvula) ? Well, I went to my ear-nose-and throat specialist recently and he told me that it looked like my apnea had returned (that is, if it indeed ever left:-), and since I never did anything more after that, I really should see someone who specializes in sleeping disorders.
So, it was off to "Dr K" at UCSF, who checked me out, stuck a scope down my nose (good times!) and told me that even though I have a deviated septum, I also have a very narrow airway in which to breathe. He then referred me to yet ANOTHER oral surgeon....someone who does surgeries that are more extensive. I'm thinking to myself: "Ummm, this can't be good".
He explained that in the more severe cases of sleep apnea, there's a surgical procedure called "maxillomandibular advancement" (a.k.a. MMA)" and I might very well be a candidate for it. Then, he explained exactly what that was. Literally, *moving* my jaw? Holy Crap!!
I immediately went home to "Google" this afformentioned procedure, and started reading blogs. The first one I read was "Rogers MMA Sleep Apnea Surgery at Stanford" blog. He's my age, great writer, and a helluva nice guy. Very detail-oriented too. I knew after reading all of his blog, how "heavy-duty" MMA surgery really is, but even after all he'd been through, he had no regrets about having the surgery done. I e-mailed him and his reply was really encouraging. He also told me about the sleepnet.com forum site where peeps such as myself discuss (in great detail!:-) everything one could imagine discussing, around MMA and more!
Fast-forward to a couple of weeks later: I went to the appointment with the other oral surgeon, "Dr C" at UCSF, who took X-Rays, lots of front and side-profile pictures, and made molds of my teeth. Since UCSF is a teaching school, they all have to collectively decide what their plan of action will be. This took another month (yawn!) to finally find out what they wanted to do.
As I suspected, it was recommended I have MMA surgery. I was given a release form for jaw reconstruction surgery and all that. In asking a few questions, I discovered that although this doctor had done "3 or 4 hundred" jaw surgeries, they had actually only done about 10 MMA ops. B-z-z-z-z-T!! Not *nearly* enough experience for my comfort level thankyouverymuch.
So, I remembered how highly Roger spoke of his surgeon, "Dr. P" (who is a pioneer in MMA surgeries), so I went home, and called up Dr P's office to make an appointment. Turns out, he's not in my insurance network, but I didn't care because I decided I needed the best.
It took several weeks before I could get in to see him. Since the sleep study I had brought with me was a little over 2 years old, he ordered another one for me that night. He also took x-rays and a lot of front and profile of pictures.
That night I went to the sleep study in Menlo Park (just north of Palo Alto). They are never that much fun, and I'm surprised I got such a good nights sleep with 436 wires and sensors (okay, I'm exaggerating a bit) hooked up to me from head to toe.
The next week I was back at Dr P's office. Turns out, in the last 2 years, my RDI (Respiratory Disturbance Index) rose from 19.6 to 24.5, and my oxygen saturation had gone from bad to worse. Then, (this sounds *so* hard to believe, that now I'm not sure if I heard him correctly, but) I *think* he said each of the 24.5 episodes (when I'm not breathing) lasted an average of 49 seconds. If that is true, I'm not breathing for about 1/3 of the time I am sleeping.
Holy Crap again!! No wonder I'm always tired!! Maybe that's why I get headaches so easily too.
So, he tells me I'm not only in for an Upper and Lower Bi-Max (MMA) surgery, but also a Genioglossus Advancement (GA) as well. The MMA would be done to move the jaw forward, and the GA will help move my big-fat-stupid-tongue forward. It's the primary offender - because it falls back and cuts off my air when I'm sleeping. Also the reason why I haven't been allowed to sleep on my back for several years.
The office staff At Dr P's was really nice. The lady who handles the insurance informed me what to expect regarding matters of my insurance. Turns out my insurance company pays 80% of out-of network stuff, and 100% after I pay the $1,600 max (of the 20% part). Easy enough. Or so I thought!! There's this little thing called "reasonable and customary", which basically means if the doctor charges more than what the insurance deems as "resonable and customary", guess who gets to pay the difference?? Yeppers! That would be yours truly! (moi')
In this case (hold on to your chair) around 20K. ...and that's not including the anesthesiologist (sp) and some other random stuff.
Remember that advice you always gave me? "You'd better shop-around, uh-huh....you'd better shop around". Well, that's what I figured I'd better do.
Long story short (too late!!) : I went to see Dr KL, another highly-recommended doctor (also in Palo Alto) who has a LOT of experience with MMA surgeries. I immediately knew he was the doc for me. Also, he was willing to negotiate his fees down a little bit, but it's still going to be a hefty 5-figure cost. That's okay. This is my health we're talking about and I want the best. I mean, I bought the Kenmore Elite washer/dryer, the temprapedic bed, and the Samsung flat-panel boob-tube, so why not get the best in my health care as well, right?
By the way, would you care to float me a little loan?? ;-)
So, the big day is June 4th. I'm scheduled for the MMA and the GA, and it should take about 5 hours. It'll be done at Stanford and I'll be in the ICU the first night, and in a regular room for 1 or 2 more nights, depending on how I'm feeling.
I should be back to work the following Monday! ONLY KIDDING!!!!! Apparently, it's a long recovery. I'm so glad I have a decent employer! They have no problemo with me taking 6 weeks off, and I'll still collect a full paycheck since I will be on medical leave.
Don't worry about a thing. Even though he's a little freaked out about all of this, I'm sure Paul will step up and be a fantanstic care-giver as usual. I told him he should run-for-the-hills, but I'm sure he's going to be there for whatever I need. He's a great boyf and I am so lucky to have him. HOWEVER, he (jokingly) said I should call *you* to come out and take care of me, while he goes to Los Angeles to see his family for a few weeks. Big chicken!
I've been in touch with a couple of people from the sleepnet.com forum and was even fortunate enough to meet (in person) this super-nice lady who goes by the name "learian". Dr KL also did her MMA surgery, and it turns out we live in the same town!! It's a small world, idn't-it? She offered to meet me for coffee and show me her before and after pix, so we had coffee at Starbucks and she and her S.O. offered-up a lot of really good information to me and Paulie. Actually, I'm hoping my recovery and attitude is half as "model" as hers was/is. I consider her my MMA inspiration! Thanks, "L"!
I'm a little concerned about the pain-management part, though. As you probably recall, I'm allregic to codene so I have to take vicadin instead. ...and lets just say, from previous surgeries (abdominal and my elbow scopings), I like the vicadin a leeeetle too much. That in itself is going to be a challenge because I'd imagine there's going to be a certain amount of pain involved. When I take more vicadin than is prescribed, I tend to get really itchy and kind of queezy, I don't poo for days at a time, and it really messes up my sleep. (i.e. I sleep lightly and wake up even more frequently than I already do) In fact, remember the morning shortly after my UPPP surgery, when I hurled up that banana yogurt? Well, lets just say, it actually *wasn't* the yogurt that made me gak. Nuff said! Paul knows all about this, so he's going to be in charge of the pain management department this time.
BTW, have I ever told you how much I love jicama? Sweet, crunchy, weird jicama! Gawd! Which, brings me to the food part: You remember how I told you about my intolerance to all sorts of foods these days, right? Marinara, citrus, coffee, and (my life-long favorite) fried foods? Well, I read that there's a possibility that MMA surgery can help...sometimes even cure this. I'm not expecting it, because I can't imagine how one has to do with the other, but we'll see. Oh, to be re-united with one of the true loves of my life, onion rings!!
So, in the next several weeks before the surgery, I'm on a mission to eat as much chewy and crunchy food as I can, because after that, it's liquids and puree'd food for a long-*ss time!
I can only imagine how creative I will become. Anybody for a steak-shake? ;-)
I bet your wondering: Why such a long-winded letter, sonny?? Well, it's because I've decided to kill 2 birds with one stone (figuratively, of course) and combine a blog and letters to you.
There are so many great and informative blogs out there, but I decided I'd take a different approach, and write in a style that more reflects my personality. Of course, I'm sure some people will find it unbearable to read, so they can skip it. After all, that's what blogs are all about. I hope by documenting my personal experience that others facing a similar surgery might benefit in one way or another.
....and since you KNOW what a "talker" I am, (and there'll not be much of that for a good bit of time after my surgery) what a better way to "talk about" my MMA experience, eh'?
So, bookmark this page and hopefully I'll update it every week or so with my progress....and if after the surgery, you get a phone call, and the person on the other end says "Ayyye moorrsh mauya owya ooin' shaya?" You'll know it's me!!
Well, enough about me. Hope you and dad are doing well, and I *really* hope it's stopped snowing there by now. You know, you really *should* move to where it's warmer!! ;-)
I'll write more later:
love;
Pinski
P.S. You should see my new office at work! As soon as I get the disco ball put back up, it should feel like home!
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