It takes a village!

Yo, Mama!

Hope this message reaches you in good spirits. Did you and dad have a decent Memorial Day Weekend? We did too although we didn't do a whole helluva lot. However, we *did* manage to squeeze in a very nice lunch with some MMA "alumni".

Before I tell you about that, I must say that sometimes it indeed *does* take a village.

You may ask: What do you mean by *that*, sonny?? Okay, I'll tell ya! When I got home from that first doctors appointment, and he had explained that I might need MMA surgery, I really didn't know a thing about it. Luckily, between Google and the internet, I was able to learn more than I could ever hope to know, all from my computer. Ain't technology great? As I mentioned, it first started with Rogers MMA blog, and then that led me to the sleepnet.com discussion forums. From there, there are also links to several different blogs (which I am proudly one of now) of other individuals and their personal MMA experiences.

....and I must say. You couldn't ask for a nicer and more helpful bunch of peeps. You have a question, and it gets answered.

Anyway, in reading the sleepnet site and blogs, I realized that there are quite a few "Bay Area" people amongst them, so I wrote to a couple of peeps individually, asking their advice and to ask if they would be willing to meet me for coffee (or lunch) to chat about MMA stuff in person.

The first person I contacted was "Learian", since it appeared she had such a "model" recovery.

Paul and I met she and her husband at Starbucks around the corner and had a really nice time. We both had a lot of questions (I as a patient, and Paul as a potential caregiver) and they were hella-helpful in answering our barrage of questions. We had such a nice time, that we met again for more coffee (Learian LOVES her cafe' mochas!) in Noe Valley a couple of weeks later.

There are a lot of great MMA blogs out there and a few of them are from the "Bay Area". One blogger ("Dreamette"..a.k.a Shelby) who is a clever and very funny writer, happens to live very close to The Emerald City (where I work), so I e-mailed her and invited her to lunch. Cool Chick!! We are also both big Morrissey (who by the way is a singer and lyracist) fans, and both of our boyfriends ARE NOT! Sheeesh!! I guess Morrissey is kind of like cilantro. You either REALLY like him a lot, or you REALLY don't like him at all!! To paraphrase:
Paul said : "Eh, I know him, and he cannot sing"
I said: "That's nothing - you should hear him play piano" ;-)
(Don't worry mama! I don't expect you to "get" that reference!)
Anywoo, she re-capped parts of her MMA journey and gave me some good advice about several post-op issues including pain management and great food possibilities....like warm cake!

Anyway, sorry to get sidetracked. So, it turns out Dreamette and Learian had always wanted to meet, but hadn't. Well, for as lovely and helpful as they both have been, I suggested the 3 of us (and our S.O's) all get together for lunch....so that's what we did last Sunday.

Learian's husband had a previous engagement, so she swung by our house "solo" and picked me and Paul up for the 20 minute trip, south to San Mateo. We met Shelby and Courtland at a nice restaurant and had a whale of a good time. I won't bore you with all the details (although it was anything BUT boring!), but we chatted for quite awhile, had a nice brunch, chatted some more, and then it was time for the photo-ops:


From Left to Right: Dreamette (a.k.a. Shelby), moi', and the lovely Learian!

Learian and Moi'...............................................................Shelby and Moi'


We're all pointing to where our little incisions are (or in my case "will be").

All in all, a fine time was had by all, and I sure hope it's not the last time we get together. I'm pretty sure it won't be, though!

It sure is nice to know that there are great people like that out there. Not just in the Bay Area but like I said: almost anyone you ask who's had MMA surgery.
I just hope that after I'm on "the other side" of my MMA surgery, that I can be as helpful to someone else as all of these folks have been to me.

The rest of the weekend was pretty non-eventful. Paul rented a movie that creeped me out, so I stopped watching it (I don't like seeing people getting tortured, but he just LOVES Diane Lane, so he opted to watch the rest of it [Untraceable] later).


Lastly, I stopped at Walgreens to get a small Dry-Erase board. I figured it'll probably come in pretty handy for the times when I have something to say, but still can't be understood.

"an euuu et nee a glsss um wada?", :-)

Poor Paulie! I'm sure he'll be okay! He just worries a lot! "no eely. m-mm fne!"

I also have some "before" pics, but they look more like mug shots, so I will refrain from posting them until after my surgery when there's some "after" mug-shots to go with em'!

xoxox:
Pinski

Pre-op Appointment with my awesome surgeon

Dear Mom;

Sorry I haven't written lately. Things have been going really well. I’m trying start tying up all my loose-ends at work in preparation for the 6 ½ weeks off I’ll be taking…….IN LESS THAN 2 WEEKS!!!!

I was shocked to hear about the tornado yous guys had, and was relieved to hear that nobody was seriously injured. I bet it especially scared the be-jeebas out of Jane, since it hit so close to her house.

There really wasn’t that much to report up until recently, but yesterday was doublely-wubbuly eventful, what with my pre-op appointment with Dr KL and my teeth cleaning at Dr N’s! …and since you’re my mom, I knew you'd want to know all the gorey details, so all I gotta say is “watch what you wish for”!

So, I got up early yesterday (Thursday), shaved off my moustache and beard, (which sort-of disguises my "chin deficit".....awwww...) and left at 7, in order to make my 8 a.m. pre-op appointment with Dr KL. in Palo Alto. The whole experience at Dr KL's office is fantastic. The office is a beautiful facility, and the staff (Linda the receptionist, Juanita, the lady who handles all the insurance stuff, and Daisy the technician) are just the best. You would love them. They are all as nice as can be and very well-organized….but first things first:
After signing a couple of consent forms and giving Linda the biggest check I’ve ever written (gulk!), Daisy led me in to the room where I got a panoramic x-ray and some other type of x-ray, using a different machine. Then she took molds of my teeth. First the lower and then the upper. After all that stuff was done, Dr KL came in looking chipper and ready to explain everything, and answer my barrage of questions.
For starters, he brought in his "display skull" to show me exactly what he will be doing with my upper jaw, and lower jaw. Wow! The reality of it all is finally starting to set in.
He started by telling me that the anesthesiologist will be calling me the night before the surgery (not sure why, but great!). Since my surgery is at 7:30 in the morning, I have to get there at 5:30, which means Paulie and I will have to leave SF by 4:30 and get up at 3:45. (Yawn!)
As usual, no food before midnight. Got that.
The first thing he’ll do in the 5+ hour surgery is attach the arch bars, (but I think they are positioned higher than these on the link) and he explained how they will be attached to my teeth with wire by weaving the wire through my teeth, as opposed to using screws in my jaw to secure them)
After the arch bars are in place, and my teeth are tightly clamped together, he will “liberate (i.e. break-out the “buzz-saw” and “go-to-town” on) my upper and lower jaw, together from where they are. The upper jaw will be cut free first (sorry no video…I asked!) and then the lower jaw will be cut (i.e. “sliced” at an angle, in order for the bone to be able to fuse together). There will be a small incision on the (outside) lower part of either cheek in order for the good doc to sink a couple of screws in my lower jaw at just the right angle. Those will be the only external incisions, and the scars will end up being virtually unnoticable. Cool beans!
He will be doing what is technically called a “counter-clockwise rotation” moving my upper jaw forward 8-9 millimeters and the lower jaw about 12, meaning he’ll drop the back down just a little bit, to enable the lower teeth to move forward a few millimeters farther than the upper.
Then comes the genioglossus. I asked him why he usually chooses the genioglossus over the genioplasty and he said there are different reasons for doing each. He said he would determine which of the 2 procedures is best for me when he is in there, getting a better look. I trust he will do the right thing!

I mentioned to him that first and foremost, I want to be able to breathe better when I sleep, but I hope that asthetically, I will end up with a nice strong chin. He assured me I will be pleased with the outcome.
I also asked him about a possible chin implant, but he said that won’t be necessary and not a very good idea at that. Why? He showed me an x-ray of a patient with one who experienced “bone resorption”. Meaning, the patient had an implant that (over time) actually ate away at the chin bone….(euuuuu!)…so he removed it and did a genioplasty on the patient. Okay, okay! No chin implant already……;-)
So, since he will be moving my upper and lower jaws in unicin, my bite should remain relatively the same, meaning no braces for a third time. There will be numbness at first, but over several months, most of the feeling in my chin, pallet and teeth should (knock on wood) return.

Next, came the battery of questions from me:

Q1: What is the plan for pain management?
A. After a short discussion about my allergy to codine and the fact that vicadin sometimes doesn’t work well, he prescribed something else he thinks will work. He also gave me a keflex prescription to thwart away any infections - which he said was highly unlikely.

Q2: Does my bloodwork and EKG look okay, and will I have to bank my blood?
A: Yes to the bloodwork and EKG, and no to the banking blood.

Q3: Will he be addressing my deviated septum?
A: Possibly, depending on how high up in my nose it is. If it is low enough, yes. If not, no.

Q4: Will you take out my adnoids? (which by the way, I was shocked to hear they were still there because I was under the impression they were removed back when I had my UPPP surgery. ...but I hear they sometimes grow back, so I can't be sure what really happened)
A: No. Not at this time. He doesn’t want to complicate things and do too much.

Q5: What about that stupid stone in my salivary gland (that showed up in my x-ray)?
A: Nope. He said it might be a good idea to have the salivary gland and stone removed along with the adnoids… later.

I wish I would have asked him that if I promised to pee right before they put me under, could I skip the catheter….but I figured I already knew the answer to *that*.

Finally, he took a couple of pics of my teeth and smile, the appointment came to a finish, and on my way out, who do you think I saw? My buddy Learian!!! It's a small world, ain't it? As always, it was awesome seeing she and her hubbsband.
I had Daisy take a pic of me and the good doc, but my stupid camera always zaps the last pic when you take the SD card out of the camera ,(which happened to be the one with Dr.KL.. ANNOYING!) so I guess I’ll have to wait for the next photo-op.Which reminds me: I took some pics myself for you to check out, because in 2 weeks, your kid ain't gonna look quite the same any more. (awwww) I'll post those in a little while.

After that, it was back in the trusty Scion (I love that car!) and back up to The City to see my awesome dentist of 15+ years, Dr N. (I love ha!) to get my teeth cleaned...although she didn't actually have the honors..it was the new dental hygenist Zora. I wanted to get my "pearly off-whites" as clean as possible now, since they will probably be very grungy for awhile after the MMA and GA. Lovely! Looking forward to THAT! ;-) My 6 month cleaning was supposed to be in September, but I figured that I probably won't be able to open my mouth far enough to have it done then. Not a big fan of the teeth cleaning experience in general, though. That's because of the receding gums I was gifted with after my last round (as you recall, there have been two) of braces. Apparently my teeth moved too quickly and it caused my gums to recede. However, I managed to make it through all the scraping and polishing, so that was one more thing to strike off my "to-do" list.

Oh! And I also called Comcast to dump Showtime (now that Weeds is done) and signed up for Logo, so we can get the TV new series "Sordid Lives", which is based on my favorite movie of all time! It should be a hoot!!

So, there you have it. A day in the life of one of Americas Next MMA patients.

who loves ya, mama?!?
xoxo: Pinsk

The dreaded pre-op visit with my GP.

Yo Mom!

This just in:

PRIMARY CARE PHYSICIAN ANNOYS PINSKI, BUT PINSKI (eventually) "RISES ABOVE".

Details at 11! ....or now!!

Okay, for starters let me say that for the most part, I really like my primary care physician, Dr. S. Well spoken, nice guy, very well educated, never tough to get an appointment, etc.....but when it comes to issues of sleep apnea, I'm not so sure.
As I mentioned before, I had to go to him to get orders for the EKG and bloodwork that I need for my MMA surgery (coming up in a little less than 4 weeks). The appointment was yesterday and I promised my friend Toni that I wouldn't "engage" with him when he started giving his professional opinion about sleep apnea (again). Lets just say, our opinions differ. You see, when he previously saw my sleep study from 05', and it said "moderate sleep apnea", he commented that my oxygen saturation "wasn't *that* bad" and not to worry about it. Okay, fine. Whatever.
So, this time he comes in, was very professional, asks me when I'm having surgery, and who the doctor is (not even asking what I was having done) Then he takes my blood pressure, listens to my heart and lungs, and illudes to asking what kind of surgeon Dr. KL is and where it's being done. I tell him Dr. KL is an oral-maxilfacial surgeon in Palo Alto and the surgery is going to be at Stanford. He says okay, and asks me if Dr. KL was going to do the Pre-op "write up" himself , explaining that there has to be a formal write-up to let the hospital and anesthesiologist know you are in good enough shape to have the surgery.
I tell him that the only thing that might be questionable is actually the whole reason *why* I'm having the surgery, my sleep apnea, and that I'm having a Maxillomandibular Advancement and a Genioglossus Advancement B-z-z-z-T! Shouldn't have even gone there, but really: How can you pass up a chance to say Genioglossus Advancement??
Without much expression except for a slight rise in his eyebrow, he looks at my sleep study and says (and I am para-phrasing) "Dr's are making too big of a deal out of sleep apnea."
I tell him "It says my sleep apnea is 'moderately severe' now, so that can't be good for my heart, long-term, right? Also, I wake myself up gasping, my partner worries I'm not going to start breathing again and die some day and I haven't been allowed to sleep on my back for the past 6 years because of all the snoring and gasping I do"
Then he says "It's not so much about your heart...what we should *really* worry about is if the oxygen saturation too low it can cause brain damage, but with your levels, it's still not that bad". Uh, WHAT???
I mention to him about my 25 RDI, and how I stop breathing for as long as 49 seconds some time and he tells me that he's a diver and he can hold his breath for over 3 minutes, "so if you're in good cardio shape, 49 seconds isn't that much".....and adds that If my RDI was in the 60's, he'd be a lot more worried. Hello??? So would I, but still.....
...and *then* he says "..but I guess you're having this done for 'the other reasons' (i.e. the noise, and trying to make my partner more 'at ease')". WTF??? So, I guess I need to have 60 episodes an hour and oxygen saturation levels low enough to cause BRAIN DAMAGE before gets onboard? Sorry Dr. S. The apnea train is a-leavin' without you!! Toot-toot!

At first, I started second-guessing myself, but soon realized that between my initial gut feeling about my apnea being a real problem and confirmation from *4* oral maxilfacial surgeons who specialize in sleep disorders, I just clammed up after that (a little late, but still not bad) "rose above", and let him say what he was going to say. He wished me good luck (which seemed patronizing, but I don't know...I guess it could have been genuine) and then got out of there.
I stopped at the desk to pay my deductable and he tells me "Come back either before the surgery or after you've healed so we can discuss your bloodwork". After I've healed??
I'm thinkin' "Okay, then I'll see you next year"
WhatEVERRRR Missy!!

So, even after all that, I'm still confident I'm doing the right thing.

Then, it was downhill from there. The EKG was a breeze, and getting my blood taken was easy, and Dr. KL will have the results FAXed to him early next week, in plenty of time for my 6/22 pre-op appt. with him.

Oh! and I'm making progress on the "list-front".
Paul suggested I centralize all my surgery-related stuff, so we bought a nice, sparkley (...okay what do you expect?) folder at Walgreens and it's got everything in it now: The lists. The disability paperwork, receipts, my sleep study. A pretty good idea, P.Smitty!

BTW, thanks for the pics of the new and improved window that got installed in your office.
It looks great, and now you won't have to get up on your tip-toes to see what the (crappy) weather is like outside!

On Saturday, Paul and I are flying to "L.A. - L.A. - L.A." to spend Mothers Day with Rose Marie and the crew. I hear it's going to be a full house, so it should be fun. Probably the last time I'll be going there for a few months. I think I'll bring shorts to wear so I can get some sun on my pale hairy legs and everyone can make fun of them! Oh boy!

much love;
Pinski xoxox