I'm miserable

I know its common to feel depressed when you've gone through a major illness but I was not prepared for this. I'm a mess. I'm beyond miserable. I have absolutely nothing I'm happy about right now. I'm done. Its been 2 weeks and 2 days since my surgery and I feel like I'm at day 1. I'm just as swollen and in pain as I was on day 3, getting out of the hospital. I originally thought and planned to be back at work by now. That day has come and gone and not happened. I had planned to be driving myself by now. Nope. Still can barely walk a straight line. I am so dizzy that just re-positioning in bed makes the room spin. Its not the pain meds either. My doc kept saying that because of the pain meds once I'm off them I'll stop being dizzy but I know that's not the case. I've been on pain meds a lot in the past years of many surgeries and injuries and I know how my body is with them. Its not the meds. Its my head. I'm miserable. I don't know how many times a day I say those two words but it sums up my life right now. I hate this. Every other blogger out there who's blogged their way through this surgery has been in a much better place than I am right now at 2 weeks. They've said they didn't regret the surgery, they've said their swelling was practically gone. Not me. I'm miserable. Eating just a cup of mashed potatoes makes me even more swollen so the next day I have to revert to only liquids. I'm sick of Slimfast and Boost shakes. I'm sick of the taste of blood in my mouth. I want cheese fries dammit! I haven't lost a single pound in over a week either. Of course my body is the exception. I knew it would be. I went into this surgery thinking the one positive thing would be the weight loss of "30-40 pounds". But of course I only lose weight when I'm pregnant so I knew that wouldn't be the case with me. Once I started eating more than 400 calories a day I started either gaining or maintaining. Don't get me wrong, I am thrilled I lost 16 pounds that first week, but that was only while I was literally starving myself and shitting out the very little amount I had in me. I barely get 1000 calories -half of what I use to get in a day - and I still gain. Ridiculous! I'm bored to death. I have zero ability to do anything around the house and this place is a freaking hell hole. The dishes haven't been done in weeks, there's clothes everywhere and dirty diapers all over the place. C is ornery every day because he's done everything for weeks but I can't do anything to help. Every time I start to do something my nose bleeds. I can't stand up very long as I get too dizzy. There are flies everywhere. It's disgusting. We have fly-strips hanging from the ceiling in 3 of the 5 rooms upstairs that are full of dead flies but yet there's still tons more. I know its because of the dishes and trash but I can't do anything about it. Living in this makes me sicker and more depressed. I'm snapping at everyone while at the same time trying to be a buffer between C and the kids because he's so short with them. I understand why he's angry, but it doesn't help or make things any easier. On top of all this I'm dealing with my company short term disability people who have still not approved my LOA pay. Its only 60% and will barely make a dent in the bills but its better than nothing. Today was payday as well. It was my paycheck with only 2 days of work and one week of time off pay with the remaining week unpaid. Half a paycheck does not pay the bills. I'm looking at my bill spreadsheet and wondering to myself what can be late and what really has to be paid with the small amount I have. Then I realize we also need food, the boys need haircuts and this half a paycheck somehow has to last us an entire month. I have to admit I have thought about ending it all. Not today but early on in the shitty hell ride. Today I just cry. I'm done. I'm pissed off and sad. I hate everything and I just want my house cleaned, my face to not be swollen, to be able to chew without pain, my bills to be paid, food in the fridge and money in the bank. Right now I'm home alone with just K. Thankfully he's an independent 6 year old that watches tv upstairs by himself and gets himself otter pops and drinks while I sit in my room and cry. How horrible a mother am I right now? My mom has little C thank goodness and C won't be home for 2 more hours. I have a nail appointment tonight which I really shouldn't go to since I don't have the money but I really need to get out of the house and get some mani-therapy. Shit, I'll just charge it. I know that makes me a shitty human being, wife and mother but screw it. I'm done.

No more pill crushing

Today I made progress. I passed a milestone. No More Pill Crushing! I swallowed my first pill all by myself today.  It was difficult and I almost gagged myself but I did it. This is going to make things so much easier. I just have to shove the pill through the tiny opening in my teeth and push it back to my throat with my tongue and then sip my drink as fast as I can but I did it!! Taking my normal daily pills has just become easier! Yippee! Now I can go back to taking them all as usual. I was only taking the 'absolutely necessary to live' ones because they were so nasty to crush and then put in a syringe full of flavoring and squirt in my mouth. Much better. Awww. Its the small things that I've missed. <3

11 days post-op

I can't believe it's already been 11 days since my surgery. I am really beginning to regret my decision to blog about this because I've been so miserable that I didn't want to come on here and say all of it. All the other blogs I read about this were so upbeat and positive that it makes me feel like either I'm a huge wimp or a big whiner. Either way, I'm obviously really slacking...
Today I woke up with some feeling in the crevices of my lips. Weird, I know... but that's all I can feel still. My tongue is completely back but everything else from my big huge Jay Leno chin to my big bulbous nose and cheeks up to my eyes is still numb. There's little bits of tingles all over nowadays here and there but for the most part I still have very little feeling. Good and bad really. Good because I know if I could feel it it'd be even more painful but bad because... well... every other reason! Its annoying first and foremost, it's impossible to eat or drink with no feeling in your mouth, lips and palette as well. Also which I'm finding a lot lately because I am getting little tingles more and more is the itchiness... OMG I itch and nothing it there! Its horrible. Nothing can solve that itch! My stitches inside my mouth have been coming out over the last couple of days so I've noticed I must be healing ok in there. I still have one big huge sore right in front of mouth on the top inner lip that is the most painful. It looks to either be an open wound from the arch bars or the surgery itself... I don't know... but it's not pretty or nice. Because of that wound my top lip remains the most puffy and swollen and my mouth remains in an always semi open position which brings forth lots and lots of drool. It's really sexy! I'll be texting on my phone or on my laptop and I'll notice a string of constant slobber down over my chest onto my phone/keyboard. Uhg.
I've been doing better pain-wise lately. I'm still on all my pain drugs and when it gets close to taking them I can definitely feel it but if I stay on top of them I'm at about a pain level of a 4 or 5. When the pain is bad now days it only gets to about a 7. Because I've been feeling better I made my first non doctor related adventure out of the house. I had my sister come over and get me to bring me over to our parents' house to go over some stuff for the anniversary party we're throwing them. I took a shower for the first time this morning all by myself standing up (wahoo!) in preparation. It was exhausting and I was sure this would have to be a short trip. Thankfully it was. I stayed about an hour and a half and then came home. I had mashed potatoes and beef broth on top to water them down with some apple juice that I was pretty impressed made mostly to my tummy and very little on my lips and chin. I did do a lot of talking while there and so when I got home I took some liquid pain meds and went to lay down. Upon waking I not at all shocked by how swollen I was. I knew it'd be a lot but I needed to do it. I am now paying for that little adventure by not being able to open my mouth and my lips and chin are so swollen I couldn't even shove a baby spoon in between with mashed potatoes for dinner. So sad. I guess tomorrow I'll have to go back to my Boost and Slimfast shakes and see if I can manage the swelling better with ice and no talking. It should be better because I'll be home alone most of the day.
Originally I had only planned to take 2 weeks off of work. That's what I had begged Dr S to put on my FMLA papers and what I had turned into HR before leaving. Everyone at work laughed at me and my boss even said he already marked me out for the month. "Oh no" I said... "I'm gonna be fine!". Um, yea. I take that back. Thankfully after getting out the ICU I knew that already was not going happen so I texted my boss a picture of my Rocky Balboa warface and said..."Just kidding...there's no way I'll be back in 2 weeks". He again just laughed at me and said ok. I called HR last week (or actually my mom did while I sat by anxiously wanting to cut in with a paper and pen writing down what to say) to let them know it's going to be 4 weeks instead. Dr S's office faxed over the paperwork to make the change and this week I just need to get things straightened out with the short term disability people at Hartford to get the 2 weeks paid for by them at the 60% rate. Lovely... even more less pay... right before Christmas, Anniversaries and Birthday end of the year crap! Oh well... nothing I can do about it. Here's my latest swollen face photo from a couple days ago... it also shows how the bruising is coming along on my neck/chin:

Can't live without. Your 'Buy before you Go' Shopping list!

So I thought I'd do a quick post of things I can't live without. I really needed this info and having to comb through a million people's different blogs and read each one searching for this info was a pain in the butt so hopefully me laying it all out there will help.

1. Blender... this should be obvious. Other people have been saying an inversion blender too but I know I won't need it so I haven't gotten one.
2. Water pick... I've not quite mastered this thing yet and it tends to get a little too much pressure at times but a good water pick will save your sanity when you really just want to brush your teeth!
3. Peroxyl mouthwash. This is from my own personal medicine cabinet but I'm glad I already knew about it. Its a special mouthwash that use to only be an Rx but is now sold OTC. Its for mouth sores and other gum infections. My dentist told me about this a few years ago when I was getting horrible canker sores and it worked wonders. Let me just say.. I'm so glad I knew about this. It's been wonderful. They had something similar that is an Rx in the hospital when I was there but they didn't send me home with any or an Rx for it so this works just as good and tastes much better. I really like the fizz the hydrogen peroxide does in my mouth and gets rid of almost all the yuckiness from wounds and blood and drinking through a straw. You can buy at a pharmacy like Walgreens or online. We couldn't find it a Walmart or Target. Here's a link to the stuff in case you're confused: http://www.drugstore.com/search/search_results.asp?srchtree=1&Ntt=Colgate+Peroxyl&N=4294839095&Ntk=All
4. Mouth Sponge Lollipops... Uh, yea I don't know what they're technically called but they had them in the hospital and I loved them. they squeeze in between your ity bitty opening and are able to sponge off a lot of the gunk. I use it with the mouthwash above. I had to send the husband out to find them. He said he had a hard time finding them and that he ended up getting them from a medical supply company so maybe order online before hand. He could only find 7 so I'm going to try that as well now. Here's a link to some on Amazon. I won't need 250 though so I'll find a smaller qty. http://www.amazon.com/Toothette-Individual-Oral-Swab-Box/dp/B0007VBDAI/ref=pd_sim_hpc_5
5. Bendy straws... again, obvious. The straight ones will work but its just easier if they bend. :)
6. Ice and large gallon size Ziploc... for the swelling
7. Aquafor.  I was using an Rx of Bacitracin on my lips right after surgery for a week until I saw Dr S but he informed me that's why they weren't healing right and I had continual scabs. He told me to get some Aquafor and keep it slathered on my swollen lips and nose. It's been heavenly. I sent my mom to the store for some and this is what she brought me back. It's huge... but I have a feeling I'll use it up pretty fast.

8. Humidifier. I guess you'll only need this if you had a turbine and septoplasty done as well which I did but it's been a must. When in the hospital they kept me connected to a high pressure humidifier along with the oxygen to help so my nose wouldn't become overly dry because of all the blood and gunk in there. I have to say that I think keeping up on that helped my nose clear out really fast. It only took a little over a week for my nose to be clear and pass most of the huge chunks.

9. Q tips and hydrogen peroxide or saline solution... Again for the nose. In the hospital the nurse had me use q tips and saline solution to clear out the boogers and blood so I could breath better. At home I don't have saline solution so I've been using hydrogen peroxide. Just dab a q tip in it and a quick clear and you're good to go.

10. Liquid high protein meals- Boost, Ensure, Slimfast or Carnation Instant Breakfast. I have a variety of all of them and I'm glad I do. They're easy and do pretty good at filling you up. You'll need the calories so you keep up your energy. I'm having a hard time getting more than 800 calories in a day but that's ok for me as I need to lose a lot of weight anyway. (down 15lbs so far). These are great when really cold and you can either use a straw or the syringe if you're not at 'level-straw' yet. lol

11. Water. Or better yet, Vitamin water or Smart Water. I tried both and didn't like them but that's just me. I don't like any water except Dasani and even then I'd rather have a Pepsi. Anyway-- those have electrolytes and vitamins and stuff so they're better for you when you need all the help nutritionally you can get.

12. The most important- Feeding syringes with tube. -- I can't believe I didn't make this number one!!!! This really is the most important. My nurse in the ICU was the genius who figured out this was the best thing every and every Rn after her said her praises. Basically it's a large syringe with a feeding tube attached to it. The wonderful nurses sent me home with about 8 of these things in various sizes. You'll need them at first to eat like a baby bird, to take your meds, and they're also good to help squirt water and suck it back up in it when you're home and don't have a handy suction sitting next to your hospital bed. Here's the picture of it in front of my huge medicine bottles. Do whatever you can... beg, borrow, cheat, steal... to get lots of these before you leave the hospital!

13. Plastic baby spoons. This one I found out all on my own. Its a good thing we still have them around because I would've had to send the hubby out to get more if not. Basically those very beginner stage tiny plastic baby spoons is what you're looking for. You can find them in the baby isle. The ones we have are from First Years and called Take and Toss and come in a set of 8 or something for $3.00.  Basically, I can't fit anything else in my mouth. I'm at the mashed potato/soft pureed foods (just like a baby) phase of this and since my mouth is still pretty banded shut its the only way anything it getting in there unless its syringed which I refuse to do with potatoes. The metal spoons also seem to be too rough on my tender swollen lips and palette.

14. Boxes of tissues. I don't normally have tissues around the house but because it was beginning of school time they were on sale and I thought I was going to need to send some to school with K. However, I didn't so we have them. And boy am I glad. I'm pretty sure I'll be going through the entire 3 pack of the largest size of Puffs Plus. Between the drooling, the bleeding, the nose runs, the syringe droplets and your failures of straw drinking you'll be a wet mess. Keep them on hand to wipe up. Since you're doing a lot of wiping you want them nice and soft.

15. Baby wipes.  Kind of along the same lines as the tissues. When you start eating you'll tend to notice you too eat like a small child. Most of what was on your spoon ends up on your lips and chin and only have your family laughs at you will you know because you can't feel a damn thing. Wipe up. Baby wipes are soft on skin and perfect for the job. I also needed them for (clearing throat) eh, bum wiping right after getting out of the hospital. TMI! Lots of people tend to have constipation from the meds and lack of food but I of course am not normal and I was given Ibuprofen which I am not suppose to take after my Nissen for my stomach so I had a horrible case of the shits. My poor little bumhole needed a little TLC so the wipes came in handy. Since you're still very top heavy you don't have a lot of stamina to be bent over taking care of your bum because your swollen and bleeding out of your face. So get in get out, use a wipe. :) 

16. Pepto Bismol. If you read #15 you'll know why. But also I guess its pretty common to have pretty bad reflux after this surgery. Because its a liquid its the best to help out. I even had some reflux problems one day and that's saying a lot since I had the Nissen to fix that years ago.

Well, that's about all I can think of at the moment. Since its after 1am I can't really go upstairs and rummage through my hospital tub full of patient care stuff my hubby keeps with him for my care. If I missed something I'll come back.

Post op, days 1 & 2

Well they say a picture is worth a thousand words. How many for 4 pictures? This progression shot shows just how miserable I am.
The first night I spent in the ICU was hell. Pure hell. I got 2 45 minute stints of sleep total because I wasn't allowed to have my sleeping pills due to my non-breathing and because of the horrible pain in my shoulder and now jaw and nose. The nurse came in every 15 minutes to do different things. I had a catheter in and that was making me very uncomfortable. I was slipping up and down the bed in the crappy ICU beds so I \had moved to the recliner chair in hopes of not  being a little more comfortable in a semi-reclined position. I was attached to an EKG machine the entire time but because of my very large bosoms the leads kept getting lose and would sound the alarm constantly. The IV in my arm would also be alarming every time I would bend my arm due to the placement. I was living breathing 'beep'. C finally came back to the hospital around 9am the next morning. I was hoping he'd come by earlier but I guess getting the kids ready for school and daycare was a lot. He hung out with me while I was poked and prodded in the ICU for hours. I was still not able to drink anything through a straw so I wasn't able to leave the ICU. I also needed to get my respiration to 80's on 20% oxygen. I had moved up a long way from earlier when I was on 100% oxygen but I wasn't going anywhere until I could do better. Thankfully the new day nurse Debaney was a genius. She had rigged the most awesome syringe up for me to be able to get my meds and some liquid down my very swollen palette. I really didn't think about the whole drinking thing when I was preparing for this. I knew I'd have some numbness but didn't realized I wasn't going to be able to sip through even a straw because I couldn't feel a thing. My jaw was banded shut but was able to open enough for a squished straw but because I had a huge swollen tongue and palette I couldn't get anything sucked up. Thankfully I was still getting IV fluids but I wasn't going to get that for long. Pain meds through a syringe are awful. My normal meds through a syringe are even worse though.
I was finally able to meet the requirements of an ICU discharge around 3pm the day after surgery. However the discharge wasn't complete...just to a regular room down the hall. Uhg. I guess my 23 hour stay was going to be a day longer. I was ok with that though because I was in so much pain and my oxygen was still not stable. Once I moved to the regular floor though I lost my awesome nurse that kept me moving forward. I now had pretty much no support. I had 4 different nurses in the first 3 hours of being there and none of them had any idea what to do with me. My surgery wasn't common and nobody knew how to handle me. My 'face-bra' that had pouches for ice kept leaking so I wasn't getting relief from ice and having to rely on pain meds only wasn't doing it for me. C left me again that evening around 4pm after I couldn't stand listening to him snore loudly beside me. I just needed my own sleep. I begged my doc for Ambien for the nights sleep and was getting excited for a shower. I was so glad I was smart enough to pack my pj's even though I hadn't packed anything else. After a quick shower with baby shampoo (that's all they had) and my own clothes, the catheter came out and I was feeling a bit better. If it wasn't for my shoulder I'd be ok. My pain level was still hovering around 8 and 9 but I was doing ok. After my shower around 10pm I got some beef broth delivered to my room for dinner. I hadn't eaten in days so I wasn't about to turn up my huge swollen nose at anything... even if it was beef. I tried spooning it into my swollen lips/mouth very unsuccessfully. Dribbling everywhere, I used my syringe. It worked...and it was good! Holy cow, that makes it official... I was actually starving to death since I was willingly eating beef broth. Not that a few syringefuls of broth made me any less hungry...but it was a start. I also tried some Boost meal replacement and wasn't too bad either. It was this day, after my surgery that I noticed my lips were also completely ripped apart. I knew it was going to happen, I always get lip infections (impetigo) when anything opens around my nose of mouth and this was major. I was so bursting with swollen lips and mouth that this was inevitable. However due to some hospital policy they were not allowed to give me any antibiotic ointment. I used my trusty Mentholatum until I got home but holy cow this was bad. Infection...everywhere.
Thankfully that night I was able to get some Ambien to help me sleep. It took a literal decree from my doc at midnight but I got it and I was fast on my way to a few good hours of sleep that night. After 4 fabulous hours of crappy hospital bed sleep I woke up at 5am in major pain. The nurse was nice enough not to wake me for my pain meds but I really needed some help. I was so swollen from the lack of ice on my face and meds. My pain was at a 9 so I was going nowhere that day either. I was still being supplemented with IV morphine to make up for the major amounts of pain in my jaw and shoulder and my oxygen was getting better but I wasn't able to be without the nasal canula yet. I then started using just regular hospital ice pouches on my face in hopes of some kind of relief. They were awkward but did a little better than nothing at all. It was now day 3 of my hospital stay. My shoulder is starting to move a little better but my face was making up for lost time.

Pain day... what the hell did I do to myself?

Before surgery. Still me.

I arrived at the hospital at 10:15am like I was told. I was hungry and freaking out. I knew I was going to be miserable but I had no idea what I really was in for. I taken back to pre-op around 11am and waited for-ever... Finally around 12:00pm I was wheeled back to the OR. I had talked to the doctor and the anesthesiologist and was given a little dose of 'guts' in the form of a med to help me not run from the halls with my ass hanging out of the gown. Dr S said the surgery would be about 4 hours and I'd stay about 23 hours. I was thinking that wasn't very long but he's been doing things differently than most of the blogs I'd read so who knew? Dr S also mentioned that even though my insurance denied my nasal surgery he was still going to do it and just not 'worry about it'. While that's nice of him, I really didn't want the nose surgery in the first place but this was not the time to break it to me. I wasn't able to get that point across before but I kept thinking about the account audit that was in my future once my insurance found out about it. Great, now my work brain was going crazy as well.

My favorite part of the hospital stay- the socks

I don't remember being wheeled back to the OR but I remember arriving there and the docs wrapping me up before surgery. I thought it was wierd then, now I know it was not good. I was use to being laid on a table with my arms out straight to each side during surgery so when they started taking both arms and tucking them beside me and wrapping me up with some binder I was not comfortable. Little did I know how uncomfortable this would really be.
I woke up in the recovery room in so much intense pain I cannot even explain it. My jaw hurt... A lot... but that wasn't the problem... it was my shoulders. At the time I didn't put two and two together and remember the pre-surgical wrapping but I do now. I had been wrapped up for hours during surgery so tightly that they ended up pinching my nerves on both shoulders. I was hysterical with pain. I couldn't even move my arms and that was really scaring me. However, it was at this time I began to 'crash'. I'm sure it was a combination of the pain in my jaw, shoulder and airway being swollen but my sats dropped majorly. The post-op people were swarmed around me like I was dying... I guess because technically I was. I had a tube still in my nose that was helping me breathe that went all the way down to my lung. I guess being normally intubated isn't possible through your mouth when your jaw is broken and wired back together. Holy cow, this was horrible. I knew I'd be miserable but this was beyond what I'd imagined. The next thing I knew I was in the ICU. I had been moved to the ICU sometime after they had gotten me to start breathing again and was on 100% oxygen. I was not breathing on my own so I was now in the ICU. My shoulder was in so much pain I couldn't do a thing for myself without unbearable pain so the ICU docs brought in the xray machines to take pics to make sure they didn't dislocate my shoulders during surgery. It was horribly painful but I knew it was only a pinched nerve. I've had it before, I knew. Sadly once the xrays confirmed it wasn't broken, the fact that I was in more pain in my shoulder was quickly ignored by everyone but me. I couldn't hold onto a cup or pull my own hair out of my face. My arm wasn't even comfortable just hanging at the side. No matter what I did I was in excruciating pain. My mouth hurt a lot, but my shoulder was way worse. After things had died down a bit I finally got some info from C that the surgery actually ended up taking over 5 hours and it was now after 9pm. My mom was calling trying to get info on when he would pick up the boys so he had to go. I was left in the ICU with my nurse for what I was hoping would be an uneventful drug-induced sleep. Again, I was wrong.
Here I am just out of surgery in the ICU:

 

Last day with chompers

It's the day before my surgery and I am lucky enough to wake up even earlier than usual. K gets up with the birds and was up at 6am. I can't believe I raised a morning person! He's slowly going to kill me! Anyway, he got up and proceeded to cough and cough and slurp his nose until about 7:30am when I decided it was not a good idea for him to go to school. After texting his TA he wouldn't be there and calling his bus driver not to come get him I was on a quest to find a sitter for him. I tried my mom all morning with no answer. Where the heck could she be so freakin' early?! Finally giving up about 8:20am I called C to tell him he's gotta take one for the team and come home-- I had major work to do today. Not 5 minutes after he agreed, my mom called to see why I've been calling. Uhg! Mom!? After she agreed to watch K I called C back to tell him he didn't need to come home. Turns out he was already on the way so I then had to call my mom back again and tell her never-mind. Whata mess! C was home from work by a little after 9:15am, just in time for me to leave, dropping off littleC at daycare and to be in the office by 10am. Phew. I'm already exhausted and my day just started!
Last day of work before my surgery tomorrow was crazy. About 20 minutes after arriving to work I got a call from Dr S's office. Panic and dread immediately filled me. 'He'd better not be cancelling my surgery again' -- is what popped into my brain. It was Natasha calling to see if I was all ready for tomorrow. I said I'm fine and I'd see them tomorrow at IMC. The next thing out of her mouth I should have guessed... "Oh, we changed your surgery to Riverton instead of IMC" Me, about ready to explode with frustration at her and that office: "Um you guys told me IMC, I even got a call from the RN at IMC yesterday to go over health history, meds, etc". Her response was "Yea... (long silence) We had to change it due to a scheduling conflict". A scheduling conflict?! WTH? That was the same excuse as last time! This office is really pissing me off and definitely not going to get a referral out of me. Nor are they instilling any confidence! I got off the phone and bitched to my coworkers about the latest drama when one made a genius comment- 'what about the authorization?' Oh boy am I glad she said something. Let me tell you...that call to Natasha was hilarious! In her words, "Oh I'm glad you thought of that, I didn't even think to do that." Seriously?! Sigh... Now I just had to preregister with the hospital and I'd be ready. Hopefully... Unless they change it again.
I had a huge report to get done and combining that with mildly annoying people and the beginning of a major panic attack things weren't looking good. And then a little past noon it got worse... The fire alarm went off. I was sequestered in my cubie trying frantically to finish everything I needed before going on my leave of absence and I DID NOT have time for a fire drill! I was pissed. I had just waved the rest of my team off in their request to go to lunch so I could work through lunch and now I have to slowly walk down 4 flights of stairs and clear to the middle of our parking lot. Unhappy was putting it mildly. After about 15 minutes outside we got the call it was safe to go back in. Oh joy! Had this not been my last day before being off I would've definitely taken the chance of being outside with my purse/keys and bolted for home. Fat chance this time. In the building I went and decided I might as well hit up the cafeteria for some lunch before heading back upstairs with the masses to get my work done. I chose an enchilada mostly because it was something I'd need to use my chompers for. :) LOL I gotta take advantage while I have 'em. Heading upstairs I carried my plate, my purse, keys & lack of will to go on. Soon after, the boss came over and stood beside me as I'm working and scared the living shit outa me. He was wondering when his report was going to be done. My response, "not for a while". It was a rough one.
Finally in the late afternoon I checked my voicemails at home and noticed the hospital had called to give me my arrival time. 10:15am. Sweet! I get to sleep in! That was a good thing. Still needed to preregister but no one had called yet. After searching for the number to call (which is funny since the call center is just a couple floors beneath me) I called and registered myself and got all that done. I was set. Oh my God...this is really happening! I'm freaking out.
At 6:30pm I left the office and met C for a childless last meal at Red Robin. I had a lovely Terriaki Chicken Sandwich and cheese fries with a yummy chocolate shake. Then picked up the boys and back home for a nice bath. Shaved my legs, pits and whatever else needed it and soaked for a while. I know this will be the last time for a week or so. After bath I still had to fill out my health history form and medication info and send it in to the hospital. After that I had to be a 'wife' for the last time for a few weeks...(wink)...and now it's sleepy time. Nothing to eat/drink after midnight for me. Clear liquids ok until 4 hours before the procedure and I can take a sip to take my morning pills.
I've made a list of groceries and honey-do's for C while I'm in the hospital and I will pack an overnight bag (basically my laptop and toiletries) in the AM.
Good night!

Oh and one last thing for today. Here's my 'boring' before pics to be able to see the difference when I post after:

Streesful Lasts

Well, my surgery is now in 3 days and my doc's office hasn't called to cancel this one so I'm thinking it's going to happen this time. I kind of got over my freaking out stage after the other one was cancelled and had a few weeks 'off' from worrying but this last week before the surgery has been pretty bad. My blood pressure has been going up within the last little while and I'm sure this and work stuff and home drama hasn't been helping it. I finally caved and emailed my awesome PCP about meds and told him what my BPs had been (150s/902-100s!) and within a half hour I had not only an email telling me to come in STAT but a phone call at both my home and cell. I guess it was pretty bad. I was swelling up and had gained a lot of weight in a really short period of time. After going to the doc last Thursday I got put on a very small beginning dose of Lisinopril and had some blood work and and EKG done. All my blood work and EKG came back normal so my doc and I are kind of thinking its just all the stress in my life right now and my BP may go back to normal (which is high-normal anyway) after the beginning of the year when I expect stuff to calm down. I love Dr M. He always knows exactly how to treat me and what to say. He lets me be my bossy self and tell him exactly what I want and barring anything actually harmful it's done. So that night I took my first BP pill. Friday morning I woke up without swollen feet and ankles for the first time in a week. I stepped on the scale after my shower later that afternoon and holyshi*...down 11 lbs! Yea, that's how swollen I was. To loose 11 lbs overnight in water made me understand why I felt so bad. My BP had also started to lower to a low high and I'm getting better each day. Because of that crappy feeling and lack of money (due to the change of surgery and Jager the dogs cancer surgery) I haven't been able to fully live out my "last requests" like I had planned. I did get to go to Training Table for a Turkey sandwich no tomato and cheese fries with dipping sauce last weekend but it took a lot of begging of hubby and the boys were pretty bad. Not really...but its really about the food for me. I made a quick stop at Jimmy Johns for a sandwich before my nail appointment yesterday so that's crossed off the list. And I think C and I are going to drop the boys at my mom's and go to dinner at Olive Garden Tuesday evening for my 'last supper'. I still wanted to try Moochies but I guess that will have to wait until next year. I also have a whole bunch of work stuff I need to do and I really only have Tuesday in the office time to get it done. A huge report for my boss that hopefully we can bend to look even better in our favor so we can get rid of this horrible consulting firm that has a contract with us for another 3 years. Stress at work is probably one of the biggest reasons for my BP issues. I'm going to have a real hard time not being there for everything happening. Oh well. I've been reading as many blogs as I can find on people's experieces with this surgery and feel like I have a good idea of what to expect but also think I will never quite know until its too late. So far I haven't read one persons account saying they regret it so that is reassuring. I just want to sleep. I want more energy. I want to dream. I want to be able to move when I first wake up from an afternoon nap and not be completely paralyzed. This disease OSA, along with Hashimotos Hypothyroid and osteoarthritis is what stops me from moving and losing weight and being out with my kids and family and cleaning the house. I'm praying this surgery helps my OSA and I am one of the 95% success rates. I hope the new thyroid med I just changed to also helps and I'm one of the 60% that do better on it, a natural drug, than the synthetic I've been taking for 10+ years with little help. And if those two work maybe I'll have the energy to get out and loose some weight! Here's hopin...

Denial

Denied! "Not Medically Necessary"-- that's what my insurance -SH- says about the turbinate and septoplasty part of the surgery. The MMA/jaw and genioglossus/tongue part is covered and medically necessary but not the nose part. This was the original decision of the authorization proposal but I got the review committee decision today after the appeal letter was sent in by me and Dr S. Basically, the reasoning... I'm fat. Yep. My insurance company called me fat. I'm hurt, I admit it. I also admit I'm fat, however that doesn't change anything. According to the appeal review because I didn't got out and loose half my body weight like 2 different physicians said to I cannot have the nose part of the surgery. Because I haven't tried "alternate, less invasive methods". Gah! Wow?! Where ever do I begin with that, I think to myself... Maybe if they would have gotten records from say oh, my PCP that I've seen for 10+ years and knows the constant struggle with weight is not so easy with a few medical conditions? But no, they have the two pages of office notes from a first time visit to an ENT the week before Dr S's initial consult for an ear infection and then Dr S's notes from my initial consult which includes the referral from my sleep doc. Oh well... It's ok. I'm conflicted though. I would know for sure we'd tried everything and done it all in one surgical stay and time off work. That this drastic MMA surgery has the best capability to reach its full potential of curing OSA 95% of the time. But, on the other hand... I'm so very claustrophobic that having my nose done too and all stuffed up at the same time of my jaw and tongue all swollen and banded shut I'm pretty sure that'd kill me! And by kill me I mean both literally and mentally! It'd be in my head the whole time that I was suffocating if I had no breathing capabilities. So, I'm going to try to not be annoyed that I didn't win my appeal and try again with the actual valid medical records from my PCP-the one who knows- and try to forget they called me fat and just let it go. Its a good thing. They don't think its medically necessary as well- that my septum isn't deviated enough (or at all?) so maybe I'll just hold on to that hope that my nose is fine- even if it is small and always infected... but at least it'll be an open passage to which I will breath while banded shut! Denial... I can live with that. :)

Surgery Day!!! Not... {Growl}

Happy Surgery Day to me! NOT.
Today at this time I should've been moaning in agonizing pain, but I'm not. I'm going about my normal day. Happy about the non-pain part... really pissed off about the non-surgery part. Oh well. Such is life. The doc obviously didn't care that I had changed my entire life and that of a whole part of a consulting company back east. It didn't matter that now I will be too swollen to attend my parents' 40th year anniversary party I am helping to throw or have family Christmas card pictures taken. He obviously didn't care that I had already begged and borrowed, turned in favors at work to get things learned and duties changed and time off granted. He didn't care that I had arranged for sitters and rides for the kids, and purchased the liquids for my new diet or the handy waterpik I was going to be relying on to clean my banded-shut mouth. It didn't matter to him that I had paid extra bills in advance thus making us scrape by -and of course it happened during a week when our youngest dog needed costly surgery and then found out it was cancer. Nope. They had "scheduled two surgeries on the same date at different facilities"...and he "couldn't facility hop". Really? Really? I personally believe there's more to the story. My surgery had been scheduled for 3 weeks now and it took them until 5 days before my surgery to figure that out? I had just called the day before to verify the hospital knew I was coming too because I knew they didn't. I work here. I know these things. I had called down to pre-registration. I know my reponsibilities. I knew they'd have the info. But they'd never heard of it. I personally think they never called to schedule the surgery and then realized he couldn't do it. Then and only then did they also decide to call and tell me it's moved and use the excuse of the authorization not being approved for the nasal part of the surgery. Not that I didn't already tell them I was fine with that and would rather not have the nasal surgery if it wasn't approved. I know how auths work. It's not gonna happen...regardless of how they beg in a peer-to-peer review or change the medical records. Blech. I'm just mad. I now have an entire month to continue to sit and stew about this and to get myself worked up into even more of a panic attack. I'm sure I'll end up with a stress induced cold sore. Lovely...
So now I can pretend to be positive about the change of date: I can be glad the date has changed for a few reasons. First of all I will be around for K's first week of school and before school testing. That's a real good thing. I can get my hair colored before surgery now since my hair lady was on vacation before. I am able to become more fluent in the new system at work...even though I'd rather I didn't and don't think I'd be missing much if not. I can go swimming with my boys a couple more times for the summer. I can still eat whatever I want. There. I feel a little less negative. Still really pissed off though...but at least I can say I tried to turn it around. Haha.

5 days before surgery

I'm in pure panic mode about the upcoming surgery. I have only 5 more days left to do so many things but I have rearranged my life for this and it's happening...well...
Nope, just kidding...it's not.
The boys and I had to run our lab mix to the vet for a surgery to get a large mass removed from his thyroid and my cellphone rings. It was Dr S's head secretary, Lauree. She's the one all the young little receptionists have to ask all their questions to. As soon as I heard her tone of voice I knew there was a problem. Lauree proceeds to tell me that the doctor has had another surgery scheduled longer than mine and its at another facility and he can't 'facility hop' the day of my surgery. I think to myself, 'OK, so it'll change a day or two...no biggie'. Then she continues to say that he feels strongly that I still have the nasal septum repair and turbinate surgery that my insurance company has denied as not medically necessary so he's continuing to appeal that denial. Then comes the date. September 18th. Oh. My. God. Anger cannot even begin to describe my feelings. I have literally put my life on hold for this. I have my leave of absence papers filed and approved at work, my actual work duties covered, babysitters arranged, hubby took off work, I've paid a whole bunch of bills early that would've been due when I was off and low on money- in turn putting us in a bit of a pinch for a couple weeks, and lastly had the consulting company that is working with our company schedule their next visit (from out of the state!- so airfare/hotels/etc) for when I would have returned from surgery - but now for when I will be gone. I'm beyond pissed off. Livid would be a better description.
Well, I guess I will make the most of this. I guess its good that the insurance authorization will be approved (hopefully) so I can have the entire surgery. I guess its good that I will be OK for K's first week of school. Now I can go to all the restaurants I've been wanting to eat at before I can't chew for months. I can learn the new system at work better before going out on leave. Its OK...right? Sigh. I guess it has to be, I have no choice.

Week before surgery

Well, with less than a week until surgery day I'm about ready to have a complete and utter panic attack. I'm so scared! I've had many surgeries, I've never been this scared for a surgery or any procedure in my life... even my kids' surgeries weren't as scary! I keep reading through all the blogs and patient experiences I can find and the phrase "life changing" is said pretty much every time. I'm literally praying for that! I need it to be. I need my life back. I need energy, less pain, less meds! I know this will lower my risks of a stroke or a heart attack. I know my organs have been deprived of oxygen for so long that they are in desperate need of help. These are all the reasons I'm putting my face on the chopping block, so to speak. I'm hoping to drastically reduce or even cut out my naps that I require I'm not working. My kids are growing up and napping while they're napping is no longer feasible. LOL! I want to be the mom who is *happily* awake in the morning with her kids while they get ready for the day....not the one that they as a toddler and kindergartner get themselves fed and watch tv while mom sleeps in till 9am. I want to wake up without a headache or even worse a migraine! I want to wake up refreshed...not in a state of confusion and achy. These are the reasons I decided to do this. Well, that and the two doctors recommendations that no surgery less than this would help my severity of sleep apnea.

Molds, CT Scan & Family Appointment

I had one last appointment to go to before my surgery today. I had to go in for my molds, a CT scan of my jaw and a pre-surgical split. I had DH come to help out with the boys as well as to hear it 'from the horses mouth' just how actually horrible the surgery is. I wanted him to hear the details and recovery info from the doctor before the actual surgery so he knew what we were getting into. I needed him to understand just how major a surgery it is. It was ironic really, because one of the papers I had to sign said as much. Paper signed and everything worked out through the office and all 4 of us went back to the room. The doc came in to talk to us and tell DH just what I hoped he would and to look at my mouth one last time. He answered some questions and then I was left with the nurse. She pulled me into the next exam room away from the may-lay that is my family to do the molds. We had to do two sets. I was so scared of it because I'm so claustrophobic but she went fast and I did OK. I guess the reason they do two molds is because one has to be sent to the manufacturer before surgery and then the doctor likes to have one to perform a mock surgery on. That made me feel much more confident. After doing the molds I was done. We were out of there. I just had to have the LOA papers for work signed and that would be the last time I saw anyone in that office again with the current face and jaw I have. The office staff filled out my papers with a 2 week leave after talking with the doc. He was hesitant to only let me off 2 weeks but after I said I'd be able to work from home the 3rd week he backed down with a "as long as you realize you can have more time if needed". Yea, yea, yea...I thought, I'm a quick recover-er, and I had stuff to do! I also asked the office staff for the CPT and ICD-9 codes for the surgery I was about to have so I could do a little insurance investigation of my own. Just for anyone's reference that cares, they are:

Dx codes- 327.23 Obstructive Sleep Apnea, 524.03 Maxillary Hypoplasia, 524.04 Manibular Hypoplasia, 524.12 Other jaw asymmetry

CPT codes- 21141 LeFort; single piece without graft, 21196 Bilateral Sagittal Split, 21199 Genioglossus, 30520 Septoplasty, 30130 Turbinectomy, 21085 Surgical Splint- to be done 2 weeks prior to surgery.

When I got home that afternoon I IM'd my boss to tell him the news and date. I apologized profusely for the timing but we agreed it'd be OK. Phew. Thank God! Now, to hurry and finish my quarter at work and learn a new system all in a 3 week period! Sigh...

Pictures of up my nose

It'd been a couple weeks since my initial appointment with Dr. S and I was still waiting for my insurance company to get the authorization underway. I had called every other day for  the last 10 days with no information. I had decided to just give up. Then after just getting to work, my cellphone rang. It was Dr. S's office calling to say they have scheduled my surgery and I needed to come in for a few more pictures and to sign papers. Yikes?! It was getting real! Natasha from the doctors office informed me that they hadn't received the authorization from my insurance yet but where not worried as they usually have no problems. That made me feel a little calmer. She then said that they would probably need more pictures for the authorization so I needed to come in as soon as possible. I needed to run home on my lunch break anyway so it was no problem to add one more stop. Then she told me the date. Wednesday August 21st. Holy shit! No, I thought to myself. I can't do it that soon. I have training at work on a new system, it was K's first week of school, I had stuff going on that I could not be out of commission for. But, I guess my schedule meant nothing and it was when the doc and the assistant surgeon could be together. I reluctantly agreed to the date, said I'd be in the office for my pictures at noon and hung up the phone. The first thought through my brain, "OMG (my boss) is gonna kill me." We had this training at work literally in the making for 18 months. There was a lot I needed to be there for. I wasn't about to rely on my coworkers to reteach me the new system when I got back. I didn't trust them to mostly, but I also knew they wouldn't have time since we were already so behind. I had purposely not told anyone about the surgery before because I kind of thought it was a long shot on the insurance authorizing it... or me even doing it. But it had just become real. I had to fess up. I immediately sent in my request for a LOA. I didn't know exactly how long I'd be out but I knew it was going to be longer than a few days and I'd need to be official about it. I'd get all the info at the doctor that afternoon, I thought to myself.
I arrived at Dr. S's office about 12:30pm after running to my house first. They were always so nice there and I still felt like a rich person coming in for a nose job and a day spa appointment there. But, alas my problem wasn't so luxurious. Its an actual medical problem. Natasha pulled me into a room and we bent in strange positions to get the pictures up my nose and from above to prove that I wasn't indeed just getting a nose job to fix a bent nose for the insurance company. That's all I had to do. I then asked about how long I'd be out of work. She said "a few weeks" but said to ask the doctor at my next appointment. I made an appointment for the following Monday and was out the door. I was going to have to break it to (my boss) soon, I guess.

The consultation

It was a blistering day in July when I had my first consultation with Dr. 'S', DDS, MD, Board Certified Oral and Maxillofacial surgeon. I dropped my boys off at the sitter and made it to my x-ray appointment the half hour before on time. It was easy enough. Just smile big for the camera while it rotates around my head and takes pictures of every angle of my jaw and head. In and out in under 15 minutes. Then down the street I went to the actual doctor appointment. I pulled into the parking lot and somehow missed the huge visible sign stating which building I was to go to and walked into the building across the way. It was hot, like over a hundred...and I was exhausted, as usual, from lack of sleep but this guy was supposed to help... at least according to my sleep doctor. I finally realize I'm an idiot and got into the right office building. Dr. S's office is amazingly beautiful...like a day spa. I immediately wondered whether this visit would even be covered under my medical insurance because I felt like it was considered cosmetic. Of course, that was the medical insurance background personality of me thinking...I needed to remind myself I had a legitimate medical condition- Sleep Apnea. Big time Sleep Apnea. I stopped breathing somewhere around 80x an hour. I don't know the specifics but I was led to believe this was a lot... even "severe". They told me my 'sats' but I don't remember those. Anyway, I digress... After checking in with the nice receptionist and signing (electronically, of course) all the necessary forms that I had already filled out online I sat down. There was a TV screen with a video of the good doctor on the wall talking about some procedure as well as other patients giving their recommendations. I felt sort of like I was in an infomercial, but if these people weren't actually paid actors I guess it was comforting. My name was called and I went back to my room. It was a very plain room with a dentist looking chair and some cabinets, a single chair and sink. The nurse informed me that I get to be in a "photo shoot" first. A zillion excuses start running through my brain. I hate cameras. I hate pictures of myself. I didn't put any make-up on...'er...I did, but it just melted off. But I guess it was for the doctor and insurance so I had to do it. She took side shots - of which who really looks good in that profile? - front shots, head shots, shots with me holding some stuff in my cheeks pulling my mouth open for my bite...it was embarrassing, but I did it with a smile. She then proceeded to tell me she 'has to inform me of the risks of the surgery'. I think to myself, "Um, I haven't even said I *want* the surgery yet, or even knew exactly what the name of the surgery was...much less talked to the doctor...why are you telling me this?" But, I let her ramble. And that she did. Ramble, on and on. Risks a-plenty! Shiest! I'm in trouble. I had already read some blogs, done my research and had a pretty good idea what to expect but hearing it firsthand was a little frightening. Here they are, now you can freak out too:

• Pain and swelling can last as long as 6 months
• Facial appearance changes 
• Numbness of the lower lip and chin for months, but can be permanent for some people.
• May need corrective braces for teeth or jaw if teeth are not aligned correctly after surgery.
• Weight loss. Due to the liquid diet for up to 6 weeks. (this one isn't bad but is gonna suck)
• Can affect TMJ (which my ENT seems to think I have, but the oral surgeon does not so who knows...)
• General surgery complications: Anesthesia side effects, breathing difficulty, loss of blood, stroke, heart attack, etc.

The good things and info about this surgery though are: 

• This is the only procedure that serves as the most effective treatment for severe OSA - and - it's 95% successful! Other OSA surgeries are below 50%.
• It is only for patients how have moderate to severe OSA who have also failed one or multiple basic methods of treatment. (CPAP- I rip it off in my sleep due to being so claustrophobic, Weight loss surgery - Yea, right! I wish I could get it paid for. Nasal surgery along with tonsils - Wouldn't even make a dent in my apnea and I'd still have to wear a CPAP mask)
• The jaws do not need to be wired shut anymore, they are just banded. However, its pretty much the same endgame.

So, the risks/rewards/info section with the nurse section was done, now it was time to meet the doctor and see what he has to say. Nutshell? He said, Hell Yes. 'You meet every single criteria for this surgery' is what he said. Let's get it done. I agreed, half heartily and left the room. Off I go to the insurance ladies to start the paperwork for the preauthorization. Working for the company that provided my insurance benefits I had a feeling this was going to take a long time and be one of those surgeries they deny as 'experimental/investigational' or not medically necessary. I was told she had all she needed and would send the paperwork to my insurance to get the authorization done. I was out the door... and Freaking Out!

PreSurgery

PostSurgery

The photos above where taken from the website below. It's a great reference and blog of one of the first surgeons in the LA area to have done this surgery. He's got lots of patient experiences that helped me to understand a bit of what to expect:  http://www.sleepapneasurgery.com/max_advance_exp.html