Fk'n insurance run around & so forth...

So we had a helluva time getting a referral to an oral/maxillofacial surgeon, but they finally found us one (yes, one. They claimed only one was available in our network which seemed a bit odd to us) Well I'll speed thru this part as much as I can, but I basically wasn't very confident in this doctors abilities right from the beginning (though, don't get me wrong... he is very nice!) He made us pay out of pocket for pan xrays & a few other things, then set up a plan of attack that involved a device called a T.I.D (temporary implantation device) being bolted into the roof of my mouth with screws on the outside gumlines above the molars that would essentially, when activated by rubberbands my orthodontist would put onto them, essentially close my open bite enough that insurance would deem the surgery "medically necessary" since I was getting the run around being told this was cosmetic and it's FAR from cosmetic. He implanted the device (which at first was going to cost us $800 out of pocket & I balked loudly, and somehow after that they got it covered. I woke up 2 or maybe even 3 different times during the outpatient surgery... saying "hi!" each time & them rushing to give me more Versed (docs, like usual, didn't believe what a high tolerance to medications that I have!) and finally the *very* uncomfortable device was in and I looked like a Cabbage Patch Kid for a week :( Awhile after that, surgery finally got approved but by that time he had (I think accidentally) told us "you know, I don't do many of these exact types of cases, I'll be honest... but I *think* I can do it!" Umm... no. In addition to that, I had asked his front desk manager for names of other jaw surgery patients and she said she'd have to ask them for their approval on it but she'd get them to me. And then she lagged... and lagged. I asked again & was again put off. Finally one day she called with 2 names. Two! By that time I was not confident & decided to search elsewhere for a qualified surgeon.

And so we checked again with our medical group, who again said there was only one. And so we went so far as to switch medical groups!! That took some time, and in the meantime my braces had already been on 2 years (way longer than they should have been) and my teeth were beginning to show signs of wear, my orthodontist was urging me to find someone PRONTO and have this surgery, and of course the T.I.D. appliance Margossian had put in had done what it needed to (closed my open bite) but was in there TOO long and the gum tissue was then growing OVER the appliance!

We went through heck trying to again find qualified surgeons. It really shouldn't have to be this hard! And you won't believe this but at one point when my GP put in for a referral as he had many times (my old GP had switched medical groups too so I had my old trusted doc doing it all for me again ironically) we got back approval to consult with... Margossian!!!  Well at this point hubby was just fed up & went to town called everybody in our medical group he could think of, talking to supervisors, writing letters. And my ortho even wrote letters as well! Finally we were given 2 names out of the general area but about an hour away. I googled the name Daniel Levin, thought his credentials sounded good, and called him.

I'm happy to say that once we got in to see him for that consultation, things moved at warp speed. Thank God!! He first needed to take more updated Panorex x-rays (and we again paid out of pocket unfortunately but hubby didn't care because we were just OVER it all at this point!) and then Dr. Levin made an appt to remove the T.I.D. device (which was unfortunately done under local anesthesia, hubby had tried to pay more to get twilight general and was under the impression that's what happens while he waited but since I'd not been told 12 hours before not to eat or drink anything... only a local w/ nitrous could be given. That all said, while it was awful, I was awake but way out of it. So I felt nothing but heard everything. And for all the trouble poor Dr. Levin had taking them appliance out (he said out loud "geez, he put this thing into your mouth like he never intended on taking it out!") I felt more comfortable with him as a surgeon honestly *because* I was able to hear him and feel the way he worked... how he treated me & his staff. I liked his sense of humor but his caring approach without being too stuffy.

So I was swollen as heck for almost 2 weeks but once THAT part finally healed, then we were ready for stage 1 of 2... upper palate surgery. Now where most docs I'd seen (I forgot to mention earlier that in the insurance run around I'd even been approved to one of the best UCLA teaching docs when it comes to jaw surgery, Alan Felsenfeld. I was so super excited because his name is just so well known when it comes to this type of surgery. Well as was so often the case for us, the "approval" was basically a ajoke

Going from BAD to WORSE... time for braces!

So I'll skip ahead a few years & save you from having to hear about the slow progression of my teeth going from bad to worse. It was however soon apparent that if something wasn't done well... soon... that I might not have teeth left in my head to be worried about!

Here's how it all began. I guess I started seeing Dr. Max in about 2007 or so. Dr. Abdel Maqsoud in Burbank was recommended to me by my buddy Rob who I'd known most of my life, so I knew it was a solid rec. I wondered what a guy with that kind of name would be like, I'll admit (sad huh?) but right when I met him all my concerns vanished. He is truly the most awesome dentist I've ever had. The office is older but all the equipment high tech. His staff is rad. He's this cool, laid back Egyptian dude who just cares about his patients and cares about what he does. Every procedure I've ever had done there, from teeth cleanings to fillings, has been totally painless. No really, I swear. So right away Dr. Max noticed my jaw was off but he wanted to try to do what he could without going the surgery route. Needless to say, that didn't work. But he did direct me to my Orthodontist, super cool doc #2... Gary Kevorkian in Glendale/North Hollywood/Porter Ranch. Yes, this is how popular this guy is, he's got offices everywhere! And same as the dentists office, clean places, great staff, easy & pain-free appointments. Dr. Kevorkian right away saw a major jaw surgery necessary to fix my open bite/crossbite/underbite & set us up on a great payment plan (once again I have to take a moment to thank those in my life who've cared enough to spend MAJOR money on my mouth & future, that being my parents & more recently, my husband Brent Ambrose!) and then put the braces I'd now had off for almost 17 years, back on again. The only plus this time was that Brent felt it necessary to pay a little more to get me the clear "ICE" braces I so badly wanted. I mean, having braces as an adult is hard, why make it harder? Turns out, I wound up kinda liking them & still do! I've had them on for way longer than I should have, due to insurance approval issues as far as surgery is concerned, so it's been about 2 years now I believe, but still... I could honestly handle having them on forever! :) I know that sounds strange but let me explain... my reasoning is as simple as this; I'm 35 and always get mistaken for younger. When I got the braces though, no one could imagine I was any older than 23! You don't see me complaining! :)

I don't remember the exact date I got them put on but I'll ask that & add it in on Friday. I'm thinking it was 2010. Getting them put on didn't hurt, just a little uncomfortable but the girls work fast. For about the first week I was so sore I couldn't eat much, and I remembered my old go-to when braces were tightened: KFC mashed potatoes & biscuit! Still good, all these many years later! The braces were only supposed to be on for about a year I believe, during that time doing what they were intended to, to straighten & prepare me for jaw surgery, also giving me time to find a qualified jaw surgeon. But that's where things got tricky. Dr. Kevorkian kept telling us all these great names at Kaiser and UCLA but our insurance wouldn't let us go there. They kept insisting that there was only ONE oral/maxillofacial surgeon within our medical group, and he was in Burbank ironically enough. So it was time to see Dr. Margossian....

What happens when you chicken out of surgery?

Where was I? Oh yes, that's right... I had put myself thru years of hell preparing my jaw & teeth for surgery, and put my parents through many pointless payments, agony, etc, etc. But they are wonderful people & would never force me to do something I didn't want to do, so they just let it go. Removed the braces, didn't force me to wear my retainer, and just pretended like nothing ever happened. No guilt trips, no animosity. Wonderful people I tell you.

But the docs had given their warnings when I left. "If you don't have jaw surgery by the time you're in your 30's your teeth will probably start falling out." "It's absolutely IMPERATIVE you have this surgery, for your health, for your speech...." Did I care about anything they said? No. I was young, impetuous, and for lack of a better term, a BRAT. It wasn't so much that I didn't believe what they were telling me. Sure, maybe it was possible my teeth would begin falling out. Maybe there would be jaw pain. I just didn't CARE because by the time I was in my 30's I rationalized... I would be OLD! *rolleyes*

And so the years flew by. I smoked a great many of them too. 2.5 packs a day at one point. Yes, from the age of 12 til I was about 22 years old, I smoked cigarettes as if they were going out of style. None too good for a mouth already at risk. I had quit completely by the time I was 22 however, when I got together with my now husband, Brent. After that I only smoked occasionally, a "social" smoker. Even that I tired of by the time I was 25. I mention getting together with Brent though for one main reason. He was the first stability I had in my life since I'd left my parents at the age of about 17. Being with him, he insisted on the necessity of adult things such as medical insurance, and yes even DENTAL insurance! As we were not yet married however, most of this was paid for out of pocket. Still, I began once again seeing dentists semi regularly. We filled a few cavities, cleaned some teeth. And the dentists once again began asking their questions. You do know you have a pretty bad jaw malocclusion, right? Your teeth, they're not wearing evenly. You don't bite at all with your front teeth, so those are almost atrophying from disuse. Do you have pain?

The answer, in general, was YES. Yes I had pain, and pretty severe pain if I were finally honest. Here I was 22 years old and everyday it felt as though I'd been in a boxing match with Mike Tyson. My jaw was always tense, as if I were clenching it nonstop, however, I knew I wasn't. I'd asked past boyfriends to pay attention while I slept. And was I absolutely sick to DEATH of not being able to chew & eat normally? Of being embarrassed to go out to eat with friends, that they'd see what a difficult time I had, and how I would NEVER order a sandwich or eat pizza in front of anyone I didn't know well, because basically in order to take a bite I had to use my tongue in place of my bottom teeth, the open bite was that big, and using my tongue against the top teeth I'd tear the food apart. Well, what was this also doing? It was tearing my TONGUE up pretty good! The tongue is not meant to be "bitten" that much, I assure you. But it wasn't until a dentist who acted like he cared said to me "Lyd, your tongue is drying out, like a piece of meat left out on a counter." Because of the open bite, air would seep into my mouth more often than it does to others. Yes my lips were able to close, but you have to pay special attention when you have an underbite of my degree to make sure you're not always basically in "duh" state of rest. Which I often was without even realizing it. You can't be "on" all the time :( Trust me, it made me crazy how often I tried *sigh* My tongue was also drying out at night as I was a mouth breather due to all this! And finally, as I said before, the tongue is not designed to be a tool for cutting. It was just tired, period. And so was I. My teeth were ultra sensitive because of all the exposure to air, the gums were eroding and the front teeth were loose from not being used (same as a muscle atrophy, so do the teeth). The dentist who acted like he cared about me.... well he actually DID. Dr. "Max" Maqsoud is a godsend. He truly cares about his patients. He said he would try to do everything possible to fix it but avoid an extensive & painful surgery. And he did. But oh, did I mention how old I was by the time I found him? I was 30. Yep, right on schedule as the doctors had said when I was a kid. Except for one thing... I wasn't OLD like I thought 30 was. No, I was still young & I wanted pretty teeth. I wanted to stop being self conscious of the way I spoke. I was now becoming prettier, getting fit, starting to model. But my teeth... they were showing their age. They were threatening to derail my budding career and if I didn't stop them, possibly my overall health :(

How this all began (aka: why I need jaw surgery)

I've always had a really messed up mouth is the only way to put it. As a kid, I had to have tons of teeth extracted, and then it was discovered I even had a THIRD set up in my cheeks & gums! At around 8 or 9 years old it was brought to my parents attention that I had a genetic bite deformity. Basically I had an open bite of approx. a 1/2 inch, making it extremely difficult to bite into things like pizza & sandwiches. I also had a pretty severe underbite, to the point kids used to tease me calling me "bulldog" :( This also caused me to have a distinct lisp, which I was also teased mercilessly about. 

After pulling many teeth they started with things like tongue thrust contraptions (essentially a FORK that came up from behind the back of my bottom teeth, to hold my tongue back... *very* archaic and aided to the teasing I was already enduring thankyouverymuch!) And then they realized my upper palate wasn't wide enough so they installed a rapid palate expander that had to be turned nightly by a "key" by yes, you guessed it, ME personally. All at the tender age of 9 years old. Of course, what kid wants to do this to themselves? None. So I used to pretend except when my parents would literally hold me down & do it themselves. Soon after braces were put on, and STAYED on until I was about 16! In between there were talks of how badly I *needed* jaw surgery & how if I didn't do it by the time I was in my 30's my teeth would fall out. The open bite was so bad that only 2 molars on one side, and 4 on the other, touched, making chewing and eating incredibly hard. At that age though, you just don't care what's supposed to happen when you're in your 30's, because you think by then you'll be "old, so what?" Still, my parents did everything they were told, spent money they didn't have, and prepared me for a surgery I didn't know I was being led to having. I only wish they would have stressed the importance of it to me, so that MAYBE by the time the day came, I would understand WHY I really needed it. 

That however, did NOT happen. What did happen was that as I approached age 16, and the date of surgery, I set about asking all my friends "should I do it? What do you think?" Well what do you think other 15 & 16 year olds would say? If they're good friends (and they were!) they would say (and they did!) "No Lyd! Don't do something so painful! Why?!" "No Lyd, don't change who you are! This is the YOU that we LOVE!" or how about "who cares about your lisp? It's what makes YOU you!" And so with a wave of my dismissive hand I went to my parents & said "Not gonna do it, sorry. Don't want to. I've had enough of this constant pain & metal in my mouth. The constant teasing. Please have this junk taken out of my mouth NOW." Did I realize at the time how much time & expense my parents had put in? How many authorizations and red tape? How much sadness that they created a child with such bad mouth deformities? No. On all accounts. But I was 16, and I didn't care. Years of progress was undone in just a few short years.