First, the good news

My recovery from last week's surgery has been surprisingly easy. It was much worse five years ago. This time, there really wasn't much post-op pain -- just some minor discomfort and a lingering headache, which still isn't quite gone, but hasn't been very severe.

Also, my hellish RA flare-up has pretty much disappeared and I'm generally feeling pretty well lately. I'm back on my usual exercise regimen and have even lost the six pounds I gained during the flare-up when I couldn't exercise at all. Yay!

Now, for the bad news: I have to do the TMJ surgery all over again in about six weeks. I had my follow-up appointment on Tuesday, and my surgeon doesn't think the procedure was successful. I guess that might explain the lack of post-op pain.

Awesome!

I love Hawkeye!

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Surgery recap

So, here’s how the actual procedure went:

The first part of it was pure torture. It was called an arthrogram, and I had to be awake for this part. It is, supposedly, the best diagnostic tool for TMJ, and involves the doctor injecting dye into your jaws and then doing a CAT scan, which apparently allows him to see exactly what is going on in there so he knows the best way to proceed. It also hurts like hell. They strapped me into a chair, restraining my head, arms, and legs, and then the doctor started jamming a big needle into my jaws while his nurse grabbed my chin and manhandled my jaw into various positions as directed by the doctor. Then they did the CAT scan. Apparently, he didn’t get enough dye in there the first time around and the pictures didn’t turn out well, so we had to do this TWICE. It was really awful. I very nearly cried the second time around, but managed to control myself.

Mercifully, they knocked me out after that. The whole procedure took about two hours. My face was very swollen when I got home, but the swelling went down pretty quickly and it doesn’t look too bad any more. Instead of a hospital gown, this doctor always has you change into a t-shirt that has his office logo on it, and you just wear that home afterwards. When I looked in the mirror, I realized the t-shirt had blood spattered all over it. Then my ears started itching and I realized they were full of dried blood. Blech. You’d think they could have cleaned that out for me before they woke me up.

But, awful as the whole thing sounds, the post-op pain really hasn’t been very bad at all. He sent me home with prescriptions for Percocet and Valium, but I’ve barely touched them so far. As long as I don’t try to chew anything, it doesn’t hurt too much. Talking is a bit difficult because I can barely open my mouth. It’s supposed to take about two weeks for everything to settle into place and then I should be able to open my mouth normally again and chew without discomfort.

I’m just glad it’s over!

Grrrrrrrrrrrrrrrrrrrr.

I really like my oral surgeon and his medical staff. They’re very good at what they do and very nice and professional about it. However, his administrative staff leaves a lot to be desired.

When I scheduled my appointment for yesterday’s procedure, the girl who apparently handles the insurance claims informed me that my insurance is out-of-network and that she would have to call them to find out if they would cover the procedure. She said she’d get back to me and let me know how much would be covered. I never heard back from her. She never called me, left me a voice mail, sent me a letter – nothing. Having not heard from her, I pretty much forgot about it and went in yesterday expecting to pay around a $200 copayment, as has been the case both previous times I’ve had this surgery.

Imagine my surprise when the girl at the front desk told me she needed to collect $2,006.00 from me before the procedure. I said, “Wow, that’s a lot more than I was expecting. Is my insurance not covering this?” The insurance chick was sitting behind her, turned around, and said in a rather nasty tone, “We spoke about this after I called your insurance company. They are not in our network and you have to pay 100% up front and then submit a claim to them and they might reimburse you.” Now, that really pissed me off, because she most certainly did NOT speak with me after she called them, and I told her, “Okay, but we did not speak about this, actually. You never informed me of this.” She just stared at me for a moment and said nothing, and then turned her back on me, leaving the receptionist (who was very nice) looking rather like a deer in the headlights.

Fortunately for me, my financial position is such that I *could* fork over two grand on a moment’s notice without any problem and was still able to have the surgery. A few years ago, that would have been a real problem for me, though, as I suspect it would be for a lot of people. What if I hadn’t been able to pay that much up front? Would I have been sent home and had to forego the surgery?

I’m seriously considering writing a letter to my surgeon about this. Not only is it bullshit that this girl never bothered to inform me how much I’d have to pay up front, but her nasty attitude when I asked why they were asking me for two grand was completely uncalled for, as was her refusal to admit to or apologize for her oversight. I’d like to continue seeing this surgeon for future TMJ needs, but if his administrative staff is going to treat me like that, I’ll have to seriously consider going elsewhere.

I’ll post later today or tomorrow about how the actual surgery went, but as you can see, I survived.

No comment necessary.

Photo courtesy of Elder of Ziyon.

Those darn antibodies

I saw my rheumatologist today, and he was none too pleased with the way my joints look. It's a good thing he didn't see me three or four weeks ago when I could barely move at all! He was most concerned about my feet, ankles, and hands, which are all still very swollen.

His theory is that the Enbrel had stopped working for me because I've developed antibodies to it. This was news to me, but apparently, after being on one of the biological agents like Enbrel for awhile, about 80% of patients develop antibodies to them and have to switch to a different one. Fortunately, there are several to choose from these days.

He decided to leave me on the Enbrel/methotrexate combination for another two months, and if I haven't improved significantly by then, he will take me off Enbrel and put me on Humira.

Call me grease monkey

I learned how to change a car battery today!

I went to get my hair done this morning, and then stopped at the grocery store on the way home. I loaded my groceries into the trunk, got in the car, and turned the key in the ignition. Nothing. I tried a couple more times. Still nothing. I tried to unlock the door so I could take a look under the hood. The automatic locks wouldn't even work. Fortunately, I know how to work them manually. :)

I got out, looked under the hood, and with all of my vast auto mechanic experience, I couldn't see anything obviously wrong, but I did note that the battery had a lot of corrosion around the terminals. I've had the car for just over five years now and never changed the battery, so I assumed that was the problem.

So, I had a trunk full of groceries wilting in the 95 degree heat, and I was stuck. Luckily, I was able to reach my dad on his cell phone. He and my mom were at an all-day choir practice at their church, but my mom left to come and get me and my groceries and take us home, and then she returned to her choir practice.

After it was over, they both drove back to my place and we went back to my car and removed the battery, then went to Sears to get a new one. I would have just had the car towed and let a mechanic change the battery, but it was too late in the day and no one is open on Sunday, so I wouldn't have had my car back in time for work on Monday. So, we took the new battery back to my car and installed it ourselves (well, mostly my dad installed it, but I helped). Of course, the new battery had the terminals on the opposite side from where they'd been on the old battery, and the positive connector would not reach -- not even close. After much struggling and a bit of help from a mechanic who just happened to be exiting the grocery store and noticed our predicament, however, we managed to get the job done and the car started right up on the first try. Whew!!

Not exactly the way I'd planned to spend my day, but I learned a valuable skill and got to spend some quality time with my parents, who I took out to dinner after the job was done.

Incidentally, Hondas rock. Aside from one flat tire a couple of years ago, this is the first trouble I've ever had with this car, and it was inevitable. I think five years and a couple of months is actually a pretty impressive amount of time for a battery to last.

Here we go again

Back in 2001 and 2002, I had a couple of TMJ procedures. My oral surgeon asked me at the time if I had rheumatoid arthritis, and I said no, because at that point I wasn't aware that I did. He told me that the type of damage he was seeing in my jaws was typical of someone with RA. After I was diagnosed in early 2003, I told him, and he said, "I knew it!" So I guess it makes sense that my jaws were the first thing to flare up six weeks ago when my downward spiral began.

In any event, I made an appointment with my oral surgeon at the first sign of trouble in July, but he was booked until this afternoon. Since I've gotten so much better after getting back on the methotrexate, I figured he'd just check me out and send me home. No such luck. After examining my jaws for about 30 seconds, he scheduled me for surgery on September 20. Apparently, he sees the fact that I can open my mouth only about an inch wide as some sort of problem. Hmph.

The good news is that he's going to do basically the same procedure I had five years ago, rather than the total jaw replacement he warned me back in 2003 that I would need eventually. The bad news is that, having been through this procedure twice already, I know how much it hurts. A LOT. If it tides me over for another five years or more before we have to do something more extreme, though, it'll be worth it.