My Upper/Lower/Genio experience

[Guest guest]

Hi there pre -oppers...

I am 5 weeks post op from upper, lower, genio and cheek osteotomies.

And fortunately I am doing great!!!

In all, the surgery was about 6 hours.

I arrived at the hospital at 5:00 am for a 7:30 am surgery.

I was a wreck before surgery - so the nurse gave me a little valium

to help calm my nerves. It didn't work..but that's ok....She also

gave me seom pepcid AC - to settle the stomach - I guess all patients

get the pepcid.

The nurse started my IV - took my vitals - drew some blood - took my

weight - not a problem.

I was wheeled into the pre op waiting room - with all other surgery

patients for the morning, and waited for about 30 minutes.

Anesthesiologost came in and introduced himself - and set up some

things. By the time I was ready to be wheeled into the OR - the

Anesthesiologist had already put his " things " to work - I was out

before I even hit the OR.

6 Hours later - my surgeon wakes me up - tells me things went really

well....Meanwhile I hear him - but I cannot open my eyes (I was still

groggy) and as soon as I realized where I was, I felt my splint in my

mouth - I almost gagged - but that went away quickly as I fell back

to sleep with all of the meds and ansthesia I was under.

In recovery, I had a tube in one nosrtil that went to my stomach (I

coudn't feel it really - but I knew it was there). This tube helps

drain all of the blood that you naturally swallow during the surgery

and mainly prevents nausia by keeping your stomach clear. I had

another tube in the other nostril that delivers oxygen to help you

breathe. Neither of these tubes were painful, you just knew that they

were there. I had both tubes removed about 6 hours after surgery

finished. When the doctor removed both tubes - it was not painful -

just a little discomfort....but once they were out - its amazing how

your body just says OK.....tubes are out....ready to do everything on

your own...

About three hours after surgery - I was wheeled to sub ICU - where I

stayed for the duration of my visit. Still groggy - I could hear

everything - I still could not open my eyes...I was very

groggy...Being in sub ICU was great becuase you get alot of attention

from the nursing staff....Primarily - you are in sub ICU so that they

can monitor your vitals continuously...If it wasn't for that - I am

sure that a normal non-sub ICU room would have been fine.

Nausea - there is some nausea..but the moment you feel it - call the

nurse and she pushes something through your IV and it goes away very

quickly. This is not something you should be concerned about!!

ICE wrap - When I came out of the OR - I did have a jaw wrap attached

to a machine - this machine cooled water that was sent through the

tubes attached to the jaw wrap to keep swelling down....this was very

cool...(literally and figuratively).

Steroids - The doctor provides you with steroids to aid in keeping

the swelling down. I continued with Steroids when I was released from

the hospital for about 7 days post operatively.

Catheter - ARGH....You know - this was the least discomfort of

all...The catheter was put in when I was already in the OR and

asleep - so I felt nothing going in....about 10 hours after surgery

the nurse removed my catheter...and it did not hurt. It felt a little

weird - but did not hurt. It was the same sensation as the tubes in

my nostrils...you knew they were there...but they didn't bother you.

Pain - There was discomfort for the first two days....The morphine

button was nice - it helps relax you and takes the discomfort

away...By the second day in the hospital - I was taken of the button

and provided codeine - liquid format....it tastes bad - but helps

equally. I was also prescribed ativan to help me sleep. By day 7 - I

was on ibuprofen - and didn't need any more pain meds....That was

great..I was afraid of becoming addicted - so I was happy that the

pain was minimal.

Congestion - This was the hardest thing to deal with. Becuase I had

Upper and cheek osteotomies - congestion was high. While in the

hospital - I was prescribed afrin nasal spray - which the dosage is

only twice daily - and the relief is minimal. I was difficult to

breath being tightly banded and unable to have a clear nostril.

Upon being released from the hospital - the surgeon cleaned out my

nose and I was much better. This is a service that your surgeon

should do for you upon request at any time. I didn't request it - and

unfortunately was uncomfortable for about 1 week - as my congestion

was very difficult. I bought a humidifier to help with

congestion....it helped a little....Q-tips were my aid in helping me

keep my nostrils clear....and Robitussin...Beyond the pain and

discomfort - I think the congestion was the most frustrating.

Food......EAT ALOT!!! This is key to your recovery. My brother and

boyfriend were taking care of me and they had me eating every couple

of hours. Lots of liquids and lots of protein shakes. Trust me...the

more you eat...the better you feel...My brother prepared consumme -

which is a protein rich broth - this, in combination with big

servings of soups with cream and butter helped me heal better. I am

so thankful for them!!! The moment I started to slack on the food

intake because my Brother an boyfriend went back to work - I became

grumpy and lethargic...trust me...food is king!!!!

Zip and Squeeze vs. Syringe - I found that the syringes that the

hospital provided was more beneficial than the Zip and Squeeze

bags..I started to drink from a cup on Day 2- my doctor encourages

his patients to sip drinks from a cup as soon as you can. I found

that Zip and Squeeze bags exploded too much while in recovery...maybe

I was not using them right - or putting too thick a liquid inside the

bags....either way - I ruined a few shirts trying to make the bags

work - ultimately the syringe was what helped me eat.

Time off - I took four weeks off of work - Did I need to take this

much time off? probably not - but in reality - it helped me recover

better. I have a high stress job that requires me to speak alot....so

I returned to work the day after my splint was removed - week 4 - and

I am thankful for time to recover. I live in california - and went on

short term disability....didin't cover my salary in full - but it

helped.

Numbness: I have it...half of my upper and lower lip are numb. But

they are tingling - so that hopefully means that I will have

sensation come back. Having the lips be numb makes kissing really

strange....Half of my chin is also numb - like novacaine numb (like

when you go to the dentist). My cheeks are also numb...but that

feeling is coming back more everyday...Every so often I get a sharp

pain in one of numb areas...and wow - its sharp...but I am hoping

that is becuase my nerves are getting ready to fire it up again. The

roof of my mount is numb....which is strange....but those are the

risks of the surgery....it may or may not come back....and that is a

risk you have to accept when considering this type of surgery.

Insurance.....Humana covered it - but there are still some invoices

lingering that they have not yet paid....I live in So Cal - prices

for services may be higher than in other parts of the country

The hospital bill was about $42K.

I have not recieved the surgeon's claim to my insurance yet...but I

am sure that will be a nice high ticket item.

Assistant surgeon - $3K - My doctor always has his assistant surgeon

help with procedures.

Anesthesiologist was about $2200.00.

Orthodontist was $6K - But I had begun Ortho treatment 2 years prior

to the surgery date...I include this as an FYI. I will be in braces

for another year post surgery.

I hope this helps any pre-oppers out there.

My experience was not as bad as I thought it was going to be. And

after 5 weeks of Post op - I am glad to have gone through it...and

don't regret any of the decisions.

Cosmetically, I am enhanced and much more symmetrical. most

importantly, functionally - I am all better!!

Let me knpow if you have any questions....

otherwise...Good luck!!!

[Guest guest]

Wow! What a nice summary of events! I'm sure several members around

here will find it quite interesting and helpful!

Thanks for posting,

Ray

[Guest guest]

Thank you SO much for your post!

I have questions regarding insurance. My surgery is scheduled for

October 5, and I'm having upper, lower, and genio as well. I have

never had a hospital visit, so I'm not quite sure how the finances

will work. I also have Humana insurance and am sincerely hoping that

they will agree to cover my surgery.

Does the hospital have a payment plan for you to pay off your bills?

My husband wants me to sell off some of my stock for us to pay for

it, but I'm convinced that we can set up an alternate plan that would

keep us from having to do that.

I'm REALLY hoping that Humana covers the surgery because Blue

Cross/Blue Shield has denied me coverage even after I filed an

appeal.

I'm so glad to hear that things went well for you and that you are

healing nicely.

How has your diet progressed? Are you wired shut or banded shut? My

doctors will be banding me shut, and I just had my lower surgical

wire put in this week.

Thanks for all your help and happy healing!

[Guest guest]

as far as i know, hospitals are legally required to work with you on

your bills. if you tell them that you need to pay over time, they

will set up a monthly payment plan, with no interest. anyone,

correct me if i'm wrong, but the times i've had hospital bills, i've

ALWAYS been able to pay over time.

> Thank you SO much for your post!

>

> I have questions regarding insurance. My surgery is scheduled for

> October 5, and I'm having upper, lower, and genio as well. I have

> never had a hospital visit, so I'm not quite sure how the finances

> will work. I also have Humana insurance and am sincerely hoping

that

> they will agree to cover my surgery.

>

> Does the hospital have a payment plan for you to pay off your

bills?

> My husband wants me to sell off some of my stock for us to pay for

> it, but I'm convinced that we can set up an alternate plan that

would

> keep us from having to do that.

>

> I'm REALLY hoping that Humana covers the surgery because Blue

> Cross/Blue Shield has denied me coverage even after I filed an

> appeal.

>

> I'm so glad to hear that things went well for you and that you are

> healing nicely.

>

> How has your diet progressed? Are you wired shut or banded shut?

My

> doctors will be banding me shut, and I just had my lower surgical

> wire put in this week.

>

> Thanks for all your help and happy healing!

>

[Guest guest]

Hi there!!

I can only share with my experience as different hospitals work

differently.

With Humana, I had a pre-authorization for this procedure at my

specific hospital (Hoag Memorial Hospital). I was not required to pay

anything up front. With my Humana plan - I have a PPO - which allows

me flexibility with " in network " physicians. My physician was in

network, but my hospital provider was out of network. Therefore, my

hospital bill was covered at 70/30 - where as if I had the procedure

at an in network hospital - it would have been covered 90/10...so be

careful - even if your doctor is in network - in order to maximize -

make sure he/she can perform your procedure in an in network

hospital. Hind sight is always 20/20....

OK....that being said, I am on the hook for 30% of the total hospital

bill....YES...the hospital will totally work with you on payment

methods.

Good luck in getting Auth'd for this procedure....I did not have a

problem - but my condition was pretty bad.

Diet....I am still on mushy food diet...and I have been banded shut

so I am able to open my mouth quite a bit. .I am not allowed to chew

for another 10 days...although I did chew into a soft strawberry this

morning and it felt good...there have been times where I accidentally

chewed...and it hurt.

I have only lost about 2 lbs since surgery...because eating is

king...I am happy that I am healing healthy rather than skinny and

miserable. Plus my body functions best at is normal weight...My

normal weight is 140 at 5'7 " . I did find that after week two, I

started to take private Pilates classes...this is a great excersize

for healing as it is no impact excersize...but you see

results...People think I have lost more weight than I actually have -

becuase of the pilates work out...Always check with your doctor on

when it is OK for you to excersize...my Doctor is a big fan of

Pilates and let me go after two full weeks after surgery - as long as

I felt good enough to work out. My trainer started slow and we slowly

worked our way up.

Good luck with your surgery...and your insurance.

-Malu

> Thank you SO much for your post!

>

> I have questions regarding insurance. My surgery is scheduled for

> October 5, and I'm having upper, lower, and genio as well. I have

> never had a hospital visit, so I'm not quite sure how the finances

> will work. I also have Humana insurance and am sincerely hoping

that

> they will agree to cover my surgery.

>

> Does the hospital have a payment plan for you to pay off your

bills?

> My husband wants me to sell off some of my stock for us to pay for

> it, but I'm convinced that we can set up an alternate plan that

would

> keep us from having to do that.

>

> I'm REALLY hoping that Humana covers the surgery because Blue

> Cross/Blue Shield has denied me coverage even after I filed an

> appeal.

>

> I'm so glad to hear that things went well for you and that you are

> healing nicely.

>

> How has your diet progressed? Are you wired shut or banded shut?

My

> doctors will be banding me shut, and I just had my lower surgical

> wire put in this week.

>

> Thanks for all your help and happy healing!

>

[Guest guest]

Hi!

One suggestion: If you do wind up paying your own fees, negotiate

with the hospital. Some folks have found that hospitals will give

substantial discounts for cash payments... At least check it out.

Same thing with your surgeon -- some surgeons give folks a break if

they know you're carrying the load yourself.

Cammie

> Thank you SO much for your post!

>

> I have questions regarding insurance. My surgery is scheduled for

> October 5, and I'm having upper, lower, and genio as well. I have

> never had a hospital visit, so I'm not quite sure how the finances

> will work. I also have Humana insurance and am sincerely hoping

that

> they will agree to cover my surgery.

>

> Does the hospital have a payment plan for you to pay off your

bills?

> My husband wants me to sell off some of my stock for us to pay for

> it, but I'm convinced that we can set up an alternate plan that

would

> keep us from having to do that.

>

> I'm REALLY hoping that Humana covers the surgery because Blue

> Cross/Blue Shield has denied me coverage even after I filed an

> appeal.

>

> I'm so glad to hear that things went well for you and that you are

> healing nicely.

>

> How has your diet progressed? Are you wired shut or banded shut?

My

> doctors will be banding me shut, and I just had my lower surgical

> wire put in this week.

>

> Thanks for all your help and happy healing!

>