Tuesday, December 15, 2009

Overcoming Fear

I think a major portion of going through with this surgery is overcoming fear. Many months prior to this surgery, I began researching it. One thing I knew is that I wasn't living healthily with severe obstructive sleep apnea. I was reflexively throwing the mask off at night in my sleep and getting very frustrated. I tried many different masks. I even saw a neurologist that put me on several different powerful medications to try to keep me down at night. They didn't seem to be helping much and these medications had pages of side effects with risk of dependency, so I eventually stopped taking them. I often spent an hour or two some nights, lying awake with the mask forcing my breathing wishing I would fall asleep. Those nights, I would throw the mask off in disgust hoping I would get some sleep, even with sleep apnea so that I could concentrate and make it through the next day. I was caught between a rock and a hard place.

At first, this surgery seemed so unnatural and like some sort of medieval torture with saws. It is literally in your face and working with bone saws. It could change your appearance, significantly. Its working around nerves and arteries. Its five plus hours long. It involves a significant recovery period where a ton of tight rubber bands are placed on your braces to keep your jaw closed and stationary. A liquid diet. Oh, and did I say it involves getting braces which is another torture (emotional and physical) in itself?

So, I was looking at untreated severe obstructive sleep apnea with likely heart disease, hypertension, and all the mental issues due to getting a fifth of the normal sleep someone gets, or what I currently saw as torture. Your not giving many options here are you? So I joined the orthognathic surgery support group at:


and started reading. I made appointments with a few orthognathic surgeons and started researching them. Luckily, I also had a good friend that had been through the surgery which I asked a ton of questions.

Things were a slow process at first. My surgeon generated several models and sent of a surgical plan to the insurance company to get approved. Apparently, insurance companies love to lose stuff (or say they did), ask for more data, and drag this process out for as long as legally possible. My surgeon's staff was simply outstanding at battling them so I had little involvement.
Eventually, my surgery was approved as "medically necessary" and we scheduled a date in the operating room.

Then things really started to sink in. Though all my research started to bring comfort, it began to bring awareness to what could go wrong. My friend Mike who had the surgery was now cured of sleep apnea, but he also had a nasty post-op infection due to a surgical mistake. Could my doctor make a surgical mistake? Funny thing is, Mike's sleep apnea was so bad he states he would of gone through the surgery again, knowing there were three additional surgeries to cure his infection to cure the sleep apnea. I almost felt like I was in the same place.

About a month prior to the surgery, I began to freak out. I found a paper on the internet which listed all the major complications of orthognathic surgery. I posted to the yahoo group and fired off email after email to my surgeon. Eventually, I scheduled an appointment with him and we went over the list of all my deepest fears about the surgery. For being a surgeon, he answered every question thoroughly and looked me in my eyes. Though there were no concrete promises, I realized if something were to go wrong, he would help me fix it. Trust had developed.

The only fear we have is...if the insurance company doesn't pay! With several days of hospitalization, anesthesia, surgeons fees, and OR time, this surgery is the price of an expensive luxury sports car (roughly $75,000). After my surgery was deemed medically necessary, this was not guarantee of payment. There is yet another pre-determination board this has to go before and things were ticking down to the wire. As all models were sent certified mail, we had proof that my insurance company received them. Then, they said they lost them. Then another department verbally said they found them. Then, another department said they don't have them a few days before my surgery and that I was still not pre-determined. @#$#$%$!
I envisioned the ill financially destitute crying homeless parents forced to live with their children from Michael Moore's Sicko, as Laura and I. Except, my kids are six and eight, so we were really screwed. I launched a nuclear assault of phone calls and threats at my insurance company. Hours were spent by several people in my orthognathic surgeon's office battling with the insurance company. Finally, the day before my surgery, it was approved and pre-determined. Phew!

Being on the other side now, the funny thing is I look back and laugh at all the emotional energy spent. If you think back to when you were learning how to ride a bike, or dive off the high dive, and it is the same thing. Fear can paralyze and dominate you. One of my fears was realized after my first jaw surgery. Loss of fixation occurred and I had an open bite. My trusted orthognathic surgeon quickly fixed it a week later. Fear dismissed, again.

I had eighteen printed out questions for my surgeon today. Some of them were still fears. Could we lose fixation again? When will I regain feeling in my chin? Could I still develop a post-op infection? My jaw hurts and is stiff, is it TMJ? Each were addressed. No concrete promises, still, but I am feeling much better.

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