Wednesday, April 21, 2004
What This Is Costing Me...So Far
I've been digging through my dental files and have come across my out of pocket expenses, and I thought I would post a schedule of some of the fees I have incurred to fix my smile:
$525...Crown, for premolar that later was pulled...March 7, 2002...(Dental ins paid $525)
$115...Tooth is pulled...Aug. 8, 2002...dental ins paid $160
$65...Orthodontic consultation with Dr. Goodman...Aug. 15, 2002
$447.50...bone graft...Sept 19, 2002...(dental ins paid same amount)
$30...Orthodontic consultation at NYU Dental...Feb. 11, 2003
$170...Records (Xrays, photographs and molds)...March 19, 2003
$973.56...SARPE surgery...July 18, 2003...(health insurance paid the rest, about $10-20k)
$900...2 years of cleanings...(6X per year at $100 each, minus dental ins reimbursement)
$3,000...Orthodontics...July 31, 2003...(after 25% discount for paying up front)
$40...lower incisor is pulled...Nov. 19, 2003 (after $50 discount and ins paid $160)
$6,266.06....Total so far
These figues do not include following:
--The root canal I had done in 2001 on the premolar that I ultimately had to have pulled
--The upcoming fees I will have to pay out of pocket for the implant(s) I will require.
--The office co-pays (at $20 a pop) for multiple visits to PCP, neurologist and ENT about the numbness
Addendum...Dr. Patel Aplogized
I forgot to mention in my post yesterday that Dr. Patel apologized to me for the delay in processing the insurance company approval for the CT scan.
I've been digging through my dental files and have come across my out of pocket expenses, and I thought I would post a schedule of some of the fees I have incurred to fix my smile:
$525...Crown, for premolar that later was pulled...March 7, 2002...(Dental ins paid $525)
$115...Tooth is pulled...Aug. 8, 2002...dental ins paid $160
$65...Orthodontic consultation with Dr. Goodman...Aug. 15, 2002
$447.50...bone graft...Sept 19, 2002...(dental ins paid same amount)
$30...Orthodontic consultation at NYU Dental...Feb. 11, 2003
$170...Records (Xrays, photographs and molds)...March 19, 2003
$973.56...SARPE surgery...July 18, 2003...(health insurance paid the rest, about $10-20k)
$900...2 years of cleanings...(6X per year at $100 each, minus dental ins reimbursement)
$3,000...Orthodontics...July 31, 2003...(after 25% discount for paying up front)
$40...lower incisor is pulled...Nov. 19, 2003 (after $50 discount and ins paid $160)
$6,266.06....Total so far
These figues do not include following:
--The root canal I had done in 2001 on the premolar that I ultimately had to have pulled
--The upcoming fees I will have to pay out of pocket for the implant(s) I will require.
--The office co-pays (at $20 a pop) for multiple visits to PCP, neurologist and ENT about the numbness
Addendum...Dr. Patel Aplogized
I forgot to mention in my post yesterday that Dr. Patel apologized to me for the delay in processing the insurance company approval for the CT scan.
Tuesday, April 20, 2004
Clear Sinuses, Deviated Septum
I had my appointment today with Dr. Patel, the ear, nose and throat specialist I had visited to evaluate my sinuses. He had the films from my recent CT scan and the CT scan report, and we looked at them together. The scan showed that my sinuses are all completely clear, with no fluid or blockage or inflammation. The scan does show, however, that my septum is deviated (crooked). He sprayed the fluids in my nose again, but he does not think this was the cause of my recent improvement, nor does Dr. Patel see anything he can do to fix my facial numbness. We talked about treatment for my deviated septum, but I am going to hold off for months before I even think about surgery again. Until then I will use nasal spray (he gave me a sample of Flonase) and also at his recommendation take regular Sudafed. He cautioned me that fixing the deviated septum will not do anything to fix the numbness. They are separate issues. He also said the surgery did not cause the deviated septum. He also said he thinks that my breathing is the same on the left and right sides of my nose, but because of numbness inside the left side of my nose, it feels like I am more congested on that side. He also recommended that I visit yet another neurologist for a second opinion on the numbness issue, as there may be something that can be done. He said there is a nerve in the palate. I have never been told until today that there is a nerve in the palate. That's where the bone was cut during surgery! He gave me the name of another neurologist. Here we go again.
I had my appointment today with Dr. Patel, the ear, nose and throat specialist I had visited to evaluate my sinuses. He had the films from my recent CT scan and the CT scan report, and we looked at them together. The scan showed that my sinuses are all completely clear, with no fluid or blockage or inflammation. The scan does show, however, that my septum is deviated (crooked). He sprayed the fluids in my nose again, but he does not think this was the cause of my recent improvement, nor does Dr. Patel see anything he can do to fix my facial numbness. We talked about treatment for my deviated septum, but I am going to hold off for months before I even think about surgery again. Until then I will use nasal spray (he gave me a sample of Flonase) and also at his recommendation take regular Sudafed. He cautioned me that fixing the deviated septum will not do anything to fix the numbness. They are separate issues. He also said the surgery did not cause the deviated septum. He also said he thinks that my breathing is the same on the left and right sides of my nose, but because of numbness inside the left side of my nose, it feels like I am more congested on that side. He also recommended that I visit yet another neurologist for a second opinion on the numbness issue, as there may be something that can be done. He said there is a nerve in the palate. I have never been told until today that there is a nerve in the palate. That's where the bone was cut during surgery! He gave me the name of another neurologist. Here we go again.
Thursday, April 15, 2004
The Results of the CT Scan
I had the CT scan of my maxillary sinuses on Tuesday, and Dr. Patel called me today with the results. He said the scan shows my sinuses are clean, and there is no evidence of infection. So the theory that my facial numbness is being caused by sinus pressure on the nerve is wrong. He recommended I go back to the surgeon (Dr. Karlis) and he also recommended I see a neurologist. Since I've already covered this over and over with Dr. K, and I've also seen a neurologist already, I have essentially hit a dead end. Since the CT scan also shows I do in fact have a deviated septum (which is the cause of my breathing difficulty), I'm going to keep my appointment with Dr. Patel on Tuesday. I'll ask him to spray inside my nose again.
I had the CT scan of my maxillary sinuses on Tuesday, and Dr. Patel called me today with the results. He said the scan shows my sinuses are clean, and there is no evidence of infection. So the theory that my facial numbness is being caused by sinus pressure on the nerve is wrong. He recommended I go back to the surgeon (Dr. Karlis) and he also recommended I see a neurologist. Since I've already covered this over and over with Dr. K, and I've also seen a neurologist already, I have essentially hit a dead end. Since the CT scan also shows I do in fact have a deviated septum (which is the cause of my breathing difficulty), I'm going to keep my appointment with Dr. Patel on Tuesday. I'll ask him to spray inside my nose again.
Monday, April 12, 2004
My "NOT IDEAL" Smile
I am still thinking over my last appointment at NYU orthodontics and what Drs. Han and Weston had to say to me. It was rather bad news. When I questioned him about the gap between my uppers and lowers, and the wisdom of having my lower tooth pulled, Dr. Han said that my final results will be, and I quote, "not ideal." Dr. Weston mentioned my "overjet" where my upper teeth will overlap my lowers. W also says I might end up with a gap between my two upper front teeth (he refers to this as a "black hole"). They are telling me this AFTER I had SARPE surgery last July and had the lower incisor pulled last November. The surgery has left me with lingering discomfort and numbness in my face and gums that I have been told may or may not be permanent. They also want me to get my upper teeth filed (they call this "re-contouring" or "interproximal reduction," but even with this additional treatment I am still going to have these less than ideal results! I am upset and unhappy at this point. I agreed to have the surgery and tooth extraction because I was told that this course of treatement would be the best thing to do. They should have told me beforehand what to expect. I don't know whether to continue with the treatment as it is going now, formally complain to NYU and ask for a review of my case, seek a second opinion from a different orthodontist, or some combination of the above. I'm thinking aloud here.
Big Delay With the CT Scan
The ENT doctor, Dr. Patel, wanted me to get a CT scan to see if there is an infection or other problem with my left maxillary sinus. According to Dr. Karils, such a condition could be causing the lingering numbness in my face. But it has been slow going with Dr. Patel. It took me two and a half weeks, six phone calls to his office and two emails directly to Dr. Patel himself to get his office staff to process the insurance approval for the CT scan, something that should have taken about 90 seconds. The soonest I could get an appointment for the scan was a week later, and the soonest I could get back in to see Dr. Patel again to discuss the CT scan results was another week after that. So after all these delays, tomorrow I am finally getting the CT scan. It will be another week before I can get any type of answer from Dr. Patel.
Facial Discomfort Eases a Bit, But Still Bothers Me Constantly
About two or three weeks ago I woke up one morning with a noticeable improvement in my upper lip. This came about five days after my first appointment with Dr. Patel in which he squirted some medicine up my nostrils. I don't know if the improvement was due to the stuff squirted up my nose, the vitamin B6 I continue to take, or some other factor, but it was the first improvement I have noticed in four or five months. The discomfort in my face now centers around the middle of the left side of my upper lip and the inside of the my nose on the left. Despite the improvement that I have had, this discomfort still bothers me day and night.
I am still thinking over my last appointment at NYU orthodontics and what Drs. Han and Weston had to say to me. It was rather bad news. When I questioned him about the gap between my uppers and lowers, and the wisdom of having my lower tooth pulled, Dr. Han said that my final results will be, and I quote, "not ideal." Dr. Weston mentioned my "overjet" where my upper teeth will overlap my lowers. W also says I might end up with a gap between my two upper front teeth (he refers to this as a "black hole"). They are telling me this AFTER I had SARPE surgery last July and had the lower incisor pulled last November. The surgery has left me with lingering discomfort and numbness in my face and gums that I have been told may or may not be permanent. They also want me to get my upper teeth filed (they call this "re-contouring" or "interproximal reduction," but even with this additional treatment I am still going to have these less than ideal results! I am upset and unhappy at this point. I agreed to have the surgery and tooth extraction because I was told that this course of treatement would be the best thing to do. They should have told me beforehand what to expect. I don't know whether to continue with the treatment as it is going now, formally complain to NYU and ask for a review of my case, seek a second opinion from a different orthodontist, or some combination of the above. I'm thinking aloud here.
Big Delay With the CT Scan
The ENT doctor, Dr. Patel, wanted me to get a CT scan to see if there is an infection or other problem with my left maxillary sinus. According to Dr. Karils, such a condition could be causing the lingering numbness in my face. But it has been slow going with Dr. Patel. It took me two and a half weeks, six phone calls to his office and two emails directly to Dr. Patel himself to get his office staff to process the insurance approval for the CT scan, something that should have taken about 90 seconds. The soonest I could get an appointment for the scan was a week later, and the soonest I could get back in to see Dr. Patel again to discuss the CT scan results was another week after that. So after all these delays, tomorrow I am finally getting the CT scan. It will be another week before I can get any type of answer from Dr. Patel.
Facial Discomfort Eases a Bit, But Still Bothers Me Constantly
About two or three weeks ago I woke up one morning with a noticeable improvement in my upper lip. This came about five days after my first appointment with Dr. Patel in which he squirted some medicine up my nostrils. I don't know if the improvement was due to the stuff squirted up my nose, the vitamin B6 I continue to take, or some other factor, but it was the first improvement I have noticed in four or five months. The discomfort in my face now centers around the middle of the left side of my upper lip and the inside of the my nose on the left. Despite the improvement that I have had, this discomfort still bothers me day and night.
