Archive | 8:44 pm

Monday shopping

6 Apr

I made a quick stop at the Safeway across the street from my dentist’s office after my appointment so that I could buy some full-sized straws. I also ended up buying some bananas for smoothies and some chocolate soymilk, which was on sale.

After a brief stop at the office to arrange a ride home from the oral surgeon’s after my procedure, I went to Walgreens. There I acquired a Water Pik (I opted for a cordless model since my bathroom doesn’t have any outlets), a two-pack of children’s toothbrushes, and a package of little brushes, called Brush Picks and made by a company called DenTek. Although nobody had suggested this last item to me, I bought it because the brushes reminded me of some brushes that I used to use when I had orthodontic braces. They came eight to a package, and each one has a small brush at one end and a flexible pick at the other end. Eight is more than I’ll probably need, but this was the only size package I could find.

I then caught a bus to Whole Foods Market, where I purchased soy protein powder, antibacterial soap, natural mouthwash (Tom’s of Maine brand) and a couple of Amazake smoothies. I bought some frozen fruit with the dual purpose of adding to smoothies and icing my jaw on the bus ride home.  I also looked for a calcium supplement, which proved to be harder than I thought. The supplements were organized by brand, so I had to look through each brand separately (rather than finding all of the calcium supplements in one place). I couldn’t find one that was specifically labeled as being vegan, and eventually an employee came over and asked if I needed any help. I told her what I was looking for, and she told me that calcium citrate should be vegetarian. I didn’t have the energy to explain the difference between veganism and vegetarianism, but I was baffled that somebody working in the supplement section of Whole Foods in Berkeley could lack that knowledge. She started pointing out different supplements to me, but I had already decided that she wasn’t going to be much help. Eventually, she left to check on something else (for which I was relieved), but she told me she would come back. I managed to find a supplement whose ingredients looked vegan (although it was only labeled as “Suitable for Vegetarians” and free of dairy). It seemed good enough, especially given the circumstances, so I took it to checkout and paid.

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An insurance form

6 Apr

This afternoon, I completed an insurance form for the cycling club. I don’t really understand what it’s for. I don’t see why there would be an insurance policy that would pay anybody other than me (the club didn’t incur any costs from the accident), but I’ve already signed a waiver freeing the club from any liability.

The form wasn’t particularly remarkable except for two things. First, it had checkboxes for 21 body parts, and I was to indicate which had been injured. I ended up checking just under half of them (10). However, most of the injuries were very minor, such as light scratches on the front of my neck and my right ear. The second thing was that I was asked to indicate whether my injuries were minor or serious, and I wasn’t sure what the answer was. While a broken jaw certainly isn’t fun, plenty of people recover from it, and relatively quickly. I assumed that there was some serious legal definition of “serious injury,” and I looked around and found that I was right, at least in the State of New York.  A Google search turned up a page on the New York serious injury threshold:

“Serious injury” means a personal injury which results in death; dismemberment; significant disfigurement; a fracture; loss of a fetus; permanent loss of use of a body organ, member, function or system; permanent consequential limitation of use of a body organ or member; significant limitation of use of a body function or system, or a medically determined injury or impairment of a non permanent nature which prevents the injured person from performing substantially all of the material acts which constitute such person’s usual and customary daily activities for not less that ninety days during the one hundred eighty days immediately following the occurrence of the injury or impairment.

I’m nowhere near New York, and neither is the insurer, but this was good enough for me. While most of that wouldn’t describe any of my injuries, I definitely have a fracture.

Monday doctor visits

6 Apr

I called the oral surgeon’s office as soon as they opened at 8AM. They were able to make an 11AM appointment for me, but they told me that  I should get a referral from University Health Services (UHS) so that my student health insurance plan would cover treatment. I called UHS, and they told me that I should come to urgent care to get my authorization.

I very much resented being required to get this authorization. It seemed ridiculous that they couldn’t just trust the emergency room doctor’s word that I needed to see an oral surgeon. I spent the better part of an hour waiting at UHS before seeing a nurse and then a doctor. The nurse took my temperature and my blood pressure (both were normal) and asked me a few questions about my accident and the injuries. She showed me a piece of paper with faces showing various levels of discomfort and had me rate my pain according to the numbers labeling the faces. However, there were two sets of labels, one from 1-10, and one from 0-5. I didn’t ask which one she wanted me to use, but I said my pain was about a 2. For the most part, my injuries have been a bit uncomfortable, but not particularly painful.  The doctor looked at my various injuries and had another nurse bandage my scrapes. This actually made me rather glad to have come in because I had so many scrapes and not enough energy to bandage all of them. The nurse also gave me material for dressing my wounds for the next five days before I go back to get my stitches removed. I left with a bill of $15.60 not covered by insurance. Most of that was for the bandages the nurse had given me, which were $55 before insurance  (and $11 after).

About an hour after getting out of UHS, I had my appointment with the oral surgeon. He seemed nice and friendly without being intrusive (and, as a somewhat shy individual, I’ve found a lot of medical professionals to be intrusive). He showed me my x-rays, and explained my fracture, a condyle mandibular fracture. I was mildly disgusted when he told me that the model skull on which he was pointing out the condyle, a thin part of the mandible near the joint, was a real human skull, and I became altogether horrified when he removed the jaw from the skull and asked me to hold it.  He told me that the condyle fracture was a common type of fracture, which usually was treated without open surgery. The usual treatment was to anesthetize the patient, prod the bone back into place, and wire the jaw shut for a few weeks. In a small proportion of cases, however, this doesn’t work, so an open surgery is necessary. He added that there was a small number of cases in which it isn’t necessary to wire the jaw shut; sometimes the bone will stay in place well enough that  it is sufficient to keep the patient on a liquid diet. He didn’t specify any time frame for the liquid diet, so I asked if this liquid diet would be for the rest of the patient’s life. “No, just a few weeks.” he answered, laughing.

In my case, the surgeon said, it will be necessary to wait a few days until my face is less swollen to do anything. He wasn’t sure whether it will be necessary to wire my jaw, and he won’t know until he has me asleep in the office. He told me he would have his receptionist call me in the afternoon to set up an appointment.

The oral surgeon also expressed concern about my two chipped front teeth. I told him that I was planning on having them fixed, but I thought that the broken jaw was a more pressing concern. He agreed, but said that I should have a dentist put a temporary seal on it. He said that since I had only  lived in the area for seven months, he couldn’t imagine that I would have had any reason to find a dentist by now. I was more than a little bit amused by this, having long been told that I should have a dentist clean my teeth every six months. I said, that I had, in fact, found a dentist, and I told him who it was. The oral surgeon told me that my dentist was a great dentist, and then made an appointment with the dentist for me that afternoon.

I also asked the oral surgeon if he had any suggestions for keeping my mouth clean if my mouth were wired shut. He suggested getting a children’s toothbrush and Sensodyne toothpaste. I wasn’t crazy about the Sensodyne suggestion, but I decided to get a children’s toothbrush to use with my usual Tom’s of Maine toothpaste.

I had plenty of time to get to the dentist’s office, but somehow I still ended up running to catch the bus to get there. This certainly wasn’t a good thing for me to be doing with broken jaw, but I didn’t fall, and I did catch the bus. When I got to the dentist’s office, he put a seal on one of the teeth, which he said almost had a nerve exposed. He said that both of the teeth were only chipped in the outermost layers, and he expects that they will be fixable. However, we’ll have to watch them carefully, and they may end up needing root canal work.

I repeated the question about keeping my teeth clean to the dentist, and he suggested a Water Pik, so I added that to my shopping list, too.

About twenty minutes after I got out of the dentist’s office, I got a call from the receptionist at the oral surgeon’s office. She told me that the next two appointments available were Wednesday of this week and Tuesday of next week. She added that she’d have to check with the surgeon to see if Wednesday would be too soon and call me back later. She also told me I’d need a friend to drive me home from the procedure, so I headed into the office to find somebody who could do that for me.

I was relieved to learn when the receptionist called me back a couple of hours later that the surgeon will be able to do the procedure on Wednesday. Although I’m not in pain most of the time, there are enough positions that are quite painful, that I’d really like to get it done as soon as possible. After scheduling the appointment, the surgeon transferred me to another member of the office staff, who told me that their office didn’t contract with either of my health insurers, and she told me the cost of the service, which was just under $3700. I knew that my insurance would cover some of the costs, even if it was out of network, but I wondered why I was referred to an out-of-network doctor in the first place. I know I’ll be able to afford whatever it costs, but of course I’d rather pay for as little as possible.

Sleep

6 Apr

Sleeping is proving to be something of a challenge. I fell asleep three times last night, but for only about ninety minutes each time. There just isn’t any comfortable position for me to sleep in. I can’t tilt my head far enough back to lie down on my back, so I’m left with a choice of my badly scraped right side or my left side with the mandibular fracture. I’ve chosen to sleep on my right side since the scrapes are less serious than the fracture, but even that hasn’t gone so well.

The evening

6 Apr

After arriving home, I showered (carefully, to avoid getting my sutures wet) and called my parents to let them know that I had made it. I realized that, as it was Sunday, the pharmacies might close early, so I should go to pick up my prescription for Vicodin as soon as possible. While I’ve generally tended to avoid using painkillers (I didn’t use any when I had my wisdom teeth out), I decided that it would be good to have them on hand, just in case. Checking online, I found that none of the area pharmacies was open later than 6PM. I hurried to catch a bus to the nearest Long’s Pharmacy, arriving in the pharmacy line at 5:45PM. Fortunately, they were still able to fill my prescription.

I also looked for Fixodent, which an EMT recommended to me earlier to temporarily seal my teeth until I could see a dentist. However, I found that this product came in several different kinds, all of which were intended to be used with dentures, so I decided to wait until I could talk to a dentist to see what to do.

I arrived home to realize that I needed to buy straws so that I could drink without getting the sutures on my lip wet. Even without the sutures, drinking without a straw would be a challenge because my lower lip was swollen. I planned to take a walk out to Andronico’s, the nearest grocery store (and one I dislike very much), to buy a box of straws. This was complicated by the fact–for which I am very much appreciative–that the ride leader was planning on bringing my bicycle to my apartment from the fire station, and I didn’t have my cell phone, which was with my bicycle. When I managed to convince myself that I had enough time for the trip, I made the trek down to the store. I looked through what I thought was the entire store twice without finding any straws, so I settled on buying the cheapest package of juiceboxes that I could find. These, of course, come with small straws. I did find the straws after paying for the juiceboxes; they were along the wall at the end of the checkout lines.

I returned to my apartment and blended a can of Amy’s Lentil Soup and then drank it through one of the juicebox straws. I don’t generally find canned soups to be very filling, but I wasn’t very hungry, so this was enough.

The ride leader stopped by with my bicycle. He was very nice and apologetic about the accident, which I assured him was exclusively my fault. Along with my bicycle was my phone (in good working order), and my helmet, which doesn’t appear to have been damaged in the slightest (I will replace it out of caution nonetheless).

I’m going to go to bed soon. I made an attempt to brush my teeth not long ago, but it was not successful due to the level of swelling in my mouth. I also haven’t taken the Vicodin that I rushed out to buy, and I don’t plan to do so before going to bed.

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