TMJ Surgery Toolbox..Ten Things That Will Help You Get Ready

1. Dealing With Insurance
If your insurance company denies coverage for your TMJ surgery there are several steps you can take. The important thing to remember is to be consistent, and pay attention to deadlines.

• You may appeal the decision not to pay by writing a letter to your health care provider stating your reasons for appealing their decision. The written denial that you receive must state their reason for not covering your service, and must also explain your right to appeal.
• Be sure to read the fine print to find the date by which you must submit your appeal. Remember, the insurance company does not have to consider your appeal if you do not meet the deadline.
• State in your appeal why you think your insurance provider is wrong to deny your surgery. Ask your doctor to write a letter that explains why you need the surgery, and what other treatments you have tried and why they didn’t work.
• If your insurance provider again denies coverage you can appeal again. Your second notice of denial should again contain a deadline for appeal. If you are again denied, you can ask for an external appeal. In an external appeal, a person who does not work for your insurance provider makes the decision.

Some of the most successful arguments and simple and use common sense. Be persistent

2. Start a Pain Management Dialogue Well Before Surgery
The time to talk about post surgery pain relief is before your surgery.  The right pain relief is key to your recovery. Here are some tips to help prepare you for adequate pain relief:

• Talk with your doctor before surgery. Discuss previous experiences with pain. Let him/her know what did and did not work for you.
• If you have chronic pain, your body may be less sensitive to pain medication. Discuss this in detail with your doctor.
• Provide your doctor with a list of all the medications you are taking,  both prescription and over the counter.
• Ask questions, find out how severe the pain is after the type of surgery you are having and how long it is anticipated to last. Ask what type of pain meds are given before and after surgery, and what the side effects are.

Post surgery pain control is a balance of benefits and risks. Finding the right balance for you is key to your speedy recovery.

3. Getting Ready For The Surgery Day
Getting organized before your surgery will help you feel more in control and is an important step in a successful recovery. Here are some tips to help you prepare:

• Write down any questions you have for your surgeon…and don’t leave your appointment without having them answered. It is always a good idea to bring someone with you to this appointment just in case there is something that you miss.
• Request a copy of your post-surgical instructions and read them ahead of time.
• Ask your physician to pre-write your post surgical prescriptions, and get them filled prior to surgery.
• Arrange a driver for drop–off and pick-up after your surgery…even better, have someone who will wait while you are in surgery.
• Consult with your anesthesiologist address any issues you may have had during prior surgeries…such as nausea.
• Discuss how your pain will be managed and by whom.
• Prepare a list of phone numbers for necessary contacts…such as doctor’s office, friends, pharmacy, family, caregivers etc.
• Get your support team ready…we will discuss this later.

Following these guidelines will ease some of the pre-surgical stress

4. Take Care of Work Responsibilities
It is important that when you first find out that you are going to have surgery you begin a dialogue with your employer.

• Ask your surgeon how much time off you will need after surgery. Many times this will depend on the type of work that you do.

• The Family and Medical Leave Act, or FMLA, provides important rights to employees who need to take family or medical leave — that is, time off from a job in order to attend to personal and family needs. But these rights under the FMLA rights are limited, and the time off is unpaid. In addition to the federal FMLA, many states have enacted their own family and medical leave laws, some of which cover more workers or provide greater benefits than the federal law. And many employers are picking up where federal and state law leaves off. Check with your employer to see what their policy is regarding  FMLA

• If this is elective surgery your employer may require 30 days advance notice.
• Does your employer have a policy regarding work from home, or working half time.

5. Take People up on Their Offer of Help
When people ask what they can do to help, give them some suggestions. Don’t be afraid to say “yes, you can help.” Everyone can use a little help sometimes. As you talk to family and friends and they offer help, take a look at your list and see where each can help. Ask if and when they’d be available on short notice, should you need an extra pair of hands-or a set of wheels.
Here is a list of things you may need help with:

• Pick up the mail and newspaper
• Water flowers outside
• Mow grass
• Shovel snow/salt the walk
• Let the dog out…better yet, send the pets to grandma’s!
• Let the cat in
• Prepare and deliver a meal for the family…this can be done in advance and frozen
• Help with laundry
• Pick up children at school, or be available to meet the bus
• Take children on a fun outing
• Bring work from the office

6. Foods, Trial and Error
Once your surgeon has given you your post op instructions (get these from him as far ahead of surgery as possible), it is time to start planning your menu during recovery.
Tips on how to get started:

• Test some protein powders and meal replacements. (you don’t want to get home from the hospital and find out that you hate the taste).
• Many health food stores carry one serving packets of protein powders,buy a few and try them out. You can also order these online.
• Stock your pantry with all the things you will need for the type of diet your doctor recommends (soft chew, no chew, liquid etc).
• Test out some blended recipes. When you come up with ones you like, you can prepare them in advance of your surgery date and freeze them.
• If something tastes really bad….add a banana….LOL
• While it is tempting to eat ice cream all the time, you will get sick of sweet foods really fast.
• You also might be tempted to chew……don’t do it until your doctor gives you the go ahead.

7. Setting The Stage For Sleep
Sleep is known to be a general healer. Not only does it promote the rejuvenation of the immune, skeletal, muscular, and nervous systems, but it is literally a healer in that the lack of sleep reduces the body’s ability to heal wounds. So, the question is: How do I set the stage for sleep after surgery?

• Be sure to discuss pain management prior to your surgery…have all prescriptions filled and waiting for you at home.
• Have pillows in your bed to make a nest out of. Two along your sides, one under your knees to keep you on your back and to relieve pressure on your lower back. Many people have used the large “body pillows” and others have used the pillows with arm rests that are used for sitting up in bed. Practice using them prior to your surgery to see what works best for you.
• Many patients have told us that they prefer to sleep in a recliner.
• Keep your room at a cool temperature

A famous person (I just can’t remember who), once said  “No day is so bad it can’t be fixed with a nap.”  I agree wholeheartedly.

8. Find a Surgery Buddy
Many patients find that after making the decision to have surgery, waiting for the surgery is the hardest thing they have to do. This is where a surgery buddy comes in. Find someone who has already had your specific surgery. Many times a buddy will be able to fill you in on some tips that your surgeon has not thought of. I recall after a surgery someone told me to put a plastic chair in the shower……it was a lifesaver! You may be able to get recommendations on protein powders, meal replacements, pillows, etc. The greatest benefit is in having someone to bounce questions off of who has been through it, someone who “gets it”. TMJ Hope is a great resource and our forum and facebook pages provide a place where you can interact with other patients.

9. Take Good Care of Yourself
While most doctors will prepare you with a list of things to do and not do after you’ve gotten out of the operating room, there are a couple of things that are just common sense when it comes to speeding up the healing process.

• Get plenty of rest and take it easy while under the affects of anesthesia. When you first wake up after surgery, you are likely to feel so tired you can barely keep your eyes open. Your body will be exhausted and your head will feel groggy. It’s best just to sleep the affects of anesthesia off and relax your mind and body for the next 24 hours. This is not to say you have to sleep this long, but you should sleep until your body feels well again. It is ok to be tired, sleep when you need it
• Try to keep as gently active as you can. Try to go out for a walk every day if it is recommended by your surgeon, and build up slowly.
• You may feel low, depressed ,sad, or irritable, some of this may be due to the medication, and some of it is just normal recovery. This would be a good time to start interacting with friends…even if it is just a phone call or a brief visit.
• Don’t do too much too soon. Listen to your body if it HURTS or is EXHAUSTED.

10. You Are Not Alone
Being diagnosed with a chronic illness such as TMJ disorder can leave you feeling alone and isolated. Once you have had time to process your diagnosis it may help immensely to reach out to others for support. It is a common belief that people who feel supported often have improved health outcomes both emotionally and physically.

• Support from others reduces stress. Stress can trigger symptoms or flares for many people.
• Support keeps you on track. Just having someone check to see that you’re taking care of yourself helps you manage your illness better.
• Support allows you to put positive energy back into the world. You can do this with family, friends, with self-help groups connected with your illness, community groups. or online groups such as TMJ Hope!
• Support can validate your feelings. When you begin to question “Is this real or all in my head?” Finding others with the same symptoms and experiences gives you a feeling that it is real and not just in your head.
• TMJ Hope offers you a home away from home with friends who understand what you are going through.