Wednesday May 16, 2007 6:41 PM

Well, we've had a few setbacks, but also a lucky accident. Here goes:

Jim's been having some really bad pain in his jaw. Almost every night he's up in the wee hours popping a Darvocet. I'm a little anxious about the Darvocet because you can get hooked on those things pretty easily, and then he'll have a whole other problem on his hands. Can you say "REHAB?" So the last Maxo-facial surgeon we saw said Jim needed to get his teeth addressed at a teaching hospital as an impatient, and of course these dentists don't understand that I'm going to 1)be lucky I can get him an appointment sometime between when the cows come home and when hell freezes over and 2) the chances of these people being in our dental and medical network are slim and 3) now I'm going to have the added problem of getting insurance to cover this stuff because who has their teeth removed as an inpatient?

Now comes the lucky accident. My mother-in-law tells me that her girlfriend has a son who's a doctor at "the hospital in Philadelphia" (well, there's a LOT of hospitals in Philadelphia) and 1) his mother's been keeping him informed about what's going on with Jim 2) the son says he can take Jim's PEG tube out if we can't find anyone else to do it and 3) he lives right in our neighborhood. So my mother-in-law gives me the son's name and phone number yesterday. His name is Kris Kaulback. So I Googled the guy. Turns out he's a surgeon at Thomas Jefferson University Hospital....JACKPOT! I called the guy today. He's home on vacation. I gave him a brief re-cap of what's happened and asked him about removing the PEG tube. Dr. Kaulback says he can do it right at our house...takes ten minutes. Then I told him about the issue with Jim's jaw and his teeth. He says, "Give me ten minutes. I'm going to make a couple phone calls and I'll call you right back." He calls me back and says, "I want to verify something with you. Your husband's had BOTH of his carotid arteries ligated?" I said, "Does that mean the same thing as tied off?" He says yes. When I told him yes he says, "Whew....and he has no loss of function?" I told him, "Yeah...we're very, very lucky." Dr. Kaulback was amazed. He hung up again and then called me back a few minutes later. First, he had the name of a maxo-facial surgeon that he'd already called so they were expecting my call. He also had the name of a vascular surgeon. He recommended that Jim hook up with one here and have yearly scans. He explained to me that if Jim has any problem with cholesterol in the future (and we know he does but we haven't been able to address it yet) that the average person would be able to tolerate it somewhat, but Jim could develop severe problems. So I got Jim into the maxo-facial surgeon this Friday, and the vascular surgeon next week. I would have NEVER been able to do that on my own. THANK YOU DR. KAULBACK! Want to know what else is great? Both of those doctors he referred me to are in network for us. And the oral surgeon is in network for both medical AND dental. YES! Dr. Kaulback went on to say that if Jim can get an appointment to get his teeth out soon, then just let him know when it is and he'll pop over and take the PEG tube out while Jim's under anesthesia. If he takes it out at home it's going to hurt.

The setback is that Jim's speech and swallow pathologist has recommended that Jim suspend his therapy temporarily until he gets his jaw problem resolved. I agreed with her. If he can't get the full benefit of the therapy because the jaw is bothering him so much, why keep doing the therapy? We're limited on the number of visits we can have paid by insurance, so why waste them.