Saturday November 3, 2007 10:39 AM

Big drama over Jim’s teeth. Here’s the breakdown of the players involved: Dr. Decidua is the maxiofacial surgeon. He’s been sick so he’s delegated to Dr. Tursin, who I’ve never met- only spoken to on the phone, and Dr. Dew, the idiot we met at our first appointment with Decidua- the one who asked, “Do you want ALL his teeth pulled out?” Then there’s Dr. Vanni in North Philly- the one who’s going to make the teeth. The game plan from the get-go has been for Jim to get something called overdentures, which are just dentures but they’re held in place by implants. Dr. Vanni had told us that Jim will either get four large implants, or eight small ones, but we won’t know what course will be taken until the teeth are pulled and they take a look at Jim’s bone structure under the teeth.

Now, very little of this is covered by insurance. Our plan only provides for 2K a year in benefits, and that’s getting eaten up by the cost of the extractions. The implants would normally be covered at 80 percent, but at a couple grand per implant, even if Jim had insurance money left, that would only be a drop in the bucket. So this is going to cost us major, major bucks. I’m guessing about 20 grand. We’re going to HAVE to move to Idaho after all this so we can get away from our creditors. Ha ha ha.

So Tuesday I get a message on our answering machine from Jill at Dr. Vanni’s office giving me the cost of finishing the implants and for the bar that goes into the dentures. See, not only do you have to pay for the implants, you also have to pay another $2500 for getting them FINISHED. I couldn’t call her back on Wednesday because Vanni’s office was closed. But I get a call Wednesday from Rita at Decidua’s office. She tells me we’d have to pay our portion of the extractions up front: $603. I ask her about the implants. She seems surprised. She says it was decided that Jim wasn’t getting implants- just dentures. I asked her, “Who decided THAT? No one spoke with US about it.” Rita said that Dr. Vanni had spoken with Dr. Dew and Vanni told Dew no implants. I told her, “Then why did Jill from Vanni’s office leave a message with the cost of finishing the implants? Our plan all along was for implants.” I know where this came from. Dew never has his listening ears on, and he’s an idiot. So I’m on the phone throughout the day with Tursin and Rita, and finally they call me and say that the implants are $1800 apiece and they’d place four of them. I say to her, “Is that the Guardian contracted rate or the I’m-walking-in-from-the-street-with-no-insurance rate?” See, I learned last year when Jim’s prior dentist was working up a price for us that if the provider contracts with your insurance plan, even if an item is not covered, the dentist has to charge you the insurance contracted rate, not the regular rate, but dentists always want to try to get over on you hoping you don’t know that. So I stood my ground with Rita, and she called back to say the implants were now $1500 each. She suggested that if Jim wait until January to get the implants that $2K of that would be covered. Well, I thought about it, but how could I put Jim through getting his teeth pulled, healing for six weeks, and then digging his gums up AGAIN to put in implants? No. The guy’s been through too much this year. Jim said he would wait, but you could tell that’s not what he really wanted to do, so I told Rita to go ahead with the implants on Monday. So away we go.

We won’t know what time the surgery is scheduled for until Sunday night.

Tuesday October 30, 2007 9:36 PM

Jim saw Beth on Thursday and she liked what she saw. He can open his mouth up into the normal range now...well- the low end of normal, but normal. However, she doesn't recommend he start therapy again until he has his new teeth. And before he starts his first therapy visit he'll need to have another barium swallow study done. If he gets the teeth pulled next week and has to wait for his new teeth to be ready, and our insurance winds up changing January 1st, I don't know what's going to happen with therapy. I don't want him approved through Aetna for 60 days and then he can't finish. I guess we'll have to cross that bridge when we come to it.

On Friday night I heard from Dr. Kozuch about my bacterial overgrowth test. I also asked her about my fungal infection because it's back. She's stumped as to why this keeps happening to me. In the meantime, she prescribed more Diflucan and an antibiotic. I take the Diflucan first, then when that's done start the antibiotic. I tried to fill the prescription for the antibiotic and it has to be pre-approved. So much for that. Good luck getting the pharmacy and Aetna and Dr. Kozuch to all connect. I still haven't heard back about it. I guess I'll try to call Kozuch again tomorrow.

Jim saw Useless Sobel yesterday and got his approval for his surgery next week. Jim told me it was a total joke...he was in there for five minutes. He had to trek all the way to Philly for that. But at least it's done and he can get these teeth over with. What he has in there now is just GONE and he's missing so many it's interfering with his ability to talk.