My Corrective Jaw Surgery Experience
Pre-Surgery PhotosClick thumbnail to view full-size
The Night Before
My boyfriend, Doug, was allowed to stay the night for the first time in four years, and I considered this to be a seriously monumental moment. He slept in the spare bedroom—only because my dad insisted that I be well-rested for tomorrow’s procedure. I wasn’t sure why I needed my rest since I would be snoozing for a good eight hours on the operating table, but I agreed nonetheless.
I slept decently that night. I knew God was going to take care of me, so I didn’t worry. I’ve never been a huge believer in the higher power above, but whenever I have something scary ahead in my near future, I look to the sky, cross my fingers, and talk to the man upstairs. I kept telling myself I was going to stay strong because if I didn’t, the surgery would not be successful.
My alarm sounded at 4:45 am. We needed to be at the hospital by 7 am. We should leave the house by 5:45 am.
I heard dad in the shower, so I went into Douggie’s bed and snuggled with him for another fifteen minutes, holding onto each other and knowing that this would be the last cuddlefest for a while.
Surgery Day: August 17, 2011
Getting to the Hospital
It was now time to put our gears in motion and get ready. I had gathered most of my things the day before. I had my laptop for my dad to use while I was in surgery, my vomit bucket for me for the ride home after surgery, and my backpack filled with items for the hospital stay: pajamas (a button up shirt and PJ pants), a book, a baby toothbrush that I never used, comfy, warm socks (so glad I brought these), and deodorant.
In the kitchen, everyone was eating Cheerios. Mom looked over at me and asked if I was going to eat anything. Then, shortly after, she says, “Oh. Nevermind,” as she remembers I couldn’t eat anything after midnight the night before so my stomach is empty of food before surgery.
Doug and I followed mom and dad in their car—there wasn't much chitchat on the way. It was a beautiful day, and once we were within miles of the hospital, the fog rolled in. We could barely see the mountains. We arrived on time and entered the hospital to check in with the lady at the desk.
In the Waiting Room
The desk lady was very nice happy for 7 am. She found me on the list of day-surgery patients and showed me a form stating that my hospital room would cost $1200. She reassured us that our insurance would cover it and instructs me to wait in the waiting area. Thank goodness we had insurance at the time.
The waiting room only had a few occupants. Mom eyed four open seats in the middle, and we began to approach them when the desk lady redirected us again. She brought us to another receptionist in the hospital area, where nurses and doctors in full hospital attire strolled the halls. I don’t remember stating my name or signing anything, but I followed the lady as she walked from behind the desk into a small one-patient room. My clan of family members followed. Mom asked if they were all allowed in, and someone responded that it would be fine for now, but that some of them may get shooed away shortly.
We enter my little room, which had a curtain, a bed, two chairs, and a big, empty, white bag with a sticker with my name on it. I’m instructed to get into my Johnny, remove all clothing items, shoes, and jewelry, and place them in the white bag. My dad asked me if I want mom to stay and help me get ready, or Doug to stay and help me get undressed. I chose the latter.
As mom and dad exit, Doug starts to smile. “Did you hear that? I can help you undress!”
We laughed, I changed, and I hopped into bed with my stuff tossed into the white bag.
Doug sat in the chair beside me. We sat there for a while. Doug looked nervous. I had a lot of visitors that morning: the nurses confirmed with me that I had nothing to eat since the night before, and the anesthesiologist team came in after. They told me what to expect in terms of tubes that would be shoved up my nose and in my breathing passage and how those might cause a sore throat upon waking up.
They asked me if I’ve ever had any weird reactions to anesthesia and tell me about the anesthetic cocktail they will be serving me shortly. Apparently, it would make me feel like I’ve consumed two alcoholic beverages.
Finally, my surgeon, Dr. Addante, comes in, calm, cool, and collected, as he always is. He told me that I should expect a good deal of swelling and that he may not need to do the chin genioplasty he had previously discussed with me. He said he wouldn’t know until he’s working in my mouth because X-ray images differ from the actual mouth. (I never had to have the genioplasty procedure.)
Then, the nurse came in to hook me up to an IV. I looked away when I felt a prick in my hand. Again, I knew God would help me, but there was no reason to look at it being inserted, so I looked up at the ceiling. Doug asked me if I was okay—I knew he hated seeing me in pain. I smiled for him.
They told me to go pee when I could so that they can take my pregnancy test. Doug looked nervous; I told him it’s routine.
They take my pregnancy test, and the lady smiles and says, "Good news! You’re not pregnant!” Doug laughs out loud and thanks her.
The nice nurse who inserted my IV came in looking annoyed. She told me they needed more blood but wished they had told her that before she did my IV. She said she hated pricking people more than once. I nodded; I, too, hated being pricked more than once. She pricks my right arm and takes two vials.
I thought about that cocktail, and I told Doug not to worry about me.
The curtain to my room opened. Dad’s head popped in. He goes to get mom, who has her big knitting bag with her. They went to the car to get all of their stuff to keep them busy for the next eight hours. Apparently, an hour had already elapsed here as mom’s made progress on her knitting projects.
The clock was ticking. I was told surgery wouldn’t begin until 8:30 am that day, per the hospital’s schedule. I was antsy to get the procedure under way, but I liked the delay—a few more minutes to spend with Douggie.
A man came in and told me it’s time for my well-awaited cocktail, and I waited for it to enter my system. I hate the feeling of liquids entering my body through an IV. It makes me cringe and just feels bad and unnatural. I looked away and thought happy thoughts.
Mom and dad said goodbye and told me they love me. Doug was the last to go and kissed my head. I hear their words and I respond, but the drug was hitting me hard.
I was wheeled out in my hospital bed. I saw mom, dad, and Doug in the hallway, smiling at me and waving. They were all blurred; I felt like a drunk. I laughed as I was wheeled past them.
The surgery table was cold. I was laughing and then I was out.
I woke up after surgery and I could barely open my eyes from exhaustion. I heard voices of my family members, but couldn’t see faces clearly. It was around 6pm and all I wanted was sleep.
Soon after, my eyes were shut once again.
I woke next around 9pm and this time much more alert. I asked the nurse taking care of me for the night where my family was. I then realized I was talking weird. I know now that she could not understand me. I asked for a book to read. I’m sure I wasn’t aware of my situation and what I was unable to do, such as read, write or talk. I also asked for a pen and paper. She complied with the latter request. On paper I asked where my family was. She told me they were there a few hours before, and I then started to recollect their visit.
I kicked myself for being asleep. I was bored and lonely in this hospital bed. I couldn’t breathe for the life of me. But I did have a cool suction thing that sucked out all my spit in my mouth. This thing was my best friend. I had a rag on my shoulder to wipe my nose, which was generously oozing lots of blood. I dozed in and out most of the night, always waking up gasping for air due to my blood filled nostrils.
I woke up at 3am and pulled my little television-set forward so it hovered in front of my face, and tuned into Hot in Cleveland. I kept the volume low but there were not many other patients present in the recovery room. The one bed directly across from me came and went all night long. I would fall asleep and wake up and see some poor bandaged soul sitting up directly across from me. It didn’t even occur to me that I looked just as bad as him, if not worse. I fell back asleep and later woke up to an empty bed across the way and thanked God that there was no one gawking at me from afar.
Morning had come at last. It was 6am and I was ready to say goodbye to this hospital bed. Or so I thought. I wasn’t really in pain but was seriously plugged up in my nose. I sat upright in bed. I then realized I hadn’t had a glimpse of myself yet. I shut off my television set. Looking in the little 7-inch screen, I checked out my massive face for the first time. Thankfully, reflections in television sets are not completely accurate. This plus the generous dose of medication made me not look as disgusting as I thought I would. I let out a sigh and turned the television back on.
Hours went by as I switched between lying down and sitting upright. My bum was going numb and I had cushy things on my legs to help with circulation. I was getting antsy. My surgeon checked in on me and found me some chapstick. He said I was doing great and told me what to expect in the next few hours in terms of moving to a regular hospital room. He discussed with me that I should think about staying another night. I had originally thought I would leave soon. This was discouraging to hear. But luckily my parents and boyfriend had stayed close by at a hotel for the night. My family swung by soon after and we wrote notes to each other. My jaw was wired shut. I could not speak but I wasn’t aware of this upon waking up. I soon realized my handwriting wasn’t much better due to the medications I was taking. We scribbled notes back and forth and said our goodbyes. I have these notes at home now and some of it looks like chicken scratch. I was writing so fast like I had so much news to tell my family. My mom though was the one who could decipher my writing and tried to make sense of what I was saying.
Below, is a kind of gross photo of me, that I posted upon request from a fellow jaw surgery survivor. I took this photo the day after surgery with my webcam on my computer. I was still in the hospital with really clogged up nostrils that you see in the picture. That trickle of blood remained there for about two weeks as I was forbidden to clean my nose whatsoever, until the second week when my surgeon cleaned my nostrils. It felt wonderful when he got out all the gunk for me! I wasn't allowed to do it myself for fear of causing serious problems since I went through such a serious procedure and somehow it affects different things. All I know is I listened and didn't clean it out. Steamy showers did help, a little, but generally left me gasping for air in the shower and drawing open the curtain to be able to breathe a bit.
The Day After Surgery: August 18, 2011
I finally spotted my nurse from last night and then understood that her shift was ending. She told a lady in red scrubs that I had trouble breathing most of the night and that she had been giving me pain meds every hour. The red scrub nurse smiled at me, introduced herself, and asked how I was doing. I told her I needed medicine as I could feel my meds already wearing off. At this point, it had already been several hours since I had any. I had them every hour at night, but I had already been awake for a few hours.
She told me she would have to examine me before giving me any medicine. I was still very out of it, but I found this odd, in any case, especially since the previous nurse had just given her the heads up. This nurse couldn’t understand me well. She came and went throughout the morning. She could never understand me when I spoke to her or wrote things down. I realized she was not going to help me—she wasn't even trying. I thought it was clear, just based on my appearance, that I needed help.
Around 10 am, I wrote down asking where my family is. The nurse didn’t understand. I must have written that question several times until she finally phoned them.
She came back to tell me she got Doug’s voicemail and hung up because she thought she had the wrong number. She was so confused.
Using all my strength, I told her who this mysterious Doug person was, and she gave me a grimacing expression, almost like she didn’t want to call him knowing that he was important to me.
I saw her pick up the phone and make an attempt, but the call didn't go through. Another RN came over to help her use the phone. I then understand that she was a traveling nurse, up from down south. I watched her as she sat at her computer trying to access files but not getting anything accomplished. She didn’t know how to help me, or she didn’t want to.
Then another nurse came in to remove my catheter. I remember wondering if I still had my catheter.
I was getting so antsy. I wanted to stand and walk around. After the nurse removed the catheter, she told me I wouldn’t have to pee for 6 hours.
I requested a chair because my bum hurt, thinking this is a normal thing to ask for. The traveling nurses found the largest, most awkward chair she could possibly find. It didn't even fit in my little room. I had to get up as she moved my bed to make room for the chair. I don’t even remember sitting in the chair after. I think I gave up and went back to my bed.
I asked the nurse where the bathroom was. Well, surprise, it was right here my room—that little pot in the corner was for me! I got to use the bedpan, with the assistance of red-scrub nurse. I have to say, using one of these things really makes you respect and idolize the toilet. I was on the hopper with the curtain barely closed, nurses walking by, and I was trying my hardest to go. It was taking forever, and I remember thinking, "Damn catheters, thanks for messing up my bladder and making it hard to go."
My Family Comes to Visit
An hour later (it felt like forever), my family came in. They were told that only two of my family could see me for 10 minutes. They were not putting up with that, especially Doug. Needless to say, all three of them came in to see me. Later, when I was home, Doug told me how furious he was with them. He can be a stinker, but I don’t mind it when it comes to my health.
Using my pen and paper, I tried to communicate to my family and find out when I’d be moved to my hospital room. They left after 25 minutes per instructions from the traveling nurse. I was to be moved to a hospital room shortly and would see them again upstairs after I am moved out of the ICU. But it took awhile. I kept asking when would I be going to my hospital room. She kept saying soon.
She said she put in a request to transport me up to my hospital room, and I didn't know what was taking so long.
My family left the ICU per instruction while I was being moved; they would join me again shortly in my new hospital room. I waited a long time for a bed to be opened up in the regular hospital for me. I had to stay another night in the ICU and really wasn't looking forward to it. I was so antsy and really needed to walk around.
Moving Out of the ICU
Forever and a day later, a little balding man with a wheelchair came to take me to my hospital room. He looked confused. He asked red-scrub nurse if I should be wheeled upstairs in my hospital bed. Her reply had an argumentative tone to it, which I had picked up on from the start, but I ignored it. I was down and out and wasn’t about to pick a fight with a nurse who, at the moment, had complete control over my life. I don’t recall what she said, but whatever it was indicated that she thought I should be wheeled up in a wheelchair.
I was so anxious to stand, but my muscles weren't allowing me. I asked red-scrub nurse to assist me, thinking this was a normal request, as my gown wasn’t even tied in the back. She told the orderly that I was feeling uncomfortable with my gown. She held it shut for me as he wheeled the chair closer. He felt bad and located a blanket to drape over me. He was still unsure of whether he should wheel me in the chair or the hospital bed. He assumed she was correct.
Even in my drugged-up state of mind, I knew all along that when I got upstairs to my hospital room, I would have no bed. I’m sure he knew it too.
Finally, I was in the wheelchair and ready to go. He wheeled me out of the ICU and it took a while. We went down long hallways and elevators until we finally reached my room. He wheeled me into the room and left me there. There was no bed. He later returned with a bed. This was surely not my bed. I just looked at it. This bed was raised so high up, I couldn't even climb on.
A few minutes later, my new nurse came in and gasped. She comments on the height of my bed just as my family enters the room. The nurse lowered my bed and hooked me up to the IV. Doug helped me onto the bed.
My family stayed with me for a while before leaving to go get some lunch while I went to get X-rays on my jaw. The new, nicer, floor nurse wheeled me downstairs to get the X-rays. I thought I was going to fall down every time I stood up. Dr. Addante asked me how badly I wanted to go home. I didn’t want to go home right away only because I knew how hard it was for me to stand up, and that worried me. I didn’t want to vomit or make my body do too much before it could. He said if I was on the fence, I should stay one more night.
Back in my hospital room, my family returned. I told them the news, and they agreed that I should stay another night. I was fine with staying, but I didn’t want to be alone another night. The night before was not comfortable, but at least I had constant attention and a nurse who checked on me often. For me, the second night was worse, and I had a feeling it would be.
Doug had to work the next day, although I wanted him to spend the night. Mom asked if I wanted her to stay. I knew, of all people, mom would not be comfortable spending the night here. She asked the nurse anyway. She replied that since I had a roommate, no visitors could stay with me. I would only be able to have visitors if I was in a single room. I wanted my mom to force the issue and stay with me. I didn’t want them to go, but I stayed strong. My family left around six o’clock. At least I had my cell phone and computer to keep me busy.
Although my family was only 45 minutes away and would be back in the morning to take me home, I was a wreck. I said I was okay, but really, I was quite emotional. I did not want them to leave and could not understand why they would leave me. Of course, then they didn't know the details of my situation—how I had waited and waited that morning to pee and get more meds.
Before Doug left, he helped me go to the bathroom, and I nearly fell over. My balance was so off. He got me back in bed, and we said our goodbyes. I took out my book and my laptop to keep me occupied. Facebook kept me entertained and feeling loved from all the messages. Just like winning the megabucks, friends come out of the woodwork to say hi when you have major surgery.
The Last Night
Around 7 pm, I started bawling my eyes out. I think this was partly due to lonesomeness and partly due to the high dosage of liquids being sent into my bloodstream. I’m not a medical student, but all the stuff going into my body through the IV was making me loopy. I couldn’t stop the huge tears from running down my face. I blotted them with tissues just as another set would come from nowhere and drop like huge raindrops on my nightie.
My roommate was an older woman, probably in her forties, and I felt sorry for her. She was so optimistic, but the next day while waiting for my family to arrive, I was beginning to feel more coherent and eavesdropped a bit. She had some visitors, her daughter, I believe, and someone else. The woman indicated that she's always in hospitals and something was really wrong. She had a condition. The curtain was drawn between us, but every time she went to the bathroom she would have to come to my side of the room. She smiled at me, but I really couldn't smile back.
I tried desperately to stop crying because I knew it was foolish, but I couldn't. It had to have been the drugs! Just then, a young, cute, male RN walked into my room. His eyes were kind and sensitive, and I knew he would take good care of me. He asked if I was in pain. Once again, he had no clue of my situation. This is what happens when nurses leave and their shifts end. It's tough trying to explain your condition, especially when you are wired shut! I tried talking but mostly wrote down my words. He came to realize I was banded shut. He told me that if I need anything, I just needed to press the call button. He patted my arm and reassured me that I would be okay. He looked at me curiously as I blotted my eyes with tissues and tucked myself into bed.
My nose was so clogged up and the tears were making it worse. Every time I dozed off, I would wake feeling like I couldn’t breathe or that I had to pee. I pressed the call button so many times that night because the catheter gave me the sensation that I needed to pee, or maybe my blatter wasn’t emptying fully. At first, I held back because it is quite embarrassing to have a cute RN help you go to the bathroom, especially when your head is the size of a basketball.
The cute RN had to empty the pee tray in the bathroom each time I needed to go. One time, he noticed my phone charger was on the floor and asked if I wanted my phone charged. I remembered my charger had fallen earlier, and there was no way I could muster the strength to pick it up. I hated feeling incapable of doing such a small thing. He plugged it in and saw my little Douggie’s face on the phone screen. I had a "Get Well" card Doug had given me on my table. I had knocked it off accidentally. The cute RN picked it up one of the times I buzzed for him, glanced at it, skimmed it, smiled, and put it back on my side table.
Besides this, my second night in the hospital royally sucked in every way imaginable. I couldn’t breathe and was sweating profusely. Then, I was freezing and asked for three more blankets. My jaw hurt like somebody kicked me in the…oh, wait.
Dr. Addante called the nursing station around 10 pm to check on me. I'm not sure if this is common, but I thought it was extraordinary. He knew I was having trouble breathing and requested a special breathing mask for me. An hour or so later, the respiratory team arrived with this mask that covered my face and supplied hot air into my nostrils. It helped a lot because I was also shivering cold.
Day 2 Post-Surgery
I woke around 4 am and couldn’t ignore it anymore. I pressed the call button. By this time, the RN knew what was up as I was halfway off my bed and motioned for the bathroom. I came out of the bathroom to see the cute RN standing by my bed, waiting to hook me back up to my IV. He smiled and told me his birthday was in July too. I didn’t know or care how he knew when my birthday was. He was the one thing I had nearby that made me smile—on the inside, of course. I still couldn't outwardly smile.
I got back in bed, and the mask wasn’t working anymore. Someone had closed my door, and the hot air was coming from outside the room. I was having trouble breathing again and had to breathe through my nose entirely. This machine helped me breathe through my nose—I think by clearing it out a little.
Crushed up Vicodin mixed with juice tastes awful. Once I was in the regular hospital room, that’s what I got. I eventually felt very nauseous from it. In the morning, I requested something other than Vicodin because it tasted so bad and made me feel sick. They started giving me something for nausea too.
I didn’t eat anything for a few days after surgery. My appetite was gone, and I was trying so hard to not vomit because I had heard that it’s common after surgery, and that was my biggest fear. Vomiting while being wired shut could be incredibly dangerous. I was given surgical scissors to wear around my neck for the following six weeks to cut the bands if ever needed. I succeeded and was so proud of pushing through the first few days without vomiting. In fact, I never once vomited during my recovery time. Yay!
Getting Ready to Go Home
Morning came at last, and I woke up with a great deal of pain. The cute RN’s shift ended, and he came in to say goodbye. This was when things went downhill.
After he left, I pressed the call button for a solid thirty minutes looking for pain medicine. I needed a shower and that took another thirty minutes—I had to get my IV removed and covered with a glove to stay dry during my shower. A nurse popped in and said, "Just a few minutes, I'll be right back." She wasn't right back. I understand that it was a busy hospital and many patients need help, but I also needed help and was getting so frustrated. Finally, she returned and covered my IV with a glove. She was so rough. It was a job for her. She wasn't there because she cared like the guy last night—or the first nurse in the ICU.
She asked if I needed help in the shower, and I said no because I was quite self-sufficient at this point. No way would I let myself stoop as low as letting someone help me shower.
There was a chair in the shower. I didn't sit in it but leaned against the shower. The shower had pumps for shampoo, conditioner, and body wash. I used the body wash and was done. I couldn't breathe and was probably not clean, but I needed to get out before I fell over.
I got out and managed to dress and gather all my belongings. I was totally ready to go home, and my family wasn't here yet. They hadn't texted saying that they had left. It was wishful thinking, I suppose.
I watched my roommate's family come in and pack up all her belongings for her and prepped her for her hospital departure. I felt jealous that she had family packing up her stuff while I had literally just thrown all my belongings into my backpack. They weren't organized, and I couldn't even brush my hair, but I did it by myself.
I turned on the TV to pass the time. It wasn't a small, personal TV this time. It was larger and mounted in the upper left corner of my room, but it was so close to me that I had to strain my neck to see it. It hurt something fierce, and I shut it off soon after.
My family finally arrived, and I was ready to bounce out the door—at least that's what I felt like doing. It turned out they had to get the okay that I could leave—and that took forever!
I was finally free! If only I had the energy I thought I had.
Leaving the Hospital
I stopped at each bench on the way out to gather my energy and try not to hurl. I was trying so hard. We made it outside to the car. Told to not drive like a race-car driver, which he can be famous for, my dad cautiously drove home. Well, cautiously for him anyway. My dad drove slowly the first 20 minutes and then began gunning. I thought I was going to lose something; certainly not my lunch but maybe all the antibiotics in me. Luckily, I didn’t vomit. I took small breaths. Vomiting has got to be my least favorite thing.
I was in the front seat with my head entirely wrapped up in a bandage and my face looking like I was a seriously allergic peanut-eater. I was so huge that when I looked in the mirror after showering at the hospital, I thought, "Oh my God, I look ridiculous!" But the crazy thing was that my skin was so clear, I didn’t mind my huge face all that much.
We stopped at a pharmacy on the way home to pick up my prescriptions. My mom ran inside to get them, and again, I waited and waited, feeling anxious and nervous at everyone who walked by and saw my silly looking face.
Recovering at Home
We finally made it home, and I plunked down in the recliner chair and slept there for the next six nights. My boyfriend's brilliant idea was to treat my family to Chinese food. He's a great, loving guy, but really? Chinese food? One of my favorite things in the world? The smell nearly killed me. I could smell it, I could taste it. I could not eat it. I was miserable.
I tried moving upstairs to my bedroom after three nights but couldn’t breathe. The first few nights were tough. I would wake up in the morning with solid pain and immediately popped some painkillers that made my jaw feel great as soon as they kicked in.
Food was my major area of concern following surgery. Well, not exactly a concern but a real, true sadness. Mealtime made me seriously depressed as I watched my family eat awesome, delicious food while I knew I couldn’t have any. In the beginning, it was the worst since I felt queasy and was quite angry that I couldn’t eat.
How I Managed Not Being Able to Eat Regular Food
After a few days, I started blending everything in the fridge. Blended cheeseburgers plus a can of tomato sauce can be a very tasty meal. Pizza blends nicely, too, as do waffles and apple juice, and stir-fry and apple juice. Of course, dessert was the easiest in terms of proper daily calorie count. I needed to strive for 2000 calories a day. It’s easy to ingest high calories of ice cream. I also included many nutritional drinks such as Boost and Ensure each day.
My secondary area of concern was movement of the facial region, particularly the mouth and involuntary laughter. Funny sitcoms would irk the heck out of me because it was painful and unsafe to smile. Maybe not unsafe, but I was worried about anything that could potentially compromise my recovery post-surgery. My elastic bands, usually four of them, were positioned in various places to keep my jaw aligned in the proper position.
Pre-surgery, my overbite was 10mm. My surgeon moved my bottom jaw forward and my front jaw back. He did an excellent job, and not for a second did I question his ability to perform the surgery successfully.
This is a very serious surgery to have. When my orthodontist suggested it to me, and at first, I thought, "Definitely not!" I thought it would ruin my life. But, of course, I thought the same about getting braces. Well, I had to have both, and neither were that bad. This was the first surgery I have ever had, so I really wasn't nervous. I was more excited for the results. My family was more nervous than I was. In hindsight, time after the surgery really flew by. Twenty days after, my surgery didn't even feel real anymore. That's why I documented it all here.
Best of luck to you during your surgery, whatever it may be for. Feel free to contact me if you have any questions regarding jaw surgery!
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2012 emilybee