Scott Lambert's Final Reconstruction Phase
Donation protected
As much as I hate to do this, after just having gotten off the phone with Blue Cross Blue Shield, I have reached a point in my reconstruction where I need to ask for help.
As many of you know, after attending a show at Echo Lounge on August 3, 2000, I was shot in the face at point-blank range with a .357 Magnum by someone who had broken into my car outside of the venue. The gunshot obliterated my upper left jawbone, took away part of my hard palate, shattered the rest of my jawbone, and took out my lower left molars. I am truly lucky to be alive.
Reconstruction began quickly with a temporal muscle flap to cover the hole in my hard palate.
After that, I was fitted with a temporary dental prosthesis, and it was decided that the goal would be to have a fibula bone graft to replace my upper left jawbone and fit with dental implants for a permanent dental prosthesis.
I went through a couple of years of laser hair removal on my left leg to prepare for the fibula graft. When it came time for the procedure in 2003, the surgeon decided to try a bone graft from my hip along with skin from my left wrist. This graft ended up failing in 2004, so they removed the bone, but left the tissue. So, my temporary dental prosthesis had to be modified, and I had to use a nose hair trimmer to trim the hair from my wrist skin in my mouth for a while. I assure you, it was as gross as you imagine.
In 2006, they attempted the fibula graft from my left leg. While still in the hospital for this procedure, they noticed that the site didn’t look right, so they went back in and discovered micro clots that were blocking the blood supply for the new bone. They could not repair these, so they just removed all of the bone and tissue I had just had implanted, and I was back to where I was in 2002.
I began the pre-approval process with my insurance at the time to put in dental implants in whatever bone I might still have up there, but it was denied several times, even after getting the Georgia Insurance Commissioner’s office involved, so in 2007, my reconstruction process came to a halt.
It remained paused over several years due to my doctors not being in network with my employer’s insurance policy, then they switched to Blue Cross Blue Shield in 2016 or 2017, and I was able to restart my reconstruction process.
In 2017, my oral surgeon, Dr. Glenn Maron recommended Dr. Mark El-Deiry, who specializes in Otolaryngology. I was finally cleared for surgery in 2018, so In June of that year, they attempted another fibula graft, this time, from my right leg. Just as he was starting, my carotid artery burst, so they repaired the artery and had to abort the graft attempt. They left the trache hole in my throat until the next attempt.
They attempted the surgery again in September of 2018, getting the blood supply from lower in my body, not near the carotid artery. The graft was successful (hallaujah!), but the trache hole was not completely closed.
Then the fight with Blue Cross Blue Shield began for the coverage of the dental implants. After winning an appeal in April of 2019, I was able to have the dental implants put in, and the trache hole was finally closed. However, a few months later, two (2) of the implants failed. Dr. Maron removed the failed implants and used bone morphogenetic protein to encourage the growth of bone. In February of 2020, Dr. Maron put in two more dental implants to replace the failed ones, and they held.
Then…COVID-19 hit. I had the implants uncapped in March of 2020, and I had a new temporary dental prosthesis made. Unfortunately, I lost my job in July, 2020 due to company layoffs in response to the COVID-19 pandemic. I’ve been having to COBRA my Blue Cross Blue Shield coverage, to the tune of over $600 per month ever since. I got a new job in September of 2020; however, it was recommended that I remain with BCBS to avoid any issues with a new insurance provider (Athena).
I am FINALLY ready for my permanent prosthesis; however, it will cost $18,800.00, and Dr. Davis, the Prosthodontist who has been with me since the beginning of all of this, is not in-network. I have to pay a $6,000.00 deductible, then BCBS will pay 60% after that, so that leaves $5,120.00 in addition to the $6,000 for a total of $11,120.00 to get my permanent dental prosthesis.
That is the minimum amount that I would need. I also have thousands of dollars in medical bills for the ongoing treatment for the nerve damage caused by the fibula graft.
Based on that, I will set a goal of $16,500.00 to cover the permanent prosthesis and some of the other medical bills that have piled up as well as the GoFundMe fees. I am sure it’s more than that, but I’m asking for enough already.
Words can’t express the appreciation of love and support I’ve received over the years. It’s truly what’s kept me focused on my reconstruction and given me the determination to keep going despite the many failed attempts and struggles. I would be so grateful for your help to finally close this chapter of my life. Thank you for your time and consideration.
As many of you know, after attending a show at Echo Lounge on August 3, 2000, I was shot in the face at point-blank range with a .357 Magnum by someone who had broken into my car outside of the venue. The gunshot obliterated my upper left jawbone, took away part of my hard palate, shattered the rest of my jawbone, and took out my lower left molars. I am truly lucky to be alive.
Reconstruction began quickly with a temporal muscle flap to cover the hole in my hard palate.
After that, I was fitted with a temporary dental prosthesis, and it was decided that the goal would be to have a fibula bone graft to replace my upper left jawbone and fit with dental implants for a permanent dental prosthesis.
I went through a couple of years of laser hair removal on my left leg to prepare for the fibula graft. When it came time for the procedure in 2003, the surgeon decided to try a bone graft from my hip along with skin from my left wrist. This graft ended up failing in 2004, so they removed the bone, but left the tissue. So, my temporary dental prosthesis had to be modified, and I had to use a nose hair trimmer to trim the hair from my wrist skin in my mouth for a while. I assure you, it was as gross as you imagine.
In 2006, they attempted the fibula graft from my left leg. While still in the hospital for this procedure, they noticed that the site didn’t look right, so they went back in and discovered micro clots that were blocking the blood supply for the new bone. They could not repair these, so they just removed all of the bone and tissue I had just had implanted, and I was back to where I was in 2002.
I began the pre-approval process with my insurance at the time to put in dental implants in whatever bone I might still have up there, but it was denied several times, even after getting the Georgia Insurance Commissioner’s office involved, so in 2007, my reconstruction process came to a halt.
It remained paused over several years due to my doctors not being in network with my employer’s insurance policy, then they switched to Blue Cross Blue Shield in 2016 or 2017, and I was able to restart my reconstruction process.
In 2017, my oral surgeon, Dr. Glenn Maron recommended Dr. Mark El-Deiry, who specializes in Otolaryngology. I was finally cleared for surgery in 2018, so In June of that year, they attempted another fibula graft, this time, from my right leg. Just as he was starting, my carotid artery burst, so they repaired the artery and had to abort the graft attempt. They left the trache hole in my throat until the next attempt.
They attempted the surgery again in September of 2018, getting the blood supply from lower in my body, not near the carotid artery. The graft was successful (hallaujah!), but the trache hole was not completely closed.
Then the fight with Blue Cross Blue Shield began for the coverage of the dental implants. After winning an appeal in April of 2019, I was able to have the dental implants put in, and the trache hole was finally closed. However, a few months later, two (2) of the implants failed. Dr. Maron removed the failed implants and used bone morphogenetic protein to encourage the growth of bone. In February of 2020, Dr. Maron put in two more dental implants to replace the failed ones, and they held.
Then…COVID-19 hit. I had the implants uncapped in March of 2020, and I had a new temporary dental prosthesis made. Unfortunately, I lost my job in July, 2020 due to company layoffs in response to the COVID-19 pandemic. I’ve been having to COBRA my Blue Cross Blue Shield coverage, to the tune of over $600 per month ever since. I got a new job in September of 2020; however, it was recommended that I remain with BCBS to avoid any issues with a new insurance provider (Athena).
I am FINALLY ready for my permanent prosthesis; however, it will cost $18,800.00, and Dr. Davis, the Prosthodontist who has been with me since the beginning of all of this, is not in-network. I have to pay a $6,000.00 deductible, then BCBS will pay 60% after that, so that leaves $5,120.00 in addition to the $6,000 for a total of $11,120.00 to get my permanent dental prosthesis.
That is the minimum amount that I would need. I also have thousands of dollars in medical bills for the ongoing treatment for the nerve damage caused by the fibula graft.
Based on that, I will set a goal of $16,500.00 to cover the permanent prosthesis and some of the other medical bills that have piled up as well as the GoFundMe fees. I am sure it’s more than that, but I’m asking for enough already.
Words can’t express the appreciation of love and support I’ve received over the years. It’s truly what’s kept me focused on my reconstruction and given me the determination to keep going despite the many failed attempts and struggles. I would be so grateful for your help to finally close this chapter of my life. Thank you for your time and consideration.
Organizer
Scott Lambert
Organizer
Lawrenceville, GA