I've been pretty hopeful since the last post that this treatment is going to work. I've certainly put it to the test. I've stayed up late, eaten at weird times (if you didn't know, sometimes not eating at the same time everyday can be a migraine trigger. Weird huh?), drank hard liquor - one rum and coke - gone to a football game, and made lots of plans I wouldn't make normally because I knew I might have to cancel. And . . . no migraine . . . well, unless the one this morning gets worse.
A not-so-crazy thing that is happening is how aware I have become of the TJMD/sinus issues. In February of 2010 I had arthrocentesis, also known as joint aspiration, done on my left jaw due to dislocation. That's right, my jaw was dislocated. The doctor told me the joints in my jaw were degenerating. Pretty painful, but mostly frustrating. It meant my mouth didn't open very wide. Yeah, yeah, maybe that wasn't a bad thing, but it was a painful thing. So, a doctor in Georgia gave me the laughing gas and drew out some fluid, relocated my jaw, and sent me on my way. The opening doubled for while. Not anymore.
Several weeks ago, I finally found a doctor in Texas that would see me. TMJD is this huge mystery in the medical world. No one specializes in the treatment, and no one regulates it. It feels like this major crap shoot. Anyway, this doctor, an oral surgeon for a maxillofacial office, works with a dentist to try and correct the problem without surgery. Here's the deal, not only do I have limited opening of my jaw, but it doesn't move to the right anymore. Try chewing gum just up and down. Did you? It doesn't work. In order to properly chew, you have to move right and left too. The doctor asked me twice if I had had orthodontic work done. I said "no" both times. In the back of my mind I was thinking, "Dude, you already asked me that once. Don't you remember?" Turns out, the reason he asked is because they generally see this problem only in patients where orthodontics have "gone bad". Of course I would be an exception to the norm. He didn't mention degenerating joints, but thinks it may be some sort of "bone" issue. So confusing! My next step was to follow up with the dentist. I had an appointment set when I got the call that insurance had approved the botox. So, I cancelled the dentist appointment. I do believe I will probably be following up with him - soon.
The pain from the TMJD starts out with lots of tension under my ears around my jaws, ear aches, and them ultimately in the areas under my eyes. Think of wearing a surgical mask. Everything covered my the mask, hurts. Well, except for maybe my nose. Now, add sinus pain/pressure above the eyes, bloody nose, and ear aches - did I mention ear aches? You get the picture. All that tension and discomfort can ultimately escalate to migraine level pain. Then there is the clicking and popping.
I have always been able to pop my knuckles, pop my back, pop my neck, yada yada. I can also move my wrist so it makes a popping sound every time I move it. It's a different kind of "pop". For my jaw, it started out with a popping sound every time I would move it a certain way. Recently, it "pops" like when you get an adjustment at the chiropractor. Really loud. Now, it's back to popping every time I move it a certain way. I don't know if all that makes a difference, but it's two very different kinds of feelings and kinds of sounds.
I'm not certain of my next steps. I know the botox isn't my last step, just a HUGE step in the right direction. According the TMJ Association, current research on TMJD seems to indicate "less is best". I'm wondering though if I'm past that stage. A little scared about it too. I know taking slow, precautionary steps are necessary, but I just think I'm beyond the "slow and easy" progress of treatment. Last week, my husband told me I'm a nicer person now with more energy at home. He said I'm easier to talk to and seem to be able to listen better. I love his honesty. It seems he is hopeful too.
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