Hi, I'm Christine, and this is the History of my TMJ Saga.
{Also, meet my husband Jay, and Scout, who have been my encouragers that have patiently and lovingly carried me through my painful and dark days}
Fall 2002
I was hit in the face by a car door. My jaw dislocated on the left side. I popped it back into place. From then on my left joint began clicking and popping. It would deviate to one side when I opened my mouth. I experienced some pain after chewing, and for a few hours my jaw would occasionally get stuck (open or closed), but once I got it back into place it didn’t hurt anymore.
2004
In the fall when my last wisdom tooth was removed I consulted an Oral Surgeon about the popping/clicking problem, however he didn’t see it as an issue and provided no treatment.
1.24.08- My Jaw completely locked shut and I couldn’t open more than a straw's width. I had pain in the joint on the left side and lots of swelling.
1.30.08- I went to my dentist who took x-rays and put me on a muscle relaxer (Methocarbam 3x/day for 3 days) to try and get the jaw to open. This didn’t work. There were no changes for 11 days.
2.1.08- I went to an Oral Surgeon in my home town who took x-rays & scheduled an MRI.
2.8.08- MRI. After viewing the MRI the oral surgeon said I had TMD and needed immediate surgery to replace my displaced disks on both sides. He recommend doing this by wearing braces and placing in artificial plastic disks, which he would hold in place with metal pins. He also said I needed a splint.
2.19.08- I began wearing a large frontal tooth splint made by a local Orthodontist. The splint was causing me increased pain and I went in for a readjustment on 2.26.08.
Before hastily jumping into surgery, for a condition for which I had had no previous treatment, I decided to pursue non-invasive options. Personal recommendations from close friends and research showed that the best noninvasive specialist was in Memphis. This was a 10 hour round trip drive from my home, but I was determined to go where I could get the best treatment.
3.5.08- I began seeing Dr. William McHorris in Memphis, TN. He suggested that I discontinue wearing the frontal splint and he made me new smaller splints that only covered my back bottom teeth. At this time my main problems were pain in my left joint, headaches and some facial, head and neck pain.
Dr. McHorris's Treatment Plan:
Wear Splints 24/7Take Xanax nightly (to stop clenching)Take Flurbiprofen daily (to reduce inflammation)Eat only a Soft DietAvoid CaffeineExercise for Stress ManagementChange sleeping habits (sleeping only on back)Begin applying ice and moist heat dailyStart Massage TherapyChange body postureAppointments every 3 weeks (10hr round trip drives)
4.08- Started to get Melasma on my face, began having stabbing stomach pains and felt so tired all of the time.
6.1.08- Due to my ongoing pain, I was physically unable to perform my job to the best of my ability. As a Counselor for underprivileged/at risk children, I was giving it my all, but it was so painful for me to talk, smile, and interact. I was really suffering. It was the hardest decision of my life, but I decided to retire. I still miss those kids so much!
7.08- I had blood in my stools and vomited what looked like coffee grounds. I had a stomach ulcer from the medication, and had to have a Colonoscopy and Endoscopy. I switched from Flurbiprofen to Celebrex for inflammation, began a no acid diet, and started medications to heal the ulcers. Within about a month they were healed.
10.23.08- I went to Dr. Orlando at Duke University. With everything that was going on with my health, we wanted to be sure there was nothing else wrong with me. I came out with a perfect bill of health (minus the jaw joint problem). Dr. Orlando didn’t like that I was on Xanax and she switched me to a new medication saying the pill would have the same effects on the clenching. Began taking Trazodone (1-2 tablets at night). It didn’t work right away, and for the first time, I began having a lot of pain in the right side of my jaw as well. Things got much worse and the pain and headaches increased. Stopped Trazodone after a few weeks and started taking Xanax again.
Fall 2008-
I continued my treatment with Dr. McHorris. My pain would become manageable, and then get worse, depending on my activity level. Over the course of a year and a half, I was able to gradually wean off my splints until I was only wearing them at night. I continued with his treatment plan.
Fall 2009- My pain got much worse. I started wearing my splints during the day again as needed. I began getting a weekly upper body massage and started taking Amrix (a muscle relaxer) along with Xanex at night.
2010
Summer 2010- My open bite got so bad that I could only get contact on my two back molars. I could not eat and the pain in my joint and muscles became unbearable. My headaches caused me to vomit and I felt I needed to be in a quiet, dark room. I experienced vertigo and dizziness. I could not talk, smile or eat without feeling horrible. I became very reclusive. I was also having stomach problems and choking a lot. Dr. McHorris referred me to an Orthodontist (to see if he could fix my bite non-surgically) and a Physical Therapist.
9.22.10- The orthodontist diagnosed me with Idiopathic Condylar Resorption. He said he couldn’t correct my malocclusion and anterior open bite with orthodontic appliance therapy. He suggested I consult with oral surgeons.
9.23.10- I started Physical Therapy 2 hours a day, 3 days a week for 20 sessions. During these sessions I was doing Exercises/Stretches, getting Massage, Palpitation, Ultrasound, Laser, and Electrode Therapy. After sessions were over I began performing daily Exercises/Stretches at home.
10.10- Went to an Oral Surgeon consult in Memphis.
10.13.10- Went to see Dr. Larry Wolford an Oral and Maxillofacial surgeon at Baylor in Dallas. Here I got a new MRI. He diagnosed me with Bilateral TMJ Reactive Arthritis, Mandibular Hypoplasia and Maxillary Hypoplasia. I found Dr. Wolford to be very knowledgeable, detailed and intelligent.
MRI Report Stated: Thinning of right and left mandibular condyles with flattening of the condylar heads. The articular discs were anteriorly located with closed-mouth positioning, without relocation on open mouth position. Left side also had increased anterior translation of the left mandibular condyle, compatible with mild hypermobility.
Dr. Wolford recommended Total Joint Replacement surgery, Multiple Maxillary Osteotomies with bone plates, along with other procedures to fix my wide columella and nasal turbinates. Before I could move forward with surgery I needed to go to an ENT, Neurologist, get a sleep study, and go back for orthodontics. (All of which I did except the sleep study and actual placement of braces.)
12.10- Dr. McHorris and the Orthodontist consulted and wanted me to try one more non-invasive treatment, before I moved forward with this very grueling and invasive surgery.
2.14.11- Dr. McHorris began the Occlusal Correction (adjustment, equilibration of natural teeth). And along with my multi-vitamin I began taking 1200mg of calcium and 600 mg of magnesium daily. The treatment was to take 6 months.
8.11- With the occlusal corrections I began feeling much better and was able to chew food again. Many of my muscle pains were relieved as well. I didn’t seem to be clenching as badly and didn’t need my Celebrex as much. Thus, I tried to start weaning off of my medicines. For 10 days I took only the Xanax. For several days I also tried taking Amrix every other day along with Xanax. However, I was feeling horrible. The headaches and joint pain returned. I also started having very intense muscle spasms in my face and neck. I started taking Amrix again.
OVERALL
I experienced periods of time with Dr. McHorris where I started feeling good again and I was able to function more normally. My appointments went from every 3 weeks, to 6 weeks to 8 weeks. During good times my pain was dull and manageable, especially when I was staying home alone and not talking to anyone. However, any time I would talk, smile or eat, my pain came back. This greatly diminished my quality of life and turned me into a hermit. I didn't want to do anything with others. Whenever I was social on the weekends it would take me the whole week to feel relief. I was unable to work outside of my home, and having children was totally out of the question because of my pain and medications. I knew I needed surgery, but I was concerned about having artificial titanium jaw joints at such a young age. Research showed that all of the previous joints had been recalled and it wasn't known how long they would last. However, I consulted with a patient of Dr. Wolford's and she was doing very well. Even with my concerns, I felt desperate and trapped. I was willing to take the risk if it could help me feel better. Dr. McHorris* again expressed serious concerns about the surgery.
Thankfully, my Dad and Step-Mom (both physicians), also had reservations about me going from non-invasive treatment, to the most invasive total jaw joint replacement surgery. They felt I needed to have surgery, but there had to be a middle ground. Plus, none of us could logically wrap our heads around an Idiopathic diagnosis. We felt there had to be a medical reason and explanation for why all of this was happening. I will be forever grateful to my Step-Mom who did tons of medical research and found Dr. Piper for me.
(*I highly recommend Dr. McHorris, and his assistant, Tina, to anyone seeking non-invasive TMJ treatment. Each of the doctors I saw subsequently said he was a real pioneer in the field. I totally agree! On top of this, he is the kindest and most caring doctor I have ever known. Dr. McHorris took a personal interest in my treatment and recovery. He did everything in his power to make me better. There is no way I would have been able to emotionally handle my almost four year ordeal without Dr. McHorris's guidance, knowledge, support, and treatment. He saved me from two surgeries that could have been disastrous. I believe everything happens for a reason, and I will be forever grateful to him.)
10.31.11- My Step-Mom and I went to my first Consult with Dr. Mark Piper in St. Petersburg, FL. Dr. McHorris also spoke very highly of Dr. Piper's skill and talent as a surgeon. This really gave me confidence and hope!
My Current Complaints were:
Jaw + Joint Pain (from smiling, talking, eating only soft foods, etc)
Pain in my neck, shoulders, cheeks, and upper back
Open Bite (it was better but still not back together)
Limited range of motion
Headaches (at the back of the head + pressure/pain behind eyes)
Nausea
Diminished hearing/ clogged, stuffy ears
Dizziness
Feeling tired all the time
My reclusive and totally diminished quality of life
And finally, I wanted to get off the medications I had been on for almost 4 years
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