2015/2016 School Year

I planned, and wrote, a blog post all about soft foods that are easy to eat when one has jaw issues but decided to journal about my career instead.

Two weeks ago, I returned to school for the umpteenth teacher work week.  Honestly,  last year was rough.  I moved back to this country, moved back into my old home, found a job (though I went from middle school to high school), and received bad news about the state of my jaw all in about a month’s time.  I was stressed, had anxiety, wasn’t sleeping, and was depressed. 

This year I apprehensively returned to work.  The anxiety that had melted away during the summer months returned with vengeance.  Even though I was uncomfortable returning, my gut instinct was telling me that this year is going to be an excellent year. 

Because I teach, I must talk a lot.  I am constantly reading, explaining, and describing the lessons I created.  There is no getting around that.  I definitely worry about how my jaw will hold up throughout the day.  I understand whether it’s a good day or bad day (pain wise), the show must go on and I must suck it up and deal with it.

Though I have only had one week with my students, all is going well.  I am managing my pain with over-the-counter pain medicine and muscle relaxers (as needed) at night.  I often wonder if there will be a time when I am unable to teach because of my jaw, but try not to dwell about it.  I will cross that bridge when I get to it…and hopefully, I will NEVER have to deal with that.

Career wise, I am also debating on whether or not to renew my National Board Certification (NBPTS).  For teachers, this accomplishment is a huge deal.  To renew my certificate, I would have to pay approximately $1,300, video one whole group activity, and prove that I have grown professionally.  I also have to write about each of these activities.  I am unsure of whether or not to renew.  If I have surgery I won't have the time to do this, and I'm pretty sure the NBPTS won't give me an extension.  This is a tough call.  Normally I am not indecisive, but in this case I just can't make up my mind.  

I go to the surgeon on September 3^rd.  After reviewing my CT scan, we will set a date for my TJR surgery.  Though I am nervous about the surgery, I know this could potentially alter my life for the better.  I am hoping to have the surgery sooner rather than later.

15 Questions to ask before having surgery

15 Questions to Ask Before Having Surgery

1.     Why do I need this operation?  What will happen if I don't have it?  Is it necessary?

2.     How will the operation be performed?  Will it be outpatient?  Will I stay over night?

3.     Are there other treatment options, and is this operation the best option for me?

4.     What are the risks, benefits, and possible complications for this operation? Will my health history and the medications I am currently taking mean the risks, possible complications, and benefits will be different for me?

5.     What are my anesthesia options?

a.     What kind of anesthesia is best for me considering my health history, the prescription medications, and vitamins/herbs I take?

b.     How will I be monitored during the operation?

6.     What can I expect before the operation?

 .       Will I need any special preparation – tests, or change in my routine medications?

a.     Will I need any special diet?

b.     When do I have to stop eating and drinking?

c.      Should I take my home medication on the day of my operation?

7.     What can I expect for my recovery in terms of treatment, medication, diet, and home care?

 .       What type of care will I have to provide for myself at home?

a.     When will I be able to return to my regular activities (work, lifting, driving, and exercise)?

b.     Will I need any medication—antibiotics, pain medication?  Can you prescribe the before the surgery?

c.      What can I do to help with my recovery?

8.     Could you tell me about your experience with this operation?

 .       Do you perform this operation regularly?  How many do you perform a year?

a.    how often do your patients experience any problems?  

b.     How can I contact you if I have more questions?

9.     Is the surgical facility accredited and properly staffed?

10. How much will the operation cost me, and what type of insurance do you take?

11.Will my jaw be wired shut?

12.What will my diet be like after surgery?

13.What is the success rate of this surgery?  What do you consider a success?  What if this surgery doesn't work-what's next?

14.Will I have stitches?

15.How will my pain be managed post op?  

If you are considering surgery, please make sure to make a list of questions and ask your surgeon.  Before deciding to have TJR, I sat down and created a list of 30 questions.  Some of the questions were general questions, just like the ones listed above) and some were specific to my surgery and my jaw problems.  If you can think of any other general questions to ask, please feel free to add to my list.

Choosing a doctor for TMJ

Doctor or Dentist?

For many years I had severe jaw pain, my jaw was locked (at least partially) shut, and I didn’t know what to do.

A knowledgeable dentist will be able to rule out tooth decay, or any gum disease or infection that might mimic the symptoms of TMD.  My dentist actually did a lengthy exam to figure it out.  At the time I thought I had a toothache, and just wanted my tooth pulled (thank goodness he didn’t do that).  I also had migraines, but didn’t think much about them.  He made me a night guard, used for bruxism, even though I don’t clench or grind my teeth because he thought it would help.  I was also given steroids and muscle relaxers.  It took a couple of weeks and the pain got much worse before it got better, but I heard a loud snap and it went back in place…at least for awhile.

After years of problems, I was told to see an Oral Maxillofacial Surgeon.  Using my insurance, I looked up local surgeons in my area and found a man.  I made an appointment, and he did an exam.  It consisted of measuring my opening, which was around a 10-12mm.  Then he pressed on the TMJ and had me open and close.  He determined right then and there that I needed arthroscopic surgery to have my joints flushed and I would be cured.  This was music to my ears.  I set up the surgery right away, and had it done.  Within a couple weeks I recognized the surgery was ineffective.  My opening might have improved a bit but it was not anything noteworthy and I was still in pain.  He decided that the best course of action would be disc repositioning and I would probably need to stay in the hospital over night.  Once again I was told this would cure my problems, and I was very ready.  The surgery was scheduled, and I was optimistic.  The day of the surgery, the doctor explained everything to my parents and myself.  When I awoke in recovery, I was shocked and horrified to find that he had just cleaned my joints again.  He explained that sometimes the joints need to be cleaned several times before they get better.  I was disappointed and didn’t believe him.  Needless to say, the surgery didn’t work.  Looking back, both of those surgeries were unnecessary.  I heard the word cure and blindly put my faith in a man who was obviously not looking out for my best interest.

I began to do research and ask around.  My orthodontist referred me to an OMS in Miami, which is about an hour or so from my house.  This time I looked up the surgeons name on the Internet and asked around.  The reviews for this doctor were wonderful.  I made an appointment.  During my first appointment, they took pictures of my teeth, did a panoramic x-ray, measured my opening, and ordered an MRI.  This made a world of difference because I knew exactly what was going on with my jaw when he read the MRI report with me.  Not only that, but he ordered a CT, checked me for rheumatoid arthritis, and checked my hormone levels.  There might have been other tests as well, but I can’t remember. 

When choosing a TMJ/TMD specialist, start with the doctors and dentist you know and find out what they recommend and who they recommend.

Research all doctors and dentists, and see what their patients say about them.

Find out if your insurance covers the doctor/dentist.

If they do not thoroughly exam your jaw and try to find the underlying reason(s) this is occurring, it is a red flag!    Most will send you to an ENT doctor, check hormone levels, check for arthritis, and sit and discuss any trauma.

An MRI is vital to fully understanding what is happening with your joints!  If a doctor doesn’t order one, it is a red flag.

If your doctor promises to cure you, it is a red flag.

Make sure you are comfortable with your doctor or dentist.

Prepare a list of questions for your doctor/dentist. 

Are the people who work in the office friendly?  This includes secretaries, nurses, and the insurance specialist.  This may not appear to be important, but when you call the office, these are the people who will work with you.

Get a second or third opinion (or as many as you would like).

Once you find a specialist you feel comfortable with, call your dentist, orthodontist, primary care doctor, etc and ask about that person.

It is vital to remember that you are your own health care advocate.  I know many people are in pain, but often there is no quick fix and you don’t want to have unnecessary procedures done.