Summer 2017

I am blessed to be a teacher and have summer vacation.  This year, it was even better since I used the time to not only do physical therapy and recover, but also make a summer bucket list.  Even though I didn't go on a vacation, this was the best summer I've experienced in years as I have been living almost pain free since the TJR.

I love living in sunny, south Florida.  The entire state contains numerous tourist attractions, most of them I have been too.  To keep myself active and involved with friends, I googled places to visit and tried to go to as many new places as possible.

Shark Valley-One can either rent a bike or bring their own, and bicycle through the everglades.  It's a bit hot for this, so I am putting this off until fall.

Venetian Pools-Coral Gables-The pool was created in 1923 from a coral rock quarry, where much of the original coral rock was used to boarder and further accentuate the pool.  It also features two large historic lookout towers, and a great view of the city. Since I still can't get my head wet, this will have to wait.

Wynwood-Wynwood is a neighborhood in Miami, Florida, United States. Wynwood overflows with vibrant artwork, restaurants, breweries, clothing stores, dance and club venues, among other retail options.  This is one of my favorite places to go!

Wynwood Walls with Annette and Kristen

Miami Mojito Company

                                                                                                                                                                                                            Wynwood Brewery

                                                         

Two Tails Ranch -Williston-This is an elephant sanctuary.  I will visit during winter break when it's not as hot.

Blowing Rocks Reserve-an environmental preserve on Jupiter Island. I It contains the largest Anastasia limestone outcropping on the state's east coast. It has some trails, but is mostly beaches.  

 Guanabanas-A restaurant right on the water with a fun atmosphere and amazing food :) .

Ancient Spanish Monastery-Construction of this monastery of St. Benard de Clairvaux began in 1133 AD in Spain.  In 1925, the cloisters were brought to the US stone by stone and put together in North Miami.

Flagler Museum-Henry Flagler built Whitehall 1902.  Located in Palm Beach, this mansion has 75 rooms.

The Breakers-A luxurious resort located in Palm Beach

FAT Village Art Walk-Fort Lauderdale-A monthly celebration of art and artists, complemented with food trucks, performances, and the unexpected. It is held on the last Saturday of every month.

The silent disco

John Pennekamp Coral Reef State Park-John Pennekamp Coral Reef State Park is a Florida State Park located on Key Largo in Florida, and includes approximately 70 nautical square miles of adjacent Atlantic Ocean waters. It was the first underwater park in the United States.  Once again, I am going to have to wait to do this as I can't get my head wet.

New Kids on the Block Concert-This was NKOTB, Boys 2 Men, and Paula Abdul

Me,Danielle, and Sherry

Me and Danny Wood from NKOTB

Bringing a Rescue Dog Out of the Kennel for a Night-As a volunteer with 100+ Abandoned Dogs of the Everglade, I can sometimes get a dog out of the kennel and bring them on a "date night."  It's fun for both of us :)  

Mortimer

  

Hiking through some of the National Parks in Northern Florida-There is hiking, camping, tubing, natural spring.  Next time, I intend to go tubing down the river.

Silverball Pinball Museum-Delray-Pinball machine arcade, restaurant & bar in Downtown Delray Beach. Enjoy vintage pinball machines, skee ball, shuffleboard and much more!

Mini golfing (2 free passes)-Still haven't used these...but I will

Perez Art Museum Miami-Sleek waterfront museum features modern & contemporary international artwork & educational programs.  I didn't make it here, but will definitely go this year.

Bowling-I will probably do this soon

Gold Coast Railroad Museum-Home to over 40 historic railcars, including Presidential Railcar. This place sounds interesting and I want to check it out.

As summer vacation comes to an end, I did not do everything on my list.  I did, however, do quite a bit.  In addition, I was with friends and/or family almost every day.  I am definitely sad to see it end, yet made many wonderful memories.

Tips for Choosing a TMJ Doctor

Within the past couple of years, I have read horror stories from TMJ/TMD Patients.  Many of those stories start out similar, "I was in terrible pain and I found a doctor who told me he/she could cure me and I trusted that person!"

It can be frustrating and difficult to find a qualified doctor because of insurance and sometimes location.  Each doctor/dentist/surgeon will have a different way of treating TMJ, so which way is correct?  How do you know who to trust?  What should you do?

Every TMJ patient who has had surgery will give the same advice: Find conservative ways to treat TMJ before considering surgery.  Once you choose surgery, there is no turning back.  Often times, surgery exacerbates the problem, causes more damage, and leads to more surgeries.

Here is the story of how I learned to not blindly trust doctors:

In 2011 my jaw was a mess, as I had suffered with TMJ since I had a tonsillectomy in 1996.  Throughout the years, my jaw joints were deteriorating, the pain was increasing, and my opening was extremely limited.  I had tried numerous conservative methods including braces, night guards, etc.  Finally, my dentist suggested I visit an OMS.  I went home, found an OMS near my house, and made an appointment.

The doctor appeared knowledgeable and caring.  He could tell by my opening that there was a problem, but he assured me that if he flushed out my joints (arthrocentesis) I would feel better.  Finally, I had hope and couldn't wait!  I scheduled the surgery.  It's a quick, out-patient surgery.  The recovery is slightly uncomfortable and I was on limited diet.  I quickly realized that nothing changed; I couldn't open my mouth and I was in even more pain.

I went back to the same OMS and discussed my options with him.  He explained that in the rare case that his patients are not healed,  they need disc repositioning surgery.  He explained what that entailed and said he likes to keep patients over night for this procedure, but he knew that this would heal me.  I was excited and once again signed the pre surgery paperwork.

The day of surgery I was once again excited and full of hope.  I woke up from surgery to find that he decided to clean my joints again.  He did not do the procedure we had discussed.  He explained that I didn't need it.  I went home that day.  I would have never signed the paperwork to have the same procedure done again and was disgusted with the surgeon. My jaw was in worse shape than before.  My opening was even more limited and the pain had increased.  He suggested Botox to help release the muscle on my left side, in the hopes I would have a better opening.  Insurance didn't cover it, but I was desperate and it did help a bit.

I made another appointment with him to discuss my concerns, and he told me that he didn't see anything wrong with the inside of my jaw and he was shocked that the surgery didn't work.  Frustrated and angry, I left his office and NEVER returned.

 In retrospect, I can see where I made mistakes:

1) I didn't research this doctor.  I was young and assumed he knew what he was talking about.  The office was right down the road from my house, so location was another factor in my decision.
2) He did not have me get an MRI or CT scan before this either surgery.  I just assumed it was because of my limited opening.  I have since learned that every reputable OMS does at least one of these after the initial consultation.
3) I didn't ask enough questions.  Here is a list of questions to consider before surgery: http://positivelytmjtmd.blogspot.com/2015/08/15-questions-to-ask-before-having.html
4) During my first visit with this OMS, I didn't ask him the right questions:
     What is your area of expertise?
     Do you treat more oral issues (teeth pulling) or jaw issues?
     How many TMJ patients do you treat and how many surgeries do you perform?

Here's what I should have done when looking for a TMJ specialist:
1) Ask around and found out what kind of doctor you needed to see. Did you need a dentist, an OMS, an orthodontist, a chiropractor?
2) compile a list of doctors in your area or surrounding areas.  These websites might help:   https://www.healthgrades.com/
http://www.vitals.com/
3)Check to make sure the doctors you are interested in take your insurance.
4)Do a "background check" of your doctor.  Ask friends, family members, other dentist, other doctors, etc what they have heard.  Double check their credentials:
https://www.certificationmatters.org/is-your-doctor-board-certified/search-now.aspx
5) Make an appointment.  How easy was it to make an appointment?  How will the staff keep in touch with you?  What is the office like?
6) Be prepared when you visit the doctor.  Bring any past records you may have, have a list of questions ready, and be able to explain your symptoms. Also, bring a list of medications you are currently taking.  Keeping a pain journal helps (there are many free apps)
7) Interview the doctor.  Ask as many questions as you want and listen carefully to the answers.
8)Go with your gut.  If you don't like the doctor, find someone else.
9) Get a second (or 3rd) opinion!

Several years ago, I previously discussed this topic in another blog post:  http://positivelytmjtmd.blogspot.com/2015/08/choosing-doctor-for-tmj.html
Between the two posts, there is a decent list of things to look for when choosing a dentist, OMS, or someone else for TMJ.

Pain clouded my judgement and I learned the hard way.

Luckily, my orthodontist suggested my current OMS, and I actually spent quite a bit of time researching him.  After the MRI, he correctly diagnosed my TMJ issues and explained why I was in pain and had a limited opening.  I have had 3 surgeries with him: disc repositioning (unfortunately, both discs dislocated approximately a year after surgery), then I had an open-joint arthroplasty to remove the the discs (they were replaced with a silicon type implant that was removed close to 3 months after surgery-unfortunately, the whatever tissue (?) that was supposed to regenerate never did), and TJR.

Before I first drove to Miami, I did my research.  I read articles about him and his practice.  I looked up patient reviews.  Even though the drive can be aggravating (Miami traffic-yuck) and he is rarely on time for appointments (you may wait up to four hours), he is very kind and caring.  When he is with his patients, he is never rushed, answers all questions, and gives a detailed explanation of the procedure/problem/whatever.  I am lucky that he is my surgeon :) .

Even though my doctor horror story is not nearly as bad as some of the ones I have read on the Internet TMJ support groups, it should be a cautionary tale for anyone trying to find a TMJ specialist.  It's imperative to remember that their is no quick fix for TMJ and what works for one person may not work for another.

TMJ Friendly (EASY) Desserts

Last Friday, I posted about TMJ friendly recipes:http://positivelytmjtmd.blogspot.com/2017/07/tmj-friendly-recipes.html
and also shared a link to a list of TMJ friendly foods and foods to avoid: http://positivelytmjtmd.blogspot.com/2015/09/lets-talk-food.html.  This week, I am sharing a few of my favorite TMJ friendly desserts.

I use to tell people my favorite food group was junk food, but my taste buds changed after surgery.  I no longer love sweets or sugary snacks.  I can't stand the taste of chocolate.  I have no idea what caused this change.  My friends and family are shocked.  Before this, I was an avid baker who enjoyed trying different recipes.  Even though I haven't baked since surgery, I found some of my favorite recipes to share:

Old Fashioned Banana Pudding

I love this recipe, but have been known to break the cookies up (or crush them) and let it sit over night to make the cookies mushy so I can eat it.  Some people even add a layer of chocolate pudding, so this is an easy recipe to play with.

Ingredients:

3 cups cold milk

2 packages (40serving size each) JELLO Vanilla Flavor Instant pudding (you can make this from scratch, but why?)

30 vanilla wafers

3 medium bananas, sliced

1 tub (8 oz) Cool Whipped Topping, Thawed

Directions:

Pour milk into large bowl.

Add dry pudding mixes and beat with a wire whisk for 2 minutes (or until well blended).

Let stand 5 minutes.

Arrange half of the wafers on the bottom of a 2-quart serving bowl.

Top with layers of half the banana slices and pudding

Repeat all layers.

Cover with whipped topping.

Refrigerate 3 hours.

Microwave Fudge

This is super quick and easy.  It takes no more than 5 minutes to make.  It tastes good to dip the fudge in peanut butter.

Ingredients:

1 pound of powdered sugar

½ cup cocoa

¼ cup milk

1 stick of butter or margarine

1 tablespoon vanilla

1 cup nuts (I leave this out)

Directions:

Combine sugar, cocoa, and milk.  Stir only once.  Add stick of butter.  Microwave on high for two minutes.

Stir in vanilla and nuts until well blended.  Pour into greased cake pan and put in the refrigerator for an hour.  Cut into squares and serve.  Store in refrigerator.

Peanut Butter Cookies

Some people place a Hershey’s kiss on the top.  Often times, I melt chocolate and dip the cooled off cookies in it and then let the chocolate cool off.  Most cookies are too hard for me to eat, but these aren't.  In addition, these cookies give me a tad of the saltiness that I crave.

Ingredients:

1 cup peanut butter

1 cup sugar

1 egg

Directions:

Mix all ingredients well

Roll dough into balls

Place balls onto greased cookie sheet

Bake 10 minutes at 350

Mandarin Orange Cake

This cake is surprisingly easy, soft, moist, and a real crowd pleaser!

Part one:

(Mix all these ingredients together)

Yellow cake mix

1 can mandarin oranges (11 ½ ounces-don’t drain)

4 eggs

½ cup oil

Bake at 350 for 30 minutes

Cool the cake

Part 2

In a bowl, put…

1 20 ounce can crushed pineapples (Dole)

1 Box instant vanilla pudding

small cool whip and fold into the mixture

Triple Layer Peanut Butter Brownies

I never really liked brownies, yet I loved these.  All the layers make the brownies extra moist.  When I am ready to eat this, I take it out of the fridge and leave it out for awhile.  This helps the layers melt, and it makes the brownie layer extra moist.  

Ingredients:

1 box (19-21 ounces) brownie mix, prepared in 13x9-inch pan (just follow the directions)

1 cup cold milk

1 package (3.4 ounce) Jell-O vanilla Instant pudding

1 cup creamy peanut butter

½ cup powdered sugar

1 ½ cups cool whipped topping (thawed)

3 squared baker’s semi-sweet baking chocolate (I often just use chocolate bars)

Directions:

Make the brownies according to the directions and let them cool.

Whisk milk and pudding about 2 minutes.  Add peanut butter and sugar; mix well.  When the brownies are completely cooled, spread the pudding mixture over the brownies.

Microwave whipped topping and chocolate for one minute, stirring every 30 seconds.  Spread over the pudding. 

Refrigerate 1 hour.

Banana Bread

This is a super easy recipe.  Any type (pumpkin, zucchini, blueberry, etc) of bread should be pretty easy to eat, or you can mix it into a smoothie.

Ingredients:

1 cup sugar

½ cup oil

1 egg

3-4 bananas (rotten)

1 ½ cup flour

1 teaspoon baking soda

1 pinch of salt

Directions:

Mix all ingredients together

Pour into greased bread pan

Bake at 350 for 45-1 hour

Coca Cola Cake

This is decadent and delicious!  This is also good served with ice cream.  Even though this is more labor intensive, is worth it.  This takes about 45 minutes to complete.

Preheat oven to 350

Mix:

2 cups flour

2 cups sugar

½ teaspoon salt

1 teaspoon baking soda (or powder)

½ teaspoon cinnamon

In a saucepan over medium heat until it boils:

1 cup butter (2 sticks)

¼ cup cocoa powder

1 cup coca cola

½ cup buttermilk (1/2 cup milk and a tablespoon lemon juice)

Take off heat & add flour mix, then add:

2 eggs

1 teaspoon vanilla

Mix, put in greased pan, and bake for 30 minutes.

When the cake is nearly done, make a glaze in a saucepan:

½ cup butter (1 stick)

¼ cup cocoa

½ cup coca cola

Once it boils, remove, & slowly stir in 4 cups of confectioners’ sugar until smooth.

Once the cake is out of the oven, pour the warm glaze over the hot cake.  (I poke holes in the cake so some of the glaze gets into the cake)

Strawberry Poke Cake

This is a quick, easy, and refreshing cake.  

Ingredients:

White cake mix

Strawberry jello mix (3 ounces)

1 cup water (boiling)

cool whip

Strawberries (optional)

Direction:

Bake the white cake as stated in the directions on the box.  Let cool for 5-10 minutes.

Use a fork, chopstick, straw, or end of a wooden spoon and poke holes all over the cake (the smaller, the batter it will be)

Boil a cup of water and mix the strawberry jello in it, wait two minutes then pour it all over the cake so it goes into the holes.

Cover the cake then let it chill in the fridge for a couple hours.

Top with cool whip and sliced strawberries.

Easy Pumpkin Pie

After surgery, I couldn't eat the pie crust.  However, I was fine with eating the pumpkin pie filling with whipped cream!

Ingredients:

Already made pie crust

2 eggs

¾ cup sugar

1 ½ teaspoon pumpkin pie spice

½ teaspoon salt

1 can (15 ounces) pumpkin (not pumpkin pie mix)

1 can (12 ounces) evaporated milk

Directions:

In a large bowl, beat eggs with wire whisk.  Stir in remaining ingredients until well blended.  Pour into the crust.

Bake at 350 for 40-50 minutes (until a toothpick comes out clean)

Cool completely, approximately 2 hours, in fridge.

Cinnamon Roll Casserole

Most people have heard of a French toast casserole, but few people have heard of the cinnamon roll casserole.  This amazing dish combines the best of the breakfast world with the snack world.  Some people add nuts, but since that is not TMJ friendly, I left that out of the recipe.

Ingredients:

2 cans Pillsbury cinnamon rolls

½ cup milk

4 eggs

1 Teaspoon cinnamon

¼ cup pure maple sugar

Instructions:

Grease a 9 x 13 pan with Pam

Cut up rolls in small pieces and lay in the pan

In a bowl, whisk eggs, milk, and cinnamon

Pour over rolls making sure they are well coated

Drizzle on the maple syrup

Bake at 350 for approximately 35 minutes or until puffed up and golden

Microwave the icing that came with the 2 cinnamon roll packs in a microwave safe bowl.

Pour on top and serve warm. 
Eat with additional syrup (if you want it more sweet)!