I got my MRI results today for my TMJ. The x-ray prior to that demonstrated arthritis in both jaw joints. The MRI looked at the discs, which are both dislocated anteriorly in the more closed mouth view & one of them is still out of place anteriorly in the open mouth view, where the other goes into place in the open mouth view. The doctor has asked staff to put in for approval on what he wants to do- arthroscopic lavage of the joints & they put some fluid in and also botox injections at trigger points to try to relax the muscles. The TMJ problems is one of my migraine triggers.
Well, they were planning to put in to the insurance and said that day, on June 23rd, to expect a wait of two weeks on approval and after that, if I go ahead, I expect they would schedule the arthrocentesis. I'm concerned right now about the doctor's experience, as I learned today he is just two years out of residency. I'm hopeful it will be alright and think I don't want him trying to manipulate the discs back into position during the procedure, in case it made something worse than now.
Well, that doctor decided he wasn't experienced enough. I saw another dr., a very experienced one last week. He called me today.
Dr. McCoy called and he said the disc is torn on the left side of my jaw and that is the one with no reduction. There is a little arthritis on both sides, but not major. He said he had major arthritis on one side himself and a therefore a replacement. He says his colleague has had a torn disc for 30 years and lives with it without a lot of problem.
He says he doesn't know if surgery would help me or not. He acted unsure about it, particularly because it is the right side that I have the most pain in and he doesn't know why that is. If it were a tumor or something progressive it would be different. I responded I thought my function situation was getting worse.
But he thinks a lavage of the joint might have a 60 percent chance of success. However, it is not a long term fix (which I had been told already) so he doesn't know if it should be done or not. It washes out some kind of chemical made by the body due to inflammation.
I said, so there's not a whole lot of hope and he said, I didn't say that. He'd like me think it over and to come sit down and talk at an appointment.
I asked him about botox, which the previous dr. had wanted to try. He said it targets the nerves and a person has to look at the muscles and everything and target the injections, not just do it. He said they had done a few and it helped some with major muscle spasms, but didn't really think it would help in my case. He said they don't do the injections anymore because they hadn't had that much success with it.
It's been a while since this happened, but here's an update:
When I requested that the experienced surgeon do surgery and residents watch, I was told residents would be involved, so I opted not to go back & I got my records. It looked like the surgeon was not contemplating just a lavage of my joints, because his note said arthroscopic surgery (which I had read was more invasive than arthrocentesis).
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