A few questions for the TMJ Doc..

[seekandfind46]

Hi,

I posted a few other responses, but I am sure you are busy with your practice, and don't always get a chance to get on here.  I am scheduled to go for an arthroscopy, coming up at the end of the month.  I am apprehensive, but the Maxillofacial surgeon doing it says there is a lot of scar tissue that needs to be removed.  I am wondering if this can impede movement.  I am always rushed when I am in his office, and had to shedule another appointment before the procedure to ask him questions.  I also want to know how my discs look.  It says on the MRI that there is thinning, of the discs on the left where most of my problems are, I also want to find out what condition the ligaments are in...  I heard that MRI's doesn't always show soft tissue up properly.  I was told it doesn't show when they are stretched.  These are the reasons I wanted to have the procedure done.  I wrote out on paper for the Surgeon, that I did not want any shaving down of the joint, nor did I want the discs touched, that it was merely for observation,and if any bad scar tissue or scar bands were impeding movement, that he can remove it..  I really don't know how he feels about that, but his interns I saw for pre-op said that should be fine, as he is conservative in his approach anyway..  The thing I worry about the most is that there are nerves surrounding the joint, and I have so much nerve pain now, I am worried about that.  THe Maxillofacial surgeon told me that he only had one person that had a problem after the procedure but the pain subsided three months later.  I am awaiting my appointment to see him to bring up these questions.  I wanted to run them by you in case you might know anything about it.  I was wondering why in some cases, that some people don't have any success with appliances, splints, ect... If it is because of a lot of scar tissue, or scar bands, impeding movement, or if the ligaments holding the joint are to loose or torn, if that is what is preventing these methods from working.  Is there any way to correct problems with the ligaments??  Does this mend over time, or does one need surgical intervention with ligaments that are torn or stretched??  The Maxillofacial surgeon I am seeing says he doesn't do anything to the ligaments.  Not sure why, if he has had some bad experiences, with the procedure....  I wrote to you previously about seeing a TMD dentist, that uses splints and the ALF appliance, as well as other appliances.  I checked and he is under certification as an orofacial pain specialist (not sure if that is correct spelling).   He is the one that uses the ALF,  one of two here, in this area. He has also had training with College of craniomandibular orthopedics... I think he mentioned he has been treating TMJD problems for over 10 or 15 years.  He is a nice chap.  He did mention that he studied with Dr. Rondeau, and Dr. Stack in the US.   I am living near the Toronto area..  I know you mentioned knowing some collegues in this area, wondering if you can let me know who they are, not just for me, but there are others here looking for specialists, and would love to know where to find them, especially the ones with experience, which is harder to find here..  The dentist I saw has a sign that says TMJD specialist...  Apparently I heard from other specialist here in Ontario, that you cannot use that terminology here in Canada.  All you can put down is neuromuscular treatments.  I have no idea how he did that... But he is very busy now....  
I was badly hit on the side of my head (left), and am having problems with my neck, back, and spine, and can hardly walk.  Its like the whole left hand side of my body is immobile, while the right is fine... The thing is I have disc displacement on the right side too, but it doesn't bother me.  I can lift things with the right but cannot lift a feather with the left.  I don't know if that is why the dentist I saw mentioned using the ALF.  I also have pain right along the joint and right up into my head on the left side.  It is even painful to the touch, and I also have pain right at the bottom of the skull.  They did tests for Trigeminal Neuralgia and said they say nothing, had it done with dye, and nothing showed any compression there, but the Neurologist I saw thinks there is mechanical problems with the joint causing compression.  So he could be right, and after reading that there are definate links between the two, that may be the case.  Anyway I don't want to take up too much of your time.  Just wanted to get some feedback, and if you know of any collegues in this area, or in anywhere in Ontario..  I would also like to know where you are located, and your name and website, if that is permissible.... I don't know if that is permissible on here or not, but you can let me know.  I have friends in the US, with TMJ problems, and wanted to know where you are located.  Thanks so much for your responses they are greatly appreciated...

Seekandfind46

PS, also was under therese46...but now under seekandfind46...


Thank you so very much..... Therese  

[seekandfind46]

Sorry I guess its not permissible to post your email address here, but if you click on my user name seekandfind46, you will be able to email me from there.  Sorry about the inconvenience.  I also want to mention.  I know I am grateful that you are on here to help individuals.  Not many Doctors are interested in doing that especially one that is already busy in his practice.  I just want to say THANKS SO MUCH.....  I am sure there are others that will benifit greatly from your advice and posts here.  I know I am grateful..

Seekandfind46...

Therese

[seekandfind46]

Hi Again,

Thanks for getting back to me...I am sure you are busy, and probably don't need new patients, but I guess many of us are desperate for relief and just don't have the funds to be throwing it into the wind to those professing to know. It is sad that their is so much ignorance out there because their is endless suffering going on.  Here so many are saying they have experience, but are more interested in the money, and could care less about what happens to the person.  Of course there may be some that are sincere but like you said previously its a little harder to find here.  I will post my email, its ***@****    Thank you very much for your input. I am sure many here will also benifit from this.   Thanks Again..

Seekandfind46

Therese

[TMJDoc]

I answered a lot of this in another response.  I'm in the midwest.  I recommend that patients use the referral area of the Academy of Craniofacial Pain.  I have a very busy practice as it is and I don't monitor this site to 'get' patients.  There is so much mis-treatment and poor advice out there that sometimes I just can't stand the ignorance any more.  I will add just one more thought.  There are two treatment philosophies for TMjoint disc displacements.  Recapturing the disc and treating 'off' the disc.  The joint naturally is on the disc, so it just makes sense to try to restore normal anatomy.  They is my approach and most in the AACP.  That being said, sometimes you cannot recapture the disc with conservative therapies and either go to surgery or if the sypmtoms can be controlled the patient can be managed as well as possible.  The more experienced and trained the clinician in recapturing discs, the more success you'll have.  That's TMD in a nutshell, incomplete thought, since there is so much more to it that this.   If you feel comfortable posting you email address I'll answer.  TMJDoc

[seekandfind46]

Hi,

I also wanted to add that if you cannot post anything in particular on here because it moderators or certain rules you can email me directly.  

Thanks again...


Seekandfind46

Therese