New year, new symptoms, new diagnosis?

Most of us start a new year with our hearts filled with hope of better times, with resolutions and promisses of doing whatever is in our reach to improve the things that were not that good in the previous year. I am no exception.

But, what can be done regarding those things we have no control?...

Up until now, my new year days haven't been any different from the old ones: I do my best to work at least a good couple of hours per day on my PhD studies, I rest as much as I can, I spend most days at home and rarely venture outside (overcast and cold weather increase my TMJ pain and discomfort), and I am always looking forward to the evenings when Davide and I can enjoy each other's company.

As for my TMJ symptoms, I didn't have any improvement since my last post. If there was a change, it was for slightly worse. So you can imagine how anxious and excited I was to have my oral-maxillofacial surgery appointment last Friday. I was hoping Mr. C. (my surgeon) would decide to go for another surgery to recapture my right disc, alleviating all the pain and discomfort on my entire jaw and both TMJs. Above all, with this surgery I was hoping to get my life back.

Davide and I went to the University Dental Hospital of Wales (Cardiff) mentally prepared for both a positive answer ("yes, let's do the surgery!") and a less favourable solution ("perhaps it is best to wait a little more time..."). But we didn't prepare ourselves for what was to come...

As always, Mr. C. was the nicest and kindest person throughout the appointment. Although we could see he was having a really busy day, he was with us all the time necessary to go through my complains,  check the function of both TMJs, review my previous two MRI scans and their reports, think, re-think and evaluate my current condition, and then answer all our questions!

The appointment started with me explaining how much worse I was feeling since the last consultation (in September 2012), with considerable increase of pain and discomfort on the right TMJ, loud clicks, pops and snaps. But the new symptoms were what concerned Mr. C. the most: the constant awful crepitus and grating of my right TMJ, and the onset of similar manifestations on the left side. He was not happy with my progress. In his words, "it sounds and feels really bad, as if you're having bone-on-bone". Clearly my right disc is still anteriorly displaced, but now I show signs of significant bone deterioration. On previous MRI scan reports it was mentioned some alteration of the bone signal which could suggest some bone wear and tear, together with flattening of the condyle head. However, at the time I didn't have this kind of crepitus and grating, which is evidence of joint degeneration.

I asked if the recent symptoms on the left TMJ could be related to a jaw imbalance caused by removing the articular eminence on the right side (maintaining the left one). Mr. C. said it was a nice theory and it made sense, but he wasn't convinced it was the cause for them.

Looking desolate, Mr. C. said it he was about to do something he never did before: requesting a third MRI scan for someone. He added it was the first time he saw this kind of symptom progression to worse in such short period of time. Both my TMJs need to be re-scanned in order to check their current condition. With new scan results, Mr. C. can evaluate what is exactly going on and what may be causing this deterioration. Although it is still very early to jump into conclusions (especially not having any recent scan to support), Mr. C. said there is the possibility of having a joint degenerating disorder, such as rheumatoid arthritis. After the results of the new MRI scan, Mr. C. may ask for other exams to confirm or exclude this possibility, and plan a surgery accordingly.

I am back on a waiting list for a date to do the MRI scan.

And so, I have a new wish for 2013: not to have rheumatoid arthritis (or something similarly bad).