Alternatives?

Davide and I spent hours and hours, days in a row, searching for anything that would reduce my TMJ pain, an alternative to the excessive use of drugs. An alternative that could give us back a little of our life prior to the arthrocentesis - no pain, no medication side-effects, no frustrations. And especially, an alternative that would allow me to follow my dream (the IODP scientific cruise in Japan) and grab the opportunities that I had been offered recently (summer internship in Norway). We found a chiropractic clinic close to where we live, offering acute and chronic pain relief through the use of neurostimulation technology (InterX therapy). We arranged an appointment for the following week (January 31st, 2012), hoping the chiropractor B. M. would be able to help me.

Usually in B. M.'s clinic, the initial consultation and examination (including X-rays) is one hour long, followed by a second appointment where the findings are reported, and a treatment plan is proposed. However, my initial consultation took almost two hours, and I still had to go back to the clinic on the following day for more physical examinations and X-rays. I was not the first patient with TMJ disorder that B. M. had seen, but I was definitely his worst case.

How things can go wrong

I was once again nervously awaiting for Mr. C.. He entered the consultation room smiling, and very kindly asked how I was feeling. "Not so good, I'm afraid..."

I explained all the new symptoms I had during the past month, since the right TMJ arthrocentesis. Limited mouth opening (max. 23mm/0.9inch), inability to chew anything solid, more pronounced lower jaw shift to the right side, and the pain. Severe pain. "Please, help me cope with the pain..."

He thought for a few moments before speaking. I took a deep breath and prepared myself for it.

One of two things had happened with the arthrocentesis: either I was taking a little more time than usual to recover from the procedure, or things had gone wrong. In the light of my symptoms, he was inclined to believe it was the second case.

TMJ arthrocentesis results

TMJ arthrocentesis

I opened my eyes. It took some time until I realised where I was and what just happened. A nurse stood on the left side of my bed, checking my blood pressure in intervals of few minutes. "How are you feeling?", she asked. "Thirsty..."

My first word after waking up from the arthrocentesis came out strange. Not the voice, but the mouth movement. It felt odd as if my lower teeth wouldn't fit into the upper, being the whole jaw misaligned. I tried to open and close my mouth slightly a few times to check how was the right TMJ. Spongy. That's the best word to describe it - spongy. There was something spongy inside my right TMJ, some extra volume that somehow felt like a thick cushion preventing the right side of my lower jaw to close completely.

"How is the pain?"

"It hurts..."

"Can you tell me from one to five how bad is the pain?"

"Errr... Don't know... Four?...", I asked myself out loud. I was still confused from the anaesthesia, although I was awake enough to start feeling the pain kicking in. I saw the nurse injecting a fluid through the needle I had in my left hand.

Sometime passed, although I can't precise how long it was.

"How's the pain now from one to five?"

"Still hurts... A four, I think..."

"Can you take codeine? Are you allergic to it?"

"I don't know... Never had it..." I never even heard that name before. What was codeine for?

Well, codeine and I would become "best friends" later.

I was waking up after a TMJ arthrocentesis performed whilst under general anaesthesia. But what kind of procedure is this? What have they done to me exactly?

TMJ in the UK

I graduated in geology in 2006, and soon after I moved away from home to work. For six months I lived in a beautiful village located in the Azores islands, right in the middle of the Atlantic. During this time, Davide and I became good friends. Once our contract was over, we both found jobs in the oil industry, working offshore in rotations of two weeks on/two weeks off. However, a few months later Davide got a scholarship to do a PhD in Cardiff, Wales (UK). From then on, my time-offs where spent there.

In January 2009, I left my family, friends and sunny Portugal to live with the best guy ever, and to fully enjoy the "great" british weather.

During these years I felt my right TMJ slowly deteriorating. I could tolerate the pain, but the discomfort on the joint was becoming more and more intense. Mouth opening was not smooth as I felt like having  sand grains being crushed inside the joint. From time to time, the lower jaw would get locked open. Although I was able to find a technique to put it back in place after the first few times it happened, it was always a really scary and painful experience. The joint noises were a constant torture. They reminded me of chicken leg bones getting broken.

Regarding the pain around the joint, it was usually more intense in the evenings, with all the normal eating, talking and general mouth movement the TMJ had to go through during the day. However, it wasn't uncommon waking up in the morning already feeling pain, or having quite strong headaches. Knowing I used to grind my teeth during the night (bruxism) ever since I was little, I considered the morning headaches quite normal.