Friday, 9 November 2012

The Pain Starts

The Facial Pain Commences

2 years into the brace work I go to the hospital for a routine check-up and movement. I leave the hospital in the usual discomfort of being pulled around, my teeth are quite sensitive and my gums are sore. By this point, I am reasonably used to this discomfort but know in two days I will be back to eating my normal diet and feeling well. Two days pass and I decide, for lunch, I would enjoy a chicken wrap and for dinner I would have Cajun chicken with salad. I have my lunch and start to develop a headache around my forehead and ear area. At the time, I thought this was caused by tiredness and exam stress. I go home that evening after having an early dinner, the pain started to spread down the side of my face. It is always very difficult when describing pain, but all I can relate it to would be a strong stabbing and aching pain that covered the whole left side of my face. Much like having a bad migraine, but it was covering one side of my face. I tried Paracetamol, my usual trusted source of pain relief but it did not work. By the next morning, I had had no sleep and was due to have my strategic management test at 2pm. I was in a panic so mum called up the pharmacist who suggested I tried doubling up the pain relief with some ibuprofen. I am slightly asthmatic but I can tolerant ibuprofen some of the time. Not being accustomed to taking pain relief of this dosage, I turned up to my exam feeling very space out and in a lot of pain.

After calling my surgeon, it was arranged that I visit the hospital to be assessed. I travelled to King’s College with my mum and discussed the issues I was having with my surgeon. At the time, the surgeon thought this would be a short term problem. He believed the pain would soon subside once the braces had done their work on straightening the teeth. Unfortunately, he was wrong. After numerous check-ups with the surgeon and orthodontist, it was decided we needed to investigate the pain I was experiencing. Firstly, x-rays were taken of my jaw and teeth and presented nothing in terms of answers. Other than the fact I had 3 wisdom teeth that were positioned very high up in upper jaw and low in the lower jaw. According to the surgeon these could be left alone and would not cause me any problems or discomfort. I then underwent blood tests and had an MRI on my jaw joints only. My MRI scan displayed that my cartilage had displaced on the right hand side of my jaw joint. However, this was seen as irrelevant, as the pain I was experiencing was on the left side of my face.

Mr Matthews called a meeting with the other maxillofacial and orthognathic surgeons, physiotherapists and pain specialist’s to discuss the next course of action. It was decided that I would be referred onto Mr Poute’s pain management team at King’s College Hospital and they would try to contain and control the pain before we could proceed with the surgery. This was a very upsetting time and I felt like I would be left in limbo forever with this horrible facial pain. My mood was so low I broke down and cried through the meeting and expressed to the surgeons how I felt the operation might resolve the pain issues. I told the surgeons, I believed the braces were restricting my movement and it felt like there was no room inside my mouth. As my curvature was so severe now and my teeth were being straightened and moved over to the left side of my mouth in preparation for surgery. Throughout, the course of my treatment there was less and less room for me to move my mouth. It felt as if the braces were rubbing on my jaw bone and this was setting off the intense and relentless pain. Unconvinced and very flippantly, it seemed that they brushed my comments aside and continued to state I had TMJ dysfunction. I was not so certain…. I was displaying some of the symptoms of TMJ dysfunction, but in my heart, I did not feel this was a satisfactory and accurate diagnosis.

Below are the main symptoms of TMJ dysfunction and the symptoms I was presenting at the time (so you can understand why my surgeon believed my issues where due to TMD)….
  • Ringing in the ear (Tinnitus)
  • Clogged ear (full ear)
  • Muscle spasms in the face
  • Dizziness/vertigo
  • Clicking or popping jaw
  • Hearing loss
  • Ear pain
  • Headache
  • Facial pain
  • Pain made worse with cold weather
  • Jaw locking
  • Difficulty chewing
  • Uncomfortable bite
  • Sore teeth caused by grinding

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