Wednesday, 10 September 2014

Temporomandibular Joint Disorder. The story of going through TMJ and getting my bite back

Over 6 years ago I went to the doctors with ongoing joint pain in my jaw, I knew I had Temporomandibular Joint Disorder as was diagnosed many years ago when I was a lot younger and going through my first treatment of braces to straighten my teeth.

At the age of 15 I was offered the surgery on the NHS to correct my jaw to eliminate the pain, but the surgery was risky, it wasn't that common and the surgery would be done through the outside of my face cutting small incisions under my jawline to complete the procedure. My parents and I agreed that this wasn’t the right time in my life to go through this type of surgery and disrupting my education right before my GCSE’s was not going to be a good idea.

Many years later at my doctors’ surgery in Cornwall after visiting them due to more pain, I was referred to the hospital at Treliske for further investigation. I was offered a treatment of steroid injections in my jaw to reduce the pain but would need these every six months for the rest of my life whilst the pain was there. Or the more complex and longer but more permanent procedure of braking and resetting my jaw to eliminate the pain.

What is temporomandibular Joint Disorder?
With Temporomandibular Joint Disorder it can sometimes feel as if nothing is wrong and other times it can control your life. If I went to loud bars or clubs and spent the evening shouting to speak to friends the next few days I would be in agony from straining my jaw muscles. If I ate anything hard or chewy my jaw would ache, it would often lock up completely, constantly click in and out of joint or simply just cause pain. At times my jaw would even react differently to what I was asking it to do and whilst eating cereal with a spoon one day my jaw just didn't open as well as it should and the spoon hit into my teeth rather than going into my open mouth.

As well as the pain, aching and clicking there was also the physical appearance, my teeth didn't meet and I didn't have a bite. Eating out in public was also a worry I couldn't bite into thin food like sandwiches or pizza and even eating burgers would have to use a knife and fork and cut the food into bite sized pieces rather than biting the chunks of food myself.
Temporomandibular Joint DisorderTemporomandibular Joint Disorder

I had suffered from Temporomandibular Joint Disorder for years and decided to go ahead with the procedure. One of the first things that the team at Treliske asked me was regarding being from Essex! I had only been in Cornwall a few years and once I started the treatment needed regular visits to the hospital and they wanted to confirm I would be around, but I was happy here and so the treatment began.

Temporomandibular surgery
It started with having all four of my wisdom teeth taken out under a general anaesthetic, this was the first time I had ever had an anaesthetic and was pretty worried about the whole thing. The surgery went without a hitch and after arriving at the hospital at 7am was back at home just after lunch ready to recover.

After the wisdom teeth were removed I had around two years of dental work including permanent braces to move my teeth into their new position ready for the jaws new position.

4th January 2012 temporomandibular Joint Disorder Surgery
The Christmas of 2011 was a low key affair with the thoughts of the operation hanging over me. I ate whatever I wanted that Christmas and stuffed my face every day knowing the after the operation I wouldn't be eating solid food for around three months.

The morning of the surgery I was petrified, my partner had taken the time of work to be with me every step of the way and took me to the hospital. I had my pre op checks and was waiting on the ward for my time slot. All the waiting around was killing me, not able to eat or drink for hours and being full of worry about what exactly it would feel like to walk into a hospital absolutely fine and later on that day be left with a broken jaw.

As the hours ticked by I became more and more nervous over what the operation was going to do, I knew it would resolve aches and pains and make eating easier but I just didn’t know how they were breaking the jaw and I didn’t want to know until after the op and I had woken back up.
When the time came to go to theatre I was having a wobble, It was time to say goodbye to my partner and go and meet the anaesthetists. By this time I was actually really scared of what was going to happen, how long the operation would take, how much pain it was going to put me in even though I felt sick with worry I also wondered when I would next eat again, everything was rushing through my mind. As I hugged my partner goodbye there were a few tears and I was taken for a chat with the anaesthetist who calmed me down before the op.

As the anaesthetist gave me some anti-sickness drugs she then told me to start counting to 10, I think I got to about 6 before I was out for the count.
The operation took just over 6 hours, I hadn’t realised that it was going to be so long I’m glad I didn’t know to be honest as it would have just added more fear inside me. Whilst I was under several knifes my partner patiently waited outside. I had told him he had to be there when I woke up, the nurses were keeping him informed how it was all going and each time he went out for a smoke or a coffee rushed back to see if there was any news. At 7o’clock that night I remember waking up in a bed in a room not knowing what the hell was going on, where I was, why I was there. I then saw the doctors and nurses and it all suddenly came flooding back what I had just woken up from. As I was coming around they wheeled me onto the ward and before I knew it I caught a glimpse of my partner and I was over joyed.

He asked me how I was feeling and not really sure what I could and couldn't move just squeezed his hand with joy that the operation was over and it had all been a success.

Temporomandibular Joint Disorder after surgery

The first night in hospital was probably the worst of my life I was attached to a drip in one hand and had self-administering morphine direct into my other hand, I was drowsy and feeling sick and feeling really confused. My partner was allowed to stay well past visiting hours and was able to stay with me until 10pm. Since we got together we have barely spent the night apart so being apart and in so much pain was horrible.

As the night rounds set in I was given more drugs, I had to use a bed pan, losing even more of my dignity and the lights were lowered. I felt like I had spent the night staring at the ceiling dosing in and out of sleep but feeling exhausted and in pain. Around 7am the lights went up and the nurses came around and injected more drugs and brought around breakfast… except my jaw is broken so I couldn’t have anything so continued enjoying my drip.

I text my partner several times through that first night at all hours and he replied each time, I did apologise for keeping him awake but he said he couldn’t sleep either. The next four days I was kept in the hospital and my partner went back to work and visited during visiting hours each day. Being in pain, tired and grumpy is one thing but doing this on a ward of loud sleepers, strange sounds and dramas you don’t get any sleep at all. All I wanted to do was come home and sleep in my own bed but I wasn’t allowed for 5 days. The second night was equally as bad as the first although I was slightly more used to the set up, noises and the nurses. This night I had drifted off to sleep but manage to pull the cannula for my drip out of my hand in my sleep. With my hand bleeding and liquid from the drip going everywhere in the bed I was then treated to new bedsheets and bed bath body wash!!! Me being the centre of the noise and drama that night. All I wanted to do was see my partner and get a hug I was finding this all really hard.
Temporomandibular Joint Disorder after surgery

After 5 days it was Saturday morning and the nurses came around and made the noises that I could possibly go home so I text James my partner as fast as possible and he screamed over to the hospital with clean clothes and the biggest smile. After what felt like hours of deliberation by about 1pm I was given the news that I could go home. 
Temporomandibular Joint Disorder after surgery

I was so happy, I was put in a wheel chair and wheeled to the car and then driven home as carefully as possible as was feeling every bump in the road. James offered to drive me past the beach on the way home but I gently shook my head I just wanted to go home. The exhaustion of getting off the ward was really starting to hit me and once home I felt like I would collapse and never get up again. James sat me in the bath and washed me from top to bottom and I felt great being in my own home. I fell asleep for what felt like days, James had the following week off to be there for me and look after me but I spent so much time sleeping that I didn’t see him. He took me back to the hospital for check-ups and went back to work the following week leaving me soups, smoothies and drugs laid out for each day.  
Temporomandibular Joint Disorder after surgery

Recovering from Jaw surgery
Looking back on it now it really didn’t seem that bad but at the time I felt like things would take forever to get back to normal. I spent the first two weeks from the operation sleeping for 90% of my days, I had to have help to walk to the bathroom and felt like I was going to pass out all the time and felt so weak. After this the swelling was going down and the stiches heeling and I was able to eat liquidized food through a straw and this was getting me through. Treating myself to custards and yogurts really helped give me some energy through the sugar and I was beginning to feel normal. I was off work for around 2 months towards the end I would work part time from home before going part time in the office before getting back to normal. Although things were slowly getting back to normal I still had my jaw shut together with elastic bands around the braces and still had to drink all my meals through a straw which wasn’t much fun.
Temporomandibular Joint Disorder after surgery

As the jaw heeled I was able to step down the usage of the elastics and gradually start learning to eat again. Mashed potato and gravy was a great choose as was macaroni cheese. Any food that didn’t require much strength or chewing, food that could slide straight down was well and truly on my menu.
Temporomandibular Joint Disorder after surgery

I continued to recover and my jaw was getting stronger all the time and after 12 months I was very nearly back to normal. The next step was to have the braces removed and another 2 years of check-ups with the use of wearing retainers at night to hold my teeth in place.
Temporomandibular Joint Disorder braces removed

On Monday the 8th of September 2014 I was signed off as a patient at the Treliske Hospital in Truro, I haven't really shared my story before and definitely haven't shared any of these pictures. I left hospital on Monday grinning from ear to ear and decided it was now time to put 'pen to paper' or rather 'keyboard to blog' and put this chapter of my life behind me. I still have to wear my retainers a few nights a week and I do still struggle to eat an apple without my jaw tiring but I am so happy to have a perfect face a perfect jaw and a perfect bite.

I want to thank the dentists, doctors, surgeons and especially my orthodontist Mr. Wenger who is just lovely and got me through the whole thing. With my straight teeth and my straight face I couldn’t be happier but it was a long journey over many years to get to the stage I am at today. It was completely worth it and wouldn't have got through it without the love and support of my partner James as well as my friends and family who looked after James when he wasn't looking after himself and spending every hour at the hospital and looking after me.
New smile after temporomandibular surgery
It was a long journey and a big chunk out of my life but was definitely worth doing and the above photo is me showing off my cheesy new smile alongside the wonderful James who stuck by me through out the whole ordeal.