The call to the orthodontist

Now that my TMJ diagnosis is official, I wanted to completely discontinue using invisalign.  I want the orthodontist to make me a normal retainer that is not active at all.  The Invisalign tray is too tight and as much as my orthodontist would like to call it a retainer, it is not because every time I put it in it moves my teeth back into position.  Then I take it out in the morning and all day the teeth move back.  At night I put it in and the cycle starts again.  The orthodontist must realize this is going on, but he doesn't believe this is causing my tmj issues.

I call and speak to the receptionist.  I told her my story and that I wanted to speak to the Doctor.  She  wouldn't let me speak to him but relayed my story to the doctor while I waited on the phone.

His response:  "I don't buy that the invisalign caused your TMJ.  That is from grinding your teeth at night.  There is no such thing as a TMJ specialist or TMJ PT.  I don't believe in TMJ PT.  The only thing that fixes TMJ is a night guard."

My response to this is:  "Haven't I in a sense been wearing a night guard with the invisalign trays?"

His response:  "If you want to stop the treatment, then stop wearing it."

My response:  "Well I would like to have a retainer made so I don't lose everything I worked for."

His response:  "Make an appointment."

This guy is now angry!!  Did I sense any bit of empathy from this guy?  Isn't that what doctors are supposed to do?  Obviously it is more about his ego, and nothing about the care and health of his patients.  I have two kids who may eventually need braces, and you can bet I will be seeking care elsewhere!!

Next week I will be getting my retainer from this quack of a doctor.  I will not publish his name here until I have retainer in hand and sever our doctor patient relationship.

A jaw dropping awakening

I got a call saying my new TMJ physical therapist had a cancellation!!!  So I grabbed the appointment, which was two days ago.

The appointment was eye opening (or perhaps the more appropriate term is jaw dropping).  I went into this convinced that my neck pain was not due to jaw issues.  The therapist had me fill out extensive questionnaires.  Then after a one hour thorough examination, I was convinced I had TMJ.  I never thought I had TMJ because I had no jaw pain.  But apparently TMJ can give you pain in other areas including the head and neck.  So there you have it.  I have TMJ, as much as I didn't want to admit it.

So, what next?  A new physical therapy regimen which will include some very strange oral movements as well as neck and chest stretches.  I started doing these yesterday and haven't noticed any change.

So exercise and therapy twice a week is the plan right now.  I have an appointment with Dr. Fink tomorrow and hope to get more insight then.

We will continue to work on this and give updates as I hopefully improve.  I am just so relieved that I may finally be on the right track.

Stopping the Invisalign treatment and the most defensive orthodontist on the face of the earth

After my appointment with Dr. Fink, I started looking back at the history of my pain and how it aligned with my orthodontic work.  It started to make sense that the orthodontia may have caused this pain.

I called my orthodontist and told him I wanted to stop the treatment.  He said to come in.  He was extremely defensive and said that the treatment had nothing to do with my pain.  He said there was no research to prove it.  He wanted me to continue.

He also disagreed with Dr. Fink about my jaw alignment.  He said "your jaw is perfect."  But my jaw is far from perfect as has been confirmed by both a physical therapist and highly qualified physiatrist.  Now that I know what to look for, even I can see that my jaw is misaligned.

My compromise was to wear the last tray and keep it as a "retainer" of sorts.  I wore this tray for about 3 weeks and my pain still continued.  It was especially painful for me to remove the tray every time I had to eat.  So I called him once again and asked if I could just wear the tray at nighttime.  After 5 days, I got the call back and was told I could wear it at night only.

I had been wearing the tray at night only for about 3 weeks.  Every morning I would wake up in incredible pain and stiffness and would have to immediately put heat on my neck to get it loose.  I attributed this to poor sleeping position.  I figured I couldn't blame the tray because now it wasn't active anymore...it was just a retainer, as my orthodontist claimed.

My world has changed

I consider myself to be a pretty fit woman.  At 53, I probably look closer to 43.  I practice yoga 2-3 times a week, pilates 2 times a week, and do indoor cycling 2 times a week.  I have ALWAYS been active.  But as time went on, I had to leave all these activities behind.  All of these activities were too painful on my neck.  Other things I was not able to do include loading and unloading the dishwasher, unloading the washer, grocery shopping (especially getting items out of the shopping basket), driving any distance, sitting at a computer, bending down to kiss my 5 year old daughter.

This created alot of stress in our household, but luckily I have a fantastic husband and kids who happily pitch in and help out.

A startling discovery

My fabulous husband was able to get me in to see one of the most respected physiatrists in the area, Dr. Kathleen Fink.  My appointment was a morning slot in late January.  I arrived at her office, and filled out all the necessary paperwork.  I was greeted by a pleasant assistant who guided me to the exam room.  After a short wait, Dr. Fink appeared, a sight for sore eyes.  She is a gentle soft spoken women, very pleasant demeanor.  Dr. Fink took the time to discuss my history with me.  She viewed the MRI on her computer, and although Dr. Balint (horrible doctor who was procedure happy) thought I had a bulging disc causing the pain, Dr. Fink quickly dismissed the minor bulge, which was a typical situation for a woman my age.

A stark difference was noted during this exam vs other exams I had.  Not one of the other two doctors even had me lay on the table...I was lucky they even touched the area of pain on my neck, albiet for only a few seconds.  Dr. Fink had me lay down and checked my allignment with hips, legs, etc.  Then she started feeling around my neck.  She identified the area of the pain immediately.  She said my pain was closer to C1, C2, not the C4, C5 that the other doctors indicated.  Then she noticed that I was wearing invisalign.  She asked me how long I was undergoing orthodontia.  She point out that my face had some asymmetry.  Diagnosis:  cervical facets atlanto-axial/atlanto-occipital with jaw alignment issues.

She said she was not claiming that I had TMJ, but she wants me to see a physical therapist who specializes in jaw issues and TMJ.  So, I call to get on this PT's calendar, and once again I must wait!!  Until April!!  So in the meantime, I continue with my current therapist.

The thing that baffles me is that the other doctors did not pick up on the jaw issues.  All I can say is a good doctor is truly hard to come by!!

Doctors, Imaging, Injections, Nightmare!!!

My first appointment was with an orthopedic surgeon.  He took an xray of my neck and told me I have bone spurs.  Gave me a prescription for oral steroids and muscle relaxers and sent me on my way.  I took the steroids as directed.  Felt great!!!  But it didn't last and the neck pain persisted.

By this time I had been wearing invisalign for about 4 weeks.

My husband told me to call a wonderful doctor he knew, Dr. Kathleen Fink.  I called her office and sure enough, because she is so good, I couldn't get an appointment until March.

In the meantime, I saw another doctor in Virginia who is a physiatrist.  A physiatrist is a type of doctor that specializes in pain management without surgical intervention.  Dr. Balint said that my problem was in my facet joints.  Dr. Balint's recommendation was to do a medial branch block.  I took his recommendation and had the procedure.  If you google this procedure, it is not pleasant.  It involves injections of steroids directly into the side of your neck.  There were no drugs to relax me and after the injection they told me to sit for 20 minutes before I left because I would be dizzy.  I asked where I shold go, and they told me to just sit in the waiting room. This seemed very strange to me, because I just sat there and nobody monitored me.  No blood pressure check, nothing.  They also gave me no post procedure instructions (like what to expect, etc.), AND I had to ask the doctor to give me some instructions for my physical therapist...completely an afterthought..

The branch block did not work.  So I was instructed by Dr. Balint to get an MRI.  During my next appointment with Dr. Balint, we reviewed the MRI.  The MRI showed minor bulging disks, but nothing out of the ordinary for a woman my age.  However Dr. Balint suggested the next step should be an epidural.  He gave me this epidural on the spot during my appointment.  I foolishly did this without thinking about it.  Once again, after the painful procedure, I was rushed to the waiting room and told to wait for 20 minutes before driving.  Nobody ever checked on me.  The epidural was not a success and afterward I researched this and this procedure is usually reserved for people who have radiating pain...something I never had.  One thing is certain, I will not be returning to see Dr. Balint.

My husband (who is a retired physician) started to feel bad for me (finally).  The following week he got on the phone with Dr. Fink and asked her if she could see me.  She saw me the next day.  And that is when we started peeling the onion peel.

A pain in the neck

In the fall of 2012 (shortly after I got out of braces and into a retainer), I started feeling a mild pain in my neck...it felt like a kink.  I am a very active person who likes to exercise quite a bit, so I figured I was doing something to intensively.  I let it go for a month, and when it didn't go away on its own, I called my physical therapist to see if she could get the kinks out.  We worked on it over a few weeks.  During this time I was in a retainer, but had just come out of wire braces a few weeks before.

I never made the connection between the braces and the neck pain...and will not do that for several months.

The PT went on and off over the next few months.  Finally in December of 2012, I decided to see a doctor about the neck pain, which kept getting worse despite the PT.

It's been a long road...and still a long road ahead

I won't bore you with the details of why I am finally here to tell you my story, but I need to give you a little background.  I have always had a slight overbite and crowded bottom teeth.  I am 53 years old, but wanted to finally have the dental care I should have had as a child now that we had the means to provide that.  So I began the journey of orthodontia at the ripe age of 52 in October of 2011.  We started with wire braces on the bottom teeth, and the plan was to remove them in 10 months and start with Invisalign for both upper and lower to correct the overbite and finishing touches.

Getting the braces was not big deal...just annoying to wear day in and day out.  I got thought it well enough, and in August of 2012, I had them removed.

Removing braces is painful!!  And long!!  But it was worth the pain and discomfort at the time because finally I will be able to eat popcorn, nuts, and other fun things I have been avoiding.

A retainer was made for me to wear everyday until my invisalign trays came in (5 weeks leadtime!!).  The trays came and I started wearing them in November.

I know, this story is pretty ordinary and boring up till now, but BRACE YOURSELF!!  You will be horrified at the ordeal I endured the following months after removing my braces and coping with Invisalign.