It’s been 6 months since my Total Joint Replacement surgery and a lot has changed. I’ll touch on some key points but here’s a little review first.
Why did I have surgery?
For over 10 years I suffered from symptoms of TMJ disorder. It began with jaw joint noise and popping. It progressed to 3 hr long sessions of lock jaw, constant headaches, neck pain, back pain, burning facial pain, shooting nerve pain, limited mouth opening of 12mm, and the most disabling symptom of migraines (including visual auras, nausea, vomiting, dizziness, vertigo) lasting 2-3 days in length, occurring 15-20 times per month. This left me unable to work and in bed most of the time.
What Treatment did I undergo?
I tried chiropractic care for 2 years, acupuncture, massage, TENS therapy, 3 different treatments with orthotic splints, vitamin supplements, Neurological treatment including a variety of heavy medications, Botox injections, 2 rounds of Orthodontics, physical therapy, and 2 jaw surgeries.
What happened in the TJR surgery?
In July I underwent a second surgery of my jaw. The TMJ joints of my jaw were so damaged that they were arthritic and degenerative. The disc that cushions your joint had worn away and bone was grinding on bone. My lower jaw had recessed itself back into my neck to support itself, cutting off my airway.
My joints were removed and replaced with prosthetic ones. My upper row of teeth was lowered and moved forward. My bottom jaw and chin was moved forward. A nasal turbinectomy was also performed. It was an extensive 9 hour surgery to reconstruct my face into optimum bone structure to stabilize my jaw and open my airway.
How are things 6 months later?
Swelling: I think most of the swelling from the surgery is gone. I do have problems with lymphodema now as an unfortunate side effect. This can happen when lymphnodes get damaged during surgery. The lymphnodes in my face and neck just don’t drain well anymore so I have to keep up with massage to treat that. Otherwise, I get a swollen face and neck, which is not pretty. This will probably be a lifelong problem. Besides just visually being an issue, my cheeks get really full and it’s difficult to chew without biting them.
Numbness: I still have a lot of numbness. Around my ears, my temples, and part of my scalp have little to no feeling. Part of the roof of my mouth has no feeling. My chin and bottom lip have limited feeling. I get a lot of weird sensations. I’ll have a terrible itch on the side of my head, but I can’t feel the skin there so itching it does no good. Supposedly this is the nerves playing tricks on me. I’ll get random shooting pains, or crawling feelings as the nerves are still going haywire.
Pain: I know this will sound bad, but it is really much improved. I am getting daily migraines (though sometimes I get lucky and it’s only a headache). They come like clockwork at 2 or 3 pm so I think it’s a reaction to staring at my work computer for so long. They last only 3-4 hours now (instead of 3 days) and respond a lot better to medication.
My key things to point out on my pain:
I still have mild facial pain but mostly it is soreness in trying to stretch my muscles. I have a lot of neck and back pain, which is my most hindering symptom right now. I have to keep in mind that the muscles are still healing. Some muscles were cut and reattached, one muscle was removed, and they have gone through 10+ years of work overload and constant spasm. It’s going to take a long time for them to heal and strengthen.
Muscle Weakness: My jaw still does not have a lot of power behind it. I can eat most foods but crunching things is near impossible as I just don't have the strength to do it.
Energy: I'm happy to report I have the most energy I've felt in at least the past 6-7 years.
Jaw Opening: This is my favorite things to report! So at my worst I opened only 12-14 mm. Maximum mouth opening in adults averages 50 mm, with women ranging from 45-55 mm and men 50-60 mm.
6 months post-op I have achieved 35 mm of opening!! Once, after Physical Therapy really stretched it out I hit 38, which was awesome! So there is still work to do but it is really gratifying to see this tangible proof of progress.
Where do we go from here?
Physical Therapy: I am in physical therapy once a week right now. I really need to go more often, but this is the best I can do with my work schedule. We are working to loosen the muscles in my neck and all the muscles in my jaw and face. After every session it's amazing how my posture changes. My head sits back further on my shoulders and my mouth can open wider. It just doesn't STAY. Hopefully, over time, the muscles will assume a more relaxed position and stay there. It is undetermined how much further Physical Therapy I will need.
Orthodontics: We just started working in December to move my teeth again. We had to wait until the bones were healed enough to withstand movement and pressure. They are working to widen the arch of my teeth and then bring my bottom teeth into alignment with those, creating a stable even bite all the way around. I know you think, "they moved your teeth in your surgery. Shouldn't your teeth already be in the correct position?" The answer is unfortunately, no. During surgery, your muscles all relax and you are laying on your back. The surgeon can only really guess at where he needed to place my jaw. Once I woke up, things were actually hitting pretty nicely, but during the healing process things move around. The bone has to settle and that can create a slight change in your bite. So now we are fine tuning, but it still make take another year of orthodontics to get things aligned.
Below is a photo comparison of before surgery (top) and 6 months after surgery (bottom).
Why did I have surgery?
For over 10 years I suffered from symptoms of TMJ disorder. It began with jaw joint noise and popping. It progressed to 3 hr long sessions of lock jaw, constant headaches, neck pain, back pain, burning facial pain, shooting nerve pain, limited mouth opening of 12mm, and the most disabling symptom of migraines (including visual auras, nausea, vomiting, dizziness, vertigo) lasting 2-3 days in length, occurring 15-20 times per month. This left me unable to work and in bed most of the time.
What Treatment did I undergo?
I tried chiropractic care for 2 years, acupuncture, massage, TENS therapy, 3 different treatments with orthotic splints, vitamin supplements, Neurological treatment including a variety of heavy medications, Botox injections, 2 rounds of Orthodontics, physical therapy, and 2 jaw surgeries.
What happened in the TJR surgery?
In July I underwent a second surgery of my jaw. The TMJ joints of my jaw were so damaged that they were arthritic and degenerative. The disc that cushions your joint had worn away and bone was grinding on bone. My lower jaw had recessed itself back into my neck to support itself, cutting off my airway.
My joints were removed and replaced with prosthetic ones. My upper row of teeth was lowered and moved forward. My bottom jaw and chin was moved forward. A nasal turbinectomy was also performed. It was an extensive 9 hour surgery to reconstruct my face into optimum bone structure to stabilize my jaw and open my airway.
How are things 6 months later?
Swelling: I think most of the swelling from the surgery is gone. I do have problems with lymphodema now as an unfortunate side effect. This can happen when lymphnodes get damaged during surgery. The lymphnodes in my face and neck just don’t drain well anymore so I have to keep up with massage to treat that. Otherwise, I get a swollen face and neck, which is not pretty. This will probably be a lifelong problem. Besides just visually being an issue, my cheeks get really full and it’s difficult to chew without biting them.
Numbness: I still have a lot of numbness. Around my ears, my temples, and part of my scalp have little to no feeling. Part of the roof of my mouth has no feeling. My chin and bottom lip have limited feeling. I get a lot of weird sensations. I’ll have a terrible itch on the side of my head, but I can’t feel the skin there so itching it does no good. Supposedly this is the nerves playing tricks on me. I’ll get random shooting pains, or crawling feelings as the nerves are still going haywire.
Pain: I know this will sound bad, but it is really much improved. I am getting daily migraines (though sometimes I get lucky and it’s only a headache). They come like clockwork at 2 or 3 pm so I think it’s a reaction to staring at my work computer for so long. They last only 3-4 hours now (instead of 3 days) and respond a lot better to medication.
My key things to point out on my pain:
- I no longer wake with a headache! I have long hours of the day with no headache at all, which is amazing.
- I am able to work again! When 3 pm hits, it’s difficult, but I am able to push through to 5 pm when I’m off work.
- I have my evenings back! I'm off work at 5, I go pick up my son and by the time I get home the pain starts to lessen. I am able to care for my child in the evening, make dinner for my family, and do some light housework. I no longer have to immediately seclude myself to the bedroom with an ice pack on my head when I get in the door.
I still have mild facial pain but mostly it is soreness in trying to stretch my muscles. I have a lot of neck and back pain, which is my most hindering symptom right now. I have to keep in mind that the muscles are still healing. Some muscles were cut and reattached, one muscle was removed, and they have gone through 10+ years of work overload and constant spasm. It’s going to take a long time for them to heal and strengthen.
Muscle Weakness: My jaw still does not have a lot of power behind it. I can eat most foods but crunching things is near impossible as I just don't have the strength to do it.
Energy: I'm happy to report I have the most energy I've felt in at least the past 6-7 years.
Jaw Opening: This is my favorite things to report! So at my worst I opened only 12-14 mm. Maximum mouth opening in adults averages 50 mm, with women ranging from 45-55 mm and men 50-60 mm.
6 months post-op I have achieved 35 mm of opening!! Once, after Physical Therapy really stretched it out I hit 38, which was awesome! So there is still work to do but it is really gratifying to see this tangible proof of progress.
Where do we go from here?
Physical Therapy: I am in physical therapy once a week right now. I really need to go more often, but this is the best I can do with my work schedule. We are working to loosen the muscles in my neck and all the muscles in my jaw and face. After every session it's amazing how my posture changes. My head sits back further on my shoulders and my mouth can open wider. It just doesn't STAY. Hopefully, over time, the muscles will assume a more relaxed position and stay there. It is undetermined how much further Physical Therapy I will need.
Orthodontics: We just started working in December to move my teeth again. We had to wait until the bones were healed enough to withstand movement and pressure. They are working to widen the arch of my teeth and then bring my bottom teeth into alignment with those, creating a stable even bite all the way around. I know you think, "they moved your teeth in your surgery. Shouldn't your teeth already be in the correct position?" The answer is unfortunately, no. During surgery, your muscles all relax and you are laying on your back. The surgeon can only really guess at where he needed to place my jaw. Once I woke up, things were actually hitting pretty nicely, but during the healing process things move around. The bone has to settle and that can create a slight change in your bite. So now we are fine tuning, but it still make take another year of orthodontics to get things aligned.
Below is a photo comparison of before surgery (top) and 6 months after surgery (bottom).
My advice to those who suffer from TMJ or Migraines:
I have been through so much I feel I should write a book on all I've learned. I meet people all the time who tell me they think they have TMJ, in small degrees or major. My advice is don't wait for it to get worse. Had I been given the right treatment from the beginning, my joints may have never had to have been replaced.
Also, THOROUGHLY research any care providers you go to in their knowledge of TMJ. I had YEARS of setbacks from seeing doctors who really did not understand TMJ and made me worse. (They could be a great chiropractor, but that doesn't mean they understand what an adjustment is going to do to your jaw.) The only doctors I've found who are qualified to treat this, are doctors who went into this field because they have TMJ themselves. My surgeon just had this same exact surgery done on himself in December (which was his 3rd jaw surgery). He literally knows the pain I feel (and we compare scars and progress which is fun). TMJ is not widely studied and they do not teach it thoroughly in med school. Every care provider will tell you they are aware of TMJ and they know something about it, but you need a doctor who understands the WHOLE BODY effect of this disorder.
To migraine sufferers, explore muscular problems for pain relief. I've talked to a lot of migraine sufferers who have sought out neurological treatment but still have problems. In further discussion, many have neck problems, sleeping problems, or surprise suprise jaw popping/pain. Most had never heard of TMJ and had never explored this as a culprit of their problem. Through this process, I have found my TMJ caused related issues in my neck, back, hips, sleep, energy levels, vision, headaches, etc. I gained a bigger understanding of how each area of my body is connected and how it affects each other. If you go to a neurologist, he's going to tell you it's a brain problem. That's just what they know. It very well could be a brain problem, but it also may not be and you have to be an advocate for yourself. All doctors are not well rounded, medical experts on every area like we want to believe. Don't give up. Even when you are out of money. Your health is worth each failed attempt until you find what works.
That's all I have for now. Thank you for following my journey and I hope it brings you or someone you know some encouragement.
God bless!
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