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referral madness

Posted Apr 11 2007 12:00am
I had my umpteenth follow-up appointment with Dr. C, who is treating me for my TMD -- tempero-mandibular disorder, informally and commonly referred to as TMJ.

Sadly, I've backtracked considerably on the progress I was showing at the end of January, so I'll be going back in again in 3-5 weeks.

My take on my situation was: Yes, I'm having headaches, but I've had this sinus thing going on, and I haven't been too great about doing all of my physical therapy exercises. (I do some nearly every day, just not the whole suite.)

Dr. C's assertion: There's no such thing as a sinus headache, it's referral pain coming from problems with the musculature in your neck.

Me: !!!!???

There followed the back-and-forth: But I'm not having the eye-stabbing headaches that got me into treatment in the first place -- Yes, those are the most uncommon, now you're having the most common headaches -- well, what about my ears feeling blocked, too? -- Jaw muscle pain can cause ear problems... -- Why does Nasonex work, then? -- Because Nasonex (a steroid, after all) treats the jaw inflammation...

To all of this I say: Hmmmm. But also, keeping an open mind.

I told Dr. C I'm going to see my ENT on Monday, and we'll see what's what. The one symptom I forgot to mention to him that makes me think there really is something going on with my sinuses is the fact that I have never-ending post-nasal drip, and if I snort enough saline (or warm water in the shower), some pretty nasty gunk comes out of my nose. But I agree with Dr. C that we shouldn't say it's a sinus infection unless there's actual evidence -- other than the headaches -- of something going on in there, something culturable.

We'll see.

Let me just say I'm a bit freaked about getting a head CT. My eye twitching is better than it was, but hasn't gone away completely, and in the last week or so, I've developed an intermittent lip twitch as well. Just now I'm experiencing something weird with my nose -- there's pressure in my sinuses which is somehow or other making the tip of my nose feel numb, the way it did when I had the local anesthesia for my front crown work. It's odd to walk around feeling that way when you haven't been to the dentist. Obviously something is going on... I just don't want it to involve either 1) cancer or 2) surgery.

Dr. C recommends doing some tests with numbing muscles/nerves in my neck to see if it alleviates the pain before anything more invasive is done. I'm fine with that, if the tests don't definitely show something wrong with the sinuses.

For now, I'm supposed to wear the splint during the day when I don't need to talk or eat, and also note if I have jaw pain in the morning. Last, try to get back to the exercises on a more regular basis -- I know that will help. I am so not in the mood for another health issue! I'm hoping it's not too late to avoid having something major done with this.

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