TMJ rant of the month

Someone just posted an article about "fad diseases" and hysterical pains to my regular mailing list. (I've saved it to text, with attributions, in case it becomes unavailable otherwise.) I just read it and now I gotta blow off some steam about the last paragraph, where some doctor is quoted as saying:

"... there's a whole world of epidemic disease attributions that is just filled with curiosities. There are people who believe they are allergic to dental amalgam. There are people who think that they have problems with the temporomandibular joint in their jaw that disables them. There's the whole fibromyalgia crowd that is sort of blended together with the whole chronic fatigue illness attribution now. This really does go on and on."

*grumble* If this guy were my physician, I'd tell him where he could stick it and go find a new one. I've had TMJ problems since I was 18, and it completely sucks ass. It's just so lovely to come across attitudes such as the above when I can point to several times in my life when my jaw locked mostly shut for a month at a time, when I've demonstrably chewed through several acrylic bite plates. Chewing a few Doritos this afternoon made my jaw ache. I wake up many mornings with one of the joint condyles slipped forward so that I can't open my mouth all the way until it slips back again.

I know when it started and probably what triggered it (pain from impacted wisdom teeth). I know what the results have been over the years (lots of pain, muscle spasms, tooth grinding and wear). I know what makes it worse (stress), and also what can help alleviate the symptoms (NSAIDs, massage, acupuncture, chiropractic). However, it's not the same for everyone. Thank heavens I'm not one of those poor folks who had surgery to replace the condyle, since a lot of them *have* been permanently disabled and/or disfigured because of the surgery. At least my problems can be helped a lot with a combination of some kind of bite plate, stress reduction, and various physical therapies (and ibuprofen as needed).

But jeez...I didn't fucking ask for all that. I'd love for it to all go away. Simply writing it off as "it's all in your head" is so completely unhelpful that it's actually bordering on harmful, in my opinion, because it just adds to the stress the suffering person experiences.

If a doctor suspects that a patient's problem has psychological components, then the thing to do is to treat those components and take them seriously. Blowing people off as part of "the whole fibromyalgia crowd" is so condescending it makes me want to spit.

"Oh, I understand now; it's all in my head. THANK YOU, oh wise and wondrous physician, for showing me the error of my brainwaves. I see now that I was a poor, benighted fool! I can feel all the pain and tension receding as we speak, now that you've demonstrated to me just what a silly git I've been!"

         NOT.

My struggle with depression has included a preoccupation with health issues. When I'm really depressed, I look at every little thing that seems even slightly out of the ordinary and start obsessing about what it might mean. I recognize this, and it's fairly common with depressed people. Last year I had a number of physical issues that were quite real; now I can see that they were very strongly tied to my emotional state, but at the time I wasn't ready to admit that I was, in fact, severely depressed. All I knew is that I had all kinds of physical symptoms that ranged from curious to downright painful and scary. I was seeing various doctors anywhere from two to four times a month.

Thank goodness for my primary doctor, who told me that I should not be afraid or embarrassed to come see him anytime I felt nervous about something. His attitude was, "If you feel you need to come in, even if it's just to be reassured that you're okay, then come in." I don't even want to imagine the kind of damage that a less sympathetic doctor could have done to me while I was in that state.

If the brain's perception of pain is so complicated, then my opinion of a doctor who would be so dismissive of a patient's reported pain is extremely low. Just what we need...more arrogance on the part of Western medicine. Yeah, right.

June 18, 2001