Monday, 25 September 2017

Health Scares : The Lump & A Diagnosis


Back in April, I shared that I had found a lump on my jaw and had seen the Consultant who wasn't overly concerned about it. I had a follow up appointment several months later  where it was decided that a CT scan would be appropriate and I had this in August. Fast forward to now and I finally have a diagnosis, much to my relief.

The diagnosis came in two parts.  With regard to the lump, I wish I had thought to ask if I could take a snap of the CT scan that I was shown but it is sitting directly on a nerve, as I had expected. There's two options, one of which is to remove it which has the possibility of permanent nerve damage or to just leave it.  Because the Consultant thinks that the sensitivity hasn't reduced too much (the right hand side is a little duller than the other), he wants to leave it for the time being and will arrange a follow up appointment in a year's time. If nothing has changed with it in that time the plan is to just leave it there.  I must admit that I would prefer it to be removed, I don't like how it feels and if I'm playing with the kids and they get over excited etc, they've knocked it a number of times and it bloomin' hurts!

So, onto the second part of the diagnosis. The other problem I was experiencing was earache and facial pain which the Consultant has told me is Temporomandibular Disorder. Or TMD, its much easier to say.  TMD is a disorder that affects what are known as the chewing muscles and joints between the lower jaw and base of the skull. 


(I'm just relieved the lump cant be seen or I'm sure I'd feel much more self conscious about it)

Symptoms

My symptoms mostly affect my right hand side and include:

- Facial pain 
- Earache. Sometimes dull but often intense and it feels as though its deep inside.
- My face will often feel tingly and heavy, especially my eye.
- Occasional neckache
- Discomfort when eating.  

From what I've read since, headaches and/or migraines can be a symptom, as well as clicking, popping or grating during chewing or movement of the mouth.

Causes

- Clenching the jaw or grinding teeth in sleep
- Osteoarthritis 
- Injury to the jaw joint, eg following a knock to the face.
- Stress
- Uneven bite
- Specific diseases such as rheumatoid arthritis or fibromyalgia. 



(Photo by Rhema Kallianpur on Unsplash)

The Dr's Advice

- I can help rest the muscles and joint by eating soft foods, so that I chew less. I should avoid foods such as chunky sandwiches and apples, where the mouth needs to open as wide as it can to get those first bites. I also need to avoid chewing gum.

- Making use of hot or cold compresses throughout the day, holding against the face for 10-20 minute periods.

- Avoiding jaw exercises found online. I was told that these aren't all that helpful and could even make the problem worse.

- Avoiding clenching my teeth.

- Trying not to yawn with my mouth wide open!

- Learning to keep my teeth slightly apart when I'm sat, whereas I often sit with my teeth resting on top of each other. Apparently this is a big no no as its fighting against gravity. 

- Asking the Dentist to create me a mouth guard to wear at night incase I grind my teeth. 

And, the two biggies:

- Learning to relax and destress. 

Stress is a big factor in TMD according to the consultant and indeed, he spent a good chunk of time talking to me about my lifestyle. I'm a working Mum of two young children and often feel stressed or anxious.This has been me for as long as I can remember.  I often feel like I'm not doing enough or letting someone down. 

- Sleep hygiene

Something else that we spoke about for quite some time. Briefly, its about creating good sleeping habits. So, limiting day time naps (I should be so lucky!), limiting screen time before bed, avoiding caffeine and foods that might be disruptive before bed and making a pleasant sleeping environment.  This one is easier said than done as T still wakes me at least once or twice in the night and D often keeps me awake with his snoring. 

So, I have some things to work on. I'm trying to eat softer foods and I have been careful to avoid chewing gum. I'm conscious that I do clench my teeth and I do yawn, a lot!

This won't be a quick cure, if at all.  I was told that it can take 18 months to two years for the symptoms to develop and they will often last a few months before improving. I'm currently at approximately six months but in all honesty, I wonder if this will be an ongoing issue as I have had similar problems with my ears since my teens. I have also suffered with migraines and headaches since I was 14 or 15, with spells of weekly migraines not uncommon. The migraines I've been suffering from recently have been really debilitating, leaving me with no energy and feeling as though my arms and the side of my face are almost paralysed so I do wonder if this is part of it. It would certainly make sense to me.  

I have a dental appointment in November (unfortunately I can't get in any sooner) so shall be asking about having a mouth guard made.  I'm making an effort to avoid clenching my teeth and from resting my chin on my hands when I'm sat working, which was something else I read so I am really hoping to see improvements soon. 

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