Metal Mouth Message Board

Back in November of 2010 I had a BSSO/Lefort 1, Genioplasty and a Septoplasty to fix a severe case of OSA. After all was said and done (about 5 or 6 months later), my sleep apnea was COMPLETELY cured. I went from an AHI of 58 to an AHI of 8 (an AHI of 10 or less is normal and Oral Surgeons are typically pretty happy with 20 or less post-op). I'm very happy about that!!

But now I have another problem. A couple of weeks after being un-wired, I started having slowly increasing amounts of pain in my left TMJ. A month later, both right and left TMJs are killing me. Currently I have to take 10mg of Flexeril twice a day just to take the edge off. After complaining to the Oral Surgeon who did the original surgery on me about this issue, he sent me to another Doc in his clinic who specializes in treating TMJ. This Doc did a Cone CT and MRI and explained to me after seeing the results that I have Bilateral Anterior Disc Displacement without reduction. I then asked how the HELL that happened, considering I never had TMJ or disc issues in my life other than some mild popping on the left side?? He stated that I probably had mild TMJ issues most of my adult life and the jaw surgery I just underwent most likely exacerbated it to the point of dislocating both of my discs. I then asked him what options I have to resolve this problem and eliminate all this pain I'm having. He said......"Unfortunately I have to re-break both of your lower jaws (IVRO) and wire you shut for 6 weeks post-op". Evidently because of how my facial bones have been manipulated from the first surgery I'm not a candiate for any less invasive measures or even less invasive surgeries to fix this disc displacement.

Needless to say I was pretty stunned to hear that I have to go under the knife again especially since my first jaw surgery was such a nightmare (9 hours in the OR and 3 nights in the intensive care unit.....Hard wired for 10 weeks). Before I left the Doc's office after he gave me the bad news, I asked the Surgical Resident working with the TMJ Doc how common it is for them to do a surgery (IVRO) like this on a person in my situation.....He shook his head and said he never heard of anything like this happening before. JUST GREAT.....

Has anyone else experienced anything like this before? I have had a second opininon and the second TMJ Doc does concur with the first. An IVRO is my only option at this point. Also, since my surgery isn't scheduled till the 1st of August, is there any medications that one would recomend to help with this horrible pain I have? I've been on Flexeril 10mg bid for 2 months now and it's starting to lose some of it's effect.

Thats awful news. I have TMJ now and am hoping that surgery actually helps. Give feldene a try. Helps me when mine gets bad.

Feldene is a NSAID right? Unfortunately I have Crohn's Disease too, so I have to kind of stay away from NSAIDs if at all possible. My Doc gave me Norflex a couple of days ago when I complained that the Flexeril was losing it's effect. Too bad the Norflex works even worse then the Flexeril. I don't know what I'm going to do now?? Not really sure I want to go on hard core opioids for the next month and a half till my surgery, but I'm not sure I have much of a choice.

Hey, beowuf, sorry to hear you have to go through this again. That is the last thing a jaw surgery survivor wants to hear! So much of this recovery is mind over matter, and it sounds like you are handling things quite well. You can do this!

As far as pain relief goes, since you cannot take NSAIDs, maybe you could try Ultram. That is what my OS uses routinely as his post op pain medication. It works on opiate receptors, but is not an opiate per se. It may be just the thing to get you through until August.

Tramadol is a good suggestion Rizzie......However, there is one little problem. I've had so many abdominal surgeries in the past due to my Crohn's disease that I now have lots of adhesions and nerve damage thru out the lower abdominal cavity which causes me a LOT of pain. This has forced me to see a pain management doc who after a couple of years of trial and error put me on Subutex. Subutex (or Buprenorphine) is a partial opioid agonist which has a very very high affinity for all of my opioid receptors and thus blocks all other opioids from bonding to those same receptors. Ultram (Tramadol), though not classified an opioid, bonds to some of the same receptors and thus.....NO JOY. My options, depending on how long I can deal with this is to go off the Subutex for a day or two and at that point my receptors will reset and I will be able to switch over to standard opioid analgesics. I really don't want to go this route because the Subutex works great for the chronic Crohn's pain without all side effects of a traditional opioid pain med but it doesn't seem to do a whole lot for the acute pain caused by the displaced discs. I was hoping maybe there is some other option, but between my docs and the research I have done on the web, it's not looking too good!

Stay away from Tramadol. Extremely addicting.

Per all the professional litature out there and the fact that Tramadol isn't scheduled (Pretty sure anyway....possibly it's a C3), it's not supposed to have the addiction potential like say Morphine, Hydrocodone, Oxycodone, etc...has. But, being that it works on some of the same receptors, and one has the right brain chemistry I guess addiction is possible. I never had any trouble with it in the past. Unfortunately it's probably not strong enough for me because I have such a high tolerance.