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Chronic Pain members - Welcome, please introduce yourself
Chronic Pain | Last Active: 5 hours ago | Replies (7051)Comment receiving replies
I developed earaches in September 2016. My primary care found no ear or sinus infection and sent me to an ENT, who diagnosed TMJ pain. I went to my dentist for help. He gave me weekly anesthesia shots into trigger points (OUCH!) and exercises to do, including massaging the trigger points and opening my mouth as wide as I could numerous times in the shower while my face was warm and wet. (I have been wearing a night guard made by my dentist for over 20 years; he replaces them as they wear out.) The pain continued and only got worse; it was at the top of my head, in my ears, in my jaw, above my palate (as though I'd eaten hot food). My dentist sent me to an oral surgeon, who did 360-degree x-rays and found no joint damage. He told me I was therefore not a candidate for surgery (YAY!) and prescribed Flexeril, a muscle relaxer. The pain only got worse, and I continued to wake up in the night with horrific pain. Ibuprofen didn't even touch it.
My dentist then sent me to a physical therapist, who didn't listen to a word I said. I came in on a "good" pain day: my pain level was about a 5 out of 10 (10 being the worst). After his examination and showing me how to do various exercises, he triumphantly told me that my pain level was now reduced. I said "No. My pain level is now about 7.5." He said he didn't believe me. He attempted to push me to go to his outside clinic to get "magnet therapy," and he tried to push me to see a friend of his who is a naturopath. Two days after this session, I was still in excruciating pain and doubt I'd ever return to this physical therapist, although he had me schedule 4 more 1-hour sessions with him.
I called my dentist again, and he called in a prescription for Tylenol plus codeine, which I can take every 4 to 6 hours. My dentist seems to have no further solutions for me.
My primary care is currently out of town, but I will see her when she gets back (in August); she may be referring me to a pain management specialist, which my dentist recommended--however, my dentist refuses to give me a referral to such a specialist, even though the specialist will take referrals from dentists or doctors.
I have been treated for many years for clinical depression and panic/anxiety disorder by my psychiatrist, and the meds have helped me immensely. On Monday I see my psychiatrist for my usual 6-month med check, and I'm going to ask him for help with the terrible TMJ pain. I have also had fibromyalgia and chronic fatigue syndrome for a long time. The fibro pain has greatly lessened over time and hardly bothers me, but the CFS continues.
The TMJ pain makes it difficult to concentrate. I'm self-employed, and I enjoy my work. But pain gets in the way, as it does in every single situation: work or pastimes. My dentist mentioned massage therapy, but I'm in too much pain right now to try it. Another friend mentioned using a TENS unit. I feel as though I'm not living; to be in constant pain is hardly living, at least to me.
Any other suggestions? Would a TENS unit help? I'm more than willing to purchase one. I'll try just about anything to be pain free. Sometimes I am pain free. But I spend about 2 weeks out of every month in serious pain. I am feeling very discouraged.
Replies to "I developed earaches in September 2016. My primary care found no ear or sinus infection and..."
Hi @contentandwell, this could happen for a few reasons... the enzyme system in your body that metabolizes PPIs is housed in your liver (called cytochrome P450). Some people, like me, have genetic polymorphisms that prevent me from properly-metabolizing medications, and I don't properly-metabolize any PPIs because the same enzyme is used to metabolize all of them. With that said, even if you don't have polymorphisms of this enzyme, you could experience issues for other reasons. For example, all PPIs actually inhibit the very enzyme the drug needs to be metabolized. (Inhibit means they slow the enzyme's productivity down; it makes you metabolize it more slowly.) On top of that, some PPIs are worse inhibitors than others. For example, you may have felt worse when taking omeprazole than the other PPIs. Plus if you were taking any other drug that inhibits that enzyme, it will further slow down the metabolizing. Then if you were to have a polymorphism like I do, it makes it even worse. Due to my polymorphism, long-term use of PPIs (12 years) made me gain weight and also incredibly sicker over a long period of time. Unfortunately, most doctors are not knowledgeable of the nitty-gritty of this enzyme system, so when this is happening to their patients, they don't know why.
@hazelblumberg, I'm glad your working with a professional who is open-minded; sometimes these people are hard to find! Enjoy your pain-cation!
I love my nurse practitioner! She's always got a new goal, and she's always learning. The last big goal was to get her doctorate in nurse practitionership, and now that she's achieved that, I wonder what she'll be up to next. She's about my vintage (I'm 64), and I just hope she doesn't retire any time soon! She is wonderful! So, if anyone's in the Tallahassee, Florida, area and looking for a primary care, just let me know, and I'll be happy to give you her name. She's excellent.
@hazelblumberg, "my vintage" <-- I love that! You just make a western New Yorker smile!
kELLy, Hazel Blumberg, this is Marie from Marield65. Do mean that the second test was exactly like the first one but more testing, and the price was that much cheaper? That would be great. I have had some awful experiences with medications, one of which I was in a Delirium state for 4 days in the hospital from the pain med after my knee replacement for them giving me DiLaudid. Marie
@kdubois Thanks Kelly, very interesting. I did know that after I had my transplant I discovered that many pharmaceuticals are not processed well with your liver being in such tough shape. The first PPI I was put on was omeprazole. That made me feel ill so two or three others were tried but they were worse so I ended up back with omeprazole. Over time my body apparently adjusted and it stopped being a problem. I was taking 20mg then but after transplant that was increased to 40mg. I think that is temporary. I hear that long term use of PPIs seems to contribute to Alzheimer's so that is not a pleasant thought.
JK
@marield65 Marie, was it definitely from dilaudid? I had some slight delirium on the first day but I believe it was from the anaesthesia.
JK
They aren't "really " sure. But they say it was. I have my report so if I need another surgery I will tell Doctors what I had for anesthesia and the DiLaudid. I have my doubts too but I got worse as the days went on, and they were increasing the DiLaudid so it makes sense. Thankful, Marie
Kelly, glad to hear you're a western New Yorker! I was born and raised in Utica, New York. NEVER ever thought of living in Florida. But my husband got a good job here, and I'm a freelancer, so as long as I have Wifi (which doesn't always work) and electricity and next-day delivery, I can live anywhere. We were living in St. Paul, Minnesota (I got a job there after law school), and so it was Jim's turn to drag us around the country. I've been in far northern Florida for 25 years, the longest I've ever lived anywhere. I've been ready to leave for about the past 21 years, but Jim loves his job And he's younger than I am and won't retire for eons, so I guess I'm stuck here. Sigh.
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Thanks so much for all the information! My primary care is a DNP, and she's interested in holistic treatment. She does traditional and nontraditional medicine, and I love her. This is probably something she's familiar with. I'll talk to her about it. The great thing for me is that my psych meds--for clinical depression and panic/anxiety disorder--work really well. I've been on the same combination of meds for over seven years now, and I'm delighted with how good I feel. And weirdly enough, the TMJ pain has left me in peace for about a week now. I have no idea why. I think that, as soon as I sent away for a TENS unit, the pain quit! 🙂 I'm sure it'll be back, but I'm enjoying the vacation from the pain.