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Old 09-22-2009, 10:13 PM   #1
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Post Surgery

Had the disc plication surgery on Monday in Innova Hospital, Alexandria, VA. and was discharged the next day. Hospital very well run, no hassles, all nice people.

Spoke with surgeon afterwards and he told me he found what was wrong and fixed it. The preoperative diagnosis confirmed the postoperative. The disc on my left TMJ had slipped off the condyle in a kind of half past one position seen from above, (antero - medial in jargon) and was displaced by around 40%. He was able to plicate/fold the ligaments and reposition it on top of the condyle where nature intended. This pathology had been reported on MRI before but nothing beats the naked eye. The TMj specialist today said no splint therapy would have been able to recapture a 40% displacement but nevertheless conservative treatment is always indicated first.

Now I'm on 'Therabite' therapy. This is a device you use to increase opening, initial target is 50mm which I'm at already. For this protocol, they say the surgery only counts as a third, the first third is appliance therapy to decompress the TMJ so the tissues are healthier to work with and the last third is a combination of a 6 week liquid diet and the Therabite rehab plus ultimately the finishing phase

Last edited by pipdog; 09-23-2009 at 11:45 AM. Reason: More info

 
Old 09-23-2009, 07:09 AM   #2
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Re: Post Surgery

Quote:
Originally Posted by pipdog View Post
Had the disc plication surgery on Monday in Innova Hospital, Alexandria, VA. and was discharged the next day. Hospital very well run, no hassles, all nice people.

Spoke with surgeon afterwards and he told me he found what was wrong and fixed it. The disc on my left TMJ had slipped off the condyle in a kind of half past one position seen from above, (antero - medial in jargon) and was damaged, on a scale of 10 a 3 but he was able to plicate/fold the ligaments and reposition it on top of the condyle where nature intended. This pathology had been reported on MRI before but nothing beats the naked eye.

Now I'm on 'Therabite' therapy. This is a device you use to increase opening, initial target is 50mm which I'm at already. For this protocol, they say the surgery only counts as a third, the first third is appliance therapy to decompress the TMJ so the tissues are healthier to work with and the last third is a combination of a 6 week liquid diet and the Therabite rehab plus ultimately the finishing phase
HI--
Glad everything seems to be going well for you..Hope you have an effortless recovery! take care--J.

 
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Old 09-23-2009, 05:49 PM   #3
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Re: Post Surgery

It sounds like all went well. That's great news. Your procedure and post-op therapy are sounding very much like what's been recommended for my TMJ after some years of splints. Perhaps even same surgeon and specialist. Here's hoping your recovery is rapid and that you continue to keep us posted.

 
Old 09-23-2009, 06:03 PM   #4
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Re: Post Surgery

Way to go Pipdog - sounds like you are on the road to a full recovery - glad the surgery was successful as well. Finally someone with some good news.

 
Old 09-23-2009, 06:32 PM   #5
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Re: Post Surgery

Quote:
Originally Posted by pipdog View Post
Had the disc plication surgery on Monday in Innova Hospital, Alexandria, VA. and was discharged the next day. Hospital very well run, no hassles, all nice people.
Now I'm on 'Therabite' therapy. This is a device you use to increase opening, initial target is 50mm which I'm at already. For this protocol, they say the surgery only counts as a third, the first third is appliance therapy to decompress the TMJ so the tissues are healthier to work with and the last third is a combination of a 6 week liquid diet and the Therabite rehab plus ultimately the finishing phase
Dear Pipdog,
Congratulations on a successful surgery.
I had a bilateral arthroplasty performed last year. One of the key's to a successful recooperation was the use of a Therabite. I found this to be true. At times it hurt to stretch with the Therabite, but I followed the doctor's orders to a tee, and all went well. I can now open wide.
Keep moving forward. You're on the right track.
Peggy

 
Old 09-30-2009, 03:33 PM   #6
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Re: Post Surgery

Quote:
Originally Posted by pipdog View Post
Had the disc plication surgery on Monday in Innova Hospital, Alexandria, VA. and was discharged the next day. Hospital very well run, no hassles, all nice people.

Spoke with surgeon afterwards and he told me he found what was wrong and fixed it. The preoperative diagnosis confirmed the postoperative. The disc on my left TMJ had slipped off the condyle in a kind of half past one position seen from above, (antero - medial in jargon) and was displaced by around 40%. He was able to plicate/fold the ligaments and reposition it on top of the condyle where nature intended. This pathology had been reported on MRI before but nothing beats the naked eye. The TMj specialist today said no splint therapy would have been able to recapture a 40% displacement but nevertheless conservative treatment is always indicated first.

Now I'm on 'Therabite' therapy. This is a device you use to increase opening, initial target is 50mm which I'm at already. For this protocol, they say the surgery only counts as a third, the first third is appliance therapy to decompress the TMJ so the tissues are healthier to work with and the last third is a combination of a 6 week liquid diet and the Therabite rehab plus ultimately the finishing phase
Hi Pipdog,
I heard about your surgery (I am quite sure it's the same doctor, since it was mentioned that the patient who had surgery on Monday was from Ireland and you just had your surgery on Monday of last week, and I had mine on Wednesday at Inova Alexandria Hospital (both left and right joints). Now, one week out and I'm using the Therabite every 30 minutes (a kitchen timer helps keep me on track) and an added benefit - I've lost 22 lbs so far. Yes it hurts but I know in the long run it will all be worth it. I have suffered for over 20 years with TMJ, had surgery on the left joint 21 yrs ago, have worn bite splints for grinding, done therapy, cortisone injections,etc. but sudden excruiating pain in June 09 left me with surgery as my only option left. I wish you the best in your journey toward health. I'm looking forward to the day I can eat steak again (have not in over 20 years).

 
Old 10-06-2009, 03:21 PM   #7
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Re: Post Surgery

Dear Henrz Mom and Pipdog,
I hope you are both continuing to progress well following your surgery. As I may be facing the same procedure (disc plication) I had a few questions which you may be able to help me with when you're able. First, was your diagnosed problem on one side of your jaw, and the recommended surgery for both sides to keep everything correctly aligned? Is the liquid diet tolerable? If weight loss is desired, I guess it's more readily accepted; but I'm dreading the diet as much as the surgery and don't currently have much extra weight to part with. The Therabite approach is to be part of my rehab, and I was wondering if that was continuing to work well. Do you expect to realign your bite with braces/crown adjustments? Lastly, I'm hoping your surgery is turning out to be wonderfully successful and the results long-lasting. Thanks for any info. you're able to share at your convenience.

 
Old 10-07-2009, 12:47 PM   #8
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Re: Post Surgery

Hi Glitz,
I was initially diagnosed with a left sided disc displacement - all symptoms were this side as well, but as the appliance therapy shifted my mandible back into the correct position the right side started to displace as well. I noticed when I was shaving that the area was becoming sore to touch. Its logical if you think the mandible is actually one bone so what happens on one side will impact on the other. The TMJ guy told me experience has taugh him that its better to plicate both sides and used the analogy of sawing down a table leg: if you only did one the table would be uneven.
Liquid diet is fine: porridge, yougurt, cottage cheese, scrambled eggs, soups and I have a juicer to make vegetable juice. Yeah you do loose weigh but I needed to loose some anyway. If you are worried about excessive weight loss you could add butter to mashed potatoes, honey to yougurt, cream to porridge etc to get the extra calories so it shouldn't be a problem.
The Therabite part is fine as well, its just a lot, its like its my 'job' at the moment. Every 30 minutes my phone alarm goes off and I'm doing my 10 reps of 10. I don't like doing it in public. I get weird looks and I feel self-conscious. I notice now that when I open there is no jaw deviation which tells me its evening out in there.
The finishing phase is described as follows: 'dental procedures to conform his occlusion to the new jaw joint position. This would probably involve crown and bridge restorative procedures or orthodontic treatment'.
I'm doing OK, there are good days and bad days. I'm trying to be realistic and tell myself its not a magic wand and that it took a long time for my jaw/neck to get into such a mess and it will be slow getting out of it. My neck has started to get sore again as if loads are shifting around which I take as a good sign and I seem to be getting longer and longer periods without the eye pain which for me was the absolute killer

 
Old 10-07-2009, 03:12 PM   #9
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Re: Post Surgery

Thank you, Pipdog, for your detailed reply to questions from a fellow TMJDer. My dentist and surgeon gave the same logic for plicating both sides of the jaw, and I can see the reasons for it; I just don't look forward to it. I also have a juicer; plus the other choices you have outlined are easy to obtain or prepare. I will, however, be looking at more solid foods with longing, I'm sure. It sounds like you are headed on the road to recovery. It's good to hear about successful approaches to managing TMJD, since there isn't a one-size-fits-all approach, and often there are more questions than good answers on which to select a treatment plan. Here's hoping to hear occasional updates on a long-lasting solution to your concerns.

 
Old 10-14-2009, 06:14 PM   #10
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Re: Post Surgery

Hi Pipdog,
Glad to hear your surgery went well. I have an MRI that shows my disc has slipped to an anterior position on my right side. I'm just curious, did you do any conservative therapy before resorting to surgery? A TMJ specialist I went to today said he'd make a flat plane splint and then do 3 injections of lidocaine/cortisone and try to re-position the disc using his hand. What do you think? Did you try anything like this first?
Thanks

 
Old 10-15-2009, 06:27 AM   #11
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Re: Post Surgery

Hi Musiclover
I wore a pivot splint for 18 months prior to surgery, it was flat and high and adjusted so that only two points made contact with the upper teeth. The specialist was up front with me and said at the start that because of the way the disc was displaced (medially - to the inside) the chances of recapturing it were only 15%. It did solve some of the more weird symptoms I was getting like dizzyness and cognitive impairment and helped decompress the whole TMJ area and so make the tissues healthier for the surgeon to work with. Even though when he went in there he told me the blood vessels were enlarged and there was a lot of inflammation. I guess this was from years of microtrauma.

My opening is now 43mm. It was 40 immediately after surgery, target is 50mm by 90 days. They explained to me that opening is limited after surgery because all the masticatory muscles are contracted which is why I have to do jaw mobilization exercises every half hour, 10 sets of 10 which amounts to 3200 stretches daily

Last edited by pipdog; 10-15-2009 at 06:41 AM. Reason: more info

 
Old 10-15-2009, 06:39 AM   #12
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Re: Post Surgery

Quote:
Originally Posted by musiclover46 View Post
Hi Pipdog,
Glad to hear your surgery went well. I have an MRI that shows my disc has slipped to an anterior position on my right side. I'm just curious, did you do any conservative therapy before resorting to surgery? A TMJ specialist I went to today said he'd make a flat plane splint and then do 3 injections of lidocaine/cortisone and try to re-position the disc using his hand. What do you think? Did you try anything like this first?
Thanks
Musiclover---PLease get another consult from another tmj specialist before you go letting anyone manually try to relocate your disc. This is extremely dangerous to do, and I've heard many tmj specialists say to never do that. I also know of a girl that let her oral surgeon try that and he actually displaced both her discs, and now she's having surgery 10 yrs. later because of it. Take care----J.

 
Old 06-17-2011, 06:31 PM   #13
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Re: Post Surgery

Hello Pip,

I realize you are probably not around any more. I hope your TMJ has properly healed and you are now healthy and happy.

I wanted to ask who your surgeon was as I live in NOVA and also have medial displacment. I'm considering expensive non surgical treatment and could use your advice and names of dr. in the area.

thanks....

 
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