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Old 10-23-2009, 07:17 PM   #1
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Joint Replacement Surgery Update

Dear Fellow TMJers,
It's been four weeks since I had bi-lateral joint replacement surgery. All in all I'm feeling pretty good, and I believe that I'll have a complete recovery.
My surgery was performed on September 25th at the University of Maryland by Dr. Gary Warburton. I cannot say enough good things about Dr. Warburton and his team. I spent four days at the hospital and the care was incredible.
The surgery took 7 hours, with 2 surgeons working in tandem, so it was really 14 hours of surgery. I'm pleasantly surprised that I'm feeling as good as I am. I'm not out dancing in the streets, but I get out for a bit most days.
I'm currently opening 32mm. Before surgery I was opening 30mm. Dr. Warburton told me that my goal should be opening at 35mm. I have a Dynasplint device that I use twice a day to help me stretch.
I'm eating soft foods, if I can mash it with a fork, I can eat it. This is the same type of food that I was eating for the last several months before surgery.
I woke up from the surgery with facial paralysis on the right side of my face. This is not unusual after surgery. I'm getting some feeling back and I'm also getting some movement back. I go for physical therapy twice a week for electrical stimulation, and it seems to be helping. I'm confident that I'll get the movement and most of the feeling back.
Pain, oh the TMJ pain. The good news is that I'm not feeling any pain in my joints, there are no nerve endings in titanium. I still some muscle pain, and I also have pain along my lower jaw bone. The pain is slowly getting better. I'm back to the same pain meds and levels, as before the surgery.
Thank you guys for your support.
I'd be happy to answer any questions that you have, just let me know.
Take care,
Peggy

 
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Old 10-24-2009, 12:06 AM   #2
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Re: Joint Replacement Surgery Update

Well it sounds like you are making some progress - glad to hear some good news of your being on the road for a full recovery - I am sure others will be pleased to hear this as well. Hopefully the pain will ease up as time goes by and things heal more and you will be able to stop the pain meds Please keep us updated.

Last edited by Thelma-Louise; 10-24-2009 at 12:06 AM.

 
Old 10-24-2009, 01:20 PM   #3
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Re: Joint Replacement Surgery Update

I am glad you are feeling better. Keep us the good work and keep us posted. Enjoy the rest of the weekend.

 
Old 10-24-2009, 02:46 PM   #4
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Re: Joint Replacement Surgery Update

Thank you for sharing, Peggy. It sounds like you are about to meet your opening goal, and that the pain is a little better each day. I take that as a sign of healing. Take care, and keep us posted. Success stories are always great to see.

 
Old 10-27-2009, 06:12 PM   #5
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Re: Joint Replacement Surgery Update

I know most people take about a year to recover from full joint replacement. I know there are a lot of ups and downs during this time. I plan on having mitek anchor surgery in about a year with Dr. Larry Wolford when my ortho treatment is done.

 
Old 10-28-2009, 05:25 PM   #6
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Re: Joint Replacement Surgery Update

Dear TMJ Friends,
Thank you for all of your support. It really means a lot to me.
My progress continues to go well. Some days are better than others, but on the whole I'm doing well. It's been raining here for the past two days, and I'm very achey, but the weather should clear tomorrow, and then I should feel better.
Again thank you for your continued support.
Peggy

 
Old 12-08-2010, 05:45 PM   #7
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Re: Joint Replacement Surgery Update

Georgek04,
Somehow your message didn't come through, all is says is hi Peggy. Do you have questions that I can answer? I'd be happy to help.
Just to let everyone know, it's been 15 months since the joint surgery, and I couldn't be happier. My pain is gone, almost all gone. I have some neuralgia left, and take Lyrica and Ultram for it. There are days that I don't need the meds at all. I've been getting prolotherapy shots for the residual pain, and problems, which is in the muscles, not joints. The shots are helping a lot, and the pain is still diminishing.
The only side effect from the joint surgery is some facial paralysis, my eyebrows do no move. It's not a problem, but I had some eyebrow hooding which impacted my vision, especially getting light in. I had a brow lift done about 6 weeks ago, and I look better than ever (as good as I'll ever look, it's all relative).
I realize that joint replacement surgery is not for everybody, but in my case, it was exactly what I needed.
Please continue to ask questions, and let me know what I can do to support you guys.
Peggy

 
Old 12-08-2010, 07:12 PM   #8
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Re: Joint Replacement Surgery Update

Hi Peggy,

I am sorry as I am not too sure what happened. I saw Dr. Warburton about 3weeks ago for a third opinion for a failed bilateral total joint surgery I had with Dr. Wolford. I found Dr. Warburton to have great knowledge. I wish I would have known about him sooner.

I began my journey in 2003 and I had braces put on for a Lefort 3-piece surgery that I had in 2005 with a surgeon in Alexandria, VA. This surgery relapsed and it was determined by xrays that I had dislocated discs with the right side being worse. I then ended up with Dr. Gregory Ness at VCU in Richmond who did Arthroscocpic Joint surgery which went great, but only for a few days. My ROM decreased back to 15mm and my bite kept changing.

After this failed surgery Dr. Ness tried a manipulation procedure and physical therapy which didn't help very much. He then referred me for some second opinions including Dr. Larry Wolford in Dallas, Texas. Dr. Wolford's diagnosis was relapsed upper jaw surgery, maxilla and mandible hypoplasia, decreased airway (4mm), and degenerative joint disease. His recommendation was Mitek Anchor Surgery and a Lefort 4-piece/BSSO.

Due to insurance issues I had the Mitek Anchor Surgery with Dr. Wolford in May of 2008 which failed. It was determined I had significant bone loss following the surgery. After this I had the remainder of the surgery Lefort 4-piece/BSSO with Dr. Wolford that has also relapsed. He then determined that I needed Bilateral Total Joint Replacement Surgery which I had with him in October of 2009. Unfortunately, a blood vessel was damaged in the fat grafting area of my stomach during this surgery and I had a seroma develop in the stomach and ended up with an emergency stomach surgery in January of 2010.

Following this all went well when I finally recovered in February and my ROM actually increased to 43mm. Suddenly in March I began having pain and my ROM decreased from 43mm to now 7mm. All of my local doctors have halted all care becaue they feel I am having joint problems whereas Dr. Wolford feels I am having muscle and ortho problems. So needless to say, I am surely not happy after suffering three failed surgeries with a world-renowned surgeon. I feel now he is trying to abandon me so I am stuck here in VA with no one to treat me.

Who is your orthodontist? I am seeing Dr. Shefferman in Washington, DC with Dr. Alan Bagden in Springfield monitoring my case. We can't even take the braces off right now with my 7mm opening. Are you on any medications now for pain? I am on three different meds including Valium.

Karen

 
Old 12-09-2010, 06:29 AM   #9
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Re: Joint Replacement Surgery Update

Sounds like you have had a really tough time.
I'm also in Virginia and had a bilateral TJR in Aug. Well, that was the second part-first was in March to prepare the joints(6hr surgery) and the second in August to place the joints(9hrs-whoo!).

If you read my thread-bilateral joint replacement/rheumatoid arthritis you can get the background story. I too have had complications, but not due to the joint replacement. The joint is fine, it's the other autoimmune issues causing difficulties. But, I had to have the surgery due to how quickly the bones were fusing together. At the rate the bones were growing together, it was projects by many many second opinions that I would have an opening of 2-4mm within a year. Kinda scary...

Anyway, I love my surgeon-Dr. Zoghby. He is located in Richmond and teaches at MCV. He has been wonderful, not only to me, but he also picks up the phone and talks to my many other drs. He and I text back and forth since I'm 3hrs away if something comes up before my next appointment. The nurses in the hospital also speak very highly of him(which is always a good sign).

 
Old 12-09-2010, 02:37 PM   #10
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Re: Joint Replacement Surgery Update

I had Arthroscopic surgery with Dr. Ness at VCU in Richmond. I surely wish I would have been able to find a surgeon closer. I have the utmost respect for Dr. Wolford, but not the way things are turning out. They are so concerned about the money end and seem to care less about their patients. I honestly shouldn't even being writing now as I am just so angry and surely don't want to hurt any future patients with this surgeon. I just feel abandoned when I needed him the most.

My ROM is at 7mm, so at least a little better than yours has been. I did read your story and it sounds like you have also been through quite a bit. What kind of prostheses do you have in? I have TMJ Concepts, but have an FDA complaint right now as my local surgeons all feel that the plastic piece on the prostheses may be broken. TMJ Concepts states this can only be visualized, but they are working extremely hard trying to figure what is going on. Dave and Eric at TMJ Concepts have both been terrific.

Karen

 
Old 12-29-2010, 08:25 AM   #11
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Re: Joint Replacement Surgery Update

I had mitek surgery with Dr. Wolford in 2008 that failed and have talked to many other patients that have underwent mitek surgery with Wolford and are facing complications, especially pain. I just talked to one young lady who had mitek surgery around the same time as me and she stated she will be undergoing an MRI because of the pain she is dealing with. So be sure to do your homework and research other options.

I went in to mitek surgery due to increased pain and decreased ROM. It ended up I had to have bilateral total joint surgery with Wolford in October of 2009 that looks like has also failed as my ROM is only 3mm to 5mm and I have more pain that I had going into the surgeries.

TMJ Association also is a wonderful place to do your research as they have talked to patients all over the US. You can also give them a call to ask them about the outcomes of joint surgeries. The president of the association has also been a victim of failed joint surgeries.

 
Old 12-29-2010, 12:09 PM   #12
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Re: Joint Replacement Surgery Update

Quote:
Originally Posted by Georgek04 View Post
Hi Peggy,


Who is your orthodontist? I am seeing Dr. Shefferman in Washington, DC with Dr. Alan Bagden in Springfield monitoring my case. We can't even take the braces off right now with my 7mm opening. Are you on any medications now for pain? I am on three different meds including Valium.

Karen
Hello Friends,
Karen, I'm so very sorry that I didn't answer your questions sooner, I don't know how I missed this.
First, I feel so badly for all that you are going through. As one who suffered from TMJ pain for 25 years before getting the much needed relief I know how bad it is.
You mentioned earlier in the thread that you had a consult with my oral surgeon, Dr. Warburton. What did he say? He's the one who changed my life with the joint replacement surgery.
You also talked about having issues with your stomach as a result of the part of the joint replacement surgery. This sounds like a real nightmare. When I had my joints replaced, Dr. Warburton didn't do the fat grafting. I don't feel like I'm missing anything. What does this part of the surgery do to help?
You ask about my orthodontist. I'm not working with an orthodontist as I have false teeth, yes, everyone of my teeth has been pulled. There are reasons for losing all of my teeth that I can go into at another time. I wish I could recomment a good orthodontist near here, but I don't know any.
Yes, I still take meds, but a whole lot fewer that before the surgery. I take Ultram and Lyrica. I also get prolotherapy treatments. The prolo has been a Godsend. My doctor who is managing my pain says that I've got some neuralgia going on. I'm hoping that at some point I can get off of the meds.
You really have been through the mill. How are you now? What is the next step for you?
Please let me know how else I can help. I promise to be more vigilant about reading here. I recently had a stroke, and at times I have stroke brain, not a good excuse for getting back to you sooner, but that's it.
I care.
Peggy

 
Old 12-29-2010, 03:44 PM   #13
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Re: Joint Replacement Surgery Update

Hi Peggy,

Thank you so much for responding. I was impressed with Dr. Warburton, but unfortunately he only agreed to provide me with a second opinion about all the complications I have been facing. He thought he might have seen something going on with one side of the prostheses and requested for TMJ Concepts to investigate further. He did state he has no choice but to go with what TMJ Concepts state. TMJ Concepts stated that it appeared everything was okay with the prostheses, but couldn't confirm 100% because the plastic piece on the prostheses can only be visualized since it does not show up in x-rays.

Dr. Wolford harvests fat from the stomach and uses it in the prostheses area to help keep adhesions from developing and for other reasons. After the surgery I noticed I had excessive bruising, but Dr. Wolford simply stated this was normal. About 3 to 4 weeks following surgery my stomach began to swell up and it was determined I had a seroma that developed in the fat grafting area of the stomach. This was caused by a damaged blood vessel that was ruptured during the surgery. Anyway, this complication ended up after numerous trips to the CVIR unit of the hospital and being admitted a few times into a major emergency stomach surgery I had 3 months following the total joint surgery. The reason I had the major stomach surgery was because I had to wear a draining bag to drain the fluid from the seroma and a blood clot developed. The plastic surgeon stated the seroma was beginning to spread to both sides of the stomach. That was by far the most difficult surgery I have ever endured.

Anyway, I am still facing complications from the total joint surgery with Wolford and my doctors here feel it is due to something going wrong with the prostheses and will not move forward until Dr. Wolford does something to produce a more favorable outcome. So that is where things stand as of now.

 
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