posted 10-05-2002 01:02 AM            

The proposed surgery has been outlined for me in laymen's terms and possible complications and side effects have been discussed including ( but not limited to ):

___A.Objectionable scarring of the incision line, possibly requiring later revision.

___B.Postoperative swelling, discomfort, bruising of the area, bleeding, hematoma (blood clot) formation, and wound infection.

___C.Adverse or allergic reactions to medications oranesthesia causing multiple side effects, some of which may be serious.

___D.Foreign body reaction and (if used) rejection of implant materials.

___E.Malocclusion (change in bite) after surgery.

___F.Postoperative development of adhesions (scarring) within the joint space which may cause continued jaw dysfunction and decreased range of jaw movement or chewing difficulty.

___G.Facial muscle weakness, particularly of the forehead and eyelid, or inability to close the affected eye tightly, which is caused by injury to
motor nerves in the immediate surgical area. This weakness may be partial or total and is usually temporary, but may be permanent.

___H.Sensory nerve damage, numbness, or other sensory alterations which may be temporary or permanent.

___I.Ear problems, including infection of external, middle or inner ear, ringing in the ear, hearing loss or equilibrium problems.

___J.Freys Syndrome

___5.I understand that additional treatment may be necessary post operatively, including physical therapy, splint therapy, reconstructive dentistry,
orthodontics, jaw repositioning surgery, removal of certain fixation devices, or further TMJ surgery including total joint replacement, bone grafts, and
arthroscopy.

___6.I understand that this is complex surgery, and there can be no guarantee of complete resolution of my present symptoms or jaw dysfunction. Occasionally
there may be increased symptoms post operatively.

___7.I have been told of my option of a second opinion regarding this procedure from a qualified professional.
___8.Recognizing that during surgery some unforeseen condition may be discovered that might necessitate a change in approach or different procedure from those
explained above, I authorize Dr. ****o perform such
procedures as are necessary and advisable in the exercise of his professional
judgment.

___9.I understand that general anesthesia will be used for my surgery and that there is risk of serious bodily injury inherent in such anesthesia, including
death. I have been told not to have any food or drink for 8 hours prior to my anesthetic and that CONSUMING FOOD OR DRINK BEFORE INTRAVENOUS GENERAL ANESTHESIA MAY CAUSE SERIOUS COMPLICATIONS OR DEATH!

___10.I have discussed my past medical history with my doctor and have disclosed all diseases and medications, including alcohol and drug use (past or
present).

___11.I agree to cooperate with the recommendations of Dr. ****,
realizing that lack of cooperation may result in a less than optimal result. I have not been given any warranty or guarantee as to the result of the
proposed procedure.

___12.I certify that I have had an opportunity to read and fully understand the terms within the and that all the above blanks were filled in prior to my
signing this form. All my questions have been answered to my satisfaction and I am willing to undergo the proposed surgery.

I also state that I speak, read and write English.

posted 09-10-2003 08:33 PM            

This is one point that should be stressed before undergoing this surgery!!! Uggh!!
I understand that additional treatment may be necessary post operatively, including physical therapy, splint therapy, reconstructive dentistry,
orthodontics, jaw repositioning surgery, removal of certain fixation devices, or further TMJ surgery including total joint replacement, bone grafts, and
arthroscopy. One surgery "usually" leads to another and on and on it goes....

posted 09-10-2003 08:48 PM            

I beg to differ with this statement. ANY invasive procedure is not to be taken lightly, and there are causes for concern regarding the outcome. The odds are not in favour of a total/complete success with surgery on the TMJ. (JMHO)

Marlene

posted 09-10-2003 09:26 PM            

My heart goes out to you ..
I think of you and what you go through and wonder where you get your strenght?
God bless you and good luck getting that implant out
(or whats left of it).

I'm still here and doing ok I guess.

posted 09-11-2003 04:17 AM            

I'm glad your surgeries went well. I'm told these procedures do work for some people.

If your reply is to me since I pulled up the form, I'm not having anymore surgeries, 7 was enough. I would be extremely worried if there was anything else surgically that I could have done. In a moment of pain and weakness, I might be tempted to try something else. I did ask last fall, when the pain became unbearable (I've been in Pain Management for the last 6 years, since my discectomy) if I could have Implants or a Total Prosthesis. I was told I had too much bone loss, nerve damage and muscle problems from prior surgeries, to have anything else done. I was told my only option was to stay medicated the rest of my life. To be honest, staying medicated the rest of my life was not the kind of "Life" I wanted and I considered another "Option" for a while. Thankfully, I did not entertain those thoughts too long. During that time is when I found this board and found people who understood my pain, frustration, and hopelessness.

Sadly, there are many who, have been so badly damaged from these surgeries and their lives so completely destroyed, reach that point of hopelessness and "they" don't make it.

I have to disagree with your statement regarding the chances of having complications is very, very slim. In my experience, very few people have any of these procedures without some type of "problems" or "complications" they did not expect. During the last 26 years, those "Standard Surgical Release Forms" for TMJ Surgeries have gotten longer and longer and more indepth. I wonder why that is? I realize all "Surgical Release Forms" have increased in their coverage of possible problems, but for Oral Surgery, particularly for TMJ problems, it's like reading an Encyclopedia.

If these problems and complications do not occur with any regularity, why are these extensive consent forms needed?

Also, just out of curiosity, at 14 were your parents not required to sign these forms for you?

Please read "Orthognathic means.. Straight Jaws" if you haven't. This is just a brief report of the problems in surgery and after, that I had with 2 surgeries. (2 Bilateral Sagittal Splits within 3 months.) In the last 16 years, I've had 4 more.
One for bone grafts, 2 bilateral arthroplasties (the first, disc replacements, the second, a discectomy) and the last surgery, not on the joints, but a nasal procedure for problems caused by the nerve damage from these TMJD surgeries. After 26 years, with my diagnosis coming from having my wisdom teeth surgically extracted (#1) , 3 ortho's, 5 surgeons, countless other professionals and every kind of treatment possible, this consent form barely touches on the problems that can occur. I have 2 others from my last surgeons office that does cover almost everything. (With all of these surgeries, I had the "Best Surgeons". They are all very well known in their field)

I am glad your Doctor has been so successful.
Hundreds of surgeries and no serious complications or problems?????? Having someone like you, who has had successful surgeries to talk to patients, is an extremely good idea. However, it does seem to me that this would give them a little bit of a one-sided view of the procedures. Do you show them the Consent Forms prior to the surgery and answer any questions they may have about all of the possible complications, future treatments and other surgeries that might be needed later?
Do you mention to them that if they have severe muscular problems, these surgeries will not help and there is the possibility that if the surgery is a success, they may have better function, but could be left with more pain?

Possibly, the determination of how serious the problems or complications are, depends on which end of the scapel you're on.

Also, it's been my experience you're handed the forms right before surgery, sometimes after being sedated a little. I've signed those papers when I could barely see, much less read.

I've been around the block several times in regard to this issue, I know the stats on completely successful TMJD Surgeries with absolutely no problems afterwards.

My story is on this board in several places and it's pretty bad, but there are those in much worse condition, due to surgeries for TMJD.

You have joined a Forum of very mature, educated and experienced people in regard to Surgeries for TMJD and all other Treatments available. Most are mature adults who have severe TMJD problems. The majority of our members are here due to Inappropriate Treatments for TMJD or they are unable to find Appropriate Treatment. Many are here due to Complications and Problems caused by Surgeries for TMJD. Others are new to TMJD and looking for help.

We would like to hear some good reports. We have very few in regard to surgery and there are those who are now considering different procedures.

Telling your story and the types of surgeries you've had would be a good idea, so everyone can get a different perspective.

Welcome to our Forum,

Cymy Sue

posted 10-08-2003 12:11 PM            

I keep hoping that my situation (if I have the surgery) will turn out fine, since it turns out my joints are okay. I first went to the doctor a few months ago because I was having all the classic symptoms of tmj. Turns out, I don't have tmj, but the muscles in my jaw are all freaky because of malocclusion and bruxism. That's what my surgery would be correcting, not anything to do with the joint itself.

In fact, yesterday my dentist told me that if I did, indeed, have joint issues, he'd send me to a specialist and not try to treat me himself. Comforting that he knows when to back off.

I am still very wary of the procedure and I'm definitely going to get more info before I agree to any of it. But after four doctors have agreed that surgery is what will fix me, I'm inclined to trust them.