Home life: TMJ, tennis elbow, and dry eye - the unholy trio
"In the midst of winter, I finally realized that deep within me there lay an invincible summer."
--Albert Camus.
I'm posting separately this entry some medical problems I've been having recently. (Don't worry, they aren't life-threatening, just painful and annoying.) I figure that people who are interested in reading my Daily Life entries may not want to wade through tons of medical stuff, and vice versa.
For newcomers: Background to my home entries.
How I reply to comments at this blog.
*** 2 November 2009: My doctor and my wallet.
This afternoon I go to the doctor's for a rather tricky exam I'm not looking forward to, since it may involve scalpels against my brain. (A cyst on the side of my head is pressing against the remainder of my head, causing me pain and nausea.) But at least it will be my usual doctor handling this; he has already successfully drained a cyst from the skin above my spine. (Cysts like me. I had another one drained a couple of years ago.)
Of course this will be out-of-pocket expenses for Doug and me. I see from the news that the latest health reform act in Congress (1) requires that health insurance be made mandatory in 2013 (with big financial penalties for anyone who doesn't buy health insurance), and (2) promises that health insurance will be made affordable for low- and moderate-income families in 2019. I love the conjunction of those two statements.
At any rate, 2019 is much too far down the line for Doug and me. I'm beginning to work again on the nonfiction book I'd been planning, not because I really want to be working on nonfiction during the fiction-composing time of my year, but because nonfiction may be my only hope for making serious money next year. (By "serious" money, I mean four figures.) We need enough money to pay for health insurance and to pay the annual property tax each year. Those are the only two worrisome points in our budget; otherwise, we do fine as a low-income household.
(Well, except that we don't have any way to put additional money aside for our old age. But thanks to the Great Recession, we're hardly alone in that fix.)
*** 2 November 2009: Well, whadya know. I have a stress-related illness.
"Your cyst is an innocent bystander," my doctor has declared.
Turns out that, in all likelihood, I have TMJ. ("Temporomandibular Joint Syndrome," explained my doctor. "You see why we call it TMJ.") To sum it up: My jaw joint aches. The pain is radiating out from my jaw joint, which was why I first thought that I had a toothache, and then thought that my head-cyst was at fault.
But when my doctor poked me inside my mouth in the general location of my jaw joint . . . Ow. Yes, that's the spot.
Ironically, my dentist had mentioned TMJ as a possibility almost the moment I walked in his door. But me being the chatterbox I am, I overrode him with a list of my supposed symptoms, which didn't fit the TMJ scenario very well, so he got distracted before I could ask him the sensible question, "What is TMJ?"
The mind is a strange thing. When I thought I had a toothache, I was sure that the pain was centered on one of my teeth. When I thought I had a growing cyst, I was sure that the pain was centered on my cyst. Now that I've been diagnosed with TMJ, it's quite clear to me that the pain is centered on my left jaw joint. (In my defense, I gather that this sort of confusion is fairly common, not only among TMJ sufferers, but also among their doctors.)
Fortunately for my pocketbook, the basic remedies for TMJ are all over-the-counter: pain reliever and anti-inflammation medicine (I was already taking Advil), eating soft foods (I was already doing that but am now doing more of that), no caffeine (ouch - there go the Halloween candies), proper posture awake and in bed (cue incredibly long thread at a TMJ forum about which pillows to buy), not opening the mouth wide (cue very sad thread at the TMJ forum about singers with TMJ), ice packs and moist heat (yes, both - I haven't figured out why they're both supposed to work), massage, certain types of vitamins and foods, and stress reduction methods such as meditation and exercise (oh, right - I'm already supposed to be doing that, aren't I?).
Second level treatment is moderate medical intervention such as prescription pain relief and tranquilizers, biofeedback, and a mouth guard to prevent grinding of teeth . . . but I hope I won't have to reach that level. Any treatments above the moderate level are scientifically unproven, according to the National Institute of Health.
According to the NIH, it's not certain whether TMJ can be caused by stress, but everyone agrees that it can be aggravated by stress, so I'm trying to be very, very relaxed now. Especially my jaw.
(Oh, and someone at the TMJ forum reported that prolonged talking aggravates TMJ. Ha. I knew there was a reason I taught myself to type.)
*** 3 November 2009: Pillows.
Last night (as I hinted above) I perused the wonderful forums at the TMJ Association. Yes, that means I had to go online off-schedule. There wasn't any alternative; the public library didn't have enough information on TMJ.
The TMJ Association had lots. It was started by some TMJ sufferers as a support group. The association expanded into education after it became clear that there was a lot of misinformation about the illness drifting around. The association's site links to the very helpful PDF document by the National Institute of Health on TMJ, which might as well be entitled Everything That You Thought You Knew About TMJ is Wrong.
The association's forums were where I found the pillows thread - or rather, threads, because this seems to be a topic of great interest to TMJ folk. Frankly, this is all deja vu for me; I went through all this at the time that I first acquired severe dry eye in 2001, when my head was so sensitive to touch that I could only sleep for a couple of hours at a time before I woke from the pain. It was then that I started using a down pillow, which is nicely soft, and which you can fluff into pretty much any position you want, high or low.
After I'd looked at the eighty-dollar pillows that were being recommended at Amazon for TMJ sufferers (basically, a very low headrest, accompanied by a higher neckrest), I said, "Heck, I can make the same sort of pillow just by squishing my down pillow into the right position." So I did.
The object of all this was to sleep comfortably on my back, which is apparently the position recommended for TMJ folk - at least, that's what the leaflet said that my doctor gave me, and people at the TMJ forum were echoing this advice. Sleep has been a problem for me recently, because I've traditionally slept in every position: left side, right side, stomach, and back. I shift as the night goes on. But sleeping on my back all night was no worse a prospect than sleeping all night in any other position, so I decided to give it a try.
It seems to be working out okay. It's not as comfortable as shifting around all night, but it hasn't caused me any sleeplessness.
The next trick, of course, is to stop grinding my teeth at night, since that's a major factor in aggravating TMJ. I now understand why my jaw has been feeling relatively good during the day and then feeling worse after a night's sleep. Theoretically, I ought to be able to stop unconscious teeth-grinding, since I've controlled other things I do in my sleep, such as rolling over or dreaming. So I'm working on it. I've never actually kept track of how often I grind my teeth - till now, it's been a trivial matter in my life - but I can say that, on the nights now when I don't grind my teeth, I wake up without any significant pain in my jaw.
The pain starts the moment I open my mouth to say hello to Doug or my apprentice. Darn it, and I was being semi-facetious in the last entry about talk aggravating my TMJ. I suppose this is the point in my life at which I learn to do more listening than talking.
*** 3 November 2009. Tiny food.
So I'm getting into the car after going grocery shopping this evening (with my left arm sore because of a tentanus shot I had yesterday), and I hit my right jaw on the car door. Then I rebound onto the car doorway, hitting the cyst on the left side of my head (remember that cyst?).
"At least this takes my mind off the pain in my left jaw," I told Doug ruefully.
My left jaw, which is the one that has the TMJ, is doing reasonably well. I've been nursing it carefully. I was at the grocery store because the food threads at the TMJ forum made me aware that food which doesn't require much chewing could make a big difference to my jaw. Resting my jaw and not opening it wide are two key ways for me to heal from TMJ.
Also, I needed a new toothbrush. My adult-sized toothbrush has soft bristles but has been causing me to open my mouth too wide when I brush the molars. So I bought an ages-two-and-older Sponge-Bob toothbrush. I'm sure my apprentice will be delighted; Sponge-Bob is the mascot of his club.
As far as food is concerned, I learned at the TMJ forum that steamed vegetables are good, since they don't require much chewing. Terrific; they're one of the staple items in my diet. I regularly eat them on whole wheat couscous, which is another plus, since couscous barely needs any chewing.
I had a look at the hot cereals, since they're tiny, but decided in the end to make do with whole wheat couscous, which works as a hot cereal and has six grams of fiber in each serving.
I needed a dessert item, since I can't eat cornbread-and-honey (too chewy) or jam on toast (too chewy) or chocolate (caffeine causes stress). So I bought tapioca pudding, which is fiberless fluff but tastes good. Then I mixed a dab of the pudding into couscous for a high-fiber dessert; popped into the microwave, it tastes especially good. Couscous is wonderfully adaptable.
Speaking of grains, sandwiches are a problem. I've been eating sandwiches two or three times a day - I'm sort of a sandwich fanatic - but they're chewy. So I'm limiting myself to one sandwich a day, filled with cheese spread, sliced tomatoes, and steamed broccoli. (No, I didn't make up that recipe for the sake of my TMJ. It's one of my daily staples.)
My other daily grain item - for the sake of my dry eye - is roasted flaxseed and a tiny bit of spaghetti sauce on whole wheat spaghetti. Spaghetti doesn't require much chewing, and lo and behold, I read somewhere that flaxseed is good for healing TMJ. I haven't found out why yet.
Soups are good for non-chewing, so I bought the ingredients to make broccoli-and-green-split-pea soup. (Or rather, so that Doug could make the soup, *cough cough*.)
Drinks are a real dilemma. This year, to increase my fiber intake and cut down on my simple sugars intake, I've been drinking water and eating fruit - mainly apples at the moment. But apples are on the big no-no list because of how wide one has to open one's jaw to bite into them. Sliced apples are theoretically okay, but really, I find that any fruit with edible skin is problematic, because fruit skin takes a lot of chewing. And as Doug points out, I'm just not the sort of person to patiently slice and peel apples.
I had a look at the sliced and pureed fruit at the grocery store, but couldn't find anything except unsweetened apple sauce that didn't have simple sugars added. (Fruit juice is a simple sugar.) So I bought whole strawberries to blend with milk to make smoothies, and I bought tomato soup because I like drinking that, and I already have bananas, which don't even need to be pureed to be soft enough to eat. That, plus my regular orange juice, should be enough.
Oh, and I took a look at the baby food aisle in case any of the pureed food there appealed to me. Man, what a racket. A dollar twenty-nine for as much food as I could eat in two gulps.
Last stop, the tea aisle. People at the TMJ forum had been talking about chamomile tea helping to relax them and put them to sleep. My usual concoction - on the rare occasions that I drink herbal tea - has been a chamomile tea bag, warm skim milk, malt, and cocoa powder. (Don't screech; it's my low-fat equivalent of flavored hot chocolate.) I'm going to drop the cocoa powder from the ingredients and see whether the malt alone makes the drink flavorful enough. I just can't drink herbal tea straight; it tastes like flavored water to me. (Maybe because it is.)
*** 3 November 2009: Less talking, more progress.
My jaw really does feel better. I'm less numb in my left cheek, the pain is virtually gone when I'm awake, and I'm sleeping relatively well (as opposed to last weekend, when sleeping was an act of torture).
This isn't to say that I'm out of the woods. A lot of my progress is being maintained by me not doing things. I'm not eating chewy or hard foods. I'm not eating on the left side of my mouth. I'm not sleeping without the aid of two Advils. I'm not sleeping anywhere except on my back. I'm not wearing my computer headphones to listen to music. I'm not brushing my teeth in my normal vigorous manner. I'm not talking very much. Obviously, I'd like to be able to resume most of my normal activities.
Especially the talking. Because you know what? I mouth words when I'm writing. I'd only been vaguely aware of that before, but now I'm acutely aware of it, because it adds into my permitted talking time.
Also, darn it, sleeping on my back all night exacerbates a left-elbow problem I've been having for several years now. (My left hand is the one that continually hits the Page Down button when I'm reading at the computer while eating with my right hand. I think that's what caused the problem with my elbow.) So while I've got less pain from my jaw, my elbow is feeling nasty. And my dry eyes aren't terribly happy either, because I'm not lying on my right side for most of the night, facing the humidifier.
If only I could get all my body parts to agree on the best sleeping position for me. But in the meantime, I seem to be doing a good job at eliminating my teeth grinding at night, which is a normal activity I do not want to resume.
*** 8 November 2009: Sleeping and posture.
"You know how I arranged to get TMJ in order to take my mind off the pain from my dry eye?" I told my apprentice. "Well, now I've acquired tennis elbow in order to take my mind off the pain from my TMJ."
My elbow really is the biggest problem at the moment. Despite my best efforts not to overuse it and to keep my arm posture proper, the elbow pain just isn't going away.
Turns out that the standard treatment for tennis elbow (so called because it's usually acquired by people who play tennis) is the same as one of the standard treatments for TMJ: ice packs, ibuprofen for the swelling and pain, and resting the affected part.
The difference is, my jaw is actually responding to the above treatment. I've reached the point where I no longer go into pain every time I brush my teeth, and the pain on the left side of my head is close to disappearing. The pain around the jaw joint is still a bit tender, enough that I'm avoiding wearing my regular headphones (the ones I use when listening to music on my computer). But it no longer hurts to wear my iPod buds.
The biggest problem I'm facing with my jaw is one that I'd predicted beforehand: my dry eyes don't like me sleeping on my back. The back of my head and my shoulder area is always tender in the winter because of my dry eye; as a result, I can no longer sleep through an entire night without waking up aching. And when I ache in the night, I'm more inclined to clench my teeth. After I woke up early this morning with back pain near my shoulder area and a pain in my jaw that told clearly that I'd been clenching my teeth against the pain in my back, I gave up and tried sleeping on my right side, at least for a while. I slept fine. So now I'm going to rotate between back-sleeping and right-side-sleeping. Left-side-sleeping is out of the question while the TMJ is bothering me, and I gather (from the stern words that doctors have to say about this practice, in connection with TMJ) that my days of falling asleep on my stomach are over.
My elbow, for a mercy, didn't bother me last night, though the only way I can keep it from feeling nasty at night is by dosing myself with Advil, placing my left arm on top of the down comforter, and stretching my arm out somewhat to the side.
If that position sounds cold, it is. I can't cuddle up to Doug's heat, my arm (even when under a light blanket I place on it) is cold, and I've got the darned humidifier blasting cold wind at me during all this.
(I've tried suggesting to Doug that we turn up the thermostat at night till I'm better. He growls about heating bills.)
Meanwhile, there's a conflict between my dry eyes and my TMJ over the best position for my computer monitor. My dry eyes say that I should be looking down at the monitor. (The lower the monitor, the more eye area your eyelids cover.) My TMJ says that, for proper neck posture, I should be looking straight ahead. What they both agree upon is that I have a lousy backrest on my desk chair. But there's nothing I can do about that; it's the only desk-style chair in the house.
I have decided that I need to get rid of the shelf beneath my desk in order that I can place my knees all the way under the desk, rather than be hunched forward in order to read the screen.
So posture, posture, posture. That's my byword for the day.
*** 9 November 2009: Desk posture.
I put my computer monitor on a stand today, so that it's head-level. "That's pretty high," said Doug dubiously. It remains to be seen whether my eyes rebel. But this is at least preventing me from continuing to hunch over to view the monitor.
(Also, I was able to place three pieces of pottery in the empty space under the stand: one holding my spare flash drive, one holding my eye drops, and one holding the water to wet my eyelids periodically. So now my desk is now less cluttered, and the items I need are closer to hand.)
Since all of the articles about tennis elbow are right next to the articles about carpal tunnel syndrome, I've handmade a wrist rest, using a towel and a piece of thin packing foam that I've been hanging onto for a couple of decades, under the theory that the foam would come in handy one of these days. There are advantages to being a packrat.
*** 15 November 2009: Now my glasses have decided to misbehave (but wow, once they behave, life'll be great).
Well, after I spent Monday getting my desk and chair positioned exactly right, I sat down on Tuesday morning at my new and improved desk . . .
. . . and my chair fell apart.
However, the good news is that my tennis elbow has largely disappeared. The change in chair height seems to be what it was demanding; once I met its demands, it stopped holding my elbow hostage.
My sleep pattern, while still far from ideal, is a little better; I've been able to stop taking Advil nightly. If I go to sleep in a relaxed state and sleep deeply, I don't wake up in (much) pain. So I'm getting as much exercise as I can, in order to fall asleep easily.
It turns out that raking leaves is compatible with plotting stories in my head.
The bad news concerns my new eyeglasses. I'd ordered a pair, then discovered, when they arrived, that they were for long-distance viewing only. Nobody had told me (including my ophthamologist, now my ex-ophthamologist, for that and many other reasons) that I'd been issued with a prescription that required me, for the first time in my life, to wear progressive glasses or trifocals. So I didn't ask for progressive glasses or trifocals at the optical department, and what arrived were glasses that only allowed me to see long-distance.
So I ordered progressive glasses - rather dubiously, because I'd read horror stories on the Web about what progressives were like. But the alternative was trifocals, and they didn't sound as though they'd be much better. I also discussed with the optical department clerk the possibility of getting glasses just for computer use.
The progressives arrived, and my goodness - you mean there's a world beyond arm's length?
I have to go backwards in time to explain. In 2001, as most of you know, I became partially sighted. In the space of a week, I lost my ability to read print; then my distance vision became affected. I remember waking up one morning in early 2001 and discovering that the distance vision in my left eye was beginning to disappear. Panicking, I called up my opthamologist (yes, the same one).
He said calmly, "Oh, that's to be expected."
So I hung up and waited for the rest of my distance vision to disappear. Within a week, it was gone.
Because of that stupid remark, "Oh, that's to be expected," it never occurred to me that I could correct the problem by getting a new prescription of glasses. I thought that my distance vision - and, as it eventually turned out, much of my intermediate vision - was simply gone, in an uncorrectable manner, and that I'd have to stumble through a blurry world for the rest of my life. After all, that was the verdict on my dry eye - that it was incurable.
For the past eight years, I've been unable to see people clearly at the front of a conference room, see dinner companions clearly at the other end of the table, or read street signs. These have been minor irritants compared to my problems with obtaining e-texts; I haven't given the matter much thought except when having to trot halfway down a city block in order to stand under a street sign, so that I can read it.
Around 2004, it occurred to me that I should probably order new glasses, for the same reason I did in the old days - because my eyesight slowly declines each year. But because of my lack of health insurance, I didn't get around to obtaining new glasses till this year. So what a shock it was to put on my new glasses and find all of my vision restored.
Darlings, I can now stand at one end of the Mall in Washington, D.C., and see the Capitol at the other end of the Mall. In clear detail.
This doesn't mean that my partial sightedness has disappeared, because that's affected by a different factor than my glasses - it's affected by the level of humidity in the air. To put it simply, my eyes don't have enough innate moisture in them to function properly under normal humidity conditions. They're only truly functional when the humidity is 80% or higher (which, thankfully, is often the humidity level in the D.C. area in the summertime). This means that, while technically I can see the Capitol from a mile away, trying to look at the Capitol from that distance during the late winter would give me a giant headache, because my eyes would have to strain themselves to function properly. Similarly, it doesn't matter how clearly I can see a printed book in the winter; my eyes rebel against having to read print at that time of year, because they don't have sufficient moisture. (There's a similar condition whereby someone with 20/20 vision can be so badly affected by light that they're effectively 100% blind, because they can't open their eyes without undergoing immediate pain.)
So I'm still partially sighted, but I'm hoping that finally getting an up-to-date glasses prescription will ease the strain on my eyes that's been caused by my trying to view objects that my current glasses couldn't focus on properly.
Alas, I think that the progressive glasses I was given have misaligned lenses, because I had double vision and problems with blurring all through Friday, when I tested the glasses out. I did a home test to check whether the lenses were misaligned, and that test's verdict was, "Yes."
So it's back to the optical department for a third time (and I haven't even dealt yet with getting the computer glasses). My schedule for tomorrow looks like this:
--Call customer service rep for my dental plan.
--Call the optical department.
--Call the medical test folk.
--Call my dentist.
--Call the local health clinic.
This is not the sort of schedule that someone with a phone phobia wants to have. And I think it's disgusting that I'm acquiring new medical problems at the rate of roughly once a week. It's beginning to appear that 2009 is going to be my Year of Ill Health.
(At least I don't have the swine flu. Yet.)
*** 15 November 2009: Yet another bodily complaint.
My right heel has decided that it doesn't like me lying on my back all through the night. In revenge, it is waking me up in pain each morning.
Only my right heel. My left heel is fine with the arrangements.
I want a new body, please. You can send it to my via UPS.
--Albert Camus.
I'm posting separately this entry some medical problems I've been having recently. (Don't worry, they aren't life-threatening, just painful and annoying.) I figure that people who are interested in reading my Daily Life entries may not want to wade through tons of medical stuff, and vice versa.
For newcomers: Background to my home entries.
How I reply to comments at this blog.
*** 2 November 2009: My doctor and my wallet.
This afternoon I go to the doctor's for a rather tricky exam I'm not looking forward to, since it may involve scalpels against my brain. (A cyst on the side of my head is pressing against the remainder of my head, causing me pain and nausea.) But at least it will be my usual doctor handling this; he has already successfully drained a cyst from the skin above my spine. (Cysts like me. I had another one drained a couple of years ago.)
Of course this will be out-of-pocket expenses for Doug and me. I see from the news that the latest health reform act in Congress (1) requires that health insurance be made mandatory in 2013 (with big financial penalties for anyone who doesn't buy health insurance), and (2) promises that health insurance will be made affordable for low- and moderate-income families in 2019. I love the conjunction of those two statements.
At any rate, 2019 is much too far down the line for Doug and me. I'm beginning to work again on the nonfiction book I'd been planning, not because I really want to be working on nonfiction during the fiction-composing time of my year, but because nonfiction may be my only hope for making serious money next year. (By "serious" money, I mean four figures.) We need enough money to pay for health insurance and to pay the annual property tax each year. Those are the only two worrisome points in our budget; otherwise, we do fine as a low-income household.
(Well, except that we don't have any way to put additional money aside for our old age. But thanks to the Great Recession, we're hardly alone in that fix.)
*** 2 November 2009: Well, whadya know. I have a stress-related illness.
"Your cyst is an innocent bystander," my doctor has declared.
Turns out that, in all likelihood, I have TMJ. ("Temporomandibular Joint Syndrome," explained my doctor. "You see why we call it TMJ.") To sum it up: My jaw joint aches. The pain is radiating out from my jaw joint, which was why I first thought that I had a toothache, and then thought that my head-cyst was at fault.
But when my doctor poked me inside my mouth in the general location of my jaw joint . . . Ow. Yes, that's the spot.
Ironically, my dentist had mentioned TMJ as a possibility almost the moment I walked in his door. But me being the chatterbox I am, I overrode him with a list of my supposed symptoms, which didn't fit the TMJ scenario very well, so he got distracted before I could ask him the sensible question, "What is TMJ?"
The mind is a strange thing. When I thought I had a toothache, I was sure that the pain was centered on one of my teeth. When I thought I had a growing cyst, I was sure that the pain was centered on my cyst. Now that I've been diagnosed with TMJ, it's quite clear to me that the pain is centered on my left jaw joint. (In my defense, I gather that this sort of confusion is fairly common, not only among TMJ sufferers, but also among their doctors.)
Fortunately for my pocketbook, the basic remedies for TMJ are all over-the-counter: pain reliever and anti-inflammation medicine (I was already taking Advil), eating soft foods (I was already doing that but am now doing more of that), no caffeine (ouch - there go the Halloween candies), proper posture awake and in bed (cue incredibly long thread at a TMJ forum about which pillows to buy), not opening the mouth wide (cue very sad thread at the TMJ forum about singers with TMJ), ice packs and moist heat (yes, both - I haven't figured out why they're both supposed to work), massage, certain types of vitamins and foods, and stress reduction methods such as meditation and exercise (oh, right - I'm already supposed to be doing that, aren't I?).
Second level treatment is moderate medical intervention such as prescription pain relief and tranquilizers, biofeedback, and a mouth guard to prevent grinding of teeth . . . but I hope I won't have to reach that level. Any treatments above the moderate level are scientifically unproven, according to the National Institute of Health.
According to the NIH, it's not certain whether TMJ can be caused by stress, but everyone agrees that it can be aggravated by stress, so I'm trying to be very, very relaxed now. Especially my jaw.
(Oh, and someone at the TMJ forum reported that prolonged talking aggravates TMJ. Ha. I knew there was a reason I taught myself to type.)
*** 3 November 2009: Pillows.
Last night (as I hinted above) I perused the wonderful forums at the TMJ Association. Yes, that means I had to go online off-schedule. There wasn't any alternative; the public library didn't have enough information on TMJ.
The TMJ Association had lots. It was started by some TMJ sufferers as a support group. The association expanded into education after it became clear that there was a lot of misinformation about the illness drifting around. The association's site links to the very helpful PDF document by the National Institute of Health on TMJ, which might as well be entitled Everything That You Thought You Knew About TMJ is Wrong.
The association's forums were where I found the pillows thread - or rather, threads, because this seems to be a topic of great interest to TMJ folk. Frankly, this is all deja vu for me; I went through all this at the time that I first acquired severe dry eye in 2001, when my head was so sensitive to touch that I could only sleep for a couple of hours at a time before I woke from the pain. It was then that I started using a down pillow, which is nicely soft, and which you can fluff into pretty much any position you want, high or low.
After I'd looked at the eighty-dollar pillows that were being recommended at Amazon for TMJ sufferers (basically, a very low headrest, accompanied by a higher neckrest), I said, "Heck, I can make the same sort of pillow just by squishing my down pillow into the right position." So I did.
The object of all this was to sleep comfortably on my back, which is apparently the position recommended for TMJ folk - at least, that's what the leaflet said that my doctor gave me, and people at the TMJ forum were echoing this advice. Sleep has been a problem for me recently, because I've traditionally slept in every position: left side, right side, stomach, and back. I shift as the night goes on. But sleeping on my back all night was no worse a prospect than sleeping all night in any other position, so I decided to give it a try.
It seems to be working out okay. It's not as comfortable as shifting around all night, but it hasn't caused me any sleeplessness.
The next trick, of course, is to stop grinding my teeth at night, since that's a major factor in aggravating TMJ. I now understand why my jaw has been feeling relatively good during the day and then feeling worse after a night's sleep. Theoretically, I ought to be able to stop unconscious teeth-grinding, since I've controlled other things I do in my sleep, such as rolling over or dreaming. So I'm working on it. I've never actually kept track of how often I grind my teeth - till now, it's been a trivial matter in my life - but I can say that, on the nights now when I don't grind my teeth, I wake up without any significant pain in my jaw.
The pain starts the moment I open my mouth to say hello to Doug or my apprentice. Darn it, and I was being semi-facetious in the last entry about talk aggravating my TMJ. I suppose this is the point in my life at which I learn to do more listening than talking.
*** 3 November 2009. Tiny food.
So I'm getting into the car after going grocery shopping this evening (with my left arm sore because of a tentanus shot I had yesterday), and I hit my right jaw on the car door. Then I rebound onto the car doorway, hitting the cyst on the left side of my head (remember that cyst?).
"At least this takes my mind off the pain in my left jaw," I told Doug ruefully.
My left jaw, which is the one that has the TMJ, is doing reasonably well. I've been nursing it carefully. I was at the grocery store because the food threads at the TMJ forum made me aware that food which doesn't require much chewing could make a big difference to my jaw. Resting my jaw and not opening it wide are two key ways for me to heal from TMJ.
Also, I needed a new toothbrush. My adult-sized toothbrush has soft bristles but has been causing me to open my mouth too wide when I brush the molars. So I bought an ages-two-and-older Sponge-Bob toothbrush. I'm sure my apprentice will be delighted; Sponge-Bob is the mascot of his club.
As far as food is concerned, I learned at the TMJ forum that steamed vegetables are good, since they don't require much chewing. Terrific; they're one of the staple items in my diet. I regularly eat them on whole wheat couscous, which is another plus, since couscous barely needs any chewing.
I had a look at the hot cereals, since they're tiny, but decided in the end to make do with whole wheat couscous, which works as a hot cereal and has six grams of fiber in each serving.
I needed a dessert item, since I can't eat cornbread-and-honey (too chewy) or jam on toast (too chewy) or chocolate (caffeine causes stress). So I bought tapioca pudding, which is fiberless fluff but tastes good. Then I mixed a dab of the pudding into couscous for a high-fiber dessert; popped into the microwave, it tastes especially good. Couscous is wonderfully adaptable.
Speaking of grains, sandwiches are a problem. I've been eating sandwiches two or three times a day - I'm sort of a sandwich fanatic - but they're chewy. So I'm limiting myself to one sandwich a day, filled with cheese spread, sliced tomatoes, and steamed broccoli. (No, I didn't make up that recipe for the sake of my TMJ. It's one of my daily staples.)
My other daily grain item - for the sake of my dry eye - is roasted flaxseed and a tiny bit of spaghetti sauce on whole wheat spaghetti. Spaghetti doesn't require much chewing, and lo and behold, I read somewhere that flaxseed is good for healing TMJ. I haven't found out why yet.
Soups are good for non-chewing, so I bought the ingredients to make broccoli-and-green-split-pea soup. (Or rather, so that Doug could make the soup, *cough cough*.)
Drinks are a real dilemma. This year, to increase my fiber intake and cut down on my simple sugars intake, I've been drinking water and eating fruit - mainly apples at the moment. But apples are on the big no-no list because of how wide one has to open one's jaw to bite into them. Sliced apples are theoretically okay, but really, I find that any fruit with edible skin is problematic, because fruit skin takes a lot of chewing. And as Doug points out, I'm just not the sort of person to patiently slice and peel apples.
I had a look at the sliced and pureed fruit at the grocery store, but couldn't find anything except unsweetened apple sauce that didn't have simple sugars added. (Fruit juice is a simple sugar.) So I bought whole strawberries to blend with milk to make smoothies, and I bought tomato soup because I like drinking that, and I already have bananas, which don't even need to be pureed to be soft enough to eat. That, plus my regular orange juice, should be enough.
Oh, and I took a look at the baby food aisle in case any of the pureed food there appealed to me. Man, what a racket. A dollar twenty-nine for as much food as I could eat in two gulps.
Last stop, the tea aisle. People at the TMJ forum had been talking about chamomile tea helping to relax them and put them to sleep. My usual concoction - on the rare occasions that I drink herbal tea - has been a chamomile tea bag, warm skim milk, malt, and cocoa powder. (Don't screech; it's my low-fat equivalent of flavored hot chocolate.) I'm going to drop the cocoa powder from the ingredients and see whether the malt alone makes the drink flavorful enough. I just can't drink herbal tea straight; it tastes like flavored water to me. (Maybe because it is.)
*** 3 November 2009: Less talking, more progress.
My jaw really does feel better. I'm less numb in my left cheek, the pain is virtually gone when I'm awake, and I'm sleeping relatively well (as opposed to last weekend, when sleeping was an act of torture).
This isn't to say that I'm out of the woods. A lot of my progress is being maintained by me not doing things. I'm not eating chewy or hard foods. I'm not eating on the left side of my mouth. I'm not sleeping without the aid of two Advils. I'm not sleeping anywhere except on my back. I'm not wearing my computer headphones to listen to music. I'm not brushing my teeth in my normal vigorous manner. I'm not talking very much. Obviously, I'd like to be able to resume most of my normal activities.
Especially the talking. Because you know what? I mouth words when I'm writing. I'd only been vaguely aware of that before, but now I'm acutely aware of it, because it adds into my permitted talking time.
Also, darn it, sleeping on my back all night exacerbates a left-elbow problem I've been having for several years now. (My left hand is the one that continually hits the Page Down button when I'm reading at the computer while eating with my right hand. I think that's what caused the problem with my elbow.) So while I've got less pain from my jaw, my elbow is feeling nasty. And my dry eyes aren't terribly happy either, because I'm not lying on my right side for most of the night, facing the humidifier.
If only I could get all my body parts to agree on the best sleeping position for me. But in the meantime, I seem to be doing a good job at eliminating my teeth grinding at night, which is a normal activity I do not want to resume.
*** 8 November 2009: Sleeping and posture.
"You know how I arranged to get TMJ in order to take my mind off the pain from my dry eye?" I told my apprentice. "Well, now I've acquired tennis elbow in order to take my mind off the pain from my TMJ."
My elbow really is the biggest problem at the moment. Despite my best efforts not to overuse it and to keep my arm posture proper, the elbow pain just isn't going away.
Turns out that the standard treatment for tennis elbow (so called because it's usually acquired by people who play tennis) is the same as one of the standard treatments for TMJ: ice packs, ibuprofen for the swelling and pain, and resting the affected part.
The difference is, my jaw is actually responding to the above treatment. I've reached the point where I no longer go into pain every time I brush my teeth, and the pain on the left side of my head is close to disappearing. The pain around the jaw joint is still a bit tender, enough that I'm avoiding wearing my regular headphones (the ones I use when listening to music on my computer). But it no longer hurts to wear my iPod buds.
The biggest problem I'm facing with my jaw is one that I'd predicted beforehand: my dry eyes don't like me sleeping on my back. The back of my head and my shoulder area is always tender in the winter because of my dry eye; as a result, I can no longer sleep through an entire night without waking up aching. And when I ache in the night, I'm more inclined to clench my teeth. After I woke up early this morning with back pain near my shoulder area and a pain in my jaw that told clearly that I'd been clenching my teeth against the pain in my back, I gave up and tried sleeping on my right side, at least for a while. I slept fine. So now I'm going to rotate between back-sleeping and right-side-sleeping. Left-side-sleeping is out of the question while the TMJ is bothering me, and I gather (from the stern words that doctors have to say about this practice, in connection with TMJ) that my days of falling asleep on my stomach are over.
My elbow, for a mercy, didn't bother me last night, though the only way I can keep it from feeling nasty at night is by dosing myself with Advil, placing my left arm on top of the down comforter, and stretching my arm out somewhat to the side.
If that position sounds cold, it is. I can't cuddle up to Doug's heat, my arm (even when under a light blanket I place on it) is cold, and I've got the darned humidifier blasting cold wind at me during all this.
(I've tried suggesting to Doug that we turn up the thermostat at night till I'm better. He growls about heating bills.)
Meanwhile, there's a conflict between my dry eyes and my TMJ over the best position for my computer monitor. My dry eyes say that I should be looking down at the monitor. (The lower the monitor, the more eye area your eyelids cover.) My TMJ says that, for proper neck posture, I should be looking straight ahead. What they both agree upon is that I have a lousy backrest on my desk chair. But there's nothing I can do about that; it's the only desk-style chair in the house.
I have decided that I need to get rid of the shelf beneath my desk in order that I can place my knees all the way under the desk, rather than be hunched forward in order to read the screen.
So posture, posture, posture. That's my byword for the day.
*** 9 November 2009: Desk posture.
I put my computer monitor on a stand today, so that it's head-level. "That's pretty high," said Doug dubiously. It remains to be seen whether my eyes rebel. But this is at least preventing me from continuing to hunch over to view the monitor.
(Also, I was able to place three pieces of pottery in the empty space under the stand: one holding my spare flash drive, one holding my eye drops, and one holding the water to wet my eyelids periodically. So now my desk is now less cluttered, and the items I need are closer to hand.)
Since all of the articles about tennis elbow are right next to the articles about carpal tunnel syndrome, I've handmade a wrist rest, using a towel and a piece of thin packing foam that I've been hanging onto for a couple of decades, under the theory that the foam would come in handy one of these days. There are advantages to being a packrat.
*** 15 November 2009: Now my glasses have decided to misbehave (but wow, once they behave, life'll be great).
Well, after I spent Monday getting my desk and chair positioned exactly right, I sat down on Tuesday morning at my new and improved desk . . .
. . . and my chair fell apart.
However, the good news is that my tennis elbow has largely disappeared. The change in chair height seems to be what it was demanding; once I met its demands, it stopped holding my elbow hostage.
My sleep pattern, while still far from ideal, is a little better; I've been able to stop taking Advil nightly. If I go to sleep in a relaxed state and sleep deeply, I don't wake up in (much) pain. So I'm getting as much exercise as I can, in order to fall asleep easily.
It turns out that raking leaves is compatible with plotting stories in my head.
The bad news concerns my new eyeglasses. I'd ordered a pair, then discovered, when they arrived, that they were for long-distance viewing only. Nobody had told me (including my ophthamologist, now my ex-ophthamologist, for that and many other reasons) that I'd been issued with a prescription that required me, for the first time in my life, to wear progressive glasses or trifocals. So I didn't ask for progressive glasses or trifocals at the optical department, and what arrived were glasses that only allowed me to see long-distance.
So I ordered progressive glasses - rather dubiously, because I'd read horror stories on the Web about what progressives were like. But the alternative was trifocals, and they didn't sound as though they'd be much better. I also discussed with the optical department clerk the possibility of getting glasses just for computer use.
The progressives arrived, and my goodness - you mean there's a world beyond arm's length?
I have to go backwards in time to explain. In 2001, as most of you know, I became partially sighted. In the space of a week, I lost my ability to read print; then my distance vision became affected. I remember waking up one morning in early 2001 and discovering that the distance vision in my left eye was beginning to disappear. Panicking, I called up my opthamologist (yes, the same one).
He said calmly, "Oh, that's to be expected."
So I hung up and waited for the rest of my distance vision to disappear. Within a week, it was gone.
Because of that stupid remark, "Oh, that's to be expected," it never occurred to me that I could correct the problem by getting a new prescription of glasses. I thought that my distance vision - and, as it eventually turned out, much of my intermediate vision - was simply gone, in an uncorrectable manner, and that I'd have to stumble through a blurry world for the rest of my life. After all, that was the verdict on my dry eye - that it was incurable.
For the past eight years, I've been unable to see people clearly at the front of a conference room, see dinner companions clearly at the other end of the table, or read street signs. These have been minor irritants compared to my problems with obtaining e-texts; I haven't given the matter much thought except when having to trot halfway down a city block in order to stand under a street sign, so that I can read it.
Around 2004, it occurred to me that I should probably order new glasses, for the same reason I did in the old days - because my eyesight slowly declines each year. But because of my lack of health insurance, I didn't get around to obtaining new glasses till this year. So what a shock it was to put on my new glasses and find all of my vision restored.
Darlings, I can now stand at one end of the Mall in Washington, D.C., and see the Capitol at the other end of the Mall. In clear detail.
This doesn't mean that my partial sightedness has disappeared, because that's affected by a different factor than my glasses - it's affected by the level of humidity in the air. To put it simply, my eyes don't have enough innate moisture in them to function properly under normal humidity conditions. They're only truly functional when the humidity is 80% or higher (which, thankfully, is often the humidity level in the D.C. area in the summertime). This means that, while technically I can see the Capitol from a mile away, trying to look at the Capitol from that distance during the late winter would give me a giant headache, because my eyes would have to strain themselves to function properly. Similarly, it doesn't matter how clearly I can see a printed book in the winter; my eyes rebel against having to read print at that time of year, because they don't have sufficient moisture. (There's a similar condition whereby someone with 20/20 vision can be so badly affected by light that they're effectively 100% blind, because they can't open their eyes without undergoing immediate pain.)
So I'm still partially sighted, but I'm hoping that finally getting an up-to-date glasses prescription will ease the strain on my eyes that's been caused by my trying to view objects that my current glasses couldn't focus on properly.
Alas, I think that the progressive glasses I was given have misaligned lenses, because I had double vision and problems with blurring all through Friday, when I tested the glasses out. I did a home test to check whether the lenses were misaligned, and that test's verdict was, "Yes."
So it's back to the optical department for a third time (and I haven't even dealt yet with getting the computer glasses). My schedule for tomorrow looks like this:
--Call customer service rep for my dental plan.
--Call the optical department.
--Call the medical test folk.
--Call my dentist.
--Call the local health clinic.
This is not the sort of schedule that someone with a phone phobia wants to have. And I think it's disgusting that I'm acquiring new medical problems at the rate of roughly once a week. It's beginning to appear that 2009 is going to be my Year of Ill Health.
(At least I don't have the swine flu. Yet.)
*** 15 November 2009: Yet another bodily complaint.
My right heel has decided that it doesn't like me lying on my back all through the night. In revenge, it is waking me up in pain each morning.
Only my right heel. My left heel is fine with the arrangements.
I want a new body, please. You can send it to my via UPS.
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