Who am I and Why am I here?

EDID for ViewSonic VX2435wm

2009-11-15T15:53:00.001-05:00

For anyone in need of the EDID for a ViewSonic VX2435wm (24" 1200p LCD w/HDMI digital input):

HKR,,OverrideEdidFlags0, %REG_BINARY%, 5A,63,1E,BD,00,00,FF,FF,04,00,00,00,7E,01,00

This will fix the overscanning problems when a PC's video hardware treats it as an HDTV instead of a PC monitor.

Google "OverrideEdidFlags0" to see how to use it.

deQuervain's release update

2009-06-01T18:13:00.004-05:00

Had the soft cast/splint removed today. I pulled the steristrips off rather than have the nurse do it. The incision hasn't healed much. It's still split right open between the stitches. The ends of the stitches were cut off and apparently they're going to dissolve in the skin. I like that. I've had "old fashioned" stitches before, not eager to repeat the experience. I just hope the two sections of skin bond before the stitches expire.

Pain isn't bad at all. I can type with that hand for short periods of time. I can grasp a coffee mug and open some doors (depending on the type of handle). Twisting isn't so good. Anything that tugs at the incision is instant screaming pain. Other than that though, it's much smoother than I expected.

My other hand isn't enjoying doing the work of both. Hopefully this cuts down on the discomfort on the other side, until we can cut that one up too. Whee. Had the option of doing physical therapy again, but I'm passing for now. I can torture myself just fine, thanks. I'd only go that route if the pain was excessive.

Sleeping should be interesting tonight.

Another day, another surgery

2009-05-23T20:51:00.005-05:00

Barely a year after bilateral arthroplasty on my jaw joints, and I'm at it again. This time it's a "de Quervain's release". I've had painful symptoms in both hands since the beginning of the year. Basically, it's painful to extend either arm and apply pressure, or to grip things with the thumb. Somehow it affects both hands, no idea what brought it on. It came on suddenly and won't go away, and is quite painful at work. The tendons get tighter and tighter and won't let go.

I tried physical therapy, anti-inflammatory medicine, and immobilization. So now I've had surgery on one side, and will do the other side once this one has recovered. The surgery was quick, done in the hospital under anesthesia. It's the day after and there's not really much pain. It's no where near as bad as I expected. Only painful if I attempt to grap things with that hand, or extend my arm. Mostly it itches where I assume the incision site is. There's a hard cast along the thumb and arm on the inside following the thumb tendons. Just bandage everywhere else. This will be removed by the orthopedist in ten days.

Going to be a long ten days. It's not very easy to function with one hand, especially being a lefty. Hopefully it heals quick, the right hand isn't pleased with having to do twice the work.

Zero Hour - America's Medic now available

2009-03-23T20:15:00.006-05:00

As a software developer, there's nothing I love more than a good simulation. The folks that creates America's Army have been hard at work with an EMS training sim called Zero Hour. I'm sure many like myself have been eagerly checking and rechecking its availability. Well, it's here!

You can access it from this site: http://nationalemspreparedness.org/

Sadly, the installer won't let you install this on Vista x64, even though the app appears to work fine.

The installer can be modified, if you know what you're doing (hint: Orca).

Update

2009-01-11T22:12:00.003-05:00

Been a while. Had my last checkup with the surgeon. I can open to 35mm and move side to side 8mm. The pain isn't gone, but the muscles are still healing. No clicking or popping lately. Still a lot of pain in the jaw with stress. The joints ache a lot, especially if I don't remember to shift the jaw from side to side several times a day. I'm very happy with the progress. It's certainly not factory new, but at least it's bearable now, and I can eat fairly normal food.

Insensitive advertising anyone?

2008-09-16T20:53:00.003-05:00

I couldn't help but notice this horrible ad placement in an MSNBC news story. The article says that a recent horrible train accident may have been caused by text messaging. What advertisement accompanies the article? It's an ad for a phone with a large keypad, which people use for text messaging. Even worse, what's the tagline of the advertisement? "Get on with life." Way to go Sprint.

Fixing "Personalize handwriting recognition" tool in Vista

2008-09-01T16:30:00.004-05:00

Onto an entirely different subject..

I finally broke the bank and purchased a new laptop/tablet. I'd been eying this one online for sometime, finally decided there's more to life than money and satisfied my craving. I swore I'd never buy one with my own money, but I don't want to carry around a corporate laptop either. This one doesn't come with a lock and chain.

What did I get? Well, I've been wanting a tablet so I could take notes in meetings without being that obnoxious fool that types while other people are speaking. That drives me nuts. But I'm also not keen on a PC that has no keyboard. So I got a laptop that does both. It's a Fujitsu T4220. I've already used it for note taking, and it's very nice.

It came preloaded with Vista Business, which has great support for tablets. Wanting to tailor its handwriting recognition for my own personal brand of scribble, I tried running the "Personalize handwriting recognition" tool one evening. No dice, wouldn't run.. told me to whine to my administrator. Yup, that'd be me.

Searched around online for the error that popped up, found a few forum threads but no resolutions. Wasn't until I dug into the event viewer and saw this that I had a clue how to fix it:

InputPersonalization (5620) InkStore: Database recovery failed with error -1216 because it encountered references to a database, 'C:\Users\Administrator\AppData\Local\Microsoft\InputPersonalization\inkStore.mdb', which is no longer present. The database was not brought to a Clean Shutdown state before it was removed (or possibly moved or renamed). The database engine will not permit recovery to complete for this instance until the missing database is re-instated. If the database is truly no longer available and no longer required, procedures for recovering from this error are available in the Microsoft Knowledge Base or by following the "more information" link at the bottom of this message.

Hmm. Users\Administrator? That's not how I log into Windows. When I first powered up the laptop, it went through new account creation and asked me if I wanted to personalize the handwriting recognition. I said no at the time, my bad I guess. It must have mistakenly set up the handwriting database in the Administator's file area. Now how do I get rid of that link? The procedures the event log record hints at are nowhere to be found.

Simple answer? Go into C:\Users\MyAccount\AppData\Local\Microsoft and rename the "InputPersonalization" folder. The name doesn't matter, just add an underscore to it at the end. Reboot. Alternatively, you could try to stop every service that accesses it, but that's a pain. When the machine comes back up you can run the Personalize tool. It creates a whole new recognition database in your account. The old one can be safely deleted. It would've been nice if Microsoft provided a tool or some indication of how to remove extraneous links like this one. It's in one of the files in that directory, but it's not XML or a text file.

D'oh

2008-06-23T19:32:00.003-05:00

Alright, I take back the pizza comment. Bad idea. Been paying for that all day. Muscle pain and spasms all day long which I attribute to having satisfied my Dominos' craving yesterday. Bad me, no cookie.

Freezable gel packs are nice for dealing with cranky muscles. Most of them can be heated as well, either in the microwave or in a pot of boiling water. I particularly like the Elasto-Gel brand. It's a firm gel pack that doesn't all glop to one side if you hold it vertically. It's very reusable, similar to what some physical therapy places use. In fact, could be the same thing.

Coincidentally, work bought pizza for our group today. Ugh. Would have been nice to blend in for a change.

Recovery..

2008-06-22T11:28:00.002-05:00

The last of the glue peeled off a couple of weeks ago. Now the incision is just a fine line following the front of the ears. It's not really noticeable unless you look for it, but once you do you can't miss it. I can open to 32mm if I really stretch. Doesn't feel like I'm going to get much more than that. The surgeon says anything over 30mm is considered successful. It's not horrible, but it's less than I had before. Of course before, I had horrible grinding, snapping, clicking, and tearing to go along with that movement. It's a fair trade for smooth operation.

I'm doubting that a cheeseburger is in my future, not sure I could eat one without nibbling at it or squishing it flat. I can eat pizza though, good enough. The clicking on the right seems to come and go, and I don't think it's as bad now. The muscles are still tender and get aggravated easily. Biting too hard, too much speaking, certain physical activities like pulling roots in the lawn all make the muscles spasm or painful. The doctor says it could be nine to twelve months for that to go away.

So far so good.

Well, I survived

2008-05-14T16:55:00.004-05:00

Surgery is over and I'm well on my way as far as recovery goes. I started back to work this week. At this point, I can't really say there's much pain. It's just uncomfortable, sometimes distracting. Most of the day my head feels like it has tight rubber bands wound around it. Later in the day it'll throb on both sides and/or feel like something is crawling around under the skin.

So do I like the results? Hard to say so far since the muscles are still very tight. I'm back to eating the same types of food I was before, albeit soft food. Both joints function smoothly, although I have had some painful snaps in the right joint. Not often though. There's no grinding anymore, no clicking other than those rare ones on the right. Every-so-often the muscles will spasm and there will be a sharp pinch from one or both joints as the jaw jumps in a way it shouldn't. I think that once the muscles relax the results will be quite excellent.

Surgery went fairly smoothly. The surgeon ended up replacing the discs on both sides with muscle tissue taken from the same area. I had only expected that on the left side. Even though they were prepared for it, I was still sick from the anesthesia. I don't remember that at all. Surgery was sometime around noon and I wasn't aware again until the whee hours of the next morning. I was released from the hospital in the late afternoon after the day of surgery.

The first week was miserable. The pain wasn't too bad in the hospital with frequent doses of morphine, but at home I only had oxycodone and choline mag trisalicylate. To me, oxycodone (percocet) does very little to ease pain. I spent most of that time in a recliner stuffed with pillows with my head wrapped in ice gell packs. Definitely stock up on those if you're having similar surgery. It's too bad the hospital didn't have them. The ice pack they had didn't seem cold to me, the ice was hard and painful to have resting against my head. The nurses ended up using disposable chemical ice packs with a lot of gauze to hold them to my head. It worked, but they lost their chill quickly.

Right now, I can usually sleep through the night if I sleep in a recliner. The past couple of nights I was finally able to sleep in bed, but I end up waking up every two or three hours. I'm not seeing a physical therapist, instead I'm supposed to stretch the jaw throughout the day. Hard to say if it's helping, but it's not hurting any.

I'm looking forward to getting back on the bike soon. I'm supposed to wait till six weeks after surgery before doing anything that could impact the head. While cycling shouldn't, I ride a stiff road bike and the shock from bad pavement can be a bit abusive to the body. Better not to risk it until the six weeks is up.

The surgical incisions were glued back together. The glue is very stiff. It's best to be super careful when getting dressed or undressed. Do it wrong, and it feels like a huge splinter of glass on each side digging in. I was so swollen after surgery that I looked like Stewie on The Family Guy. My head was a football sideways. No bruising though, I almost never bruise. My appearance is nearly back to normal. There's some swelling still, but I think I'm the only one that notices. My cheeks are a little sunken in, but I only know that from shaving. The joints and the area above is still very sensitive to touch.

So far I'm very pleased. Like I said, I think once I'm done healing, the results will be excellent. Whether or not it will last? Who knows. My only other real choices were do nothing or total joint replacement. Neither of which were attractive options. If it continues healing as it has, I think I see a cheeseburger in my near future. It's been so long..

Surgery this week..

2008-04-21T19:07:00.002-05:00

Surgery is coming up this week. Bilateral arthroplasty. Two weeks ago was the pre-admission testing. Blood work, pulse, blood pressure, pulse-ox, long Q&A with an anesthesiology intern, and a long Q&A with a nurse. Last week I went back for a physical exam, an in-depth description of the surgery and possible complications, consent forms and all that fun stuff. Feels like I've been waiting forever for this.

Surgery

2007-12-03T20:21:00.000-05:00

A lot of time has passed since May, and I think I'm finally making some progress. Joint replacement was ruled out, sort of. Either way, I'm not keen on the idea. Instead, they're going to try and replace the cartilage with muscle tissue and sew it in to place. In addition, they'll try and clean up the joint, smoothing out what the degeneration has caused.

It's going to be an overnight stay in the hospital, which I think is ambitious. Follow that with three weeks out of work and a new course of physical therapy. The goal is to increase jaw function and hopefully lessen the pain. There's a bit of a waiting list for surgery, but not any worse than waiting for an appointment with a specialist usually is.

2008 is already looking good.

No Arthroscopy

2007-05-31T20:07:00.000-05:00

I saw the joint replacement surgeon earlier this month. He is the third surgeon I've seen. We had a good discussion about my injury and about joint replacement. Basically, I'm not a perfect candidate for joint replacement. My joints aren't as degenerated as the typical candidate, and I'm young. Being only 31 means that I would no doubt need replacement joints at least once later on in life.

That being said, his opinion was that there aren't any other useful treatments for my type of injury. Since there are no other options and the pain is affecting my quality of life, joint replacement is a valid option. He stressed the fact that it may do nothing to decrease the amount of pain, it may even make things worse. It would likely reduce "bone pain", and I'm confident that's most of what I'm experiencing. My time with physical therapy helped me learn the difference between muscle, nerve, and bone pain. The treatments made the intensity of each vary.

There are many negatives with the surgery. The joints can't move side to side or in and out. My jaw would only be able to open and close, and would likely not open as far as I can now. That's not a huge deal since I don't eat bulky food like large subs or burgers. That's because I can't, I'm not able to chew solid food. The joints would be custom made from a special CT scan. It will take 8 weeks to create the joints. It'd likely be a long, drawn out process to get this approved through my insurance.

I was referred to another surgeon to consider arthroscopic surgery as a last hurrah before joint replacement. I was told that it was unlikely to have any lasting impact, but it was worth a shot since we'd be removing the joints anyway. Worst case, it would be a failed attempt to save joints that would be removed. Best case, my pain and joint symptoms could subside.

I saw that doctor (surgeon #4) twice this month, and arthroscopy was ruled out. The surgeon felt it would not have a lasting effect because of problems with my bite, and because of the tight muscles around the jaw which he's convinced is due to clenching. I'm not so convinced, but it doesn't really matter. He recommends reconstructive jaw surgery to reduce the gap between my rear teeth when the jaw is closed, and possibly orthodontics.

I had ruled out that approach with the second surgeon I saw. I had orthodontics after the accident, and it was rather painful. Combined with the joint and muscle pain I now have, it wouldn't be bearable. I wouldn't be able to wear a splint either since the position of the teeth would constantly be changing. This would make the joint pain that much worse.

I spoke to the joint replacement surgeon again, passing on what I'd been told. He presented a new problem. Jaw surgery or orthodontics would likely damage the joints even more, and could possibly cause them to lock. The next step is to meet with him again in person and decide on a next step from there.

Meanwhile I had another visit to the neurologist. The tremors are worse, so I started taking an anticonvulsant medicine to try and control it. So far it doesn't seem to have helped much. A brain MRI may be in my future.

Holding pattern

2007-04-08T19:53:00.000-05:00

I finally saw the neurologist a couple weeks ago. Long story short, it doesn't sound like there's anything serious going on neurologically. The dizziness appears to be caused by "positional vertigo", which is usually caused by head trauma. That's interesting because the dizziness has been going on for quite a while, but I don't recall it going so far back as the bicycling accident. The tremors were diagnosed as "essential tremor", I can't decide if I should take a prescription for it or not. It's bothersome, but I don't want to add a new variable to my health equation.

I saw another surgeon the week before that. She presented me with three options. The first was re-constructive surgery on the jaw followed by orthodontics. This would correct the gap in my teeth when my jaw is closed, which is likely contributing to the TMJD problem. I would be unable to wear splints while this is going on, and the pain would likely be more than I could handle for the 2-3 years it'd require. Option one is out. Option two is total joint replacement. This isn't a new option, but her opinion is that without correcting the bite problem, the pain would likely return within a year following the surgery. I hadn't heard this before, but it seems to make sense. Option three is to replace the joints and do the re-constructive jaw surgery surgery at the same time. This sounds like a lot of surgery and I imagine the recovery wouldn't be pleasant. Still, it sounds like the best option. I was referred to another surgeon that does this type of surgery, so I'm in a holding pattern until then.

I also had the CT scan. Compared to the MRI, it was amazingly quick. I haven't seen the radiologist's report, but my doctor looked at it and said that the joints look nothing like each other. One side is squared off and doesn't have the smooth surface that a condyle should have. The other side is similar, but not as severe. Both sides are arthritic. They put physical therapy on hold since it's not having any lasting effect, and they're suggesting that I see them again after meeting with the surgeon. This is a sharp change in their opinion, since they had all but dismissed surgery when I first saw them.

So for now, my jaw joints are screaming, my facial muscles are painfully strained, my teeth feel like they're moving around, and I'm having awful headaches again. Worse yet, it's spring and I was looking forward to venting some frustration on the bicycle, yet it's still snowing here! Ugh. More news in early May when I see this new surgeon. I wish these referrals didn't take so long.

Treatment

2007-03-10T15:09:00.000-05:00

I saw the doctor many times through February, monitoring my progress with the splint and a soft food diet. Initially the splint was great. The pain decreased quite a bit, the joints seemed to calm down, and the headaches relaxed. Then, after several weeks, it started building up again. I was taking ibuprofen (still am), which is nearly useless. Ice packs helped and lasted a bit longer than moist heat.

I was having bad headaches, facial pain, a tearing pain in my chin, and joint pain. The area under my eyes was especially hurting. The doctor and I discussed what could be done. Since the damage was the result of trauma and considering the MRI results, the doctor felt that complete joint replacement on both sides was the last resort option. His opinion was the physical therapy wouldn't offer any long term help, and any other surgeries would only have temporary results, at best.

Starting in January, I started going to a center that specializes in craniofacial pain. I saw several doctors on my first visit and heard their opinions. They dismissed the thought of surgery and thought that splint therapy and physical therapy would work. They took impressions and created an upper splint for use at night. It covers all the upper teeth and has a chunk of plastic up front that pulls my jaw forward and keeps it centered.

They modified my lower splint to reposition the jaw and create a bigger gap to relieve the pressure on the joints. One of the doctors noticed a tremor in my hands, and urged me to get a primary care doctor and have it checked out. On a later visit, they prescribed flexeril (a muscle relaxer) to use with the night splint. As with the first splint, the pain mellowed out for several weeks. The facial muscles loosened enough so that I could get a fairly tolerable night's sleep.

Just like before, the results were short lived. They modified the lower splint several times in following visits, but it didn't do much for my symptoms. I saw the oral surgeon again and we discussed what was going on. We decided it was a good time to get a second surgical opinion, which would help make the case for surgery with my insurer. That surgical consult is coming up in a couple weeks.

I found a primary care doctor and had a physical. They took blood and checked for any thyroid problems, nothing turned up. They referred me to a neurologist for the tremors, who I'll see at the end of the month. I also saw a nutritionist because of high bad cholesterol, although it turns out that my diet isn't bad. Some small changes ought to improve the number.

I started physical therapy the same day as the physical, at the suggestion of the pain center. They do ultrasound therapy, and massage the neck and facial muscles. It helps relax the muscles and relieves some of the facial pain slightly, but I notice pain in the joints much more so now, and my ears seem to hurt more. The area under my left eye is still painful.

In the past few weeks I've had some awful dizziness (loss of balance, feeling of movement when there isn't any), blood when blowing my nose, and I think the tremors are worse now. I saw the pain center doctor again and mentioned these new problems. He told me to stop the flexeril. We had a second appointment the next week where several doctors listened to my story, examined my jaw, neck, and arm muscles. They asked a lot of questions about my symptoms, what I do for work, how I sleep, and the like.

In the end, they stressed the need to see a neurologist. They modified the lower splint after finding that my arms are weaker with my jaw in the closed position. They're recommending an experimental pain treatment with pulsed radio waves, but I'm not sure I can get to the city as many times as they need. They also want me to have a CT scan, which I'm trying to get scheduled.

Initial diagnosis

2007-02-28T18:26:00.000-05:00

As I mentioned in my last post, I saw an OMFS in October. The OMFS that repaired my jaw after my bicycling accident had moved to the midwest, so I ended up seeing a new doctor. They started off by taking a panaromic x-ray. That showed evidence of the original breaks, plus the pins that held my chin together. I could plainly see that one of the condyles (the ball of the jaw joint on the end of the mandible) healed at an obvious angle from where it should be. The breaks look to be right at the base of both condyles.

The doctor listened to me tell the tale of the accident, how long my jaw had been wired, when/why/how long I had braces, and what symptoms I had noticed when. After feeling the joints as I opened and closed my mouth and some other similar tests, we scheduled an MRI and an appointment to take impressions so that a mandibular appliance (splint) could be made.

The splint is basically two molded pieces of plastic that fit over my bottom rear teeth, held together with a bit of metal that fits behind my bottom front teeth. It's purpose is to keep my jaw from closing too far, which was causing the menisci (disks) to move painfully out of the joints. The splint is removable, in fact, I can pop it out with my tongue. I was to wear it 24 hours, taken out only to eat and brush.

I had the MRI a week later. It showed post-traumatic deformity of the condyles, osteoarthritis of the joints, and bilaterlly displaced menisci. The MRI itself wasn't bad. The machine looks like the machine they use on the TV show House. I laid on my back on the moving bed, with a plastic frame holding my head somewhat. The radiologist positioned rolled up towels behind my back so I'd be comfortable laying on the very flat surface. He also placed some under my arms and legs.

The machine is a very tight fit. I'm not a large guy, I'm 5' 9" and maybe 165lbs. My arms were squished in somewhat. The machine wasn't loud, although I did have headphones with XM radio. The radiologist could talk through the headphones and kept me updated with what he was doing and how long was left after each scan.

I would've been anxious seeing the machine right there above my nose, but I kept my eyes closed the whole time. That made the experience bearable. He did several scans with my jaw closed. Five minutes, Eight minutes, and twenty minutes.. something like that.

The tricky part came when he needed to scan with my mouth open. They use a bite block. I couldn't open wide enough for the normal one, not even for the smaller one. He made an even smaller one which worked well. It was uncomfortable, but I was able to do it. I think he just did the long scan a second time.

The worst part of the scan was being on my back. For some reason, I had difficulty breathing. Not enough that I squeezed the panic button, but enough that I was a bit frustrated. You can't move during the scan and they don't want you to move between them. Even when I was slid out of the machine for the bite block, I was still encouraged to stay still.

The MRI cost around $1500 which my health insurance happily paid. The hospital had been remodeled since the last time I had been there, so it was interesting to see it from the inside. The MRI machine was also a new addition, they had one on a trailer only certain days of the week before.

Dizziness.. Ear infection?

2007-02-23T20:42:00.000-05:00

July 2005. I had been having problems with dizziness. I was losing my balance frequently, sometimes having a sensation that the room was spinning, or that I was moving when I wasn't. Although I wasn't stumbling around and tripping over myself, I was worried that I wasn't particularly safe to drive.

I decided to seek a doctor's opinion. They checked my blood sugar which turned out to be fine. The doctor figured it was an ear infection and prescribed Antivert for the dizziness. The medicine was ineffective. I went back and saw a different doctor who blamed the problem on clogged sinuses, and suggested taking Sudafed. That didn't help either.

I figured that since we were talking sinuses, my allergist could help. I'm allergic to quite a few things and I get allergy shots, so I mentioned it during one of my monthly visits. He had a nurse administer a shot of prednisone. This relieved the symptoms for a short time, although they never completely went away.

I repeated the prednisone shot at least once, even tried a round of antibiotics in case it was actually an ear infection. Eventually the dizziness lessened. I still occasionally felt motion when there wasn't any, but it wasn't so bad that I had difficulty driving.

Thinking back on things, this may have been an early sign of a TMJ problem. I sought treatment for the dizziness in July 2005; by July 2006, I had started to notice increasing jaw pain.

I mentioned the pain to my dentist in September, who sent me to see an oral and maxillofacial surgeon (OMFS). I saw the OMFS in October, which is when the diagnosis of TMJD was made. That was also when I learned that dizziness can be a symptom of TMJD.

Braces

2007-02-19T15:02:00.000-05:00

I had two problems after my jaw went wireless. The first problem was related to the accident. My jaw wasn't aligned the same way as before, and I think the jaw had a slightly different shape. As a result, I would often bite down and end up biting my teeth. Instead of lining up and closing naturally, I'd hit the surfaces of the teeth in unnatural and uncomfortable positions. It got better as time went on, I had to close by shifting my jaw slightly forward and to the left.

My second problem had been an issue before the accident. My teeth were overcrowded, there were too many of them up front. As a result, some were pushed behind the front row of teeth, and my incisors were aimed a bit outward. I should have had braces as a child, but didn't.

In order to address those problems, I went to an orthodontist in September of 1998. The same doctor that wired my jaw after the accident removed four teeth to make room to pull the others where they should be. I had braces for two or three years, and I wore a retainer for about a year afterwards. The whole process was painful. I dreaded the frequent appointments where the braces would be tightened.

The alignment of my teeth was greatly improved after braces. Eventually I had to stop wearing the retainer because it was too painful. I probably should have seen the orthodontist then, but I figured that I had worn the retainer for so long that everything should be fine. Not a brilliant line of reasoning, but I generally dislike doctor visits. Perhaps that had something to do with it.

Ever since I was able to move my jaw after the wires came off, I had frequent clicking and popping noises from both joints. The doctor that wired the jaw said that this was to be expected given the nature of the injury. The noise wasn't painful, although it did make me uncomfortable at first. I eventually got used to it.

How did I end up with TMJ?

2007-02-18T19:25:00.000-05:00

March 29, 1998. It was pleasant day for bike riding. I was signed up for a USCF criterium (a bike race) that would take place in April, so I was out on a practice run. I had chosen a route that would take me along curvy back roads where there would be little traffic. I was in great shape, and moving along on this one road in a sprint, somewhere around the 30mph speed limit.

Well, obviously something bad happened. I had crossed a small bridge over the public water supply. Ahead was curve, and I knew the pavement was bad at the other end. I looked back over my shoulder to see if I could safely move out to the center of the road where the pavement would be smoother. I'm not sure if I saw anything.

Next thing I know, something snapped my attention forward. In a split second, a glimpse in time, I noticed the handlebars were straight, but the frame of the bike was turned partway to the left, and tilted just slightly downward. At that speed, I had no chance to react. I had a single thought, not in words, but in a feeling. "This is going to hurt."

Oh yes, did it ever. What I discovered later was that a crack in the pavement had grabbed hold of my front wheel. I had narrow racing tires on my Cannondale. The wheel must have slipped into a crack and gotten caught there. I went from 30mph to 0 right there on that spot. The bike pivoted forward on the axis of the front wheel, and drove me head first into the road.

I didn't even have time to bring my arms forward. My next observation was of my chin hitting the pavement at a horrendous speed. I felt tremendous pain as my jaw was driven back towards my throat. My chest smacked down and knocked the wind out of me. My limbs crashed down onto the road. All of this seemingly happened at once. Then, as luck would have it, I bounced a few times.

I tried to get up at first, thinking I had only cut my chin. It was a ridiculous thought, but it's not everyday something like that happens. The pain from trying to move was so overwhelming that I passed out. I didn't try it again. I could tell by the sharp bits of bone piercing into my mouth that I was in bad shape. All I could see were my outstretched arms and my sun glasses which were laying a few yards away. I have no idea where my bike was.

I dared to move my right arm, and I cradled my mouth with that hand to relieve the pressure. It was an ugly scene, and I'll save you the details. Needless to say, I was in and out of consciousness and bleeding profusely. Since I picked a route with little traffic, I was a piece of road kill for quite some time before someone happened by. Things got worse as I was blacking out for longer periods of time (I could notice the shadow of the trees moving each time). I could feel blood gushing through my fingers as I desperately tried to keep the weight of my head off my damaged jaw.

Eventually a motorist came up the road and stopped. "Are you alright?" I would've laughed if I could. She called 911 on a cell phone (lucky she had one back then). A crowd gathered and someone couldn't help freaking out, "look at how much blood there is!" Time passed and I listened to the conversations going on behind me, blacking out frequently. Next thing I remember, there was a police car facing me. Then it was the back of an ambulance, doors open and no stretcher in back.

A voice told me that they were going to flip me over now. I remembered my experience the last time I tried to move, and I wanted nothing more than for them to leave me there. It was a completely irrational thought, but I think I had accepted the inevitable at that point. Sure enough, as I was strapped to a backboard and flipped face up, the pain was extreme. For the first time I saw the firemen, a cop, and the EMTs that came to the rescue.

I remember one of the EMTs saying I'd feel a pinch as he placed an IV. I felt nothing beyond the pain I was already in. I wanted to tell him that he could rip my arm off and shove the IV in the stump for all I cared. The ambulance raced to the hospital. I don't remember much of it, but at one point we took a corner so fast I feared I might fall out the back.

The EMT administered some morphine, but it had little effect. He insisted on a cervical collar despite the obvious jaw injury. That was no treat. I awoke in the ER staring up at bags of saline and blood, and a rack of noisy monitoring equipment. Here's a horrible fact I discovered then: the ER won't administer pain medicine if you have a head injury. I was strapped to that backboard for so long that I thought my skull would split open. After two rounds of x-rays I finally found some comfort with a pillow and more morphine.

The ER doctors were convinced that my jaw was merely dislocated. I was quite distressed as they told me they'd "pop it back in." Unable to speak, I could just lie there in fear. Luckily the on call surgeon showed up and noted three breaks. One on each side right below the jaw joints, one diagonal break behind the chin. My jaw was in two separate pieces, detached from the skull.

I had surgery that day to reposition the pieces of jaw. The surgeon pinned the chin together with titanium pins. My jaw was wired shut. I spent several days in the hospital, and I spent several weeks at home before returning to work. I started bike riding again on the second week, although I didn't get over 5 miles until a few months later. After almost 3 months, the wires came off. It took a couple weeks before I was able to move it enough to chew soft food. It took about the same to figure out how to close my jaw without biting my teeth. My new mouth wasn't quite the same as my old one.

What's my motivation?

2007-02-18T18:35:00.000-05:00

Does the Internet need another blog? Probably not. Do I have anything interesting to say? Doubtful. Will that stop me? Nah. My primary goal in starting a blog is to track my progress in dealing with TMJ. It may be helpful for others who have it or know someone who suffers from it.

What is TMJ? It is the temporo-mandibular joint, or more directly, it is the jaw joint. TMJ is also a commonly used acronym for any sort of disorder or injury to the jaw joints. A person can develop TMJ problems any number of different ways. A person might grind their teeth at night, their jaw might be mis-aligned, or they may have had head trauma.

In my case it's the latter.