Bionic Women: TMJ Horror Stories

NOTE: This post references graphic accounts of TMJ treatments, complete with pictures.

TMJ disorder is sadly and surprisingly common. What is also shockingly common is the nature of surgical treatments that are frequently used to treat TMJ. If there was ever an instance of the cure being worse than the disease, this has to be it.

TMJ implants that completely failed to help

This is an X-ray of 52-year-old Lisa Schmidt. All of that hardware has been implanted into her jaw via a series of surgeries that began once she was diagnosed with TMJ disorder in 2000.

Actually, that’s not entirely accurate. That’s just some of the hardware that surgeons added over the years. Here’s the showstopper.

TMJ surgery implanted screws in jaw

 

TMJ patient required to adjust screws herself

Doctors decided Lisa needed to restore some of the bone they had cut out of her jaw during all those surgeries. So they installed yet more hardware in her jaw, complete with screws. And gave her instructions to adjust the screws herself from home.

(According to Lisa’s account, the pain and complications from all those TMJ-related surgeries eventually led her to abandon a career in aerospace, training astronauts for NASA.)

Now meet 50-year-old Jenny Feldman.

TMJ treatments led to jaw replacement twice for one patient

These are pictures after her second total jaw replacement. (Yes, they did it to her twice.) Which, according to the written account, is her 24th – twenty-fourth – TMJ-related surgery since being diagnosed with TMJ at the age of fifteen. That’s an average of one surgery every year and a half. Today, she lives in constant pain and struggles to eat solid food.

Then there’s Tricia Kalinowski.

Numerous jaw implants left TMJ worse than before

After being diagnosed with TMJ disorder as a young mother in her 20s, she has had a total of 13 surgeries over the years to replace disks, attempt to replace bone eaten away by those artificial disks, perform tissue grafts, and insert (and later remove) implants. Now in her early 60s, she lives with headaches and jaw pain every day, and neck pain that is worse than before her surgeries. The most heartbreaking portion, for Kalinowski, is that all those surgeries cause permanent nerve damage on her lower face, so she hasn’t felt her husband’s kisses since the 1990s.

While these patients may be on the extreme end of the scale in terms of the sheer volume of treatments they’ve undergone, they’re hardly alone in their lack of results. A huge percentage of patients experience more pain and discomfort, not less, in the wake of surgical intervention. The National Academies of Sciences, Engineering, and Medicine conducted a review of decades of research on TMJ disorder treatments, and concluded that the TMJ disorder treatments most commonly utilized are based on “strongly held beliefs” and “inadequate research” rather than hard scientific evidence. Moreover, treatments like installing braces or crowns or grinding down teeth have “no supporting evidence” and, according to the National Institutes of Health, “don’t work and may make the problem worse.”

There’s a social media personality who goes by Footless Jo. As you can probably guess from her nickname, she is missing a foot, and it’s because she asked doctors to cut it off. After experiencing a catastrophic ankle fracture due to falling off a horse at the age of thirteen, she underwent ten surgeries throughout her teenage years to relieve her chronic pain and restore her full function, attempts that were ultimately futile. At the age of 27, after it became obvious that even a full ankle replacement was only a stopgap measure before she would need to eventually have her leg amputated in her 60s or 70s, she suggested to her doctors that maybe it was time to stop postponing the inevitable. In time, they agreed, and she is now an amputee.

While that’s a reasonable course of action if you’re experiencing debilitating pain in an extremity, you can’t amputate your jaw, no matter how bad it’s functioning. But it’s hardly stopped surgeons from trying.

There’s a better way to go about this: addressing TMJ disorder with therapies and treatments that are non-surgical, non-invasive, and provide short-term pain relief with long-term remedies. If you are experiencing TMJ disorder, but want to avoid the predicament these and other patients are in, contact us and we’ll do what we can to help.

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The recall of Philips Respironics DreamStation breathing machines in 2021 sent shockwaves through millions of households worldwide, and kicked off a class action lawsuit we blogged here. What can get missed with something like this, though, is the tangible human cost involved. To better illustrate that cost, a filmmaker made a short documentary looking at the recall through the eyes of a doctor and three patients directly impacted.

The documentary is equal parts heartbreaking and infuriating. Observations:

  • The damage inflicted by the defective machines is permanent, but for patients with preexisting conditions, it’s devastating. Mark Edwards had severe asthma, chronic obstructive pulmonary disease and sarcoidosis prior to going on the CPAP; according to three specialists he visited, the Philips machine “destroyed the walls of his lungs.”
  • Dr. Radhika S. Breaden, the sleep doctor profiled in the film, shared her anger over the scandal. In part she’s angry for her patients who are suffering, but she openly speaks of the trust her patients have lost in her. “When I prescribed CPAP, I thought I was prescribing air. My name is on those CPAP machine prescriptions, and there was nothing I was ever given to say to patients, ‘Yes, you’re getting air, but these are the risks.”
  • When it comes to getting a replacement machine – which Philips promised to provide – the patients are stuck in a Kafkaesque labyrinth of corporate idiocy. They go online and submit requests, they’re told their case file isn’t found in Philips’s systems, calling gets them nowhere. Some of these patients say they have been waiting literally years for their replacement machine; others say their replacement machine doesn’t work. Others end up using old machines they have on hand that – ta-da! – also have recall notices.

What’s most unfortunate is how many people suffering from sleep apnea labor under the belief that they have no other alternative besides the CPAP. “If your two choices are not breathing at night and getting terrible sleep and falling asleep talking to a patient in the afternoon or driving home at 5 o’clock at night, or risking toxic chemical exposure, it’s an impossible choice.”

No. These are not your only choices. Contact us today to learn more about our CPAP-free treatment options.

Source: How Patients and Doctors Are Navigating the Fallout of the Massive Recall of Philips Breathing Machines (ProPublica)

Many people end up reaching out to us to get tested for obstructive sleep apnea because they’re experiencing the hallmark symptom of the condition: chronic snoring. But there are other lesser-known symptoms that can be signs that you’re one of the tens of millions also suffering from the condition. Here are five unusual symptoms that could be indicative of obstructive sleep apnea:

  1. Night sweats. While various factors can cause night sweats, research indicates that about 30% of people with OSA experience this symptom. The body’s lack of oxygen during OSA triggers a sympathetic fight-or-flight response, leading to night sweats.
  2. Frequent awakenings. Nocturia, or waking up at least twice a night to urinate, is commonly associated with OSA. Addressing the sleep disorder can reduce these nighttime awakenings.
  3. Teeth grinding. Known as bruxism, grinding or clenching teeth during sleep may be linked to OSA. The theory suggests that blocked airways prompt mouth and jaw muscles to move, causing teeth grinding. This can lead to temporomandibular joint dysfunction and headaches.
  4. Morning headaches. Studies have found a connection between OSA and waking up with daily or frequent headaches. The cause is not well-established but may be multifactorial, manifesting as a pressing sensation on both sides of the forehead.
  5. Depression, fatigue, and insomnia. OSA symptoms can mimic mental health issues such as depression, fatigue, and insomnia. Sleep disruption may lead to difficulties in thinking, reacting, remembering, and problem-solving, affecting both men and women, although women may underreport atypical symptoms.

If you or a loved one exhibits any of these signs, it’s crucial to seek professional help. Untreated obstructive sleep apnea not only affects the quality of sleep but also poses serious health risks, including hypertension, heart disease, type 2 diabetes, and depression. Don’t let the silence of the night mask a potentially life-threatening condition.

Source: Five weird signs of sleep apnea (CNN)

Attention-deficit hyperactivity disorder is the bane of many parents nowadays, and the subject of a lot of debate. Some believe that the inattentiveness and impulsivity that are characteristic of ADHD is simply behavior within the range of normal restlessness on the part of highly energetic kids. Others say that it’s a genuine neurological disorder requiring some level of clinical and/or pharmaceutical intervention.

But what if some number of cases are neither? What if, in some cases, sleep apnea is masquerading as ADHD? Consider the following example. In the spring of 2010, a patient walked into a doctor’s office reporting problems with procrastination, forgetfulness, and an inability to consistently pay attention – in short, a textbook case of ADHD. The twist was that all the symptoms had only surfaced two years earlier at the age of 31, contrary to the usual childhood onset associated with ADHD.

In time, the patient was found to be suffering from a chronic sleep deficit. (His troubles began when he took on a job that required him to wake up at 5 a.m., conflicting with his natural inclination as a night owl.) Once the patient’s sleep schedule was properly addressed, his symptoms almost vanished within two weeks.

Well, this is all fine and good, particularly for an adult who only began experiencing the ADHD-like symptoms well into adulthood. But this misdiagnosis prompts a closer look at the relationship between sleep and ADHD, challenging the conventional understanding of these conditions. Consider:

  • Research indicates that a significant number of children diagnosed with ADHD also experience sleep-disordered breathing, such as apnea or snoring, restless leg syndrome, or non-restorative sleep. A 2004 study published in the journal Sleep found that children with ADHD displayed a deficit of delta sleep, a deep, rejuvenating sleep crucial for growth and development.
  • A 2006 study in the journal Pediatrics revealed that children scheduled for tonsillectomies due to sleep-breathing problems showed a higher incidence of ADHD compared to a control group. Remarkably, a year after the surgery, half of the children who initially met the criteria for ADHD no longer did. This suggests that what appeared to be ADHD was, in fact, resolved by treating a sleeping problem.
  • While the focus on sleep and ADHD is more prominent in childhood, adults with ADHD exhibit similar sleep dysfunctions. Research from Massachusetts General Hospital draws parallels between sleep issues in adults and children with ADHD. A study published in the journal Nature Neuroscience indicates a correlation between the amount of delta sleep in seniors and memory test performance, reinforcing the significance of quality sleep across all age groups.

None of this should be interpreted to claim that ADHD isn’t an actual condition, or that some (or even most!) of the people who are diagnosed with it wouldn’t benefit from the right kind of clinical or pharmaceutical treatment. But before reflexively going for a prescription, it might be worth looking to see if your kiddo isn’t simply suffering from a sleep disorder such as pediatric sleep apnea. Giving a sleep-deprived kid some meds to keep them focused seems like cruel and unusual punishment.

Source: Diagnosing the Wrong Deficit (NYT)

In a recent blog post, we shared how an upcoming smart watch from Samsung will include sleep apnea detection technology. As it happens, Samsung isn’t the only industry player getting in on the game.

Google rolled out a range of new sensors in its Pixel Watch 2 in June. It included a range of software features normally found in Fitbit – which Google acquired in 2019 – but also a blood oxygen saturation sensor, which can help detect sleep apnea.

Now Apple is launching its response to these Android-driven devices with the 10th anniversary model of the Apple Watch. The tech giant is including a range of health-centric features on the new iteration of its wearable, including blood pressure monitoring, hypertension monitoring and sleep apnea detection.

As Apple’s wearable technology nears its tenth anniversary, it’s worth pointing out that wearables are hitting a new level of maturity that should be of interest to users with even passive interest in health and wellness. If you’re looking for ways to better monitor your health, you have a number of options within reach at different price points.

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Jet lag can turn your world upside down, especially after an exciting trip to a different time zone. Your body’s internal clock might need some time to catch up, making you feel sleepy at odd hours and out of sync. But crossing time zones doesn’t have to mean signing up for a wrecked sleeping schedule. Here are some ways to make the transition smoother and minimize the effects of jet lag.

  1. Understand your body’s clock. Our bodies run on a 24-hour cycle called the circadian rhythm, which is influenced by light. When we travel across time zones, our internal clock struggles to adjust quickly, causing jet lag.
  2. Look into melatonin supplements. Melatonin is a hormone that helps regulate sleep. Some travelers find melatonin supplements helpful in adjusting to a new time zone. However, always consult a healthcare provider before taking any medication.
  3. Modify your light exposure. Light is a powerful tool in resetting your internal clock. Use apps or websites that create a sleep schedule based on your travel itinerary. They’ll guide you on when to expose yourself to light and when to wind down.
  4. Modify your eating schedule. Consider a 12-to-16-hour fast before and during your flight. This fasting technique may help reset your internal clock. Also, be mindful of what you eat, especially right before bed.
  5. Relax and unwind. If sleep is elusive, engage in calming activities like reading or meditating. Avoid stimulating activities or bright screens that might keep you awake.
  6. Address your mental health as much as possible. During the adjustment period, practice self-care and healthy habits. Stressing over jet lag can worsen the situation, so take it easy and allow your body to adapt naturally.

Jet lag can be a hassle, but it doesn’t have to ruin your trip so long as you prepare ahead of time.

Wearable electronics have become more commonplace over the past six or seven years. Now one major electronics manufacturer is launching a feature in its product line that may achieve early detection of obstructive sleep apnea.

Samsung recently announced an upcoming sleep apnea detection feature in the Samsung Health Monitor app for the company’s Galaxy Watch line of smart watches. Set for launch in early 2024, this new feature is designed to spot sleep apnea symptoms in their early stages, allowing for timely intervention and better management of this serious medical condition.

Samsung’s new sleep apnea feature utilizes the Galaxy Watch’s BioActive Sensor to monitor blood oxygen levels during sleep. By analyzing how the blood oxygen values change in response to apnea/hypopnea, the device estimates the Apnea-Hypopnea Index (AHI), a critical measure to assess the severity of sleep apnea. Users will be prompted to track their sleep at least twice, with each session lasting over four hours within a ten-day period to gauge the presence of sleep apnea symptoms.

This cutting-edge sleep apnea detection feature is a significant addition to the existing health monitoring capabilities of the Samsung Health Monitor app, which already includes blood pressure monitoring, electrocardiogram (ECG) detection, and irregular heart rhythm notification (IHRN). By integrating these features into the Galaxy Watch series, Samsung aims to provide users with a comprehensive understanding of their overall health right from their wrist.

Now for the bad news: Samsung will initially be rolling out this new feature only in its home country of South Korea. However, given the availability of other health-related sensors in numerous markets – not to mention Samsung’s status as one of the world’s largest consumer technology manufacturers – it’s a safe bet that the company will offer the functionality in the U.S. in fairly short order. (It’s worth pointing out that the announcement of the feature was made available in English, and that the announcement included information gleaned from American medical institutions.)

In the meantime, if you’re concerned that you’re suffering from sleep apnea, there’s no need to wait – contact us today for an at-home sleep study.

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The CPAP has been the most frequent form of treatment for obstructive sleep apnea for many years. Unfortunately, for a variety of reasons, the CPAP doesn’t work for many people. But researchers may have discovered an alternative involving electrical stimulation.

Transcutaneous electrical neurostimulators (or TENS machines) are devices that deliver low levels of electrical currents directly on the skin through adhesive patches. These electrical currents serve in place of neurological stimulation to keep muscles firing. While TENS machines have been used for years to treat pain and muscle spasms, researchers have begun to test the effectiveness of TENS machines to treat obstructive sleep apnea.

Sleep apnea is generally caused by obstructions in the airway due to the soft palate and other portions of the throat to obstruct air flow. Research believed that using electrical stimulation on the throat to target specific muscles might help keep the airway open during sleep. They found that patients who used TENS machines while sleeping experienced a significant reduction in their AHI (apnea-hypopnea index) decreased, which means they had fewer pauses in their breathing during sleep. The study also showed that patients who used the TENS machine had improvements in their sleepiness levels, meaning that they felt more awake and alert during the day.

This could be good news for patients who have trouble using the CPAP. The TENS unit only involves using adhesive patches applied in strategic locations on the neck, with no need for a mask. The TENS also doesn’t require a separate machine for cleaning like the CPAP.

It does have some drawbacks. The TENS machine did cause skin irritation and headaches with some patients, and like the CPAP, it also requires access to electricity, so it does carry some of the same limitations.

But overall, this new approach to treating OSA could end up being a promising development in the field of sleep medicine. It offers hope for those who struggle with traditional treatments and provides a potential option for managing OSA symptoms.

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Doctors and scientists have known for a long time that a pregnant woman having trouble breathing during sleep can cause complications. But figuring out how it affects the new babies has been a bit tricky. Now, a new study in the American Journal of Perinatology has given us some important clues.

Researchers led by Dr. Arlin Delgado from the University of South Florida looked at the sleep patterns of over 2,100 pregnant women. They measured if these moms had trouble breathing during sleep, like snoring or sleep apnea. Specifically, they used the apnea-hypopnea index to identify which women were experiencing sleep-disordered breathing, meaning they had five or more apneic episodes (complete cessation of breathing) or hypopneas (slowed breathing).

They then watched the babies after they were born to see if they had any health issues. And the results are interesting:

Ultimately, researchers found that babies born to mothers who showed signs of sleep-disordered breathing in early pregnancy shared a similarly low risk of adverse health outcomes to those whose mothers showed no signs of SDB. Meanwhile, babies born to moms who developed sleep-disordered breathing mid-pregnancy had a 42 percent higher risk of adverse health outcomes and neonatal death.

Bottom line: suffering from sleep apnea while pregnant can be risky, but developing it midway through pregnancy is especially dangerous for the baby.

If you’re pregnant and you think you might be experiencing obstructive sleep apnea, contact us to discuss a sleep study.

Source: How Sleep Apnea and Snoring During Pregnancy Might Affect Newborns’ Health: New Research (Sleepopolis)