More Alternative Therapy: Part 2 – a Scattering of Needles

…As soon as he entered the room, the practitioner began to work on my neck. It felt like he was using his fists; starting from my collar bone and then rubbing them up my neck with vigorous force. My skin began to burn from the friction, and the procedure felt like it would have been more relaxing and pleasant, had it been performed with massage oil. After about 10 minutes of the neck burning massage, the practitioner began to slowly push down on my head, encouraging it to bend towards each shoulder. I couldn’t believe how far I was able to stretch. It was as though the stinging massage had loosened all the tension in my neck.

The practitioner then walked away from the massage table and when he reapproached I could see him putting on some blue latex surgical gloves. He asked me to open my mouth. He then inserted his index finger inside my mouth and started to press gently inside my cheek. His thumb pressed lightly through the outside of my cheek so that it met with his index finger. He massaged using a pressing motion, and in small circular movements. He mumbled something about the temporomandibular joint (TMJ). This massage lasted a few minutes and was repeated on the other side of my face.

Again the practitioner moved away from where I was lying. This time he exited the room. After a few minutes he returned, and whilst leaning over me he announced, in a matter-of-fact tone, “Acupuncture”. Oh, I wasn’t expecting that! I had never had acupuncture before. I asked if it was going to hurt. He assured me that it wouldn’t. He swiftly placed the needles in different points around my jaw, forehead, and the top of my head and my collarbone. The needles felt like they were being elegantly scattered in to place. The majority of the needles glided into my skin, with ease, and caused only a slight sensation of my skin being pricked. But, the insertion of a needle in the part of my jaw below my ear, where it forms an angle to make my chin, caused immediate and intense pain. A tender soreness radiated deep into my jaw. I was in pain, I exclaimed and alerted the practitioner to the offending needle. He responded saying, “Oh, yes that one will hurt!” I was asked to continue to lie still for 20 minutes. I heard the sound of the door close as the practitioner left the room, and I was left listening to the soft jazz and wondering how many needles were in my face, and what I looked like.

After about 10 minutes a woman, who I hadn’t yet met, entered the room. She greeted me with a jolly sounding, “Hola” and told me as she was turning the needles slightly, that she was there to do just that. A few seconds later she left the room. I was again left lying motionless on the massage table, listening to the soft jazz.

Another 10 minutes passed and again the door opened. I could see from my lying position that it was the same woman who had turned the needles, who was now entering the room. She swiftly collected the needles from my face and neck, with the ease in which they had been placed.

This new practitioner was a comical woman. She told me that she was a nutritionist and she spoke to me about my diet. She presented me with a list of suggestions for a healthy diet, that she told me she had spent time translating from Spanish to English, and to excuse any unusual translations; blaming Google Translate for such errors. The focus of the diet was on eliminating animal products, dairy, and sugar. I was amused by the Spanish theme of the diet. I was allowed a typical ‘Spanish breakfast’ consisting of toasted soda bread with crushed tomato and olive oil; this was something I assumed the Spanish clients would refuse to abstain from. Chorizo and sugary products from the Pastelería (bakery) were ‘prohibited’. I started to think about the foods I liked. Hmm, there was no mention of Marmite or PG Tips tea…There was also a list of suggestions for dietary supplements including Vitamin C powder, Omega 3, a B vitamin complex and Magnesium.

Next, I was asked again to sit opposite the mirror and she began to explain some exercises, which I would need to carry out three times a day. She laughed each time before beginning her explanation and demonstration. Maybe she was unsure of her translation. Maybe she found it humorous to watch our reflections as we performed the exercises together, which involved contorting our faces into different shapes, putting our tongues in different positions, and making clicking sounds with our tongues on the roof of our mouths.  These exercises I would most definitely be performing at home, in private!

And so my experience of the craniofacial rehabilitation concluded.  I liked the holistic approach. I would continue to attend appointments every week in the hope that some of the pressure in my ear could be reduced…

More Alternative Therapy: Part 1 – Skin Popping Included!

My consultation with the maxillofacial doctor, which by this time was 6 weeks previous, had concluded with her recommending some treatments for me to try. One of her recommendations was that I embark upon some craniofacial rehabilitation. This is a form of physiotherapy that can help temporomandibular (TMJ) (jaw joint) disorders, by using a variety of methods; understanding the relationship between the neck and shoulders, and the head and the TMJ.

This would be yet another alternative method I would try, to see if the pressure in my ear could be reduced, by addressing issues with my jaw. At this point in my story, I was continuing to see my chiropractor, who was also doing jaw adjustments. I was also wearing my new night guard to help with my teeth clenching and grinding, whilst sleeping. Maybe this new therapy would complement the other things I was trying.

I had come to terms with the fact that the hearing in my left ear wasn’t going to return, and I was developing strategies to manage my life with unilateral hearing. However, I wasn’t prepared to accept that I would have to live the rest of my life with the constant discomfort of the feeling of pressure in my ears. The doctors had been unable to provide me with any medical-based relief, and so there was nothing to lose by seeking alternative help.

I arrived at the clinic on a Tuesday morning in May, and quickly found myself sitting in yet another waiting room. It was early in the day and I was the first person waiting. The clinic had a clean feel to it. There were white walls, and a light coloured wooden floor. In front of where I was sitting was a light wooden coffee table, with a white candle placed in the middle. Also on the table was a small metal tray in which sat an ornament of a Buddha, alongside some incense sticks. On the wall opposite me was a circular logo, with an outline of a head pictured sideways-on. Above the head, were the words ‘Integrative Craniofacial therapy’. To the right of me, hung a small print of one of Picasso’s paintings; adding a slight touch of lively colour to the otherwise sterile-white wall. Around the room were a variety of different sized leafy pot plants; some small, and perched on top of shelves, and some bigger and nestling into the corners of the building. The feeling of serenity was complete when the music speakers were turned on; initiating the low and warm tones of Nina Simone singing jazz, that floated around the clinic.

First I met the main specialist. I immediately recognized him from the website, and I believe it was he who had originally set up the practice. He asked lots of questions. This initial meeting was conducted at a swift pace and with seemingly professional efficiency. He asked me questions about my general health, my diet, whether I was stressed, and about my sleeping patterns. He didn’t seem surprised when I told him about my sudden hearing loss. He scribbled down notes in scrawled handwriting. He felt around my neck and jaw and asked me to open and close my mouth a few times. He said I have issues with my TMJ muscle. He then took me to the room adjacent, where I met another practitioner, this time a woman.

The woman spoke in English and gave me a lot of explanation about what my treatment would consist of. She explained how first she would work on my lower back, and then gradually work upwards towards my neck and face. She began by massaging outwards from my spine. I sat in my underwear, on the edge of a massage table in front of a mirror. I watched as she worked her way up to between my shoulder blades. The therapist was very friendly and seemed to be using her time with me as an opportunity to practise her English speaking skills; which I was very happy about, as it meant that I was able to relax and forget any language-based stress. Whilst I was gazing into the mirror, focusing on nothing in particular, she told me she could see (without touching me) that there was inflammation on the left side of my jaw. I glanced up and looked at my face in the mirror. I could see the inflammation too. I had seen it in my reflection since the day I’d lost my hearing. Yet I couldn’t recall if there had been swelling there before my hearing loss.

I was then asked to lie down on my stomach, on the massage table. She started pulling at my skin around the base of my spine. As she pulled there was an occasional loud popping sound. This was a new experience that no amount of massages enjoyed and endured whilst living in Thailand could have prepared me for. It was quite a painful and uncomfortable experience, yet was also quite satisfying – like tension was being forced away from my back with every pop. The practitioner explained that she was releasing my skin from the bone.

I asked the practitioner if she’d ever seen anyone who’d suddenly lost their hearing. She said she had. She said she had seen people with all sorts of problems: problems with facial muscles, problems with senses, neck problems etc… The walls around the small massage room were decorated with posters. The posters were diagrams of the mouth and teeth. The posters showed the connection between the ears, nose and throat. The posters showed how issues with the neck can affect other parts of the body and face. Hmm, these were all familiar issues.

I then asked the practitioner more directly if she thought my jaw problems could be connected to my hearing loss. She immediately replied, “Yes”, as though it was a question that didn’t require any thinking time to answer. She then quickly added, “But obviously I don’t know what’s going on inside the ear…” When I told her that my MRI scan results had been normal, that there was no virus, that my blood tests had been normal, and that the doctors couldn’t explain my hearing loss, she said, “Well, if they don’t know, then 99 per cent I think it could be connected to your jaw.” She also mentioned some other possible attributing factors including stress, serotonin levels, and hormones.

After about half an hour of massage, the woman left the room and the original guy returned…

Dentist Mission: Part 2

… A few days after my first Spanish dentist experience, I was back in the brown waiting room, waiting to be seen by the little dentist.

When I entered the dentist’s room, he greeted me again with a muffle. His younger assistant was also present and looked keen to begin part 2 of my dentist journey. I had thought that maybe my mouth guard would be ready, but I was told they needed to take some more measurements before making it, in order to make sure it would fit my mouth properly.

The measurements were extensive. First I had to sit with a small cotton roll between my front teeth, and I was told not to close my mouth. I didn’t quite understand why I was doing this – something to do with my jaw muscles. I was accustomed to doing things by now, just because I’d been asked to, blindly obeying specialists’ instructions, unsure of what they were doing or why. I sat for some time with what was basically a small tampon between my teeth! My jaw muscles started to spasm, and my teeth felt like they were shaking.

The dentist melted some small pieces of blue mould in a metal heating basin. The basin was the size of a tissue box and was filled with what I assumed was water. This blue mould was different from the pink putty which had been used previously to take impressions of my teeth, and was instead a soft plastic-type material with a texture similar to toffee. Imprints of my front teeth and back teeth on both sides were taken one at a time, in three stages. During each stage, my translator gave me clumsy instructions in a mixture of American English and Spanish, as to what to do with my mouth. The blue hard gums were placed in my mouth and I had to bite down on them, and then cold water was sprayed from thin tubes into my mouth, followed by cold streams of air; to set the gums in shape. Next came more measurements.

I was asked to open my mouth as wide as possible, and a rectangular metal plate the width of my mouth was forcefully inserted so that it filled the whole of my mouth cavity. Attached to the plate was more gum-type substance, this time a red colour. An imprint of my teeth was made by me biting down onto the gums, and then the metal plate was removed. The next contraption featured stethoscope-style earplugs that I had to insert into my ears, whilst the dentist moved the attached metal arms of the device around to my forehead. He used a screwdriver to slightly tighten the arms in place. My entire head was encased inside these metal arms. Then came the finale. For the final measurement, I had to open wide again and the metal plate was again inserted. The earbuds and head-hugging metal armed contraption was also moved into place. I sat in the chair unable to move my mouth that was full of metal, and with my head imprisoned by the metallic arms. Yet another moment in my story of looking completely ridiculous! The buds were forced tightly into my ears and I bit down on the plate as they pushed it upwards. The dental technician lifted the ear part and the dentist used his screwdriver at the same time to tighten all the screws in the device. I couldn’t help but wonder if there was a more comfortable way of taking these measurements, such as using a laser… ‘Ya!’ I heard the dentist say – ‘finished’. I carefully removed the ear part of the facial device and handed it to the dentist, and he took the contraption to the side counter and wrote down all the measurements.

During my time sitting in the dentist chair, the dentist and the technician had been chatting continuously. It seemed like the younger of the two was trying to pursue a conversation about a trip he’d recently been on, whereas the older was intent on explaining the measurement procedures to him, step by step.

Oh, but they hadn’t finished. The doctor was concerned about my jaw. I hadn’t mentioned anything about my jaw to him, or the fact that I had suddenly lost my hearing nearly 8 months ago. They only knew that I was deaf in one ear and that I needed a new night guard. The dentist was explaining and gesturing to the younger, and was pointing to parts of my mouth as he mumbled insistently. I heard the Spanish word, ‘articulación’ – which I thought meant ‘movement’, but when I later translated it, I found it meant ‘joint’. The little dentist spent some time feeling my jaw joints again. He asked me to open and close my mouth, and to move my bottom jaw forward. He then asked his companion to stand opposite me and I had to smile widely at him as he observed me. I felt a bit like an animal in a zoo, or some kind of unusual specimen to be prodded and observed. I think they were talking about the deviation of my teeth and jaw. I hadn’t previously told them any information about the maxillofacial specialist in the hospital…maybe next time I would tell them more of my story. But at the moment I was impressed with how thorough they were being with their observations. The little dentist seemed interested in finding out more, and in trying to help me. He was obviously extremely knowledgeable in his specialism.

They would send my measurements to the laboratory so that my night guard could be made. I was to wait for them to call me and would return in about 10 days to have it fitted. They also wanted to do another x-ray of my jaw, which they described as a cross-section, so they could see what was ‘going on in there’. The dentist shook my hand, taking his mask off to say goodbye, and he gave me a friendly and almost a humble smile.

I ended up returning to the dentist before I received their phone call. About a week after I had been measured for my mouthguard, one of my back teeth broke, of course, it was on my left side. It had broken due to my teeth clenching – a clear sign I was in need of the mouth guard. This was also strong evidence of the amount of pressure I must have been putting on the left side of my face.

Let’s see if wearing a nightguard helps reduce some of the pressure in my ears…

Dentist Mission Part 1

I was sitting in a waiting room, waiting for an appointment to get a new night guard for my teeth. The type of mouthguard I needed was similar to the ones that boxers or rugby players wear to protect their teeth. This type of dental guard, however, is custom made, in order to fit individual mouths comfortably. I had been aware of grinding and clenching my teeth whilst sleeping, for at least 15 years, and had recently been waking up in the middle of the night with my teeth clenched tightly together. It was as though my subconscious was intervening and was now warning me when my teeth were engaged in this habit.

I already owned a mouth guard which I wore on my bottom teeth, and which had been made over 10 years ago, when I lived in England. I had worn this guard on and off for many years. In the past, when I went to the dentist, the only question I was ever asked about the guard was whether or not I had one. Nobody ever asked me how old it was. It had been expensive to have made, and I never thought about getting another one. It was only recently after my consultation with the Maxillofacial doctor; who seemed confounded that I had been using the same guard for over 10 years without having it adjusted, checked or replaced, that I realized perhaps I should get a new one. Of course, our faces change with age, as do or jaws and teeth.

The relationship between teeth grinding and clenching, and problems with the temporomandibular jaw joint (TMJ) causing problems with the ear are well documented. Curious that this connection was never mentioned by any of the many ear specialists I had consulted with. Typical symptoms of a TMJ disorder include ‘hearing loss, an earache, tinnitus, a sense of ear fullness, and vertigo’. Hmm, I had experienced all of these and continued to do so with all except vertigo. I had even read stories of people who had suffered a hearing loss, and then after wearing a night guard for some months, their hearing had gradually returned. I was not hoping for this kind of miracle, but I did have some optimism that a new night guard could help reduce some of the pressure I was feeling in my ears and my head; this being the most difficult of my symptoms to tolerate.

The dentist surgery was in an old-style apartment block. The waiting room felt as though it was probably once someone’s living room, many years ago. The room was square and dark padded sofa chairs lined three of the walls. There were no windows, and the walls were a plain dismal-cream colour. Around the bottom of the walls was dark brown skirting. There was a dark coffee table, situated in the space made between the chairs, with Spanish magazines arranged on top, in three piles. It was simply decorated, with two large framed pictures, one on each chair-lined wall. In the far corner, situated up high, near the entrance was a small box TV playing a Spanish soap opera with subtitles and low volume. As well as the low rumble from the TV, jingly-sounding elevator-style music attempted to liven up the atmosphere. The surgery had looked so clean and white on the photos on the website. This definitely did not resemble the sterile and shiny images that had been advertised.

The receptionist called me to her office to speak with her. She had a confident, sociable and easy-going attitude. I stumbled my way through the general health questions and she corrected my Spanish a few times, each time smiling with friendliness. She was the kind of person who made me feel like she immediately liked me. Perhaps it was the child-like Spanish I was speaking to her. For this appointment, I hadn’t prepared any Spanish phrases or helpful vocabulary. I had become accustomed to meeting new specialists, doctors and receptionists, and the taking of basic details didn’t feel too scary anymore. I then went to sit back in the waiting room.

Shortly I was greeted by the guy with whom I had spoken on the phone, who had given me an appointment within 45 minutes of me phoning. He was younger than me, and spoke to me in a mixture of Spanish and American-sounding English, as he led me to the dentist’s room. When I entered, I was met by a small old man, who was wearing a medical face mask, dentist overalls, glasses with magnifying mirrors attached, and whose bald head was covered in age spots. He muffled a greeting through his mask, and I wondered what he looked like under the medical disguise. He resembled a little mole, as he shuffled calmly around the room. He asked me why I was there and whether I had had a ‘ferula’ before. Ferula is the Spanish word for mouth guard – this was my new medical Spanish word of the day. He asked me to perform some jaw movements as he felt around my head and under my jawline. He also examined my teeth. He mumbled constantly into his face mask, directing his speech towards his companion. I could only hear and understand a little of what he was saying. The younger dental technician spoke to me in his broken American English and explained that they would need to do an X-ray to make sure the night guard would fit properly, and then they would be able to do the moulds of my teeth. After that, the dentist left the room, and that was the last time I saw him during this appointment. The dental technician took me to a room to have the X-ray. Later he filled my mouth with pink putty to form the moulds, chatting happily at me whilst my mouth was unable to move. I would return the following week…

Underground Scanning

Back to my story…

Two weeks after my consultation with the Maxillofacial doctor, I went for a bone scintigraphy scan. The scan was to be performed in the basement of the hospital. I walked down some red painted steps into a concealed underground hospital corridor. It was a world of large metal pipes and echoes. Since the scan involved radiation, I guess it was to be performed in an isolated area to protect other patients. The first step of the scanning procedure was an injection of radioactive dye. I was then asked to wait in a room with around twenty other people. The room was square and painted a tired off-white colour. At the entrance to the room were two toilets. There were no posters on the walls. The perimeters of the walls were lined with plastic chairs. In one corner was a table covered with a plastic table cloth and large bottles of water and plastic cups. I was told to drink at least 5 cups of water, and to use the toilet as much as I needed to. I had to wait for the dye to travel in my bloodstream around my body. I watched as people’s names were called. They were asked to go to the toilet, and then they would go out of the door of the waiting room for their scans. As time went on I watched as people started to become agitated with the long wait. One old man started to pace back and forth, leaning heavily on his walking stick. Another man positioned himself near the door, making himself very visible; seemingly hopeful to be the next person called. I waited for 5 hours.

The scan took about 20 minutes. The machine was white and resembled an MRI scanner. At one end of the machine, there was a ring doughnut-shaped compartment. Positioned at the entrance to the centre of the doughnut hole, was a long examination table that had a groove that ran through the middle of it. I was asked to lie down on the table. My body slotted into the groove. My head was supported with a pillow, and another pillow was placed under my knees. I was then wrapped up in a blanket, with my arms hugging my body, and a belt was fastened around me. I imagined that my blanket-swaddled body resembled a snug-fitting battery in a remote control battery compartment. The technologist positioned another part of the machine around my head, and then she went into a small room behind a glass screen and turned on the machine. The robotic arms of the machine rotated slowly around my head, making loud clicking sounds. Next, the battery compartment started to move like a conveyor belt towards the entrance to the doughnut. I was transported inside the doughnut. I looked up and saw the top of the machine was only a few inches from my head. I focused my stare on a small area of the machine above my head, so as not to move, and to prevent my thoughts from drifting to the contemplation of my confinement. More loud clicks followed, and more images were taken.

About a week after I had the scan, I met again with the new ENT (Ears Nose and Throat) specialist. He said he was happy to see me looking well, and asked if I was back at work yet. In my previous consultation, he had been concerned about my well-being. I told him I hadn’t yet returned to work. He said I would have to try soon, but he was worried about me being in an environment with lots of noise, as he knew I’d find it difficult.

Then he changed the subject of discussion. He asked about my breathing; in particular, whether I had any difficulties due to my deviated septum. He asked whether I breathe through my nose or my mouth. I was asked to sit in a big black chair opposite his desk. He then performed a Fiberoptic Nasopharyngoscopy. This is an imaging technique, using a long thin black flexible wire with a light on the end, that is inserted into the nose. It can allow visualization of the nasal cavity, septum, and other structures. The specialist slowly fed the viewing tube down my good (right) nostril until I could feel it brushing past my throat. My eyes started to water involuntarily. I remained in rigid stillness. This was a procedure that one of the other specialists had done before, so I knew the level and type of discomfort I would experience. Then he removed the tube and started to insert it into my deviated (left) nostril. This I had never had done before. He got as far as the top of my nostril; the furthest area you can touch with your finger. Then he stopped. He said the nostril was completely blocked due to the deviation of my septum. But then, to my bewilderment, he continued to feed the tube into my nose; forcing it further down towards my throat. I was in extreme discomfort. My eyes continued to produce uncontrollable tears that streamed down my face. He carefully removed the tube. My body was shaking. The specialist told me that my left nostril was completely blocked. He said that I couldn’t breathe through this nostril – this I was obviously something I was aware of.

I then sat down again at his desk, more relaxed now, and he asked if I wanted to have an operation to correct my septum; that would help me breathe better. He said I would probably need the operation in the future anyway. I said I’d like to wait for the results of the jaw scan first, and then if everyone was OK with that, then I’d prefer to have the operation sooner rather than later. I thought it would be better to have an operation in the present, rather than in old age. Also, I’d like to be able to breathe better, especially when I’m trying to sleep. He said he thought this was a good plan. He said that correcting my breathing should help to make me feel more comfortable, and could possibly help with some of the stuffiness I was feeling in the left side of my head, since my hearing loss. I would meet him again in a month.

Two weeks after the bone scintigraphy I was back at the hospital for a consultation with a maxillofacial (jaw) specialist to get my results of the scan. I was going to find out whether I had Mandibular Condylar Hyperplasia (a rare bone disease that causes asymmetry of the face amongst other things). My boyfriend accompanied me for this appointment, as I was feeling nervous. The specialist explained that the results of the scan showed that I didn’t have the rare bone disease…Breathe…She said that it did, however, show deviation of my jaw. I was then led to the adjacent room where I sat in a dentist-style chair and she examined my jaw; asking me to open and close my mouth. She told me there was a problem with my jaw muscle. My boyfriend asked whether my problems with my ear could be related to my jaw issues. She answered discernibly carefully, saying that ‘the ear pressure could be associated with the jaw’. She wrote down recommendations of treatment for my jaw problems on a piece of paper for me:

  1. Go to a dentist and have a new nightguard made. This would protect my teeth and jaw muscles from night-time clenching.
  2. Try taking Robaxisal (a muscle relaxant) for 5-10 day cycles. The specialist felt my jaw was probably in spasm. This medicine could help release some of the tension.
  3. Seek treatment from a specialist in craniofacial rehabilitation  – this is a type of physiotherapy for the jaw.

…Next stop the dentist…