Recovery From Trauma, Grief and Loss; A Practical Approach
As a follow-up to my blog, I have written an e-book titled "Recovery From Trauma, Grief and Loss; A Practical Approach". This book goes even deeper than my blog and relates my experience back to the stages of loss and grief and the 3 criteria necessary for a successful recovery. If you like my blog, I know you'll appreciate my book.
Here is a short description of my book:
This e-book is based on Diane's personal journey of healing and self re-discovery. Her dental and facial trauma began in 2004 and climaxed in 2012 with a 10 hour bilateral Temporomandibular Joint (TMJ) Replacement surgery. Diane leads you through a series of steps, the same steps that she followed in her journey to recovery and answers the important question… How did she get through it all.
To purchase my ebook, please go to: https://www.smashwords.com/books/view/327616
Or you can send $1.99 by Paypal to: [email protected] and I will email you a copy in the format of your choice. My book is also available thru Barnes & Noble, Sony, and Apple. The monies received from the purchase of my e-book will go towards publishing costs andblog costs so that I may continue to help others in the future.
The next good news is that I have already started writing my second book. The next book will be titled "Recovery from Trauma, Grief and Loss; a HEALTHY Approach.
Here is a short description of my book:
This e-book is based on Diane's personal journey of healing and self re-discovery. Her dental and facial trauma began in 2004 and climaxed in 2012 with a 10 hour bilateral Temporomandibular Joint (TMJ) Replacement surgery. Diane leads you through a series of steps, the same steps that she followed in her journey to recovery and answers the important question… How did she get through it all.
To purchase my ebook, please go to: https://www.smashwords.com/books/view/327616
Or you can send $1.99 by Paypal to: [email protected] and I will email you a copy in the format of your choice. My book is also available thru Barnes & Noble, Sony, and Apple. The monies received from the purchase of my e-book will go towards publishing costs andblog costs so that I may continue to help others in the future.
The next good news is that I have already started writing my second book. The next book will be titled "Recovery from Trauma, Grief and Loss; a HEALTHY Approach.
About My Surgeon - DR. DAVID PSUTKA
My surgeon is Dr. David Psutka from Ontario Canada. He has a practice in Mississauga Ontario and is affiliated with the TMJ Clinic at Mount Sinai Hospital in Toronto Ontario Canada. Together, Drs. Baker and Psutka run the largest center of its kind in Canada; there is one smaller centre in Alberta. They perform about 35 prosthetic TMJ replacements on about 22 Ontario patients annually, with additional patients arriving from outside the province who are funded separately. They also train foreign surgeons in the procedure. The surgery typically takes eight to 10 hours for a "bilateral" replacement - replacement of both joints in the jaw. Patients normally spend three or four days in hospital, then go home for post-operative care that includes "exercise, exercise, exercise," says Dr. Baker. (Taken from http://www.medec.org/content/temporomandibular-joint-replacement)
Questions & Answers With Dr. Psutka
NOTE: The answers to these questions are comprised of interviews with Dr. Psutka and other information that I've acquired on-line and from TMJ Forums and my contain my interpretation or understanding of the answers. The figures or percentages are estimates and are reasonable approximations for reference purposes only. Hopefully it will provide you with some enlightenment on the subject.
How many of these surgeries have you done?
Dr. Psutka and Dr. Baker have performed TMJ replacement surgery on approximately 780 joints as of year end 2011. More than half of these were performed by Dr. Psutka.
Should I be patch tested for allergy to the material because I have a lot of allergies?
No. I already have dental implants and metal in my mouth and I've had no problem, so I should not have any problems with allergies. Dr. Psutka has not had anyone will allergies to the posthesis.
How long will the prosthesis last before I have to have another surgery?
It is unkown. There is not enough data in order to provide an answer to this question, as this surgery is still very new. Currently, there are people who have had the prosthesis for 14 years. Therefore, you can hope to have the prosthetic for atleast 14 years.
How many screws do you put in?
Approximately 4-5 on the top and 5-7 on the bottom, per side.
The brochure says that you shouldn’t have this surgery if you have bruxism. I have bruxism and will get a mouthguard made by Dr. Glazer. Is this a concern?
No. "All my patients have bruxism".
What results should I expect?
The surgery will help to restore jaw functionality, but it may not necessarily eliminate my pain. I should hope to move my jaw better, restore my bite and increase my range of motion.
Will the surgery relieve my jaw pain? I’ve read that this surgery is a procedure of last resort that is not meant for pain relief. (Severe pain in left side, mild-moderate in right)
The following statement appears on my web-sites: 'You might need a ‘TJR’ if you have severe, late-stage degenerative changes within the joint that have caused loss of function and/or severe pain. Replacing the joint is intended to restore the functional properties of the TMJ only.This means that for many patients, it is a procedure of last resort that is not meant for pain relief. It is very important to understand that the goal of any TMJ total joint replacement procedure is not pain relief. Many patients deal with several types of pain (bone, muscle, nerve) when managing this condition. A replacement surgery only replaces the bone.'Approximately 85% do not have a complete reduction in pain.
What is the percentage of complications you’ve encountered and what are the complications?
Some complications are, but not limited to, more pain, infection, bleeding, numbness (common - permanent & temporary), weak forehead, inability to close eyelids, bite shift etc.
Have you ever had to remove the prosthesis afterwards due to complications?
Not immediately after surgery, but some prosthesis (5%) have been removed later on due to infection or growth of bone or scar tissue around the joint.
Will the way my face looks change?
No.
How long will surgery take?
Approximately 8 to 10 hours for bilateral TMJ replacement.
Does another surgeon assist you with the surgery?
No, but my interns assist me.
Are the fixation wires left in place after surgery?
My jaw will be wired shut at the start of the surgery and the fixation wires/screws should be removed once surgery is completed, before I wake up. However, there are times when the fixation wires/screws need to be left in place for a few days or month(s) to adjust the bite.
Will you need to remove any facial muscles?
No facial muscles are removed. They are detached and then re-attached.
How long will I be in the hospital?
Approximately 3 to 5 days. For example, In Tuesday, out Thursday.
How much pain will I be in after surgery?
I will be given plenty of meds!
How long is the entire recovery process?
"Months!"
Will I need to do physiotherapy?
Yes, but it is done by myself at home using an exercise contraption called "Therabite". if you reside in Ontario Canada, it can be purchased from Ontario Home Health at 1-866-964-5984.
How long before I will be able to open my mouth?
I should be able to open my mouth immediately approximately one finger. The key is exercise, exercise, exercise with the Therabite immediately!!
For more information about the surgery, risks, potential outcome etc., please refer to the following:
My surgeon is Dr. David Psutka from Ontario Canada. He has a practice in Mississauga Ontario and is affiliated with the TMJ Clinic at Mount Sinai Hospital in Toronto Ontario Canada. Together, Drs. Baker and Psutka run the largest center of its kind in Canada; there is one smaller centre in Alberta. They perform about 35 prosthetic TMJ replacements on about 22 Ontario patients annually, with additional patients arriving from outside the province who are funded separately. They also train foreign surgeons in the procedure. The surgery typically takes eight to 10 hours for a "bilateral" replacement - replacement of both joints in the jaw. Patients normally spend three or four days in hospital, then go home for post-operative care that includes "exercise, exercise, exercise," says Dr. Baker. (Taken from http://www.medec.org/content/temporomandibular-joint-replacement)
Questions & Answers With Dr. Psutka
NOTE: The answers to these questions are comprised of interviews with Dr. Psutka and other information that I've acquired on-line and from TMJ Forums and my contain my interpretation or understanding of the answers. The figures or percentages are estimates and are reasonable approximations for reference purposes only. Hopefully it will provide you with some enlightenment on the subject.
How many of these surgeries have you done?
Dr. Psutka and Dr. Baker have performed TMJ replacement surgery on approximately 780 joints as of year end 2011. More than half of these were performed by Dr. Psutka.
Should I be patch tested for allergy to the material because I have a lot of allergies?
No. I already have dental implants and metal in my mouth and I've had no problem, so I should not have any problems with allergies. Dr. Psutka has not had anyone will allergies to the posthesis.
How long will the prosthesis last before I have to have another surgery?
It is unkown. There is not enough data in order to provide an answer to this question, as this surgery is still very new. Currently, there are people who have had the prosthesis for 14 years. Therefore, you can hope to have the prosthetic for atleast 14 years.
How many screws do you put in?
Approximately 4-5 on the top and 5-7 on the bottom, per side.
The brochure says that you shouldn’t have this surgery if you have bruxism. I have bruxism and will get a mouthguard made by Dr. Glazer. Is this a concern?
No. "All my patients have bruxism".
What results should I expect?
The surgery will help to restore jaw functionality, but it may not necessarily eliminate my pain. I should hope to move my jaw better, restore my bite and increase my range of motion.
Will the surgery relieve my jaw pain? I’ve read that this surgery is a procedure of last resort that is not meant for pain relief. (Severe pain in left side, mild-moderate in right)
The following statement appears on my web-sites: 'You might need a ‘TJR’ if you have severe, late-stage degenerative changes within the joint that have caused loss of function and/or severe pain. Replacing the joint is intended to restore the functional properties of the TMJ only.This means that for many patients, it is a procedure of last resort that is not meant for pain relief. It is very important to understand that the goal of any TMJ total joint replacement procedure is not pain relief. Many patients deal with several types of pain (bone, muscle, nerve) when managing this condition. A replacement surgery only replaces the bone.'Approximately 85% do not have a complete reduction in pain.
What is the percentage of complications you’ve encountered and what are the complications?
Some complications are, but not limited to, more pain, infection, bleeding, numbness (common - permanent & temporary), weak forehead, inability to close eyelids, bite shift etc.
Have you ever had to remove the prosthesis afterwards due to complications?
Not immediately after surgery, but some prosthesis (5%) have been removed later on due to infection or growth of bone or scar tissue around the joint.
Will the way my face looks change?
No.
How long will surgery take?
Approximately 8 to 10 hours for bilateral TMJ replacement.
Does another surgeon assist you with the surgery?
No, but my interns assist me.
Are the fixation wires left in place after surgery?
My jaw will be wired shut at the start of the surgery and the fixation wires/screws should be removed once surgery is completed, before I wake up. However, there are times when the fixation wires/screws need to be left in place for a few days or month(s) to adjust the bite.
Will you need to remove any facial muscles?
No facial muscles are removed. They are detached and then re-attached.
How long will I be in the hospital?
Approximately 3 to 5 days. For example, In Tuesday, out Thursday.
How much pain will I be in after surgery?
I will be given plenty of meds!
How long is the entire recovery process?
"Months!"
Will I need to do physiotherapy?
Yes, but it is done by myself at home using an exercise contraption called "Therabite". if you reside in Ontario Canada, it can be purchased from Ontario Home Health at 1-866-964-5984.
How long before I will be able to open my mouth?
I should be able to open my mouth immediately approximately one finger. The key is exercise, exercise, exercise with the Therabite immediately!!
For more information about the surgery, risks, potential outcome etc., please refer to the following:
- Lorenz Stock by Biomet Microfixation: http://biometmicrofixation.com/downloads/BMF-7014%20TMJBro%20(d)4Final.pdf (See picture below)
- W. Lorenz Total TMJ Replacement System Patient Information http://www.fda.gov/ohrms/dockets/ac/02/briefing/3889b1_tmj%20patient%20information%20final.pdf
- TMJ Concepts: http://www.tmjconcepts.com/patbro.html