Chronic Pain Whatever the cause, support for managing long term or intractable pain.


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Old 12-05-2006, 04:49 AM #1
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Default suggestions please...

Hi all

I could use some suggestions about a situation with my doctors.

I have a symptom (numbness, tingling and muscle fatigue in my face).

My primary care doctor said to ask the neurologist and rheumatologist.

My Neurologist says it is stress/anxiety.
My Rheumatologist says it is stress/anxiety.

My psychairtist says it's not stress/anxiety.

Unfortunately, this psychaitrist is not a great as my old one - he will not give me a magic letter to bring to my other doctors to tell them "this is not stress".

So I am stuck in this loop - the body docs say it is all in my head. The head shrinking doc says it is a body thing not a head thing.

I honestly don't care if it is stress or body - I just want the symptom to get treatment of some sort. I tend to agree with the psychaitrist because the symptom does not change with my stress/anxiety levels.

How do I get out of this loop? Any wise words of wisdom or suggestions?

Thanks all,
Liz
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Old 12-05-2006, 07:11 AM #2
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Try an oral surgeon? Or maybe a dentist? Since it may have something to do with your jaw and or face, they may be able to help you.
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Enjoy when you can, and endure when you must. -- Goethe

Diagnoses: FM, Sciatica, Rosacea, Piriformis Syndrome, SI joint disfunction, Joint Facet Syndrome L3-L5, Pinched Nerve (somewhere on the left side), Depression, Anxiety and Bipolar II

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Old 12-05-2006, 10:39 AM #3
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((((((Liz)))))),

Cheese-and-crackers. I wish these doctors would GROW UP and get over themselves and get some bedside manner and STOP telling women it's all in their heads

I like that idea about the oral surgeon or the dentist.

I saw a show on one of the Discovery channels the other night -- little girl with horrendous cheek pain. Everyone was saying it COULDN'T BE trigeminal neuralgia 'cause children DON'T GET THAT. :WRONG:

I just had a thought, Liz. You're entitled to get a copy of ALL your records -- doctor's notes, x-ray results plus x-rays, MRI plus results. Could you ASK for a copy of all your doctor's clinical notes?? That would give you the written 'thingy' that you need to take to the other ones.

BIG HUGS.

Barb
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Old 12-05-2006, 10:36 PM #4
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Default Boy...do I hate that!!!

I would like to know how they know it is stress and anxiety without checking it??? Seems like an EMG should have been run. The physical should have been ruled out before accusing.
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Old 12-06-2006, 12:13 AM #5
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Thanks all.

I wish I could see a dentist or oral surgeon, but my insurance does not allow any type of dental - so if the doctors office does any type of work that concerns teeth it is not covered even if I am there for something that has nothing to do with teeth.

It's just so frustrating to have my facial muscles get so weak and useless. Thankfully the muscles involved are on my forehead and cheek area and not my mouth area. If this fatigue/weakness caused problems with my mouth I probably wouldn't be able to chew properly. Unfortunately, it does affect the muscles around my left eye, which causes my eye to go buggy when those muscles get so fatigued.... I have gotten used to watching TV and reading with my left eye closed so that the muscles can rest and not go buggy.

I see my primary care doctor later this week, and I really want to see what she says now. Last time she told me to talk to the specialists - and now I have done that and gotten nowhere, so maybe she will now step in and figure this out. She is very good, so I know she will do something, but I fear that her something will be to send me to another specialist -- which would mean waiting a few months for an appointment, and I don't want to wait anymore, I want my facial muscles to work properly now!

Anyway, sorry to babble, it's a bad habit

Thank you all for the suggestions and support.... I will let you know what the primary care doc says. Hopefully it will be good news of some sort.
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Old 12-06-2006, 08:02 AM #6
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Liz, sorry to hear that insurance won't cover a visit to the dentist or an oral surgeon.
Knowing about your primary doc, I am sure she will help you out. Darn, you are like me, everytime you turn around something else is happening to you.
Ah! The life of a CPer!
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Enjoy when you can, and endure when you must. -- Goethe

Diagnoses: FM, Sciatica, Rosacea, Piriformis Syndrome, SI joint disfunction, Joint Facet Syndrome L3-L5, Pinched Nerve (somewhere on the left side), Depression, Anxiety and Bipolar II

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Old 12-07-2006, 01:36 AM #7
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Ugh...

Primary care doctor is stumped.

It's getting annoying to be told that my medical history is interesting, and my test results are interesting, and it is all so "interesting".... I am learning that the medical community uses the word 'interesting' as a way to avoid saying 'I don't know what is wrong with you'
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Old 12-10-2006, 11:33 PM #8
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Default Just a thought,

Hi Wittsea,

I recognize your name from another forum where I have been a lurker for many years.

I was just wondering, would the weakness and pain in your face and jaw and teeth area be related to either grinding your teeth at night? or maybe it could be TMJ or what ever they are calling that temporomandibular joint disorder these days???

Is this a new symptom for you and does it have anything to do with your current pain management issue?

In doing some reseach, I found something called myofacial pain-dysfunction (MPD) syndrome. Most cases are a result from tension relieving jaw clenching or grinding habits, or a centrally generated increase in masticatory muscle tonus in response to stress. The ensuing muscle fatigue in turn induces spasms of the masticatory muscles. This sounds like what they are trying to attribute your symptoms too.

Diagnosis is based on clinical findings, the patient c/o unilateral, dull, aching, preauricular pain that radiates to the temporal region, tenderness in one or more muscles of mastication, jaw limitation, joint pain upon awakening. Since you don't have any issues with chewing, this seems to rule this dx out somewhat.

Degnerative arthritis can also cause these same symptoms so this must be ruled out.

X-rays of the area are usually normal although secondary degenerative changes are seen in the very late cases. Also arthritis can be dx by x-ray in this area.

I was wondering, do you have any swelling or discoloration in these areas that are bothering you?

Oh one more thought I had, there is something called mysthenia gravis. I believe I spelled that incorrectly but I know the main symptoms for that are facial weakness and I don't mean total weakness of the whole face, but weakness that is either one sided or are in a specific muscle areas.

You may have better luck going to an eye/ear/nose/throat doc since these symptoms are related to that area of your body.

I hope some of these ideas help although these may have already been suggested to you. I hope that I don't come across as a "know it all".

Its just in my line of work I have alot of experience with sypmtoms that cause pain and different ways of trying to relieve that pain.

No, I am not a Doc. I am an Rn of many years and I work in pharmacetical research which specializes in testing new pain medications. I don't actually develop the new pain meds, I test already developed "investigational" pain meds on subjects who have a variety of painful conditions. My job involves gathering info for the docs to dx the condition each subject has, then I actually dose the person with the experimental drug and record all the data including how well the med does or does not work as well as any potential side effects.

Although I have signed a confidentiality agreement where I can't talk about the drugs we are currently testing. I can say that for us folks that have to use pain management just to get through the day. I can tell you there are alot of new, wonderful things being tested out there and hopefully if they get passed by the FDA, we will have many more options for pain management.

Oops, I got a little off topic there, I hope they can figure out what the heck is going on and that it is an easy fix.

oh, by the way....I think docs use that"stress/anxiety dx when they haven't got a clue themselves!

Be Safe,

Satchelle
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Old 12-11-2006, 01:13 AM #9
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Hi Wittsea,

Just wanted you to know I'm thinking of you and hope your doc can come up with something to help you.
Take care,
Linda
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Old 12-12-2006, 12:40 AM #10
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Default Trigger Points

Quote:
Originally Posted by Wittesea View Post
Hi all

I could use some suggestions about a situation with my doctors.

I have a symptom (numbness, tingling and muscle fatigue in my face).

My primary care doctor said to ask the neurologist and rheumatologist.

My Neurologist says it is stress/anxiety.
My Rheumatologist says it is stress/anxiety.

My psychairtist says it's not stress/anxiety.

Unfortunately, this psychaitrist is not a great as my old one - he will not give me a magic letter to bring to my other doctors to tell them "this is not stress".

So I am stuck in this loop - the body docs say it is all in my head. The head shrinking doc says it is a body thing not a head thing.

I honestly don't care if it is stress or body - I just want the symptom to get treatment of some sort. I tend to agree with the psychaitrist because the symptom does not change with my stress/anxiety levels.

How do I get out of this loop? Any wise words of wisdom or suggestions?

Thanks all,
Liz
Liz - A large percentage of your symtoms may be the result of Myofascial Trigger Points in the muscles of your neck especially the Sternocleidomastoid.
Read the below link and review. Some of these can be self treated. There are many ways to treat trigger points in the muscles. The most important treatment is a home stretch program.
http://www.round-earth.com/HeadPainIntro.html

Last edited by painfree; 12-13-2006 at 09:45 PM.
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