Should I go to the E.R. -- what would you do?
 

I feel like I have asked the same question before! But I need your opinion as I am still somewhat new to MS and on Tysabri.

This morning my mouth felt fine. By afternoon I felt like my left upper gum by the teeth was swollen compared to the other side--I noticed it when I ate and it was sore. When I run my tongue over it, it definitely feels swollen compared to the right side. Hours later I am feeling it in my jaw which is aching and now the side of my jaw (skin) feels achy/tingly.

Could I have an abscess? I know my immune system is low from Tysabri so I wonder if I should go into the E.R. since it seems to be getting worse. 3 weeks ago I went to the E.R. with severe abdominal pain and they thought I had appendicitis. Turned out to be a ruptured ovarian cyst!

Is the life of a person with MS, constantly having to deal with piddling (or not so piddling) health issues? I start teaching tomorrow so I can't go to a dentist and I doubt I can get an appointment with my internist. I'm worried if I let it go it will just keep getting worse/weirder? The thought of waiting hours in the E.R. is annoying. But I think I'm worried just because of the immunosuppression factor of the Tysabri.

Should I go? It's always better to be safe than sorry, right?

When I see a thread with that title, I start nodding my head "yes" before I even open the thread. In my opinion, anybody who is wondering whether or not to go to the Emergency Room probably should. Like you said, better safe than sorry.

from a non MSer:)


Can you take a small flashlight and a mirror to see if you can see anything that might be suspicious?
or have a friend/family member look for you.

look for any swelling, pinkish or redness, sores

my daughter gets sore tonsils and such so i look in her mouth a lot LOL

Natalie,
If it is a tooth abscess, you need Antibiotics. If it is T.N. you need to see your Neuro. Jaw, tooth, face or side of ear, head, etc., are all problems that need to be seen by someone when they cause pain.

Don't wait if it hurts. If you don't decide to go to the ER, then get to the doctor or dentist right after school tomorrow. No later. Okay? I hope you feel better soon.:)

Pain is a sign of a symptom. Your body telling you something is wrong.:hug:

I learned the hard way that inflammation = infection, and infection is about the worst thing for me. It almost always sets off an attack if it is left untreated for any length of time.

(It was my tooth too, where I learned the lesson.)

Cherie

Looking for an update, Natalie....

I get gum issues when my ear infects. isnt that silly? my mouth hurts, and gets very sore, and sometimes swells with an ear infection. then a few days later, my ear will start banging.

anyone on Ty with any new sx or worsening of old sx needs to be seen. At the least I hope you called your MD.

How are you feeling?

Thanks all. I decided to go to the E.R. just to be safe. WOW...we were only there for 1 hour. Shortest trip ever to the E.R. Anyhow, the doctor gave me heavy duty antibiotics and told me to call my dentist for an x-ray. He said that it may just be on the cusp of an abscess (where it hasn't really gotten bad yet--inflamed red) but I could still feel it. I also looked in my mouth and it did look swollen with some sort of raised pustule. I don't have tonsils anymore! I started the antibiotics and already my mouth feels better--way less pain and soreness. Very interesting...makes me wonder if it was bacterial. So I will call my dentist. I think sometimes I get freaked out about the Tysabri and infections. It's not that I've had weird ones--just a few I never used to get like a bad respiratory infection, a couple of UTI's, a staph infection on the skin behind my ear. I just NEVER had infections of any kind before I went on Ty--I mean the last time I had a respiratory infection was 10 years ago!!

Anyhow, better safe than sorry I think.

By the way what is T.N.? And Polar, what did you read about Tysabri and jaw/tooth problems??

I'm glad you got it checked out Natalie. I hope this isn't a trend for you with Tysabri. Let us know what the dentist says.

I've had one UTI in over two years on it now, (knock on genuine wood desk) but I often feel like one is coming on and I drink tons of water and use the potty often when that happens.

Glad to hear you got it checked out!

Tysabri or no Tysabri, never wait when something like this happens. An infection is bad enough, but when it's on your face, ear, etc, it's in close proximity to your brain and there are a LOT of blood vessels there and the infection can spread very quickly if it gets into the bloodstream.

I have all my docs and my dentist on notice that if something is wrong, I need to be seen THAT day or ASAP (the next day). If they cannot accomodate me, I will find someone who will. So far it's worked. The eye doc saw me immediately when I started my journey with MS with the optic neuritis. He was the one who said MS and he was right. The dentist is the one who took care of my broken tooth the day it broke and told me to call no matter what my problem is and he would fit me in. A few weeks later I had an abcess on the same tooth and again I was in two hours later, prescription was issued and a followup scheduled. My regular doc is the same way. My neuro wants a call ANYTIME there is any change, real or imagined, and told the old man to call if he has to because I am stubborn and insist nothing is wrong...:p

Try to sit down for a few minutes and talk to your healthcare team and let them know about MS/Tysabri/etc. and what you may be dealing with. Ask them if they will be there when you need them. I found that talking to them made all the difference in the world when it came to calling when I had a problem.

Thanks RW for such great advice! I have the cell phone number of the nurse of my new internist now--she said call her if anything is ever wrong and she can squeeze me in (especially if the people at the front desk are being difficult). She was so nice about it -- she also works in the ER.

My dentist is not open on Fridays and I can't go in today because it is the first day of classes. It took 10 calls to find a dentist to see me tomorrow morning. I'm really hoping it's not an abscess. Does this mean root canal??

Nowadays, root canal is the trend, before they fill a tooth or cap it, if bad. But they won't do anything until a week on the anti-B's and the infection or abscess had cleared. I hope you feel better.:)

BTW, you asked what T.N. is. It is Trigeminal Neuralgia of the jaw, face, temple or ear area. Can be one or all of these areas at once.

It is hard to chew or sometimes of open the mouth and talk without terrible pain in the jaw/face. It is a very strong pain, you would know if you had this even once.

It can last a few minutes, weeks, months or even years, coming and going when you least expect it. The mouth looks normal, so does the face, but the pain is a rough one. Sometimes the Neuro-surgeon has to cut the Trigeminal nerve in the cheek, inside the mouth. It runs does the length of your head to jaw.

Many had this surgery with great, immediate relief. Clip and it's done. I had the pain a few times, TG, it didn't last too long. You can't open your mouth other than to get a sip of water in.

I didn't need a root canal after the abscess I had, but it depends on how bad it is, I think.

My dentist has an answering service and I have called on a weekend and he called me back that day! He called in antibiotics for me because what I was describing to him sounded like an infection and his feeling was if it was infected, we could start treatment, and if it wasn't, he would see me Monday anyway. It ended up being an infection due to food stuck in the pocket and all he had to do was pick it and water jet it out.

I've had all sorts of problems with my teeth and I go every three months now to ensure that I don't have them anymore. This was ongoing before being on T, and we just decided that vigilance was the best policy after I started T.


My whole focus with all my docs is "Will you be there when I need you, including weekends and holidays? and if not, you ain't on my team!"

I don't bother them when I don't need them, I do what they tell me to do, I ask questions and discuss concerns and I want them to advise me and treat me to make sure I am as healthy as possible so I don't need them.

Toothaches suck and I hope this clears it up for you! You've had enough!

Hi Natalie, glad you got it checked and are feeling better with plans to go to you dentist :)

When I started Tysabri my son a bio-chemist recommended I take vits/supplements to keep up my immune system. I said but it's my immune system attacking me, therefore ms ( I do not capitalize disease/give it no respect). He said different components to the immune system (he's in cancer research). I take a multi, B-100, C,E, Calcium with D-3,Fish(that is also Borage & Flax)oil and Magnesium. I stay well when those around me are sick, when I flew many times in the middle of winter (to get my Ty infusion), and thank G-d I've not had a uti. I am a believer in the vits/supplements I take.

Hope you are well soon!

Linda

Well I saw the dentist this morning. No tooth abscess!! BUT...I did have a small abscess/infection in my gums near the teeth. So antibiotic mouthwash for awhile, brushing longer, and religious flossing begin today. I thought the new dentist was great. She actually presented something at a DDS conference on the immune system recently and so she was very careful and thorough to make sure it wasn't something big. She also left to read up on Tysabri while I was getting X-rays. I think I have a new dentist now! :)

Lady, thanks for the info on T.N.

RW, finding a team that is willing to take calls on weekends sounds like a great idea.

Linda, I take D3, fish oil, magnesium, folic acid, and B-12. I'm supposed to take a multi but I have to confess I haven't been very good with that.

So....another problem averted. No root canal. Jeesh....3 weeks ago it was a ruptured ovarian cyst. But I have to say I have been feeling really great on the Tysabri lately -- lots of energy, no MS symptoms, no depression. So I try to put PML out of my mind as best I can.

I'm so glad everything turned out OK!
What I had heard is that any, even minor problem you may not be aware of, with teeth, jaw, ears, etc, could get worse quickly with Ty simply because of the way it works on the immune system. I wish I could remember where I saw that. Duh. Anyway, I've tried to be more careful since I started my infusions. It's good that you went before this blew up into something big!:hug: