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Concerned about TMJ disorder - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Dental Health
Answered by

General & Family Physician
Practicing since : 2004
Answered : 40 Questions
Doctor :   Hi Dr anvekar here
Doctor :   how can i help you ?
Doctor :   are u there ?
User :   Hi There I have been dealing with a problem for a very long time. First off I will say that I have a health anxiety and have had for a very long time. I constanly worry about cancer and think that I have it as soon as something hurts in my body. Iam on lexapro for this. Now my problem - Starting in october I had a left ear pain. I went to to the doctor and was told that I had a bad ear infection and was given augmentin for 10 days and cipro ear drops. After the course I then had ear pain again in both ears along with some head pain along the top of my head. Went back to the doctor and was given another round of antibiotics of the same thing. After that course I still had ear pain in the left ear and was reffered to a ENT. ENT said my ears looked clear and said that the ears are very slow healing and give it another 4 weeks. After 4 weeks I returned to my regular doctor with throat and ear pain. I was positive for strep infection along with tonsilitis. At this time I was still complaining of head pain just on the top of my head and about 2 inches away from the center. I was given another round of antibiotics for 10 days. After that course I came back still complaing about ear pain and head pain. My doctor drew blood labs - A CBC, Liver Panel, Thryroid, Cholestral, and Mono. Everything came back negative. He then ordered a Head CT Scan and a Sinus CT scan. Sinus Scan came back with minimal mucosal thickening. The Head Ct scan came back with possible anrysem. I then had a MRA done was told that I had tortuos vessels which made the ct abnormal but there where no anrysms found. So i went home. I returned to the ENT another 3 times after this for left ear pain and each time I was told that everything was clear. The third time he prescibed be VERAMYST nose spray for a possible eustachian tube disfunction. I still have head pain so i was reffered to an internal medicine doctor. She drew some blood work for a full CBC and came back negative.
Doctor :   let me read ur query
Doctor :   give me a few minutes
User :   She told me that I have mild TMJ and maybe neuralgia and that is why I have head pain. She prescibed me amitriptyline 25 mg and carbamazepine 100mg every day. I have been taking this for about a week and see no difference. She said that I may have to come back and have a MRI to rule out tumor. Now Iam freaked out. I thought that maybe the MRA and Head CT scan would show that. The pain is directly on top of my head towards the left a bit and in like a band. Sometimes it is spotty and in differnt spots. The pain is mild and not always constant. It comes and goes. I sleep well with no pain during the night. I also have a left ear pain that comes and goes and is also mild. Has a slight ring but no discharge. Sometimes I have a head pain in my forehead that comes and goes. Iam a 26 year old male that recently lost 85 pounds. I was diagnosed with a fatty liver 1 year ago because is was overweight and ate fatty food. I now weigh 200 pounds and am 6ft tall. I completely changed my eating lifestyle. I do not smoke of drink. I do have stress and Anxiety and now am worried about a brain tumor.
Doctor :   ok
Doctor :   now from your extensive history, I can make out that u have a fear of cancer . is this right ?
User :   yes yes yes
Doctor :   how do u have symptoms like fever, loss of weight , loss of appetite , blood in stools ? or nausea , vomiting etc ?
User :   just sometimes loss of appetite but i also forgot that I have gerd and and sometimes the heartburn i think gives me no appetite
Doctor :   the current issue that you have could be CSOM (chronic suppurative otitis media or TMJ disoder
Doctor :   have u lost weight of about 10-20 pounds recenlty?
Doctor :   CSOM can have persistant ear ache which can be annoying too
User :   no I have been maintaining my wieght for a month if anything maybe gained weight
Doctor :   In that case u should not be worrying about any cancers
User :   doesnt a ct scan or mra show tumors of the head
Doctor :   as far as the diagnosis of TMJ doscrder , you need to have a long standing pain in the JAW BONE joint
Doctor :   yes they do show it
Doctor :   but what ur doctor could be asking is a MRI specific of the TMJ THAT can diagnosis Arthritic of the TMJ
Doctor :   AS WELL as tendon damge in that area
User :   i was told that a ct scan is not very accurate and that it may miss soft tissue tumors and for this reason they want a mri of the brain and mastoids
Doctor :   yes that is right
Doctor :   MRI is specific of the soft tissues and tendons
User :   I gues I am very scared and have a major fear of cancer. my neighbor is a 24 year old female and has brain cancer and the only reason they found it was from the headaches. - so and mri that I will have done may still find tumors of the braib right?
Doctor :   since the CT of the brain is normal, there is no need to worry at all
User :   can this tmj or csom cause some mild throat irration
Doctor :   CSOM does persist with a bit of phayngitis (sore throat) as all areas are interlinked and a infection in one location can cause infection in the nearby area too
User :   ok so without you seeing me it is safe to say that i dont have brain cancer
Doctor :   yes
Doctor :   i can say this as u have mentioned that the CT and the MRI have been normal
Doctor :   and also that u dont have major signs of cancer physically
User :   it was a MRA and not a MRI
Doctor :   thats fine too
User :   is that the same - the doc said that it is not
Doctor :   no its not the same
Doctor :   MRA is the IMAGING of the blood vessels
User :   ok the ct scan and MRA was normal with all the labs
Doctor :   but the my interpretation is based on the whole history that u have given me
Doctor :   as well as all the investigations done so far as well have been normal so far
Doctor :   you need to continue the treatment started for TMJ disorder for another 4 - 6 weeks for proper effects to be seen
Doctor :   are u there ?
Doctor :   are u following my advice ?
User :   yes - ok I know u are a doctor and i pray everything will be ok as you said it would
User :   thank you
Doctor :   yes
Doctor :   you are welcome
Doctor :   having a postive outlook will help you and allay your apprhensions about ill health
User :   i know it - iam always very negative
Doctor :   i do believe that u will be fine
User :   ok - symptoms would have worsened by now over 3 months if it was cancer right?
Doctor :   yes definitely
User :   ok thank you
User :   bye for now
Doctor :   bye
Doctor :   take care
User :   you too
Doctor :   have a good and happy new year and happy holidays too
Doctor :   bye for now
User :   thanks you too
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