Wikipedia redux: from tmj, trigeminal neuralgia to dog diseases, cherbuism and a list of Star Trek races

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Disclaimer: The first part of Day 11′s prompt is meant as satire, and not to belittle chronic pain, nor the WEGO #HAWMC’s April project. I was feeling a bit tongue in cheek. I did get more serious for the second part.  And, WordPress messed up my fonts again!

The task for todays #HAWMC was to “revise your condition’s Wikipedia” page. . .  . Has Wikipedia forgotten to include your condition.” So, I wikied atypical facial pain, choosing it over health issues. Now, I didn’t expect to find it – atypical by its nature means there is no injury, trauma or disease that caused the condition. And, there are many reasons why your face would hurt.

The list of the first 20 were what you would expect: trigeminal neuralgia (several entries), TMJ, migraine. It was the next series of entries where the randomizing of the words “atypical,” “facial,” and “pain” got interesting. These included:

List of dog diseases

Other symptoms can include stunted growth and a ferret like facial … The atypical form and the form caused by abrupt withdrawal of steroids

List of Star Trek races

of initiating first contact was atypical; they brought other races to  Denobulan: The Denobulans are humanoid with facial ridges

Cherubism

disproportionate due to the fibrous tissue and atypical bone formation. the facial nerve as well as the zygomatic branch of the facial nerve.

When I added “chronic” the list got shorter; there was no generic description of atypical chronic facial pain. That’s the problem with a diagnosis that has a community of one; there’s nothing to hang your hat on, no list of symptoms and treatments, no organizations specifically targeting your health issue.

So, the sentence or three I would put in my entry:

Chronic Atypical Facial Pain: pain in the face not caused by any underlying trauma or disease. The severity of the pain can increase with time, use of the jaw in talking, chewing, smiling, position of the neck (can be related to impingement of nerves), and life. It can be treated with opioids, drugs for neuropathy (Lyrica), NSAIDs. The pain resembles a combination of several sensitive abscessed teeth with large cavities, a severely infected sinus, a black eye, and pressure like a thumb being scrunched down on the face. Trigger point injections, nerve blocks, acupuncture, massage, chocolate, white wine, and cheesecake are other methods that can be used for treatment. It is an invisible illness; there is no cure for this condition as there is no cause.

K, so white wine, cheesecake and chocolate would never be prescribed. But then, until I found my doctor in 2004, I also never met a health care professional who truly believed that my face hurt. She would no doubt agree with the chocolate!

While I was at it, I wikied “atypical chronic odontalgia” and I was surprised when I got an answer as part of a broader discussion about toothaches:

Atypical odontalgia is a form of toothache present in apparently normal teeth. The pain, generally dull, often moves from one tooth to another for a period of 4 months to several years. The cause of atypical odontalgia is not yet clear, although some form of nerve deafferentation is plausible.

I would add to this that a) the pain isn’t dull, it can be excruciating, b) lasts for many years (6 and counting), c) can affect multiple teeth at the same time, d) most pain medications do not work on this condition, e) is disbelieved by almost all health care and dental providers, f) if you have it, you are not imagining things or nuts; perfectly healthy teeth can feel like they need a root canal.

Tomorrow’s prompt: “Ekphrasis (writing about another art form) Post.” Find a Flickr image in Creative Commons that inspires you and free write about it for 15 minutes without stopping. “Brave bonus: publish it without editing![You can include a disclaimer])”

Oh boy, does that include typos from my fingers finding the wrong keys or writing words I wasn’t thinking about? I’m getting nervous already! Winking smile

#HAWMC: prompts 3 and 4

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For expediency, and lack of creativity, my April 3 post will be a simple Yahoo answers post about one of my chronic pain issues.

I created the question and the answer, which should not be taken as solid research, but anecdotal information from my own experience, and information gleaned from the few articles that exist on the topic. Please note the lack of footnotes/references. Had I been feeling more creative, the question and answer might have been more fun. This is not a happy Yahoo Answers Post! Be forewarned if you are queasy/touchy about dental stuff.

230px-Aching_tooth_cropWhat is chronic atypical odontalgia?

Chronic atypical odontalgia, also known as “phantom tooth disease,” is the sensation of dental distress in healthy or “dead” teeth (nerves removed through root canal, for example). Although the tooth may feel like it has, for example, a cavity or abscess, upon inspection by a dentist (through observation and x-rays) no visible reason is seen for the persistent pain.

Chronic because it is ongoing and atypical because no cause can be found for the pain. People often have the painful tooth removed, only to discover that the missing tooth still hurts, like people who feel pain in a limb that has been amputated. There is a theory that the pain is caused by overactive nerves within the jaw firing rapidly and repeatedly.

Although chronic atypical odontalgia usually starts with one or two teeth in a specific area, it can increase to encompass the entire upper or lower jaw. It is difficult to treat with pain medication. Some people find relief with NSAIDS such as naproxen; others need a stronger pain med such as something from the opioid family.

My experience: a tooth became badly abscessed (but with referred pain to another tooth) and went untreated for a period of time during which pulp and nerves inside the tooth died, and began to “rot.” Once the filling was removed, along with the dead material, and a root canal performed, the tooth seemed to be “dead: nerveless”, and thus not painful.

Approximately 10 years later, that tooth began to ache. Some of my “live” teeth, given the length of the roots, impinge on the sinus cavity, and as a result are often painful and “pressurized.” But this pain was different. It was as if the tooth had become alive and abscessed again. A root canal specialist/oral surgeon, based on x-rays, did some refining of the previous root canal through the gums. But this did nothing for the pain.

The number of teeth involved is increasing; my dentist does extensive x-rays to prove that these teeth are part of my increasing chronic atypical odontalgia. It is just one of the areas where I experience chronic atypical pain. And, some days, there is nothing that will take the edge off the pain.

April 4th’s goal is “Ludicrous Headline or Cure. Do a news search and choose a ridiculous headline or proposed cure about your condition and write what you think about it. Can’t find one? Write your own.”

Patting the Top of Your Head While Rubbing Your Belly and Walking and Chewing Gum at the Same Time Will Cure Atypical Chronic Facial Pain.

Scientists at the Barnum and Bailey Research Think Tank in upstate New York made a break through this winter when they utilized the highly co-operative cohort of highly functioning graduate students on loan from Google Labs in Santa Monica.

First, the students were divided into a control group, and several experimental units. Each student was given a “a good, swift kick” to the butt, and a “slap” to the cheek. The control group were instructed to do nothing nothing; they stayed in their circle and cried. One group was instructed to pat the top of their heads while rubbing their tummies; another group was asked to chew gum and walk at the same time. A third group patted their head while chewing gum, and so on.

After an intensive hour of crying, patting, rubbing, chewing and walking, students were interviewed as to how their bottom and cheeks felt. To the scientists doing the experiment delight, they discovered that the small cohort engaged in head patting and stomach rubbing while walking and chewing gum reported that the pain was less intense from the onset of their activities, and after an hour, they felt no pain in their face at all. Meanwhile, the control group was still crying, and the various other units were in some degree of pain.

An article is slated to be published in the Journal of Ludicrous Medical Headlines and Other Silly Remedies this Spring. Several large pharmaceutical companies have expressed interest in developing drugs that will enhance people’s abilities to pat their head, rub their stomachs, chew gum, and walk at the same time. And, gum manufacturers could not be more pleased as a blind study was used for the gum. Each can now lay claim to the curative properties of their particular chew.

Unfortunately, the “good swift kick” part of the experiment will have to be replicated, as it was difficult to tell if each participant received the same force of kick as more than one kicker from the Barnum and Bailey University football team was used. A specially calibrated electronic slapper was used so that an equal amount of force was applied against each of the participants cheeks.

The participants were compensated for their involvement with beer and pizza – the favourite food groups of university students.