ozarque ([info]ozarque) wrote,
@ 2005-12-28 14:09:00
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About that wheelchair...
I mentioned in an earlier post that our underground house was designed so that I could get around it easily in my wheelchair, and that we hadn't known that moving to Arkansas would get me out of the wheelchair, and several of you asked for an explanation. I'll try; it's hard to make it clear in written language, but I'll try.

What put me in the wheelchair in the first place was severe rotational vertigo. I don't know if you've ever had the experience of having drunk more alcohol than you should have, and then having the room seem to be whirling around you. Rotational vertigo is like that, except that it doesn't go away. It kept getting worse, until the time came when I couldn't stand or walk; instead, I would stagger into walls, and fall down, and various other ungraceful maneuvers. The rotation was superimposed on an additional form of vertigo, in which every surface I was in contact with moved constantly under me .... like being on a small boat on a choppy sea. Often, there was nausea, although I'm not inclined to motion sickness; I suppose it was because there were so many different kinds of motion going on at the same time. It was horrible; the wheelchair at least made it possible for me to stay out of bed, after a fashion.

I was in California then, and I had the fanciest doctors -- La Jolla doctors -- that anyone could have asked for. Over many many months I saw platoons of specialists; I had the well-known Every Test Known To God And Man, including a number of tests I wouldn't have believed existed if they hadn't been happening to me. None of this helped, because all the tests showed nothing whatsoever wrong with me, and as always happens in such cases the medpros decided that it was all in my head, and I was sent to various psychiatrists; they couldn't find anything wrong with me either. Eventually I was so incapacitated by this nothing-at-all-wrong-with-me that I had to retire from my teaching post, and -- as you already know -- we moved to Arkansas.

When we got there I went to the internist I'd been referred to by the fancy California doctors, and his first move was to send me to an ear/nose/throat specialist. Who, five minutes into his examination, said, "Ma'am, you don't need a doctor, you need a dentist," and went off to have his secretary make a dental appointment for me.

I went into that dentist's office afflicted with that horrible rotational vertigo, everything whirling around me; I came out an hour later with the problem fixed. Not that the vertigo was gone; it wasn't. I was still on a small boat in a choppy sea, and I still am, to this day. But the rotational part of it was almost fixed. It was almost gone.

I say "almost" because once in a while, there'll be a sudden episode of the rotational stuff; the floor just swoops out from under my feet and the whole world swings up to the right, taking me with it. Because it always happens without warning -- and is as likely to happen when I'm next to a hot stove or a fireplace or a stairwell as it is to happen anywhere else -- I don't go out without a cane. And I never babysat for my grandchildren until they were competent at walking, because I was terrified that it might happen when I was carrying one of them, and that they'd be injured when I fell.

But in a single hour with an Arkansas dentist I went from being the prisoner of chronic rotational vertigo that was getting ever more severe to being someone who might have thirty seconds of the filthy stuff half a dozen times a year. That, in my perceptions, qualifies as a miracle many times over.

Not once, in the years I spent with all the fancy doctors, had anyone ever so much as suggested that a dentist might be able to help. Not once.


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[info]the_red_shoes
2005-12-28 02:11 pm UTC (link)
Wow. What, if you don't mind saying, did the dentist do?

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[info]frankie_ecap
2005-12-28 02:12 pm UTC (link)
What did the dentist fix?

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[info]woodwardiocom
2005-12-28 02:12 pm UTC (link)
-Forgive the personal question, but what did the dentist do? Was a wisdom tooth pressing on a nerve or somesuch?

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[info]rabidsamfan
2005-12-28 02:13 pm UTC (link)
What on earth did the dentist do?

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[info]burr86
2005-12-28 02:22 pm UTC (link)
*joins everyone else in wondering what the dentist did* ;)

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What did the dentist do?
(Anonymous)
2005-12-28 02:23 pm UTC (link)
I'll try to get to that tomorrow.....

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Re: What did the dentist do?
(Anonymous)
2005-12-28 02:25 pm UTC (link)
Live Journal insists that I'm anonymous this morning -- sorry about that. It's not that "someone" said they'll try to get to that question tomorrow; it's me.

Suzette

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The whole person
[info]hilleviw
2005-12-28 02:27 pm UTC (link)
Please, add me to the chorus wondering how the dentist could help. Whatever it was, I'm so glad it made such an enormous difference.

I have a couple of severe chronic illnesses (and one, avascular necrosis, took quite a bit of diagnostic effort; there were two hospitalizations before it occurred to anyone that I might be falling down for a reason). One of the (many) factors I consider when I have to choose new specialists, is whether they notice that there's more to me than just the bits which are their specialities, and whether they remember that the other bits can affect "their" bits (and another is whether they remember that "their" bits are actually mine). I've ditched a couple of pulmonary people for trying to give me more prednisone instead of sending me to my orthopedist to find out why the pain is waking me up at night (that's right doctor, I'm not waking up because I can't breathe, I'm waking up because I hurt, and my oxygenation is deteriorating because I'm sleep deprived).



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[info]jehannamama
2005-12-28 02:29 pm UTC (link)
I moved from the midwest back to southern California where I was born and raised. My menier's, which got sometimes quite bad in Ohio, has drastically improved in the dryer air. I think mine partly was allergy related but you know I had some dental work done just before it started getting better. Now I am wondering...

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To jehannamama...
[info]ozarque
2005-12-29 03:07 pm UTC (link)
I understand the wondering. My personal inclination, whenever I meet someone who has a physical symptom for which no doctor seems to be able to produce a diagnosis, is to suggest that they see a dentist. Just in case.

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[info]neonchameleon
2005-12-28 02:31 pm UTC (link)
"internist"?

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[info]asciikitty
2005-12-28 02:46 pm UTC (link)
Doctor of Internal Medicine.

or something very like that.

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Internist....
[info]ozarque
2005-12-28 02:55 pm UTC (link)
An internist is a medpro specializing in diagnosis; other specialists, when they can't figure out what's wrong, will send a patient to an internist.

One other thing about internists: They have the lowest rate of usage of non-trauma medical services of any medical specialty, both for themselves and for their families.

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Re: Internist....
[info]londonbard
2005-12-28 08:59 pm UTC (link)
I wonder whether they are nipping problems in the bud or whether it's because they don't have much faith in the other medical professionals? (I'm not sure whether we have internists here; I suspect that we need them but the other medpros might be too arrogant to refer to them.)

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Re: Internist....
[info]neonchameleon
2005-12-29 03:31 am UTC (link)
Thanks - very interesting.

It also seems to be completely backwards compared to the way we do things in Britain. The first step in getting medical treatment is to see a General Practicioner - who specialises in diagnosis and simple remedies (the vast majority of people who see them have only trivial complaints and are sent away with antibiotics/chalk tablets/a nurses appointment/nothing save greater knowledge of the condition and that it will clear itself up). The general practitioner then figures out the ballpark of what is wrong and sends you to the relevant specialist.

In short, we triage and diagnose the area before talking to specialist consultants.

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Re: Internist....
[info]griffen
2005-12-29 02:58 pm UTC (link)
Oh, we have GPs in America, too. And they are the first ones seen, usually. But if you have a long history of medical problems, or a family history of them, sometimes an internist is the first one you go to.

They're like a GP who also has a specialty: diagnosis of weird or unusual stuff. Most GPs only deal with common problems: colds, vomiting, contagious illnesses, general difficulties. The more odd or unusual ones require an internist to diagnose, because no GP can be a truly "general" practitioner. No one person can know enough.

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[info]kyra
2005-12-28 02:42 pm UTC (link)
I can't wait to read what the dentist did that fixed you up so rapidly!

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[info]redbird
2005-12-28 03:09 pm UTC (link)
My girlfriend has chronic migraine, and while dentistry hasn't fixed it, it has helped her significantly.

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[info]greybeta
2005-12-28 03:23 pm UTC (link)
Us Arkansans don't need no fancy doctors to fix what ails ya.

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To greybeta....
[info]ozarque
2005-12-28 03:31 pm UTC (link)
Nor us Arkansawyers neither.

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[info]sunfell
2005-12-28 03:28 pm UTC (link)
I have BPPV. My Arkansas doctor fixes it by making me lay down and turning my head in some interesting ways. It comes back, though and he showed me what to do when it gets really bad.

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[info]lyonesse
2005-12-28 04:10 pm UTC (link)
how bizarre! what did the dentist do?

we occasionally get vertiginous patients in my building (i work at an mri center). but except for the ones whom we are able to diagnose from that, i don't generally know what becomes of them.

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To lyonesse....
[info]ozarque
2005-12-29 03:18 pm UTC (link)
It seems to me that there is a profound medical ignorance about vertigo, and that medpros who encounter vertiginous patients generally do not, as you say, "know what becomes of them." That worries me, because I suspect that what usually becomes of them isn't anything pleasant.

The source of the problem, in my opinion, is linguistic. Patients can only say "I'm dizzy" or "I'm light-headed" or "My head feels funny" or "I have vertigo," and they don't have any way to provide a coherent description of their perceptions. I'm a professional writer with decades of experience expressing things in written language(s), and it was nevertheless a real struggle for me to write the LJ posts for yesterday and today that include descriptions of my own distorted perceptions. Getting that done in the very brief time doctors ordinarily spend listening .... I don't think it's possible. And the medical literature on vertigo is impoverished.

During the years I spent wandering around in the medical environment before I realized that there was nothing useful to me there, I had the naive idea that doctors would welcome a detailed description of the various vertiginous phenomena I was experiencing and of the coping strategies that I was using. I was wrong about that.

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Re: To lyonesse....
[info]lyonesse
2005-12-30 03:26 pm UTC (link)
i think the problem with talking about how one feels is that feelings are the product of a great many central nervous system body-maps, and there is no subjective way to tell if a vertiginous feeling comes from say an impacted nerve (as with you), a brain lesion, an inner-ear infection, a feverish delirium, or actually falling through the air. the information provided to the mind just doesn't reach that level of meta-awareness. so even the best subjective descriptions will often fail to discriminate among the large possible set of causes. consider "i feel terribly sad" -- which might represent serotonin insufficiency, a brain lesion, or an actual personal loss. i recently read an interesting case in which an obviously iatrogenic effect -- turning on a particular implanted electrode in a patient being treated for (iirc) parkinson's -- caused the patient to feel tremendous grief, with crying and unhappiness about her disease, as long as that electrode was turned on. turned off, she reverted to her previous cheerful and coping sense of self. but from her words, you can tell that her grief was as real as anything, and she subjectively felt that it was caused by her life, not by the electrode.

i think the professional people who would welcome your descriptions the most are scientific researchers and science writers. remember that clinicians' goal isn't to get good words about something (most of their patients aren't as articulate as you are anyway, so there's no future in relying on that) but to *fix* something. sometimes the best verbal description in the world is still not an adequate diagnostic tool.

fwiw i think a structural mri might have found your problem (your tooth impinging on a nerve in a peculiar way) and a functional mri certainly would have (mri's are loud, claustrophobic, and scary, so you would probably have clenched your teeth, and your nerve lit up all bright). if you don't mind my asking, did you happen to have one?

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Re: To lyonesse....
[info]ozarque
2005-12-30 03:34 pm UTC (link)
Interesting; thanks for posting this.

About the MRI .... I didn't have one. This was long ago, in the days when a CAT scan was considered cutting-edge. However, it was vastly less expensive to have an ENT man and a dentist just look in my mouth and notice the problem.

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[info]ab_xnfp
2005-12-28 05:58 pm UTC (link)
First off, I am AMAZED the E,N&T doctor wasnt one of the first they sent you to. that's pretty amazing to me.

Dental work can change alot of things. I think my fertility issues were due to having wisdom teeth that were in an advanced state of decay, once I got that toxin out of my body...bang!

I've heard of a professional singer who suddenly lost her ability to carry a tune, years later it was discovered that her wisdoms were the cause.

My MIL has vertigo and they have her doing exercises to try to 'rehabilitate the cilia in her inner ears' She's taken some bone breaking tumbles. One split her head open, the other smashed her wrist. We pray every day she stays on her feet as she's 81 now.

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To ab_xnfp....
[info]ozarque
2005-12-28 07:12 pm UTC (link)
I agree with you; it certainly would have been amazing. However, they did send me to an ear/nose/throat specialist first -- a very fancy one -- and to two or three others before it was over. But none of the California ENT specialists said anything at all about going to a dentist.

My best wishes to your mother-in-law; she has my sympathy.

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[info]beckyzoole
2005-12-28 06:23 pm UTC (link)
Since the inner ear is the organ of balance, I'm sure you'd seen an E, N & T or two before.

I'd love to know what the dentist did. Was a tooth root pressing on a nerve?

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[info]elfwreck
2005-12-28 06:43 pm UTC (link)
One of my friends online mentioned once--
One of the highest "cure rates" in mental illness was achieved in the late 1800's. Somebody decided to pull all the teeth of people in institutions, and presto, an enormous amount of the institution population were cured. It was the infected teeth, affecting their brains, that was at the base of their "insanity."

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Other dental connections
(Anonymous)
2005-12-28 08:34 pm UTC (link)
from Maggie:

A friend of mine (in her 70s) found herself increasingly dependent on a wheelchair because of trouble in her right hip. Visits to doctors suggested that she needed a new hip. Then her partner changed jobs and their coverage moved to a local cooperative HMO. When she went in to inquire about a hip replacement, the doctors were willing to talk with her about such a surgery -- and went over all the details as if she was about to get one -- but before they would schedule the surgery, they insisted that she would have to go to a dentist. Because it had been a long time since she had gone to one and she did complain about pain in her mouth, they said that she had to take care of that problem before such a major surgery.

My friend was quite indignant about the side-track to a dentist and complained to me about the HMO, knowing that I was a long-time member and thought quite highly of its doctors. I told her that I thought that, based on my experience with challenging health problems that had odd connections with each other, she should do as she was told; and, finally -- tired of the wheelchair she had to use now -- she did.

Presto! She got her teeth fixed, the infections taken care of, and her hip problems went away. She was astounded. The doctors told her that they had suspected that the dental problems caused the hip problems, but experience had taught them not to bring it such up with their older patients, who never seemed to believe it. Patients would accept that "other problems" had to be taken care of before a surgery, but not that bad teeth could cause a bad hip. It wasn't "common sense."

The other doctors hadn't made the connection, though, and she probably would have gone through the opertion and never gotten her teeth fixed.

(It really gets frustrating when your internest -- who receives glowing reviews from any other doctors who hears that he's your doctor -- is still stumped over a problem. Sigh.)

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[info]sculpin
2005-12-28 08:47 pm UTC (link)
Fascinating!

I've read that temporo-mandibular joint problems can cause vertigo, and also that TMJ-related illness has been a remarkably controversial subject among medical professionals, especially non-specialists. Sounds like a lot of folks with TMJ Syndrome follow a similar path, getting passed along from one doctor to the next with no luck for years.

I pity the people whose psychiatrists do find something wrong with them. (Perhaps that they are so distressed over being dizzy all the time that they exhibit signs of depression.) It's easy enough to wind up in therapy for months or years for a supposedly psychological problem that's really a difficult somatic problem.

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[info]leora
2005-12-28 09:02 pm UTC (link)
Fascinating... I get vertigo periodically, usually just an episode now and hten, not often, although for a time I had mild vertigo regularly (which was really difficult). If I can ever afford to go back to a dentist, I should look into that. I already had a dentist mention possible TMJ to me. Which would explain the migraines... My parents took me to eye doctor after eye doctor throughout my childhood, because my mother was convinced it was my eyes. And while I had eye problems, none that affected the migraines. But we never mentioned the migraines to a dentist, because it just didn't seem relevant. And I had no idea the vertigo might tie in too...

... I wish more doctors had the time to truly ask about the whole picture, regardless of their speciality. When I find a doctor who will listen to the vasty array of odd problems that may or may not be related, I certainly trust the doctor more.

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[info]kelsied
2005-12-28 09:12 pm UTC (link)
ha. I am put strongly in mind of the recent discovery that ulcers are not caused by stress, but by bacteria. Astonishingly, however, people who were sick with ulcers were stressed out by the pain...

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(Anonymous)
2005-12-28 09:10 pm UTC (link)
Neurological, I could understand, but psychological? I find myself higly skeptical of that. I'm glad you finally got to a doctor who could help you.

However, it sounds like quite a trial. As one who suffered seizures for years while growing up, I empathize -- it's awful and scary, not knowing when your brain and body are going to revolt against you.

But medical science is full of wonders. I hope they figure out something that will help you more...

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[info]kelsied
2005-12-28 09:10 pm UTC (link)
Whoops! That was me!

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[info]abishag
2005-12-28 09:25 pm UTC (link)
I certainly second that last bit from [info]sculpin . I had chronic and disabling back problems for years, severe pain and incapacity, caused by collapsed discs and knock-on effects on the joints and muscles. And I had to endure constant psychiatric referrals from doctors who could see roughly what was wrong with my back, but couldn't cure/help it, so fell back on the idea that if I handled my situation better psychologically I would feel less pain...
Just getting to/ sitting through the consultations would significantly aggravate my back/legs.
One psychologist suggested that we were weird because I slept on my husband's *left*. He was the one who thought all disease had a sexual component. Then there were those who diagnosed hysterical symptoms to escape maternal responsibility, because I was the child of a widow, and had a disabled sibling so I "couldn't" have been mothered properly myself.
What I needed was some relief from the pain, and some way of being able to do more; or failing that help with the children.
Eventually (after 12 or 13 years)my physio discovered a surgeon who'd invented a new operation which I was fortunate enough to be able to have. He reconstructed my spine, two years of rehab, and it was like a new life starting- though I still have flare ups and muscle-spasms.
And my migraines are much less too- in my case they are obviously back- rather than jaw-related ( yes I'd had TMJ-type treatment for that too!)
I'm so glad it worked for you though!

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psychological
(Anonymous)
2005-12-29 09:26 am UTC (link)
Some people want everything to be psychological. And some doctors hope that, if they can do nothing to help, it will turn out to be psychological. Our son was sick for years, with a mysterious ailment that had as one very serious symptom a sleep disorder. Our doctor referred him to a psychologist, and when the psychologist said "This isn't psychological in origin," he suggested we try a different psychologist. But I think he was just frustrated by his inability to help, and wanted it to be psychological, because then he wouldn't have to feel guilty about not being able to figure it out.

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[info]lily_durona
2005-12-29 01:10 am UTC (link)
My mother had to be rushed to the hospital because her skin turned yellow one day--her liver had stopped working and the cholesterol had built up to the point that you could see it. Turns out it was caused by her rosacea medicine. Everything is connected...

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