This week from a personal point of view has been great - I've taken two weeks extended sick leave, and am at home with my family who have just been fantastic.....I sometimes forget what I've been through when around them given the love and support that they give me. I am very fortunate to have them and am now happy that i took the opportunity that work had afforded to me in taking this time off.

As for how I am feeling? Bizarre would be an understatement. I have different sensations/feelings everyday......teeth tight one day, strange gumbs the next, saw jaw here, headache there. When my family ask me how are things today it is very difficult to conceptualise.

I think i feel better because i am with loved ones, and for the first 8 weeks of my injury they were over 1000 miles away.

As for medicine - the Tegretol has done more for me than anything and has killed the pain significantly. internally it is playing up with some of my pathology which if untreated can become problematic....that is the problem. I'm scared that if they have to change the medicine the 24/7 pain will rear its ugly head again. The tegretol has been a godsend.

And I am sleeping well.......finally!!!!

how are you travelling this week??

I'm starting to decrease the dosage of the anti-depressant that I was prescribed because I want to see if I can handle my numbness without it. The combination of it and the medication for my increased migraines make me too tired and disoriented. I'm having trouble focusing at home and work...and preparing my taxes has been more overwhelming than usual!

So I understand what you mean when you say you're scared to change meds. I never want to go back to feeling how I did in the first few weeks. My doctor explained that if I notice a return of symptoms after going off the anti-depressant, then I can just start taking it again. I hope I won't have to.

I hope you get to do lots of enjoyable things today that help to take your mind away from your discomfort, etc...

I do feel that I'm recovering (I'm at the 3 month point) but I don't know how far it will go. It seems to have been more rapid since I started taking the Nocertone for my migraines (neurologist prescribed last month). I have no idea if taking that particular med plus the anti-depressant made the difference in recovery rate or not. I've been trying to find out if Nocertone is the same type of med as Neurontin. Have you heard of it?

I'm concerned now because the 'tingles' in my lip have subsided alot lately (as mmdonahue wrote before, I kind of miss them!) With more feeling coming back, I feel throbbing in all of my bottom teeth on the numb side from time to time. I am really scared that this is as good as it's going to get. I'm trying to be hopeful though.

It's been cold and raining for weeks here. I had to be outside alot yesterday and there was a constant feeling of icewater 'running' in my chin. Combined with the burning in my lip. It was very uncomfortable...these cold and hot feelings in my face.

How lucky that you had four vacations to the Gulf of Mexico...wow..how did the sun feel on your face? I dream of that these days...

thats for sure the drugs take a toll on the mind, body and soul..along with the injury..good thing your tingles have tamed down at 3 months..imo thats a biggie and your getting more feeling back...thats great..i never heard of nocertone..(ive asked reesatay if she knows) what anti depressant are you on ? i got the most relief from the burning and the tingles from neurontin..they say it helps with the abnormal nerve stimulation..it really helped but not totally...these days when the burning flares and the vice like feeling flares up i take flexaril..its a muscle relaxant..kills everything except the numbness..i dont know if that works on the lip and chin ? the sun is a wonderful thing !!

you are so right about being with loved seemingly speeds up the process - thankfully I have an amazing mother and father and sister who have just made me feel unbelievable in the past week......we all recognize this handicap is absolutely soul destroying but it is the support network which keeps us going - to me nothing is more important at the moment. nothing else matters than getting emotional control over this so i can move on, albeit in some form of pain.

Even being in the presence of the family dog has made me happy - as I type this she is sitting at my feet wanting a scratch on her belly. these little things i've come to learn are the things that are helping me through.....whilst I have the ability to lose it at the drop of a hat, i try and limit the incidences or situations which would lend themselves to an outpouring of emotion.

Externally the meds are doing a wonderful job from a pain perspective but internally they are throwing around my pathology. Unfortunately I have no control on what my platelet level does as a result of taking the Tegretol.

Will keep you posted....12 weeks tomorrow and a different pain sensation every day.

Ask your doctor about taking Trileptal. It is my understanding it is very similiar to Tegretol, but has a lower possibility of messing with your platlet count.

"T"

to your knowledge, isnt trileptal, tegretol and neurontin all in the anti seizure med family ? i remember my neurologist telling me he could give me tegretol because it was cheaper but it had more unpleasant side effects. i think its sgdaus on tegretol..they have charlotte on nocertone and a anti depressant..do you know what nocertone is ?

The main side effect of Tegretol for me is the tiredness and fatigue.....man I must yawn three hundred times a day and feel in a perpetual daze. But it has quelled the pain to the point where i don't have to take anything else. (ranging from 3-6 out of 10 on a pain factor)

They had me on Endep (amitryptyline) and it did absolutely nothing (pain was still a 9) and i will never go back on that stuff.

Are the other drugs you speak of similar and do they have the same effect?

One of the side effects of Nocertone is sleepiness. For me, I feel tired but I can't nap anymore and I often stay up until 1 or 2 in the morning. But, when I do get to bed, I sleep well during the night and it's the first time in years that I've slept for 8 hours straight.

Bo, the information leaflet with Nocertone says that the main ingredient in Nocertone (an anti-migraine med) is "fumarate d'oxeterone". I have no idea what that is. This medication is manufactured in Portugal so maybe it's not available in North America or it's known by some other name? It's working very well to control my migraines. I've only had two - one the day after starting the med mid-March and the other about two weeks ago.

If I get a migraine, I'm to take another med for the crisis...it's called Tigreat (Frovatriptan 2.5 mg). I took one for the last migraine and it worked well to control it...but I was very spaced out. I slept during that day!

The anti-depressant is an amitriptyline and is called "Laroxyl Roche". I started taking four drops a day and have now gone down to two drops a day hoping to stop taking it if possible.

I wonder if I'm having increased pain and throbbing in my teeth because I've decreased the dosage...sigh. When is 'somebody' going to do some serious studies on what works or not with these injuries?

I remember asking my OS at my first appointment (pre-surgery) if there had been other patients with numbness that he had seen. He said he had but I got the impression from him that they recovered with little or no problem so I didn't pursue it or ask any more questions. I wish I had asked more questions.

I'm pretty sure this is the first time that my family doctor has seen this condition...I'll ask him next time I see him. The town that he works in is quite small. My dentist was aware of nerve injury because she immediately referred me out after she did the xray. I don't think she knows too much about how to treat this but she is compassionate and empathetic (sp?)...and that has definitely contributed to my healing to this point.

I have to say again that I don't know where I would be today without this forum...I would have been totally alone (in a foreign country) with this and that is a frightening thought. I often think about all the people with IAN or lingual nerve injuries who don't have access to a computer or who don't have money or insurance which allow them to even seek advice or help from medical/dental professionals post-injury. It must be terrible for them.

You're right that this forum is a wealth of information. I am so glad that it's here...a big thank you to the webmaster!

I didn't think it could be related to the meds I'm taking because I had been taking the anti-depressant for weeks and the Nocertone for a month without any severe side effects except for a little 'mind numbness'. Anyway, the D kept getting worse so I checked the insert for this drug again and it says that it may cause "D". Then I checked on the internet...found a French forum where they were discussing Nocertone and its effects. People on there said they got "D" after a month of taking this drug so they stopped taking it...sigh.

Yesterday, I tried phoning the neurologist about this, but he's out of the office until Monday...so I had to call my poor family doctor yet again to ask him to look up Nocertone to see if it would be safe for me to stop it quickly. He came back on the phone and said "Yes..Nocertone can cause D...and you can stop taking it now".

So....last night, I stopped the migraine med and the anti-depressant (I had been down to one drop a night for about 4 days). Today, I had to take a couple of Ibuprofen (are those safe??) for the pain in my teeth...and otherwise I don't notice too much of a difference. I still feel 'spaced out' but hopefully that will lessen in a few days.

I've started going to a "kinesitherapeute" (sorry, I don't know what that is in English?) as the first step in trying to get my jaw joint to unlock. That was supposed to have been fixed by having my wisdom tooth out...but that didn't happen. I've had three sessions with her so far..and I'm not sure if it's helping my jaw yet...but it definitely helps with relaxing my facial muscles....something else I think I need to learn to do to help speed this healing up a bit more!

I got caught in a traffic jam on the way home from work today and had lots of time to think. My lip was burning, my teeth were aching and I couldn't wait to get home to take some Ibuprofen. Anyway, I was seriously contemplating just getting all my back teeth pulled on the lower left "numb" side. The prognosis for my second molar isn't great now anyway (that's another story). I know that the pain I'm in is way less than other's pain...but, I'm honestly sick and tired of this situation..literally.

I can compare how I feel now to then. My lip is still numb with altered sensation but only burns when I'm tired or if I've had to talk alot. My lower teeth on the injured side don't ache anymore...so I'm really glad I stuck it out and didn't have them removed! My gumline is still slightly numbed but I can feel when I brush. My front tooth still feels very wierd (still tight) and "out of place" in my mouth (it's the tooth that had the vice grip feeling in it really badly). I'm still getting shoots of pain occasionally in my chin and lip but nothing that some Ibuprofen can't take care of. My chin is almost back to normal...some abnormal feelings when I scratch it but nothing like a year or two ago! Migraines are still bad...growing in intensity and length.

One thing hasn't changed however. I'm still sick and tired of this situation. I've reluctantly accepted the fact that I've probably been permanently injured...but I am having more trouble accepting whether or not the injury had to have happened on that fateful day 2 and a half years ago or whether it could have been prevented! In my heart, I still believe it could have been prevented.

for the first 8 weeks post operation sleeping was terrible - i was lucky if i got 3-4 hours a night.....with the advent of the tegretol i have been sleeping like a baby, and to be honest I almost look forward to the evening more than anything.

I find around midday 1pm i am knackered and almost want to have a sleep but push through it....have started some light exercise also which seems to be helping.

I've got my bite back (can feel both sides of my mouth when biting dowm) don't know whether that is a good sign as i still cannot chew on the damaged side but i guess it is sometihng.

Normal function......what a lovely thought that would be!!!

best wishes to all

SD

C. YARASCAVITCH, G. REGEHR, B. HODGES, and D.A. HAAS, University of Toronto, Toronto, ON, Canada

Objective: The demonstration of empathy in dentist-patient interactions significantly affects treatment outcomes, however studies have shown that empathy declines as dental students progress through training.

In our previous work with dental students, evidence of decreasing emotive empathy (Emo) combined increasing cognitive empathy (Cog), localized to the professional context, was interpreted as being consistent with the formation of detached concern as a model of professional empathy

http://iadr.confex.com/iadr/2009miami/webprogram/Paper118320.html

It sounds awesome; it sounds difficult. It probably is the most important part of the dentist - patient relationship. If you’re talking with a patient and can identify to the extent of thinking, “If I were he, knowing what I know about dentistry, how would I want to be treated?” then you have achieved empathy. This is the beginning of trust.
http://www.spiritofcaring.com/public/218.cfm?sd=75

Further, first-year dental students had significantly higher empathy scores than students in any subsequent year. Consistent with the literature in medical settings, the timing of the decline in empathy levels corresponded to increases in patient exposure. We suggest that training students in the interpersonal skills designed to enhance the dentist-patient relationship should continue throughout dental school training.
http://www.jdentaled.org/cgi/content/abstract/69/3/338