Openings

This is not a very attractive picture, but it shows what my real jaw opening currently is: two fingers in my mouth, or approx. 22cm. The goal with surgery is to triple that opening (more or less). I am not sure how long that process will take.

I am trying to get myself into as good of shape (physically) as possible before the surgery. The more flexible I can get myself NOW, the easier things will be post-op. In that spirit, I went bike-riding today (over 5 miles!). Exercise is important to ANY singer, with out without TMJ problems! It keeps muscles limber and keeps the blood flowing to them. GET OUT AND DO SOMETHING!! Make it fun (bike-riding, dancing, etc.) ... but I am positive that anything is of benefit. 

Despite my teeny tiny mouth, I continue to take voice lessons. Why? What's the point anyway? My teacher and I spend most of our time now on breathing and intonation, which can be done without opening the mouth very much. And in the larger picture, it gives me some amount of hope that this will all be better someday SOON and I can move on with my life.

I've started to wonder about the role of the singer in silence. How does she maintain her persona? Is her instrument all she is? What other depths of life are there? Just some musings for the evening ...

The Pin Cushion

The muscles surrounding the jaw are directly impacted by the trapezius and other muscles in the neck. These literally run up the neck or over the skull; tightness in this muscles can further problems with the TMJ. 

Of course, with any injury, there is pain, and pain leads to muscle spasm (of course the disc damage to my neck did not help either. I receive trigger point injections every week from my MD, and cervical spine epidural injections every other week, all in an attempt to relax the muscles as much as possible before surgery.

 A trigger point injection involves the doctor palpitating the sore/tight regions of the neck and feeling for the extremely painful knots (trigger points). He circles the area with a pen and then injects a mixture of a small amount of medication with lidocaine directly into the muscle. The patient feels strong pressure and pain as the medicine is injected. The goal of the injections is this: when muscle is in spasm, no blood supply is going to the region. By poking them with a needle, blood rushes to the area, thus relieving (or partially relieving) the spasm.

My MD was very into my blog project, and allowed me to take pictures of the procedure.

And yes, it hurts! But it provides immediate relief (and helps release the muscles in the face). It is important that people with TMJ problems explore ALL their options for relief of muscle spasm. Surgery is less successful with muscle tension. Pre-op, patients should get themselves in as good of shape as possible ... again, so that the muscles can relax.

How to Comment ...

Not like I've had anything interesting to say yet, but whenever you wish to comment, simply click on comment and type in any of your addresses under the categories listed (ie: if you have a Google account, type it in) .... OR click OpenID and just type your name.

Hope that makes sense!

A Brief Anatomy Lesson ...

This is the tempro-mandibular joint (TMJ for short). Unlike other joints in the body, it slides back and forth. As a result of my accident, the meniscus (in blue) was dislocated, which can block movement. Anything that disturbs the sliding motion of the joint reduces opening (duh).

Purpose

I am a young mezzo-soprano and was recently injured during a production of the Marriage of Figaro, where I was singing Cherubino. Due to a collection of small mistakes (by management/production), I tripped and slammed the side of my face full-force against the stage wall.

Apparently, I bounced right back up and didn't miss a cue ... I just remember exiting into the closet and feeling blood coming from my ear!! I finished the production (I am quite stubborn).

That accident occurred on May 16. Over two months later and I am still needing medical intervention for three bulging discs in my neck and other issues. Yes, I do whine from time to time. It's not easy.

But the worst injury by far was to my jaw. The main impact was on my left tempro-mandibular joint (where I needed stitches to close the wound in my ear), and my jaw has not healed properly. My opening is less than half of a normal persons opening ... and much less than what I need as a singer. I am scheduled for surgery on September 10, which will have a 6 week recovery period, then more rehab.

I never blog, but I've started this in the hopes of sharing my story with others. Having an injury that directly affects a musical talent/emerging profession is particularly heartbreaking. My depression worsens with each day that I can't sing ... I feel silenced, and I wonder what I am supposed to do during these muted moments.

So that's the deal -- I hope to post updates as well as research on TMJ disorders ... we'll see what happens. This is so much more than an injury; because of this, I have been forced to conquer personal demons, question my faith and spend endless hours wondering WHY and HOW this happened.

Thanks for reading.