Jaw-Botox | Arthritis Information

Saw my pain dr. today. This is the same dr. the surgeon would have referred me too anyway. I have been seeing him over a year. He already sees a number of the surgeon's patients-nice coincidence.

Anyway, he felt and moved the jaw all sorts of directions. He feels that Botox injections could help. Basically, it will weaken the overactive muscles and hopefully allow for more movement. I am still at a 20mm opening-30mm is considered functional. Now it is a matter of insurance approval. It really isn't a matter of if they approve-it's how much they will cover. If it is too expensive, we will have to think of something else.

Unfortunately, I am not scheduled until May 20th. This is to allow time for insurance. He wanted to increase the percocet dose but I am not a fan of that idea. He also noted increased inflammation in a number of joints. He wants me to take the percocet twice a day(which I have been) and dexamethasone at the same time. This is a longer lasting steriod. Basically, I take the pain med before school and when I get home. My speech is still a bit off-the kids find it very amusing. Actually, they have been great about it-sweet kids. Hopefully the steriod will help with inflammation of the jaw and the other joints. He isn't ready to pass judgement on the Rituxan. I had the first two doses in Feb. Both he and the RD want to get to a point where the jaw has calmed down. They feel I have been under stress both physically and emotionally since this rollercoaster ride began. I am getting ready to think this is not the med for me...but I have also worked totally up the ladder. Going back down probably won't improve anything at this point.

Positive to all this---always try to be positive---I have lost 15lbs.

Obviously, I am really frustrated. So far, I have been able to keep working most of the time. Pain Dr. told me to call him if I need a sick note-but those would be days without pay. 6 weeks until summer vacation...End is in sight!!!

I am glad you are making progress with your doctors, or so it seems, and summer is near! 20 mm, jeesh! That is rough. I am actually on dexamethasone now for all the itchiness I've had! I didn't know exactly what it was. Positive thoughts your way, and congrats on the weight loss i guess, although I know it was miserable probably and I don't know whether you needed/wanted to lose!!

I am having pain in my back tooth right now, that I have assumed is related to jaw pain but now I am sort of wondering, becasue the Humira is working so well...but, honestly, not for my jaw...

My pain dr. has wanted me to lose 20lbs so the 15lbs is welcome. I gained about 30lbs while on steriods for 5 years. I was up to 90mg at one point. Steriod weight is hard to lose. That is one reason for the dexamethasone. I am very anti pred. at this point. Of course, I know there are times for every med. Dr. agreed to start with dexa and leave the pred. for later if necessary.Rebecca, I so hope the botox is approved! Wouldn't it be great if you and your son could spend a wonderful, relaxed (jaw too!) summer full of fun? I hear your frustration but maybe this is the answer for you and you will come out on the winning end of things at last! That is my constant hope for you anyway! I think of all that goes on with my RA friends everyday and send up special wishes, hope, and positive energy for those needing it most and you, Rebecca, are on my daily list!

Your continually humming friend,
Waddie
Wow botox- I'm glad they are still coming up with ideas for you. So glad you have a silver lining- 15 lbs. gone! Good for you! Steroid weight IS very hard to lose. What does the dexamethasone do? I never heard of it. Here's a chart that compares steriods. Basically, dexamethasone is longer acting and can be prescribed in lesser amounts. As to why it isn't used more often, as opposed to pred., I don't know.

Glucocorticoid	Approximate Equivalent dose (mg)	Half-life (Biologic) hours
Short-Acting
Cortisone	25	8-12
Hydrocortisone	20	8-12
Intermediate-Acting
Methylprednisolone	4	18-36
Prednisolone	5	18-36
Prednisone	5	18-36
Triamcinolone	4	18-36
Long-Acting
Betamethasone	0.6 - 0.75	36-54
Dexamethasone	0.75	36-54

Chart headings didn't copy....the second column is equivalent dosage, and the last one is half-life of the med.

The first group of meds is short lasting, second group is intermediate lasting, and the third group is long lasting.

I am taking 4mg which equals about 26-27mg of prednisone.

rocckyd2009-04-27 19:04:31

I really hope you get the chance for the Botox. My sisters doctor used it on her to repair a collapsed food tube and then she has had more or less the same probelms with her jaw, so it was used again with great results.

I am seeing a specialist about my jaw , the joined has been badly inflammed for a long time and i am having to wrench my mouth open lately, the cracking sound is awful and the pain is worse.

Take care

Lisa

[QUOTE=rocckyd]6 weeks until summer vacation...End is in sight!!! [/QUOTE]

What a difficult time you have had. It is always a joy when the end to anything is in sight. I can only imagine the frustration of this wait for approval on top of all the recent waits you have been forced to negotiate.

Best wishes for a positive outcome, Shug

Good luck with your insurance approval for the botox treatment!

Hope it gets approved. Congrats on the weight loss!

Keep us posted!