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TMJ cure (temporomandibular joint (TMJ) disorders or TMD)

If I  EAT ON THE LEFT SIDE (WHERE THERE IS PAIN)_ IT HURTS LESS

STOP CHEWING AND ONLY SWALLOW FOOD.
Jaw muscle is clenched tight.
STOP ANY THING THAT MAKES THE JAW POP
HEAT IT AND ICE IT

FIRST STUDY THE ANATOMY

IN MY VIEW THE SINGLE BEST ADVICE HIS THIS:

THESE OTHERS ARE OK as SUPPLEMENTARY ADVICE.



https://www.youtube.com/watch?v=Kaaw3a14nYc

 

How to Eat Right When Temporomandibular Joint Pain Flares Up

 

  • Take small bites
  • Chew slowly
  • Cut all foods into bite-size pieces
  • Limit jaw opening to the extent that is comfortable
  • Select moist foods or use gravies or sauces to moisten foods
  • Chop whole foods to consistencies that can be comfortably tolerated
  • Peel fruits and vegetables that have skin

Food Preparation Tips for People With TMD

Fruits

  • Peel all fruits with hard or chewy skin (example: apples, peaches, plums, pears).
  • Chop whole (peeled) fruits.
  • Use the blender to puree or “sauce” any fruits.
  • Make smoothies with peeled fruits in the blender, adding ice, milk or yogurt.

Vegetables

  • Wash, steam, or cook greens such as spinach, chard, kale, or collards for 2 to 3 minutes, finely chop into a ribbon-like thickness.
  • Chop tomatoes.
  • Peel and finely chop cucumbers.
  • Peel and either shred or finely chop or mince root vegetables like carrots, parsnips, or beets. If chopped, cook after chopping.
  • Cook broccoli, cauliflower, or other similar vegetables until tender, then chop.
  • Juice or make smoothies with any vegetables by following the juicing machine instructions.
  • Make vegetable soups and purees.
  • Peel, cook until tender, and chop other vegetables with skin.
  • Cook, chop, and mash potatoes (white or sweet).
  • Try purchasing commercial vegetable or tomato juices.

Legumes & Nuts

  • Cook and mash or puree legumes that are larger than the size of a pea.
  • Use nut butters (any nuts can be used).

Protein Foods

  • Cook poultry or meats until tender; moisten with broth, gravies, or other sauces; cut into bite-size pieces.
  • Cook and cut fish into bite-size pieces, soften with sauces as desired; make tuna salad.
  • Chop tofu and tempeh into bite-size pieces; tempeh may need moistening.

Dairy Foods

  • Consume all milk products, yogurt, and cheese as tolerated.

Dairy Alternatives

  • If unable to eat protein foods or nut butters, try alternatives such as meal replacement beverages (example: instant breakfast and whey protein beverages or powder).

Grains

  • Prepare hot cereals.
  • Try couscous, quinoa, farro, rice, and other cooked grains.
  • Cook orzo and other small pasta until tender.
  • Cut thin toast into small pieces.
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Tooth mousse – what is it and how to use it

My dentist said I should use Tooth Mousse. BROCHURE.

GC Tooth Mousse is a water based, sugar free creme containing RECALDENT™ (CPP-ACP), which is derived from cows’ milk.

This video explains it:

 

FOR HOW LONG TO USE TOOTH MOUSSE

I have been using Tooth Mousse for a few years now (love the strawberry flavoured one) and it absolutely does work if you use it properly. It reduced my sensitivity to the point where I can eat ice cream now, and I noticed a reduction in the white spots on my teeth. Didn’t completely remove them, but they certainly weren’t as noticeable. I do follow the instructions very carefully and thoroughly and the longer you keep the product in your mouth, the better it works. [Source]

Three months later the teeth were reviewed – they were no longer sensitive and the patient was comfortable and able to eat normally [Source]

 

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Link between Vitamin D and prostate cancer


http://www.harvardprostateknowledge.org/low-vitamin-d-tied-aggressive-prostate-cancer

https://www.vitamindcouncil.org/health-conditions/prostate-cancer/

https://www.sciencedaily.com/releases/2015/03/150322080155.htm

when men with low-grade prostate cancer took vitamin D supplements for a year, 55 percent of them showed decreased Gleason scores or even complete disappearance of their tumors compared to their biopsies a year before (J. Clin. Endocrinol. Metab., 2012, DOI: 10.1210/jc.2012-1451). – SOURCE

http://www.webmd.com/prostate-cancer/news/20160302/low-vitamin-d-levels-may-signal-more-aggressive-prostate-cancer#1
Compared with white men, Blacks have a higher incidence of prostate cancer. Comparatively, their disease is more aggressive, which leads to higher mortality rates. Hollis noted that Black men also exhibit a high prevalence for vitamin D deficiency. [Source]

https://www.healthafter50.com/prostate/article/aggressive-prostate-cancer-and-low-vitamin-d

http://www.albany.edu/news/13412.php

http://militarymedicine.amsus.org/doi/pdf/10.7205/MILMED-D-12-00540
“veterans who were initially vitamin D deficient were significantly less likely to survive than those who were not initially deficient” – source

http://www.drmagaziner.com/vitamin-d-deficiency-increased-risk-prostate-cancer/

 

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How long does it normally take to return to work after prostate surgery?

Notes:

My urologist performed a radical retropubic prostectomy on Tuesday, Jan 6th and I was back working on Monday Jan 12th. I’m fortunate enough to telecommute, so I’m working from home for a while. [Source]

You should not plan to go back to work for 2 to 3
weeks after surgery. This will depend on the kind
of work you do and how fast you heal. Your
surgeon can tell you more about going back to
work. [source]

After prostatectomy, take it easy for the first few weeks. Do not lift anything over 10 pounds or engage in any strenuous activity, as this could cause serious, long-term complications. If you have a desk job, you should be able to return to work after three to four weeks. prostate cancer survivors who return to work are as productive on the job as other workers. [source]\

Most men get back to normal a few weeks after the prostate surgery and you should be able to return to work within six to eight weeks. This will depend on the physical demands of your job. Take your doctor’s advice about when you are ready. [Source]

Some people take five months to return to work [Source]

You may feel surprisingly good after the surgery, but don’t go overboard. “Too many patients want to prove their manliness,” Thrasher says. “They need to rest and give their wounds a chance to heal.” He tells patients not to lift anything heavier than 10 to 15 pounds for at least six weeks. Many patients can quickly return to work, as long as it’s not too strenuous, he says. [Source]

As soon as you’re free of the catheter you’ll probably feel fine being back at work. [Source]

 

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How is the prostate removed through a hole in robotic surgery?

The holes in robotic surgery are quite small (generally 5 cuts/ holes)

“a few small holes in the skin, each roughly the size of a dime. A small plastic tube known as a “port” is inserted in each hole to keep a channel open for laparoscopic Port Placement image tools to reach through.” [Source]

The prostate is a largish organ. How is it removed through these small holes?

It appears the removed prostate is put into a metallic mesh bucket at the end and sucked out by the machine through the hole. Presumably some cancer cells might get pushed off during this process?

The video below shows some portions of material being dumped into a “bucket” at 53 minutes 45 seconds or so.

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Focal laser therapy + Nanoknife for prostate cancer in Australia

“What we are doing with prostate cancer now is like using a sledgehammer to kill a flea.” [Source]

“This focal therapy provides a middle ground for men to choose between radical prostatectomy and active surveillance, between doing nothing and losing the prostate,” Marks said. “This is a new and exciting concept for prostate cancer treatment.” [Source]

Focal therapies are less invasive than prostatectomy and therefore carry fewer risks and side effects are greatly reduced: – Fewer complications (such as bleeding, infection, injury to other organs, risk of death), reduced pain, shorter recovery along with reduced aftercare and rehabilitation.

Focal therapies are new methods of treatment which have recently been made possible through more precise diagnostics and improved MRI technologies. The idea behind this technique is that only the cancerous tissue is treated so that as much healthy prostate tissue as possible is retained. [Source]

Laser ablation generates intense heat that completely encompasses the targeted area. [Source]. Also see this.

IN AUSTRALIA

Macquarie University

NANOKNIFE – $30,000

http://www.smh.com.au/national/health/prostate-cancer-patients-zapped-with-electricity-in-new-treatment-20151118-gl1ybg.html

BUT CANCER RETURNS QUITE A BIT: “in a study of 25 patients, in 76 per cent of cases the cancer had not returned after eight months.”

 

 

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Any proven way to reduce the spread/ metastasis of prostate cancer?

CLINICAL TRIAL

http://trials.cancervic.org.au/details.aspx?ID=vctl_actrn12612000523808

 

This is a cut paste. Analysis later.

CARROTS

Contains amygdalin [Source] – assuming it works!

  • bean sprouts
  • beans
  • raw almonds

CUT WEIGHT!!!

obese men with prostate cancer are more likely to have aggressive tumours.  prostate cancer cells were more likely to invade nearby tissue when mice were obese  – this was due to the presence of more fat tissue. [Source]

ASPIRIN – MEDICAL OBSERVATIONAL STUDY

“We found that regular aspirin intake after prostate cancer diagnosis decreased the risk of prostate cancer death by almost 40 percent,” Among men with prostate cancer, regular aspirin use after diagnosis was associated with a 39 percent lower risk of dying from prostate cancer.  [Source]

Allard speculated that aspirin’s ability to suppress platelets in the blood — which is why aspirin can cause bleeding as a side effect — might help explain how aspirin could prevent the lethal progression of prostate cancer.

“Platelets probably shield circulating cancer cells from immune recognition,” he said. “By depleting those platelets, you’re allowing the immune system to recognize the cancer.”

Allard added that aspirin likely helps prevent the cancer from spreading to other areas of the body, such as the bone.

In the study, men without a diagnosis of prostate cancer who took more than three aspirin tablets a week had a 24 percent lower risk of getting a lethal prostate cancer.

NATIONAL CANCER INSTITUTE RECOMMENDATIONS ON DIET

foods and dietary supplements to lower the risk of developing prostate cancer or for treating prostate cancer,

  1. pomegranate
  2. processed tomato
  3. Vitamin D
  4. Selenium

OMEGA-3

eating a diet rich with omega-3 polyunsaturated fatty acid could stop the spread of prostate cancer, but omega-6 fatty acids appear to promote the spread [Source] = READ THIS STUDY IN FULL.

freeze-dried black raspberries and strawberries [Source].

UNPROVEN

B17

Patients’ story: https://cancercompass.com/message-board/message/all,31581,0.htm

CUT DOWN ANIMAL FATS??

Arachidonic acid (AA) – a type of omega-6 fatty acid found in meat and fish. Cancer cells exposed to AA became rounder in shape and sprouted projections which helped them squeeze through gaps in surrounding tissue. But treating the cells with statins prevented the changes, says a report in the British Journal of Cancer. [Source]

ANTI-DEPRESSANTS [Source]

 

vascular-targeted photodynamic therapy (VTP),

In a broad clinical trial at 47 treatment sites across 10 different European countries, 49 percent of patients with early prostate cancer that were treated with VTP went into complete remission, compared with 13.5 percent in the control group. [Source]  – but this is not necessarily superior.

Focal Laser Ablation

Focal Laser Ablation

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Decision regarding the surgery

Having ruled out active surveillance and radiation therapy, the final decision I needed to take was about the type of surgery and the timeline. I initially thought that I could wait a few weeks, but new information received on 23 May has prompted me to be a bit more aggressive about the surgery date.

However, various circumstances mean that the date is broadly as predicted, in mid-July.

I initially thought I’d undertake surgery in the public system, but finally decided on robotic surgery for a single reason.

I undertake open (not robotic) surgery in the public system at the earliest date (allowing around 4-6 weeks for recovery from the biopsy) and to undertake any feasible portion of the trip to Europe/India before the surgery.

QUALIFICATION: Given that I knew nothing about prostate cancer till 18 May, and have learnt everything I know about it in the past week, I will change my decision if new and more persuasive information comes in.

Reasons

1. Type of surgery

I will undertake open surgery (not robotic) given there is no difference in outcomes between the two, particularly after the first three months.

2. Timeline for the surgery

a) Waiting for biopsy surgery to heal

It is a good thing to wait 6-8 weeks for the biopsy surgery to heal (details here).

b) Going only my biopsy results and PSA, it is OK to get surgery within 75 days from biopsy

The table, below, from a major study on this issue is very useful (Study: Delay From Biopsy to Radical Prostatectomy Influences the Rate of Adverse Pathologic Outcomes William T. Berg,1 Matthew R. Danzig,1 Jamie S. Pak, et al. -PDF is available online)

The table above shows that PSA is more influential in determining the severity of the cancer than the Gleason pattern score, alone. Further PSA is more reliable (being objective, compared with Glaeson scores which are subjective). My cancer is ranked Gleason 7 (but 3+4, not 4+3). Since this is a milder form of Gleason 7, a delay of between 105 and 150 days should be OK.

But even if biopsy has been poorly done and a portion of the tumour with Gleason 8 was accidentally excluded, I have up to 75 days.

Data from the biopsy suggest that a delay of 75 days is ACCEPTABLE (i.e. till 25 July 2017, given the biopsy took place on 11 May 2017. Surgery between 5 July and 25 July should not meaningfully impact the spread of cancer.

c) Relevant data: My tumour is located in the transitional zone and is pushing the edge

My MRI report is shows that the cancer is located in the transition zone (abutting it for 1 cm) and is causing a slight bulge in the body of the prostate.

 

There is evidence in the literature [see this] the the location of a cancer is related to the prospects of metastasis. Although there may be some time, I should not wait unnecessarily.

d) Relevant theory: At my age the cancer may become aggressive

It is a fact that even after radical surgery, prostate cancer returns (having probably spread prior to the surgery). All it takes is one aggressive cell to get out.
An oncologist from Mumbai told me that at relatively younger ages, cancer can mutate into the aggressive varieties more quickly, compared with what happens in one’s 70s and 80s. This, too, suggests, not waiting unnecessarily. 

There is contrary evidence that “in the vast majority the cancer is born with a particular Gleason score.”  “You might see progression in an individual, but we think that it’s uncommon,” she says. “We just can’t rule out this possibility in our study.” [Source]

“advanced cancers [that have spread] are not being found as much because PSA testing has identified them earlier, but aggressive cancers (high Gleason score) are being found at the same rate. The aggressive cancers are being found early (i.e., when they are “born”), rather than transforming into aggressive cancers over time.” [Source]

However, on balance, the logic does suggest that there remains a risk of metastasis given my age profile. Medical science doesn’t have all the answers.

CONCLUSION

I am now processing the surgery in the public system (which is free compared with $10,000 or so for robotic surgery through private health insurance). There is a wait time of around 30 days for prostate surgery in Victoria (such as here).

This is likely to take some time and might allow me to undertake a part of the planned trip.

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MRI report for prostate

My MRI report dated 20 April 2017

MRI PROSTATE

Clinical Notes: Elevated PSA 3.95.

Report: Routine multi-parametric 3T imaging of the prostate. Prostate volume 35ml.

There is a large PIRADS 5 lesion centred within the right anterior transitional zone involving the mid gland apex. This measures 20 x 8 x 15mm in size (AP x CC x trans). Anteriorly, this abuts the anterior fibro-muscular stroma, with subtle bulging of the capsule but no visible tumour extending beyond the gland. The tumour has more than 10mm of abutment of the capsule and has at least moderate likelihood of microscopic extra capsular extension. The left side of the transitional zone shows mild nodular change and BPH, with no suspicious lesion.

The peripheral zone shows mild diffuse low T2 signal change without a focal nodule or restricted diffuse and there is no lesion involving the peripheral zone.

The prostate contour remains smooth and the recto-prostatic angles are preserved.

The seminal vesicles are normal. There is no pelvic lymphadenopathy. Bone marrow signal within the imaged field is normal.

Conclusion: 20mm PIRADS 5 lesion, right anterior transitional zone in mid gland and apex. There is capsular abutment with minor bulging and abutment of the anterior fibro-muscular stroma. Moderate likelihood of ECE.

Seminal vesicles, lymph nodes and bone marrow are normal.

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Which is better for prostate surgery – open surgery or robotic?

CONS OF USING ROBOTIC SURGERY

This doctor does not recommend robotic surgery http://www.drcatalona.com/qa/faq_initial-treatment.asp

Reasons: “it is far more difficult to get consistently good results because it does not afford the surgeon as much control as with the traditional operation. Also, it does not provide tactile feedback, and it is more difficult to suture laparoscopically.  The surgeon cannot tell how hard the robot is grasping tissue, or, if the angle of the needle is wrong and if the needle does not pass through the tissues easily, the robot continues to “muscle” its way through. With tactile feedback afforded by open surgery, the surgeon would “feel” the mistake and make the necessary adjustment.

Having seen laparoscopic and robotic surgery performed by most of the world’s most experienced experts, I don’t believe it allows nerve-sparing to be performed with the same degree of fine control without risking thermal damage to the neurovascular bundles, and I do not believe removal of the cancer is as consistently complete.

STUDY

the most significant outcomes (cure, continence, and potency) are no better with LRP or RALRP than with conventional ORP. Therefore, in experienced hands, ORP remains the gold standard procedure [ Open Versus Laparoscopic Versus Robot-Assisted Laparoscopic Prostatectomy: The European and US  experience – Julia Finkelstein, BSc, Elisabeth Eckersberger, MPA, Helen Sadri, MD, Samir S Taneja, MD, Herbert Lepor, MD, and Bob Djavan, MD, PhD]

STUDY IN AUSTRALIA – no real difference in outcomes

Expensive robotic prostate surgery, marketed as “ground breaking”, “revolutionary” and “nerve sparing”, has been found to be no better at preserving men’s urinary continence and sexual function than traditional surgery. A landmark Australian study made the finding after comparing the advanced surgery, which can cost more than $10,000, with traditional open surgery three months post operation.  Patients who had the open surgery lost more blood during the procedure but none of them needed transfusions. Patients who had open surgery had a longer hospital stay post surgery and experienced more pain doing day to day activities one week after the operation but, on average, both groups spent the same number of days off work.

President of the Urological Society of Australia and New Zealand Mark Frydenberg said the study, published in The Lancet medical journal on Wednesday, showed both techniques were “equally effective”.

Professor Frydenberg said “patients without access to robotic surgery should not feel in any way disadvantaged or be concerned they will have an inferior outcome”.

“Our view is that both robotic and open surgery are very valid treatments for prostate cancer but what is of most relevance to outcomes is the skill and experience of the surgeon,” he said.

[Source]

MY CONCLUSION

Robotic is new and potentially OK, but because there is no longer term difference in outcomes, I think open is OK. At least at this stage, when surgeons trained in open surgery are still available. In the future such surgeons may become fewer and fewer.

ADDENDUM

But there is a major issue that has low probability of occurring but can cause real problems. Scar tissue can be formed due to poor healing, causing enormous problems.

http://urology.jhu.edu/newsletter/prostate_cancer825.php

Worse thing is that the problem returns every three months once it starts:
Apparently, this is less of a problem with robotic surgery since it can apply a running suture (12 stitches). The manual surgery (open) is only able to apply seven, and not very well.
It has a few other advantages as well: “Cutting and putting in stitches is easier with the robotic assistance” (Source), recovery is quicker, etc.
As a result I’ve gone for robotic.

Comparison of Prostatectomy Surgical Options: Open, Laparoscopic, and Robot-Assisted Laparoscopic

  Open Surgery* Robot-Assisted Laparoscopic*

 

Surgery Time 3 1/2 Hours 3 1/2 Hours
Hospital Stay 2 Days 1 Day
Total Incision Length 5 inches 2 inches
Estimated Blood Loss 375 cc 116 cc
Visualization 3 D 3 D
Magnification of Visualization up to 3X with magnifying glasses 10-12 X (utilizing a pair of high resolution cameras)

 

Instrument Handling Normal Normal (Optional Micro-precision)
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