I hadn’t heard of this before, thank you!
CraigMichael
Karma: 639
Thanks for this! I’ll ask my PCP the next time I see him (hopefully soon here).
I switched jobs recently, and it is stressful. So there’s that. But with the kind of pain and stuff it feels like it has to be more than just stress, although stress could for sure have been a distal cause.
Do you feel unusually fatigued / sleep deprived? Frequent headaches? mental fog? worse at concentrating lately? short temper?
I’ve had sleep issues since a traumatic event around 2012. Short temper, yes, but mostly because I’m worried about this and it’s kind of exhausting. Not many headaches to speak of. Concentrating has been an issue, but I think that’s because my body feels weird and it’s distracting.
It could be, though. I’ll discuss it with my PCP next time I see him. It’s mostly a diagnosis of exclusion, yeah?
With only Google-knowledge of jaw anatomy, I don’t think it’s a lymph node, but I could be wrong. Feeling it now (it’s better than when I posted originally, but is still fairly sore) it’s feels like it’s right on the masseter muscle.
Looking at the image, it’s not near the lymph nodes identified. https://www.medicalnewstoday.com/articles/325947#what-are-they
Feels like it’s right on the masseter as shown mid-article here:
http://cioffredi.com/tmd/
And thank you for posting! Every idea is a good one for me here in terms of feeling less hopeless.
I’ve been a Wikipedia editor with various degrees of activity for… checking now… wow… 16 years. I’m somewhat unresolved about the cadre of editors that work on all things “alternative medicine” there (mostly people with the userbox linked here). My current model is that they’re not granular enough about various degrees of alternative, it’s too binary the way they Like there’s currently two buckets on Wikipedia (alternative and not-alternative) there should be a few buckets:
(1) evidence decidedly against—it’s been studied and was found to be categorically harmful.
(2) evidence mixed—it’s been studied and is a mix of helpful, harmful, or neutral.
(3) evidence low—it’s been studied and evidence exists but is low on the hierarchy.
(4) literally no evidence—there’s only mechanistic speculation or hypotheses put out by various people, but it’s never been tested.
(5) good evidence exists—multiple large RCTs, meta-analysis, etc.
There are probably other relevant categories, but I think those would be an improvement.
Thank you! This is one area where I’m going to follow up.
Would any DO be a candidate here, or would there be a specific feature you’d look for?
Do you find you’re able to do this on your own, or do would you recommend a certain kind of massage specialist? I’m seeing some results of Google for myofascial release in my area. Does that sound right?
And thank you! I have a lot more to try now.
My psychiatrist has said recently that he thinks I may be having some kind of trauma response and recommended a trauma-focused therapy (that he doesn’t specifically do, he’s more for med checks and emergencies).
You interest me when you talk about woo allergies… In my model there’s something like three camps. The first being people who adhere to POVs like those on sciencebasedmedicine.org and dismissive of anything that smells alternative, my guess is that their model is overfit and they have a lot of false positives when it comes to treatment. The second being ACX/LW types that are a bit more open-minded but evidence-aware. The third being like woo-heavy ways of reasoning that I try to avoid.
Do you see the camps similarly? I try to assign various woos reasonable probabilities and not dismiss them unnecessarily. But I also cautious not to get trapped in vortexes of woo.
Will check out the trauma resources.
One thing I wish I had made clearer in the original post—I’m concerned that I’m communicating with various doctors/practitioners in a way that makes me sound crazy or low-priority, but I also don’t want sound contentious or obnoxious in a way that makes them dismissive.
To your first bullet, yes my PT did suggest laying with rolled up towel on one side of my neck for 30-60 minutes at a time. I have done this, but should be doing it more regularly.
To the second bullet, the neurologist ordered an AP (anteroposterior) and lateral x-rays. It’s hard for me to tell if this are both necessary and sufficient, or if a CT would show more (e.g. looking at the Wikipedia article). The PT saw these and thought they were concerning because of the way my neck was bent when standing straight. The radiologist thought they looked normal. Blood tests performed were basic metabolic panel, vitamin b12, vitamin b6, CBC with auto diff, iron binding panel, ferritin serum/plasma.
Third bullet—I’m not sure what expectations are reasonable. I know, for example, neurologists are in short supply and maybe there’s patients that are in worse situations than me? But I do have a high opinion of both my neurologist and PCP.
Fourth—I would rather no go bankrupt, but if this continues I know it will have an impact on my work performance… but I’d like to spend what resources I have not wisely. I’m thinking “yeah, just see doctors until someone comes up with an answer.” But I’m not sure that’s the most efficient route… but may be the only one available.
My PCP thought the same thing. Fasted b6 was normal and I check everything for b6 now. No new medications before it started.
Gout and autoimmune are good ideas, will follow up on those, thanks!
These are excellent, thanks!
[Question] I’ve become a medical mystery and I don’t know how to effectively get help
I’ll take a stab at this. TL;DR—it’s not a very Bayesian comment (how much to change your opinions based on new information or how to encourage other people to update their opinions in this way).
Why do you think that the federal government shouldn’t override states that absolutely suck at putting any rules in place whatsoever? Why are you anti-mask? Why do you want people to keep getting covid when it increases risk of heart disease and all kinds of other problems?
This first go of questions is unfair. If you’ve read Zvi, you know that he’s pro-mask in all of the situations where he sees they make sense from a cost-benefit perspective. For people who are immunocompromised (or who really really really don’t want covid) he’s been advocating for P100s for a longtime (a position that gets very little mainstream traction, I’ll say). People can debate the relative cost and benefits of mask-wearing in various circumstances, but Zvi isn’t anti-mask by any charitable reading. To me, and I suspect with many other readers, that came across like a slur or an invective rather than a “hey, have you considered this evidence or argument for why you should update your opinions on mask-wearing frequencies?”
The same reasoning applies for long covid. Long covid definitely exists and there’s definitely people who have it. Again, policies come to to cost-benefit compromises, legality, morality, ethics, etc. What percentage of people who get covid also get long covid? How bad is it? How does that compare to the social cost and effectiveness of NPIs? It seems that the risk of long covid is correlated with the severity of covid. So what degree of NPIs are justified now based on the risk of someone getting long covid when we have vaccines (including now the non-mRNA Novavax), Paxlovid, fluvoxamine, etc? The purpose of government is not to stop everything bad from happening. there’s always trade-offs. Of course, with very very very strict well-implemented NPIs (lockdowns, p100 masks, etc) you could prevent some number covid cases and therefore some number of of long covid cases. You also could perhaps reduce traffic accidents by punishing people who speed with floggings. Is that the world we want to live in? Is the juice worth the squeeze?
The bit about who gets the lion share of power (federal vs state vs county vs city) is a reasonable question but also phrased uncharitably here. People who have the means and opportunity can move to a different area where covid policies make them more comfortable. I’ll admit not everyone has this kind of mobility. But, consider a counterfactual—if the federal government had more power (or exercised it more often) but also currently had people from the other team in charge, it easily could have overridden states with mask mandates, federally prohibiting them.
I personally don’t have a hard and fast rule as to federal vs. state vs. county vs. city. I do think a relatively painless way out of the culture war would be for both sides to agree to decrease the authority of the executive branch (e.g. no more ruling by executive order, etc) and give more power back to local governments. Then maybe give a stipend to families who would like to leave locations where they feel alienated by their government to other states/counties/cites where they’re more culturally aligned. Then we could all just live places where whatever group we designate as the out-group is far away.
Our testing sucks—I have covid right now and have gotten 4 negative at-home tests 4 days in a row but have all the symptoms. PCR test results take up to 4 days.
This seems reasonable. Our tests may suck more, especially as new variants emerge and it may be worth discussing. Would have been better if it was your anecdote plus some supporting evidence that it’s wider spread.
This is abysmal. Stand up for disabled people and stop normalizing this as “eh whatever” because your blase attitudes are harmful to REAL PEOPLE.
Zvi is very clearly putting in a massive effort to understand covid and covid policy as comprehensively as possible. So it’s very far from abysmal.
I’m also not sure what the point is. I think we’re all in agreement that preventing people from getting long covid is good, and we have several methods to do this that don’t involve excessive NPIs (again, cost-benefit).
There is maybe an open unaddressed question of for people who do have long covid, what is the best thing we can do to help them recover quickly?
I also want to acknowledge that you have covid right now. I know when people are sick (particularly with covid) that they have less of a filter. I’m sure I’ll be guilty of this the next time I’m sick (or depressed or over-worked, or etc).
So I’m really impressed that you asked and will be more impressed if you read this whole long-winded comment of mine.
Is there some place I can see an example?
Thank you for continuing to write these. They’re still my most significant input for how I make day-to-day pandemic-related decisions.
Colorado is weird
I think most of us are still just happy to get noticed, even with our weed and decriminalized psychedelics. - A Coloradan named Craig
Maybe if they spent the estimated amount of time on the page to read the article (or more), that counts as a view.
You have the most awesome place for these meetups. Looking forward to hanging again!
Okay, yeah, that’s a really good point. I’m going to go for 100% compliance with whatever advice I get. I’ll put it on my calendar and set a reminder and I’ll make sure they know I’m doing this.
Going to look for another TMJ specialist, and based the other comments here likely an osteopath and orthopedist.