A Real Jaw Dropper

Nurse seeking TMJ therapy learns she has vertigo

Brenda Day was looking for “an expert” to treat her temporomandibular (TMJ) disorder. But instead of just one, she was helped by two experts at Parkwest Therapy Center at Fort Sanders West.

Physical therapist Jennifer Galloway was evaluating Day’s symptoms when she noticed something else askew. It was Day herself.

“I was getting up from a mat to get in a chair and when I did, she saw my balance was off,” said Day. “She said, ‘Stand there just a minute.’ I don’t remember exactly what she had me do – close my eyes and hold her hand or something – and I had no stability at all. From that, she said ‘You really need to be looked at.’”

Fortunately, Galloway knew just the person who should do the looking: Suzanne Moskal, a vestibular therapist working just a few steps away. “I was very concerned about her balance and I knew I could not get her better if we didn’t address the vertigo issue,” said Galloway.  “We have a wonderful staff and we have therapists who specialize in that. So I was able to just walk across the room and talk to Suzanne about Brenda’s symptoms. I was able to get an order and we were able to treat it very quickly.”

Day’s jaw problems began hours after her vehicle was rear-ended at an exit ramp three years ago. The collision tore the labrum (a fibrocartilage ring surrounding the joint) in each of her shoulders, one of which later required surgery. “When I went home the night after the accident, my jaw locked in an open position,” Day said. “I’m sure it was only for about 30 seconds or so, but seemed like forever before I could get it unlocked. Two months later, I started having jaw pain.”

A dentist diagnosed the TMJ and prescribed muscle relaxants to loosen the jaw muscles. That helped for a while, but the pain returned.

In the meantime, Day began to notice other problems. “I was having balance issues that were getting worse,” said Day, whose primary care physician ordered tests to rule out any potentially serious issue, such as a tumor, as the possible cause. “We had done all of that workup but hadn’t found anything. I was slowly getting worse, my vision was blurring and I had fallen a couple of times.”

Through a series of TMJ mouth exercises that she practiced at Parkwest Therapy Center and at home, Day says her life has changed. “I still have the popping and I will have that for the rest of my life,” said Day. “But the pain is gone and the alignment is 60 percent better. It’s not completely corrected because that would require surgery, but it is much better and I’m not in pain.”

Likewise, Moskal worked wonders on Day’s balance and vision. Determining that she was suffering from benign positional vertigo (BPV) with nystagmus (involuntary eye movements), Moskal repositioned the crystals in Day’s inner ear canal by using a series of head and body movements known as the Epley Maneuver.

“It was really cool!” exclaimed Day. “Just her maneuvering my head cured it – it fixed me! I don’t have balance issues now. I thought I was going to be on a cane. I really did.”

While Day says that Galloway and Moskal went “above and beyond,” Galloway says such teamwork is common throughout Parkwest Therapy Center.

“We want to do everything we can for our patients,” she said. “We want to address all of their problems, not just an immediate need. So it’s common for us to have dual treatments. What makes our clinic so special is all of our clinicians are always striving for extra certifications. We encourage each other and help each other when a patient has more than one issue. You might not have a lot of experience in one of their issues, but there’s a coworker here who does.”