Hi guys,

Just reading up on another post and realised that i can only insert two fingers into my mouth. Does this indicate that i have trismus? Should my ENT surgeon picked it up? I'mn learning so many things on this forum that my ENT and RO never mentioned that i'm wondering whether i'm getting the best care.

I did go to another ENT for a second opinion recently and he said i should stick with my current ENT as he was the one who originally did the surgeries and would know my situation best. I'm not so sure that he's the best anymore though. During my last check up with my ENT, i mentioned to him quite a few times that i was struggling to deal with the cancer "mentally" but he did not suggest or offer any advice. Am i wanting too much from from an ENT? Also, after i left, i realised that he did not or asked about any medications that i was on ( my MO prescribed me a few meds for pain and anxiety). It feels weird that he's the one i see most regularly now but he has no idea what i'm on. Am i overthinking it? a What should i do?

Minh

Hi Minh
No you are not overthinking but you are applying your own values to your ENT who may not have your social skills. It is very clear from your level of support of others that you are highly empathetic - something your ENT clearly is not.

I think the other ENT is worried about treading on your original ENTs toes but if you push, and if give your reasons, maybe the other one will relent.

The other idea is to go to another healthcare professional for advice around general stuff that is not strictly in the ENT's area of expertise. Your GP? nurse? counsellor? who can act as your co-ordinator/go betwen and listen to your concerns? Your GP may know nothing about cancer treatment but will know heaps about depression, fear and the importance of knowing what all your medications are and be much more likely to refer you on to the right person.

I have no idea if you have trismus but I can get 4 fingers into my mouth (hope the neighbours aren't watching) and I haven't had oral cancer. The bits I have read about trismus talk about exercises to prevent deterioration which in turn suggests you need a referral to a speech pathologist.

Keep pushing to get your own way Minh, it is your life and you have every right to service that you are confident about and comfortable with.

Minh

My RO, ENT and prothodontist all said that if i can't fit three fingers into my mouth, I have trismus. The OCF write up on Trismus also gives this test
[quote]A simple test for trismus

Trismus tends to develop slowly. In some patients, it progresses so slowly that they may not notice it until they can only open their mouth to 20mm or less. Treatment that begins early in the progression of the condition is likely to be more effective, and easier on the patient. Because of this, it is important to be proactive in looking for early signs of trismus. One simple test is the 'three finger test'. Ask the patient to insert three fingers into the mouth. If all three fingers fit between the central incisors, mouth opening is considered functional. If less than three fingers can be inserted, restriction is likely. [/quote]

The full OCF text is here with simple stretches. Trismus OCF

Luckily you can start stretching exercises without a prescription or doctor although after the surgery and recurrence and second radiation TX, mine got so bad I did need a Therabite which I still use daily.
Charm

Then I must have it. I have no teeth and it's a job to put 2 fingers in and has been for since the implants. Thanks for the Post again Charm that helped me. I never gave that a thought until now.

Thanx Karen - guess my surgeon is just a "surgeon" and i cant rely on him for much else. Maybe i was expecting too much from him. I will look at other healthcare professionals for help in the other areas. Thank you for your suggestion.

Thanx Charm for putting up that link. Will be doing my excercise from now on "7-7-7". Hopefully it will help. Still suprised my ENT did not suggest that i do though.

MInh