January UpdateBy Vivek Gohil -
Welcome to January,
The month of dieting adverts, Goji Berries or Joe Wicks clones on Youtube. Receiving the right nutrition through a healthy balanced diet is an essential part of caring for your body. Nutrition is not only related to eating but also with the mechanical processes involved.
Currently I’m confronted with an unexpected problem with jaw contractures, which prevent me from correctly opening, chewing or closing my mouth (Temporomandibular Joint). I can barely fit my electric toothbrush into my mouth, funnily at Christmas my Mum had to squash a mini Bounty chocolate with a hammer.
This jaw issue began about 8 years ago after I had my PEG feed inserted into my stomach and just receiving all my nutrients through that, however this meant I also stopped exercising my jaw through chewing.
Psychologically, the PEG feed did solve my major difficulty with food by removing the fear before mealtimes. I began to hate food as it took me 30 minutes to finish a slice of toast or a bowl of cereal for breakfast. Receiving a continuous amount of food from my feed has increased my daily productivity, mood and most of all energy levels.
However, the lack of active chewing or jaw exercises since my PEG was fitted has been detrimental to me by misaligning my bottom mandible, mouth and general facial stiffness. I wish either my nutritionist or speech and language therapist informed me about this possible risk due to jaw inactivity.
My Care Adviser Yvonne Julien was excellent as I received a quick referral letter for a physiotherapist appointment; initially I was unsure that the physiotherapist would be capable of improving my jaw flexibility.
The physiotherapist was knowledgeable about MD; his assessment was that the majority of my stiffness was due to my bottom mandible was positioned too far forward. I was given a list of passive facial exercises: I had to open my mouth as wide as possible 3 times a day, with assistance I have to push my lower jaw back into alignment with my top jaw, lightly massage my cheek or jaw muscles & chew a big ball of chewing gum.
In the future many adults with DMD may face this tricky issue, so it’s important to increase awareness on such an unforeseen difficulty. Once you have a contracture it is difficult to reverse so having access to regular neuromuscular physiotherapy support is extremely essential for managing your DMD or quality of life.