<human>: Dear Sir or Maddam. I have a situation i understand you can not help me with dental issues but it is just to explain to you how i got where im at now. As we speak i am unable to eat anything by mouth. I have a Dr willing to prescribe some home health care for me for some physical therapy and iv nutrician because of a possible eating disorder that i have developed due to everything that has been gpoing on in the past few months. I have servere Agroaphobia, social anxiety, PTSD, and panic attacks so as we speak i am notable to leave my home. my kids are with my mom because right now physically im not able to take care of them. Dfacs has a home parenting aid that comes out on a weekly basis, and i have been working with a CBT on-line councelor for a little over 2 months now. I have lost alot of weight gone from 289lbs to 215lbs since the end of June because I am unable to eat, I dont really have an appetite. I can small food think oh yummy and not eat. I am very weak because I have lost so much weight. I have some mobile atrophy going on, i am unable to climb the stairs or even remotely able to get out of bed because of how much weight i have lost it causes shortness of breathe if if i sit up or try to walk. Parts of my belly are numb because of how immobilzed i am, I am needing some in-home physical therapy and iv nutrician to get my strength back up. I can not do a peg feeding tube because of my attacks or i would so i have been told doing iv nutrician would be the best way to get it back up to where i can feel better in order to go back on my medications, stil work with the CBT therapist and the parent aid, and the dentist that is going to be working with me on a new guard for my TMJ. My nurse practionier is willing to do PPN (in-home iv nutrician threw the home health,) but she does not know enough about the dosages to write the script to have it done. She asked me to contact the Atlanta center for eating disorders to see if there is a nutricionist that can possibly help us in writing the orders and helping us with this. I do not want to be hospitalized because my agrophobia is to servere and I am willing to go back on the meds and continue to work with the therapist that i currently have. We have talked with several People an this is in the best interest right now. The in-home care told us that they can come out and administer the Iv nutrician and monitor it and help me with physical therapy to get back on my feet so that i can get some strength and be able to care for my kids again. Here is my story below: was told to contact your office by several local dentist and the dental association because of my situation i have agraoaphobia social anxiety and panic attacks that makes it impossible to leave my home as we speak. i am needing someone to come to my home and evaluate my situation. i have panaramic xrays an teeth impressions etc if needed. i am really trying to find some help the thing is i have agarophibia so i cant leave my home i have a friend in another state that went threw the same thing as me and due to her situation they went to her instead of her going to them,.the mobile dental clicn that went to her was a kids one also but shes 36 they just charged her out of pocket which is fine with me just in order to get some help i know thats asking alot but in certain suituations you just work together i supose. anyways here is my situation i desperately need some help because its effecting my breathing an my swallong. several months ago i was in my bath tub an i had yawned really big an my jaw had popped i immediately noticed alot of fullness in my ears when i would sit up or try to walk i would feel dizzy an almost feel like i was going to fall over, i went to see my dr thinking it was a ear infection that came on all of a sudden but it wasnt. i look up on the net for about 2 weeks and came across TMJ so I tried a sports guard at first to see if it would help at all it did at first, then i moved to a denteck boil an bite because it wasnt as thick. then i had seen online that you can buy the acrlic ones so you dont have to keep getting the boil an bite ones, so i got the kit did the impressions an about aweek later got the guard, i wore it 24/7 for a good month, my dr wanted me to go on lexapro an xanax for the agraphobia, social anxiety, panic attacks so i started that but eventually had to come of it. i noticed my breathing was different an my bite possibly, where i couldnt get a full breathe of air from my mouth or when i would breathe threw my nose, i was havign air come from the back of my throat when i would breathe threw my nose, and from my ears at times.i had several ekg s done, an blood work my white blood cells came basck elevated the dr wanted me on zithromax but she couldnt tell me what we were treating where i got it from where it was in my bpody oranything.. so i didnt even take it i read that stress can cause your ewbc count to go up too i came off of the acrlic mouth guard an went back on the denteck one to basically wheen myself off the acrlic one. i have had ekgs, blood work, xrays at a chiropractor remind you my breathing did not change or my swallowing until AFTER this mouth guard is there ANYWAY possible it could of changed my bite or my jaw to where it if effecting my breathing an swallowing, the swallowing is bascailly not tight but its where im having to struggle to swallow at times. or ill cough until i burp. IF this is my bite/jaw causing this can it be corrected to where it goes back to normal agagain i have panaramic xrays avalible, and teeth impressions avbalible also. my dr an i believe that i jumped to soon into gettinmg the acrlic guard offline because i had no insurance at the time and was looking for somethiong more permernt. i got the impressions about a week later got the guard it was pretty snug at first for the first week or so, then it started to even out, i wore it 24/7 for entire month an thern started to notice the breathing differences, i stopped using it for about 2 weeks an started having swallowing issues, i started the guard back it was snug again but evened out in about a day, and the swallowing issues went away, so needless to say the guard has been causing all of this an i need someone to help me get my bite back in place my jaw has now started poping on the left side when i yawn my dr is willing to talk with you about my situation also i have panaramic xrays and teeth impressions prior to the guard i started to wear thats causing all of this.
<bot>: Hello thanks for asking from Chat Doctor I have read your detailed explanation of symptoms and can understand your problem. Your main issues are related to mandibular joint (TMJ), dental issues and anxiety. As dental problems coupled with anxiety have resulted in reduced feeding so first I would advise you to get yourself reevaluated to find out any abnormality in dental and TMJ. The problems of agoraphobia, anxiety, PTSD, panic disorder have probably resurfaced because of dental issues. This is the reason for eating disorder. I would advise you to consult a psychiatrist for detailed treatment. Medicines like SSRIs especially Escitalopram, Fluoxetine can help to reduce your problems related to anxiety and will help to control eating disorder. For severe eating disorder you may need feeding tube but as you have normal appetite so as per my opinion there would not be any need for feeding tube. Thanks