Chapter 250
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Translator: Ace
Chapter: 250
Chapter Title: Da-jeong's Breakthrough
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Neither affirming nor denying it,
I instead calmly palpated the masseter muscle.
The muscle most responsible for TMJ pain.
"You got Botox here too, right? Does it hurt when I press?"
"Yes, yes. Ouch! It hurts."
As expected, I found a distinct tender point at the lower part of the masseter, near the jaw.
I then palpated the temporalis muscle.
"Do you get migraines too?"
"Sometimes when my jaw suddenly hurts a lot, my head hurts along with it. Lately, the grinding noise has been more annoying than the pain, and the pain doesn't happen frequently. Maybe once or twice a month?"
"I see. You can open your mouth wide enough for my hand to fit in. How does this feel?"
Wearing gloves, I checked the medial pterygoid inside her mouth and the lateral pterygoid on her cheek.
Lee Dajeong winced in pain at every single spot.
"Your muscle tension is severe. Not just the muscles causing the TMJ pain, but your neck is stiff all the way through."
"Right? I have no idea what's causing it. I even do stretching on my own."
"The joint issue is causing compensatory tension in the muscles. Hold on a second—let me show you a video."
I played a short video of TMJ movement for her.
When opening the mouth, the mandible—the lower jawbone—slides down along the articular eminence of the temporal bone, with a small disc normally acting as a cushion to prevent bone-on-bone friction.
"In that video, the disc isn't coming down with it, right?"
Having visited several hospitals already, Lee Dajeong knew the basics.
"Exactly. The clicking happens when the disc doesn't move down at first, and only after you protrude your jaw fully does it slip past the bone with that 'click.' Now it's worse—the disc isn't moving at all, so the bones are grinding directly without any cushioning."
"...It's gotten worse?"
"You haven't been back to the hospital since the grinding started?"
"It hurt off and on before, so when the noise lessened, I thought it was getting better."
"It has gotten worse."
I stated it firmly.
When both pain and noise decrease, it's easy to mistake it for improvement if you're unaware, but the joint condition has actually deteriorated significantly.
"Ha... really..."
Lee Dajeong took a moment to vent about the doctors she'd seen so far.
"I haven't missed the golden window, have I? You can treat me, right, Director?"
"Of course."
That didn't mean it was incurable, of course.
It would just take time. Hadn't I even straightened Grandma Heo Soon-nam's severely curved back?
With Lee Dajeong cooperating well, her jaw disc could be fully treated too.
"See here. Excessive muscle tension and imbalance have displaced the disc, and since it's not moving, it's straining all the surrounding joints and muscles. Inflammation can even develop in the joint space."
"Yes..."
"I can't snap the disc back into place right away, but by relieving the over-tension and getting the muscles to function properly, the joint will stabilize gradually, and the disc will realign."
The same went for other disc issues like in the back.
The goal was sustained treatment to reduce pain while guiding the displaced disc back into position.
At my assurance that it was possible, Lee Dajeong showed clear faith.
"Alright, let's record your jaw movement for now. Since the noise is subjective, tracking objective changes via video is best."
But I couldn't let my guard down.
There was a high chance she'd claim no improvement a month later even if things were getting better, so I documented the evidence.
"Oh my, I was protruding my jaw like that when I talked..."
I'd noticed it while conversing with her earlier, but with her teeth together, her lower jaw didn't drop straight down.
It deviated slightly to the right before returning to center.
"I had no idea my jaw moved like that."
With the disc problem, protruding it that way probably felt more comfortable.
I recommended correcting it in front of a mirror as much as possible and taught her a few more TMJ exercises.
"Okay, let's head to the treatment room."
After the somewhat draining consultation,
I sent Lee Dajeong to the treatment room.
"Why the hot pack? Does warming the jaw help? Ah, not there—more over here."
...She wasn't an easy patient in the treatment room either.
"It promotes blood circulation to ease stiffness and spasms~."
Fortunately, Seol Yuhee handled it sensibly.
After finishing physical therapy smoothly, I performed acupuncture.
"You're checking my neck too?"
"Of course. In cases like yours, Da-jeong, it's hard to pinpoint one single cause."
If she'd come in 2-3 days after the jaw pain started with an isolated masseter issue, I'd treat just that.
But with years of buildup, every muscle and joint supporting the jaw and cervical spine ends up problematic.
Pinpointing the root cause becomes meaningless.
"Injecting pharmacopuncture into the joint space now."
I injected into the TMJ space and meticulously treated the four muscles I'd palpated in the exam room, plus her neck.
After acupuncture, back in the exam room for chuna manipulation.
I corrected not just the TMJ but also the alignment of her cervical and thoracic spine.
"This feels like it'll really work. Now I finally feel like I'm getting proper treatment."
"It will get better. No—it'll heal."
I could hedge conservatively by saying it might be hard to cure fully, but if it didn't improve, she'd inevitably blow up anyway.
The previous doctors had probably practiced defensive medicine in their own way.
Instead of recommending every possible treatment, I chose to fully heal her.
"We have affordable mouthguards here instead of pricey splints. If cost is an issue, I won't insist, but watch for teeth grinding habits. Otherwise, rest your tongue behind your upper teeth with a slight gap."
"Yes, I'll do that."
Lee Dajeong accepted the treatment plan without issue
and left the clinic very satisfied after the first session.
"It already feels smoother. Looking forward to more."
Whew, patients like her carry risk,
but if they become loyal, they bring in plenty more.
I treated her diligently, casting aside all biases.
Park Siha and Lee Dajeong alternated visits, one per day.
You'd think friends would come together, but they never checked in at the same time.
Park Siha's treatment progressed smoothly.
We were doing extra sessions after reaching the target cycle, and she always left feeling less stressed, happy about it.
She was firmly on a stable track.
"How did you feel after that single treatment last time?"
Lee Dajeong, on the other hand, had a long way to go.
On the first day, we'd released all her muscles from face to neck and shoulders.
A question to check if the treatment had been too much or too little.
"Ah, the spots we treated felt a bit more sore the first day. I worried if it was okay, but then for three whole days, no noise at all, right? If we keep going, it'll get even better."
A touch too much, then.
But the slight soreness hadn't upset her mood.
Her trust in me was still at 200%.
"Your movement still isn't smooth."
She still had grinding noises, and the trajectory when opening her mouth hadn't changed much from the start.
"Let's keep at it steadily with patience."
"Yes, thank you, Director."
I did pharmacopuncture into the joint space like the first day, followed by acupuncture and chuna.
The next week, Lee Dajeong came twice more,
fulfilling the minimum visits I'd recommended.
"Please take good care of me today too."
At the start of treatment,
and
"It definitely feels better after. Thank you."
at the end.
Lee Dajeong always greeted politely each time.
"Ah, it feels so good. I noticed Siha's complexion brightening and thought it was amazing, but now looking in the mirror, mine's improved too? I had no idea less noise would boost my quality of life this much."
Early on, symptoms improved with each session.
"Thank you as always, Director."
Even during a few weeks of plateau midway, she didn't waver.
Perhaps because the substantial progress spoke for itself.
Her declaration to trust me held firm while I stayed vigilant.
She visited twice a week, same days, for over a month.
After six weeks of treatment,
"...For the whole week, not a single noise."
Her mandible movement had normalized.
Comparing the first-day video to the new one confirmed the difference.
"Good. You're healing well."
"Really... thank you so much. I thought I'd live with that clicking forever..."
Lee Dajeong rubbed under her eye with her index finger.
No tears flowed, but the emotion came through clearly.
Half the initially projected time had passed, with over 80% progress.
The main symptom had improved quickly, but relapse risk remained.
For an easy patient, I'd reduce to once a week by now.
If busy and burdened by frequent visits, I'd warn of relapse risk and let her return only if discomfort arose.
But not with Lee Dajeong.
I had to treat thoroughly to seal off any future TMJ issues.
If I sent her off like this and she hurt again in a year, she'd blame me for two months of treatment wasted, right?
"Stick with it to the end. Your body is still used to the old joint state and might revert out of habit. We'll repeat treatments until it stabilizes here. Better to expand from face-focused to full-body now."
Treatment so far had gone beyond TMJ to cervical and thoracic,
but now I suggested including the pelvis with chuna.
TMJ and sacroiliac joints were independent, but the whole body was structurally and functionally linked.
Rare cases existed where dental corrections improved pelvic alignment or vice versa, resolving jaw pain.
Unable to pinpoint the TMJ root cause precisely, I'd treat everywhere that could butterfly-effect it.
"Oh, treating down to my lower back too? Of course I'm all for it."
No extra cost for pelvic adjustment, so Lee Dajeong had zero objections.
I added one more treatment I'd wanted to recommend from the start.
"I'll prescribe some herbs too. Covered by insurance. Eogan Powder—great for muscle spasms."
Hard to convince on herbs for TMJ, so I'd held off until now.
Thankfully, she nodded readily.
"Ah, like a muscle relaxant? Western meds did nothing... If you say take it, I will."
Haha, it'll get even better.
Haha, thank you.
We chuckled as we planned ahead.
'Looks like Da-jeong's on a stable track now.'
Just when I thought the expanded treatment was going well,
"Director, I clearly told you at the start I had no psychiatric symptoms. Why prescribe me antipsychotics?"
The very next day,
I heard Lee Dajeong's sharp voice.
'Hmm~ Knew something like this would happen eventually!'
This kind of ominous hunch was never wrong, but it'd stayed quiet so far.
Who'd have thought she'd erupt in anger right when nearly healed.
First, I needed to get through to her.
"I explained the treatment goals clearly. It was prescribed to relieve muscle spasms."
I spoke kindly but firmly.
She flinched.
Lee Dajeong trembled as the air shifted.
She'd apparently searched Eogan Powder online.
This part was entirely factual.
Eogan Powder was indeed usable for muscle spasms.
Especially excellent for nerve-induced tension.
Herbal formulas don't map one-to-one with Western diagnoses and drugs. I didn't diagnose her with any mental illness either."
I took her hand and clarified.
That was true too.
To me, it wasn't depression or anxiety disorder.
Narcissistic personality? No.
No perfect match for any specific personality disorder.
"It's for your TMJ treatment. Calm down and listen."
...But it did look odd to anyone.
No diagnosis didn't mean no issue to address.
"I'm not particularly angry or excited—"
Couldn't really deny it.
Of course, Lee Dajeong wasn't yelling.
Just a bit sharp.
She maintained clear pronunciation.
But her breathing was rapid.
Wrinkle between her brows. Tension not just in jaw and facial muscles, but her entire upper body to neck and shoulders.
Smiling, I stood and gently kneaded her shoulders.
"Ah......"
Only then did she seem to realize something, her face flushing red.