Voice Actor Recovers From TMD By Taking Ambien

BoingBoing / Cory Doctorow:
Jeffrey sez, "Tom Rohe is a professional voice actor. He had a tooth extracted in 2009 and was then diagnosed with TMD, which left him unable to speak properly, and therefore unable work. Curiously, when he takes Ambien, his speech returns. Tom made this video (and another one) to try and get some help. He's not looking for a handout, he's looking for a referral to a specialist. At the very least, this is one of the WEIRDEST things..."

It is absolutely bizarre -- it's hard to believe that the same guy is speaking before and after. I can only imagine that if this was my mouth (and livelihood), I'd be out of my mind trying to find someone who could figure out what the hell was going on.

-- http://en.wikipedia.org/wiki/Temporomandibular_joint_disorder
spoco2says...

>> ^bmacs27:

Sounds to me like he solved his problem. Pop a pill before the audition man. What else are you looking for?
(I'm at a university studying neuroscience)


Um, how about not having to be constantly popping pills just to talk. Especially because Ambien's effects include sedative/hypnotic and memory impairing effects... yeah, that'd be great for a voice actor.

catbuttsays...

>> ^bmacs27:

Sounds to me like he solved his problem. Pop a pill before the audition man. What else are you looking for?
(I'm at a university studying neuroscience)


Wow, you're going to be the most awesome doctor and help so many people!

Paybacksays...

Also from the Wikipedia:

Zolpidem (Ambien) may provide short-lasting but effective improvement in symptoms of aphasia present in some survivors of stroke. The mechanism for improvement in these cases remains unexplained and is the focus of current research by several groups, to explain how a drug which acts as a hypnotic-sedative in people with normal brain function, can paradoxically increase speech ability in people recovering from severe brain injury. Use of zolpidem for this application remains experimental at this time, and is not officially approved by any pharmaceutical manufacturers of zolpidem or medical regulatory agencies worldwide

bmacs27says...

You guys don't seem to understand where I'm coming from. I'm in basic research, so I don't really worry about my bedside manner. At our current stage of understanding, being able to do something as relatively benign as taking an ambien and having results that profound is about the best you could hope for. Substances like that effect incredibly complicated systems that aren't well understood. I suppose it's possible there might be some direct electrical stimulation that might work, but if I were that guy, I'd rather take a pill. I mean, seriously, what more do you want than a pill that solves your problem? A better pill? We'll get right on that. The kids at Dana Farber will just have to wait.

Porksandwichsays...

Ambien is a nasty drug. It works for a for months for most people, then it starts to make you into a sleep walking zombie. I never took it, but my mother does (long term) and I've been to a number of sleep disorder support group meetings where people who've taken ambien wake up covered in food crumbs from where they were snacking at night and have no memory of it. I use a CPAP, and many people who take Ambien need to be on some sort of CPAP-like machine to find a long term solution to their sleep issues.

Ambien is like a 6 month MAXIMUM temporary solution until you see the side effects of memory loss, sleep walking, sleep eating. Basically you need to figure your shit out in 6 months or you're opening yourself up to a whole other set of problems, and possible addiction to Ambien in that you need it to fall asleep after a period.

So this guy has the right idea, Ambien is not any kind of lasting solution.

spoco2says...

>> ^bmacs27:

You guys don't seem to understand where I'm coming from. I'm in basic research, so I don't really worry about my bedside manner. At our current stage of understanding, being able to do something as relatively benign as taking an ambien and having results that profound is about the best you could hope for. Substances like that effect incredibly complicated systems that aren't well understood. I suppose it's possible there might be some direct electrical stimulation that might work, but if I were that guy, I'd rather take a pill. I mean, seriously, what more do you want than a pill that solves your problem? A better pill? We'll get right on that. The kids at Dana Farber will just have to wait.


Wow, seriously, you don't get the issue here? You really are going to suck if you never see the larger picture.

"Garry, we've done it! This pill makes people be able to speak for a couple of hours at a time!"
"Awesome, what are the side effects?"
"Pffft, like I give a shit, it works man."
"Um, you aren't concerned at all about long term effects?"
"Nope, I made someone talk... I'm a fucking GOD man"
"Ok, good luck with that."

bmacs27says...

>> ^spoco2:
Wow, seriously, you don't get the issue here? You really are going to suck if you never see the larger picture.
"Garry, we've done it! This pill makes people be able to speak for a couple of hours at a time!"
"Awesome, what are the side effects?"
"Pffft, like I give a shit, it works man."
"Um, you aren't concerned at all about long term effects?"
"Nope, I made someone talk... I'm a fucking GOD man"
"Ok, good luck with that."


No, I don't think you get the issue. The guy is downright lucky an existing drug "solves" his problem. It isn't as though he's part of a large group of post tooth pull TMD sufferers. This isn't the sort of thing you can convince anyone to spend any money to research. Simply saying something like "look ambien works" doesn't really mean somebody can just run to their garage and whip up a new drug that only targets the specific parts he wanted it to target, or some stem cell therapy that could repair damage.

Part of my snarky undercurrent, and I hesitate to say this, is that I think this might be fake. If it is fake, it isn't funny because people do suffer from these sorts of disorders. If it isn't fake, the diagnosis is probably wrong because it is likely a central not peripheral nervous issue. I was just watching the video with a professional speech therapist. She pointed out that not only does he have the temporomandibular joint issue, but he also seems to be having tongue and mouth shape ataxia. His facial symmetry is good, which suggests it isn't lateralized nerve damage (like you might expect from a tooth pull). Further, it is difficult to conceive of a mechanism by which pharmacology could have that sort of effect on "damaged wires" so to speak. It's possible he's simply the victim of a misdiagnosis, in which case I feel bad him. However, given that he is a voice actor, I fear this might be a publicity stunt in horribly poor taste. That's not even mentioning the fact that he looks remarkably cogent for a guy on ambien (you know, all those side effects you were talking about).

SveNitoRsays...

>> ^bmacs27:

If it isn't fake, the diagnosis is probably wrong because it is likely a central not peripheral nervous issue. I was just watching the video with a professional speech therapist. She pointed out that not only does he have the temporomandibular joint issue, but he also seems to be having tongue and mouth shape ataxia. His facial symmetry is good, which suggests it isn't lateralized nerve damage (like you might expect from a tooth pull). Further, it is difficult to conceive of a mechanism by which pharmacology could have that sort of effect on "damaged wires" so to speak. It's possible he's simply the victim of a misdiagnosis, in which case I feel bad him.


I agree it seems strange that nerve damage from pulling a tooth would create such symmetrical symptoms. The deterioration of the symptoms seem to suggest whatever happened is still happening. Or maybe it is simply that the spasticity is becoming worse, just as it does in cerebral palsy?

The sad part is that he is lucky to have medication which can actually help him at all.

snoozedoctorsays...

I say probably fake. TMJ dysfunction does not result in the dysarthria this guys appears to exhibit. Because it's symmetrical, it would almost have to be a central brain lesion of some sort. Nerve injury from dental extraction would be unilateral and involve sensory, not motor nerves. Whatever this guy exhibits, it has nothing to do with a dental extraction.

ReverendTedsays...

>> ^snoozedoctor:

I say probably fake. TMJ dysfunction does not result in the dysarthria this guys appears to exhibit. Because it's symmetrical, it would almost have to be a central brain lesion of some sort. Nerve injury from dental extraction would be unilateral and involve sensory, not motor nerves. Whatever this guy exhibits, it has nothing to do with a dental extraction.
Unless they're using TMD to mean something other than Temporo-Mandibular Disorder, I agree that it is extremely unlikely that it's post-extraction trauma. Possible neurological defect as a result of over-sedation or reaction to the sedative?

snoozedoctorsays...

Nope. Little, to no, chance of that either. Hypoxia from over sedation would more likely affect the frontal lobes. If he had hypoxia severe enough to produce brain stem injury, he would have associated severe cognitive dysfunction as well. If this guy's symptoms are real, he would appear to have a cerebellar/brainstem lesion, such as a tumor or stroke. Only problem with that is, Ambien would have no effect on it. A serious "reaction" to sedatives would be of the allergic type and would not result in such a focal deficit. Can't prove it, but I think this guy is either faking his symptoms (most likely), or has some type of psychogenic dysarthria.
>> ^ReverendTed:

>> ^snoozedoctor:
I say probably fake. TMJ dysfunction does not result in the dysarthria this guys appears to exhibit. Because it's symmetrical, it would almost have to be a central brain lesion of some sort. Nerve injury from dental extraction would be unilateral and involve sensory, not motor nerves. Whatever this guy exhibits, it has nothing to do with a dental extraction.
Unless they're using TMD to mean something other than Temporo-Mandibular Disorder, I agree that it is extremely unlikely that it's post-extraction trauma. Possible neurological defect as a result of over-sedation or reaction to the sedative?

bmacs27says...

I'm glad I'm not alone. Whatever this is... it wasn't caused by a pulled tooth. My suspicion is he's practicing for a part, and wants doctors to coach him. My friend mentioned it could be psychogenic as well. It would be extremely strange however, and she agreed, most likely fake.

>> ^snoozedoctor:

Nope. Little, to no, chance of that either. Hypoxia from over sedation would more likely affect the frontal lobes. If he had hypoxia severe enough to produce brain stem injury, he would have associated severe cognitive dysfunction as well. If this guy's symptoms are real, he would appear to have a cerebellar/brainstem lesion, such as a tumor or stroke. Only problem with that is, Ambien would have no effect on it. A serious "reaction" to sedatives would be of the allergic type and would not result in such a focal deficit. Can't prove it, but I think this guy is either faking his symptoms (most likely), or has some type of psychogenic dysarthria.
>> ^ReverendTed:
>> ^snoozedoctor:
I say probably fake. TMJ dysfunction does not result in the dysarthria this guys appears to exhibit. Because it's symmetrical, it would almost have to be a central brain lesion of some sort. Nerve injury from dental extraction would be unilateral and involve sensory, not motor nerves. Whatever this guy exhibits, it has nothing to do with a dental extraction.
Unless they're using TMD to mean something other than Temporo-Mandibular Disorder, I agree that it is extremely unlikely that it's post-extraction trauma. Possible neurological defect as a result of over-sedation or reaction to the sedative?


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