Dr. Amy Hartsfield – My Journey From Pain Sufferer to Specialist

Many people have asked me to share the story behind why I left general dentistry to become an Orofacial Pain and Dental Sleep Medicine specialist. Ultimately, it was because I personally suffered from both of these issues and could not find help. My story runs deep and is quite lengthy but it has a happy ending. I pray someone can find hope and benefit from hearing it. So here it goes….

In 2013, I became what I refer to as chronic: I had chronic neck pain, fatigue, anxiety, joint pain (including my TMJ) and headaches. It was all I could do to go to work every day. I was a general dentist in Birmingham, AL with a very busy practice and 8 employees under me. I left for work every day in tears, soaked up the tears during the day, stomached the pain, and then came home again in tears. I counted the weeks because I knew I would have one good week a month and 3 bad ones.

My journey to find help started prior to 2013. After my infertility treatment and successfully having my son in 2010, I started noticing that the neck pain, anxiety, TMJ disorder, heart palpitations, and headaches I had always suffered from were getting worse. Over the next 3 years I went to wellness physicians, endocrinologists, rheumatologists, orthodontists (getting my 2nd set of braces in 10 years for TMJ disorder), chiropractors, massage therapists, acupuncturists, and the list continues. Each one would tell me my problems were rooted in something different. I was tested for rheumatoid arthritis, adrenal dumping, amalgam poisoning from my career, etc. but not successfully diagnosed with any of these. I was diagnosed with mitral valve prolapse, dysautonomia and Vitamin D deficiency but treatment was not helping even though it was obvious I had these problems. I was diagnosed with problems in my neck and steroid injections were given to me 2 times with little to no help. My husband started referring to my neck as the million-dollar neck because we spent so much time and money trying to find out what was wrong with it. We even bought ergonomic chairs for me to practice dentistry in case it was coming from my career. My career and posture were mentioned by many of my physicians.

Towards the end of my rope, my neurologist referred me to a physical therapist. With my first physical therapist, I found no results, but this was not due to his lack of skills. So, I referred myself to a friend of my friend who was a physical therapist. The best thing he did for me was listen. I kept an in-depth calendar of my pain, anxiety, and fatigue. We started with a rheumatologist which, as mentioned above, did not find a diagnosis. But then I shared with my physical therapist my neck pain had to do with my menstrual cycles. I had one good week (approximately week 2 of my cycle) and the rest slowly started a crescendo of pain events that reached a peak and came down. He knew of an older OBGYN that he wanted me to see. When I told her my issues, she put me back on birth control without placebo even though I was infertile. Slowly some of the headaches and neck pain started lessening but were not completely better. The fatigue, joint pain, and heart palpitations were still there.

During this time, dental sleep medicine started becoming more known. I started studying dental sleep medicine and I realized there was one thing none of my providers had asked me about: my sleep. I had no idea it wasn’t normal to wake up in the middle of the night with a racing heart, gasping and waking up with night sweats. I also woke up from the many naps I had to take, because I was so chronically tired, with severe heart palpitations. There was a point during all of this where I woke up from a nap in such a panic that my heart couldn’t find its rhythm. I drove myself to a local ER just to be told I had Pre-Ventricular Contractions (PVCs) and anxiety. But still no one asked me about my sleep. I discovered I had sleep issues by studying dental sleep medicine. Did you know there is a 50% correlation between heart arrhythmias and sleep disordered breathing? Did you know that a common misconception of obstructive sleep apnea is that it is ‘the old fat man’s’ disease? I like to tell patients that us skinny, young females can have it as well. Funny, but true!

Fast-forwarding to today, I can now explain what was going on with me all along. After finishing my boards in Dental Sleep Medicine and finishing my part 1 boards of Orofacial Pain, I finally have an accurate diagnosis, the holy grail for someone who has been seeking answers for as long as I had. I have menstrual-related migraines and obstructive sleep apnea. Looking back on my own history, from my teenage years until I finally found help, these problems were always there. I had headaches all of my life. Headache sufferers without treatment have a high chance of turning from episodic to chronic and this is what happened to me. My neck pain and TMJ pain were referred pain from my migraines (see my first blog and you will understand more about this referral pattern). It is a known fact that headache prone individuals need sleep to help mend them and prevent headaches. This was impossible for me because I had an undiagnosed and untreated sleep breathing disorder.

I started treatment for Obstructive Sleep Apnea as soon as I was diagnosed. This, along with the hormone therapy for the migraines, slowly started healing me. Then I was faced with another challenge. I told my husband I wanted to hit the books again and start studying to be board certified in Dental Sleep Medicine and Orofacial Pain. This would require 450 hours of continuing education over a 2-year period along with running my full-time general dental practice. I knew I had to be getting better because in the past I would never have been able to accomplish this. The stress alone would have triggered a chronic attack.

Two years later with a ton of stress and no chronic attacks, my goal was reached. Orofacial pain and sleep patients were seeking me out and it was taking away from my general dental practice. This was hard because I loved my general dental practice and all of my patients. I knew that I had been given a new purpose: to help patients who have suffered from some of the problems I had. I felt confident in this decision because a wonderful dentist was led to my practice who I knew would be a good fit to take over.

So here we are in a practice in Homewood, AL – set up to treat Orofacial Pain and Dental Sleep Medicine. We are here to help and work in conjunction with the patient’s physicians and their dentist to get the proper diagnoses and care. Luckily for me, several of the physicians who had been referring these patients to me asked me to get centrally located since I would be the only Orofacial Pain specialist in the area (and in Alabama) and one of the only dentists in Alabama certified by the American Board of Dental Sleep Medicine.

I pray I can help those who have been suffering as I have. I pray I can be an adjunctive service to their physicians and dentists to try to help them; working with open communication to help patients find answers. I know that my story is not going to be all of my patients’ story and what fixed me may not be what fixes them. That is why my goal was to be board certified in both Orofacial Pain and Dental Sleep medicine so I could gain the knowledge to help patients with multi-faceted problems. This practice was strategically planned to make a patient feel at home. I have been that patient who has been into doctor’s office after doctor’s office and felt weary of the clinical feel. I do not want patients to feel as if they are coming to a clinic; I want them to feel as if they are coming to a home away from home where they can find hope.