Oromandibular Dystonia (OMD)…


Dr. Michael J. O’Connell, Barrington, New Hampshire, has suffered with his own variety of OMD for the past 4 1/2 years, following a snowboard jumping accident.  This unusual neurologic disorder can have several causes, but more often has no obvious cause at all.  It can be severe or mild, generalized or focal, or in between.

Dr. O’Connell had just mastered the skillset of doing vertical flips and during a final practice run had made sure to wait a full minute for the landing zone below the jump area to clear.  His account of the incident follows:  “No skiers or boarders were even present on the terrain park, given that it was a mid-week afternoon.  I hit the ramp with my knees gently flexed and accelerated high into the rotation of the jump, during which I briefly saw what appeared to be a skier doing a snowplow far below me in the landing zone.  I recall contacting him (or her) with a glancing blow of my board on his shoulder, but then recall nothing more until waking up with a ski patrol staff member standing over me.  The skier was gone and fine according to the patrol and I was soon on my feet, and rode off ten minutes later, slightly dizzy but OK.  As I boarded from the slope into my vacation home, I noted a slight pulling sensation over my entire lower lip.  Glancing in a mirror I saw no asymmetry of my mouth as with a stroke.  There was no numbness, but the pulling sensation remained.  I decided to leave then for my permanent home and during the two-hour trip noted some relief of the pulling by chewing food, and gum.  The following day at work, my speech was ever so slightly impaired; I found it tiring to speak at length to patients, and my speech toward the end of day was distinctly slurred.  Again there was no asymmetry or motion about my mouth or face, but the struggle to speak, which was mild but persistent, was resulting in a dyscoordination of my entire lower lip.

I self diagnosed this as oromandibular dystonia, in this case a result of a head injury with concussion.  Seeing no progression of the symptoms I verified the likely diagnosis over the phone with some neurology and physiatry friends.  Eventually, I visited a motion disorder neurology specialist in Boston, and an MRI confirmed a small scarred lesion in the putamen, an area of the brain that assists in coordination of muscle function, explaining the symptoms and lack of sensory loss.  I had been very lucky, in that the scarring likely represented a hemorrhagic infarct, and obviously could have been much more extensive.  I have tried numerous treatments including Botox injections and physical therapy, stretching and strengthening exercises, topical oils, acupuncture, chiropractic manipulation, but nothing provided relief except chewing gum or sucking on hard candy.  So I do a lot of the latter and have just learned to live with the inconvenience.”

This experience of Dr. O’Connell’s provides several lessons:

1.   Although Dr. O’Connell obviously monitored himself carefully, and survived, doctors should not risk self treatment.

2.   While the OMD has caused Dr. O’Connell to gravitate away from and eventually cease his work as a physician, he has elected to continue as administrator, and with snowboarding (albeit without major jumps), and has taken up rock climbing to maintain endurance, concentration, and upper and lower body strength.

3.   Despite wearing a helmet, Dr. O’Connell sustained a significant head injury and concussion.  What would have been the consequences had he not worn the helmet?

Dr. O’Connell noted that he was a very lucky guy on the day of that accident.  “While a definite inconvenience and career affecting problem, there surprisingly were benefits.  For one, I take nothing for granted.  I try to enjoy and be enriched by each day, and my former sense of invincibility has certainly been tempered a bit.  I am doing OK for a sixty year old.”

About Dr. Michael J. O'Connell, New Hampshire
Dr. Michael J. O'Connell of Barrington, New Hampshire, has forged a distinguished career spanning over three decades, as entrepreneur, physician, businessman, philanthropist and healthcare consultant. As former owner, administrator and CEO of a 225+ employee multi-specialty medical practice, Dr. O'Connell has dedicated his entire professional life to helping patients with family medicine and especially those experiencing chronic pain and all aspects of addiction. Since selling his family of healthcare businesses, he has never once contemplated retirement despite his rich and fulfilling journey, but instead has turned his focus to consulting in an industry starved for courage and creativity. Having weathered many political, technological and legal challenges, there is hardly a storm he has not confronted, a tempest he has not quelled, an urgent need he has not met. While the talking heads and self-proclaimed experts in the field have assumed the conventions and standards of the times, Dr. O'Connell does not believe in merely reflecting the herd mentality, but rather in leading the charge. Eschewing political correctness, Dr. O'Connell says and does what needs saying and doing, and not what the mindless masses expect. In addition to the continual education afforded by his variegated life experiences, Dr O'Connell earned his BS in Biochemistry at the University of NH in 1975, his Medical Degree from Dartmouth College in 1981, interned at Walter Reed Medical Center in 1982, Residency/Fellowship at UCSF in1986, and finished his Masters in Healthcare Administration at UNH in 1995. Dr. O’Connell enjoys many outdoor activities, including rock climbing, snowboarding, hiking, and golf. Through the decades Dr. O'Connell has supported many non-profit charities to include the St. Charles Home in Rochester NH, the Tri City VNA and Hospice, Hyder House, and Cocheco Valley Humane Society. To the latter organization alone Dr. O'Connell has donated over $180,000 and pledged another $250,000 in the “Bring-Us-Home” campaign for a new building. His “Matching Donations Christmas drive” has generated over $175,000 in charitable giving from the community. In addition Dr. O'Connell has participated in many dozens of other volunteer and donation efforts locally as well as in Africa and the Dominican Republic. For a listing of how I gave back to the community during my career and continue to do see: https://michaeloconnellmdnh.wordpress.com/

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