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April - Trigeminal Neuralgia

Trigeminal Neuralgia Pain Treatment

The Story of April

Patient Story
Trigeminal Neuralgia Patient:
The Story of April
Trigeminal Neuralgia Patient, The Story of Apri
Trigeminal Neuralgia Links

It all started a year and a half ago, a couple of weeks before a family trip to Las Vegas.  I felt dental pain in my left lower jaw and went to the dentist.  Dental X-rays did not show any problems, but I had begun grinding my teeth so the dentist made me a bite guard and gave me a prescription for Vicodin.  He also sent me to an endodontist, but there was no indication that I needed a root canal. 

By the end of our trip, I was in such pain that it was unbearable to eat, talk, or even smile.  When we returned home to LA, the dentist suggested doing a root canal "to see" if that would rid me of my pain.  I said "no thanks."  But I was still in pain so I went to see another dentist who specialized in TMJ.  He did a panoramic X-ray of my mouth, which came back normal.  Upon examination, it was determined that I had a slight case of TMJ and needed a second (very expensive and mostly not covered by insurance) bite guard made.  It didn't help. 

Several months later, the pain intensified.  My regular dentist still could not determine the source of pain and referred me to a different endodontist.  By then, I had done my own research and although I didn't display classic root canal problems, I thought perhaps I had a hairline fracture deep in my tooth.  I was so desperate for relief that I was open to, and proceeded to have, first one, then another root canal.  But the pain didn't go away. 

The constant pain was wearing me down and made it difficult to take care of my little ones (now ages 5 and 3).  Out of frustration and desperation, I googled my symptoms on the internet and came across something called "trigeminal neuralgia" (TN).  A family friend who is a neurosurgeon, Dr. Tony Feuerman, referred me to a neurologist, Dr. P.B. Andersson.  My MRI scans ruled out brain tumors and I began taking Lyrica, working up to 150 mg doses twice a day.  It helped take the edge of the pain at times, but it would always return. 

Around the New Year the pain started to worsen again, so my neurologist added a second medication, Carbatrol (200 mg twice a day).  I was already tired from the Lyrica, and the added medication increased my fatigue.  Three months later, the medication was deemed ineffective and my neurologist referred me to Dr. Antonio DeSalles, a Radiosurgery expert at UCLA.  Dr. DeSalles specializes in minimally invasive gamma knife (radiation) treatment, which involves partially deadening nerves with precise doses of radiation.  After reviewing my records, Dr. DeSalles said that gamma knife treatment was an option, but that based on my age and relatively good health he strongly recommended microvascular decompression surgery and referred me to Dr. Neil Martin, head of UCLA Neurosurgery.  Both my neurologist and neurosurgeon friend said that Dr. Martin is the "Best in the West" for this specialized procedure.

Dr. Martin explained the procedure and its possible side effects.  Basically, an incision is made and a nickel sized hole drilled in the skull.  Using microscopic instruments, Dr. Martin would locate, separate, and stop the compression of the blood vessels pressing against the trigeminal nerve (which was the cause of pain).  It's still hard to imagine that something happening inside my head was causing pain in my jaw. 

Microvascular decompression is low-risk major surgery and if successful, would completely cure me.  While the thought of undergoing brain surgery was scary, the thought of being pain and medication-free was more compelling.  Planning for a 2-4 week recovery time, I decided to schedule the procedure in early summer when my sister, a schoolteacher in Hawaii, could help me with the house and kids.  However, by the end of March, my pain was continuing to worsen and I could wait no longer.

On April 17, I underwent a six hour surgery.  Dr. Martin found and addressed three areas that were compressed.  During the initial recovery period, I was not able to fully appreciate being pain-free.  I experienced normal side-effects like headaches and double-vision.  But by the time I was off all medication and my sutures were removed, I started feeling better for the first time in awhile.  I still felt fatigue four weeks after surgery, but was comforted to learn that it would be a month or two before I felt 100% like myself.  It has now been just over two months and I am happy to report that I am fully recovered and that the constant, unbearable pain caused by TN is gone for good.

I am so very grateful for Dr. Martin (THANK YOU, DR. MARTIN) and his great expertise, patience, and precision.  He gave me my life back.  I can read to my kids again and joke with them (I told them that the doctor took out the grumpy bug).  Dr. Martin's staff (Jennifer, Antoinette and everyone) was so efficient and my admission and hospital stay went very smoothly.  The neuro-recovery ward nurse, Audry Hamill, was especially terrific.  I was discharged from the hospital on my birthday and she brought me a cake.  This gift was actually "the icing on the cake" since Dr. Martin's gift of making me pain-free was the best possible birthday present.

In hindsight, I wish I had done the surgery even sooner instead of hoping and waiting to see if the medication would eventually work (in a last ditch futile effort to avoid surgery, I even had a tooth extracted and now must face a dental implant).

I feel so fortunate to have a supportive husband and family (a great sister and the best sister-in-law) who helped with my kids and home in many times of need, and the friends who showed so much care and concern throughout my ordeal.

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