Matt has always driven me to hospital appointments because I'm still struggling with my ears and balance but today nobody was around to drive me so I had to drive myself. I was anxious about it because its a 40 minute drive, but I made sure I left with plenty Of time, so I could take my time and wasn't rushing. The drive wasn't too bad but when I arrived at the hospital the parking was a nightmare as usual!
I eventually got parked and made my way to the clinic. When I checked in at reception another patient in the waiting room said she recognised me from my blog and we had a little chat about our surgery and recovery. It's so good to chat with people who are going through similar things as you. Although every operation is different there are similarities in every case. It was nice having someone to chat to as there was a 30-40 minute delay to see Mr D.
Eventually Mr D called me in, firstly we discussed my cheek. He poked around the area of the cheek plates and didn't think there was infection.
Then we moved onto the chin. He asked me to remove my brace elastics then started prodding around. First he touched my gums at the plate locations to see if there was any pain that could indicate infection. There was tenderness but no pain. The tenderness is likely to be scar tissue. Then Mr D moved to the right hand side of my mouth and he touched exactly where is giving me grief. I jumped out of my skin then burst into tears it felt so awful.
I think Mr D was horrified that I was crying, he was so reassuring and was trying to calm me down. He asked me some questions about what triggers the pain and my response was anything really, teeth brushing, talking, shouting, laughing, smiling, washing, moisturising, walking. Basically anything that involves my chin moving. Mr D injected some local anaesthetic into the inside of my mouth. The idea of this was if the pain disappeared when the anaesthetic worked he could diagnose and treat me. He sent me for an X-ray while the anaesthetic started to work. The X-ray was to check for signs of infection around the plates.
As I was walking to X-ray the anaesthetic was working and the pain had gone, oh my god it felt amazing to be able to move my mouth without having intense horrible sensations whizzing around the lower part of my face. I had my X-ray then headed back up to the clinic. Mr D checked the X-ray and there was no sign of any infection around the plates. He said there was a bit of arthritic shading at the jaw joints that he would expect and all in all the X-ray looked great.
So as the pain had gone with the local anaesthetic Mr D is certain the I have Trigeminal neuralgia.
(information for NHS choices website)
Trigeminal neuralgia is sudden, severe facial nerve pain.
The pain is almost always on one side of your face, although in rare cases it is on both sides. It can be in the lower jaw, upper jaw, cheek, and less often the eye and forehead.
The pain may last from a few seconds to two minutes each time and you may also feel:
tingling or numbness in your face before the pain develops
a slight ache or burning feeling during the attack
You may have spasms of pain regularly for days, weeks or months at a time. In severe cases, you may feel pain hundreds of times a day. Some people experience a constant dull ache in certain areas between episodes of pain. However, it is possible for pain to disappear completely and not reoccur for months or years.
Triggers of trigeminal neuralgia
Episodes of trigeminal neuralgia can be triggered by certain actions or movements, such as:
talking
smiling
chewing
brushing your teeth
a light touch
shaving
swallowing
a cool breeze
head movements
Living with trigeminal neuralgia can be difficult, and it can interfere with your quality of life. You may feel like avoiding activities such as washing, shaving or eating in order to avoid triggering pain.
Living with pain, especially if it affects your quality of life, can also lead to depression (feelings of extreme sadness or despair that last a long time).
Mr D prescribed with some Gabapentin tablets that are given to people with epilepsy and peripheral neuropathic pain which is long lasting pain caused by damaged to nerves. The tablets aren't painkillers, they desensitise the nerves that effectively lessens the pain. So I have to start taking one tablet a night for two days, then one tablet twice a day for two days, then one capsule of a morning and two of a night thereafter. They can cause drowsiness and dizziness and may make you giddy! So I'll have to assess driving after each increase of tablets.
In regards to the Eustachian tube dysfunction effecting my ears, cheeks and nose Mr D has requested a CT scan to check my sinuses to see if they're blocked, so I'll be having that in the next few weeks. All in all, a very productive appointment. Mr D knows I'm not a baby and I'm normally in his words 'a tough cookie' so he knows things must be bad for me to be reduced to tears with the pain.
Mr D said that I was to take it easy in the afternoon as once the local anaesthetic wears off the pain might come back with a vengeance! So I drove home, had some lunch, took advantage of brushing my teeth virtually pain free then chilled out. Mr D was right, once the anaesthetic wore off it was back in its full glory! Totally depressing.
At 11pm I went to bed, took my tablets and fell asleep nice and easy. I'm not sure if this was because I was so tired or if it was the tablets, but I was ready for a good nights sleep.
So I woke up this morning nice and fresh, my chin, cheeks and ears are still the same but at least now we're working towards some relief now. That's reassuring in itself.
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