The Pain In My Face Is A Pain In The @ss

I’d like to introduce you to a condition I have called Trigeminal Neuralgia. Another one of those invisible illnesses, it has been described as “the suicide disease” by both patients and doctors because of how outrageously painful and debilitating it can be. Here’s the official description, from the Mayo Clinic:
Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve, which carries sensation from your face to your brain. If you have trigeminal neuralgia, even mild stimulation of your face — such as from brushing your teeth or putting on makeup — may trigger a jolt of excruciating pain.
I feel the pain just under my right cheekbone, into the right eye socket and the right sinus cavity. In fact, when I first started experiencing pain, I thought it was a sinus infection – but when none of the other symptoms of an infection came along, I realized it had to be something else. I’ve been having flare-ups of TN going back almost 14 years now, but they were so few and far between that I didn’t put a name to them at the time. It was easy to brush them off – maybe a sinus thing, maybe a dental thing…as long as they went away fast, I had other health issues to deal with and I didn’t need more. Unfortunately, over the last 6 months or so (give or take a few months), I’ve had flare-ups that have been so much more frequent, I had to finally talk to my doctor about them.
Now, before going any further, I want to tell you about my family doctor here in Victoria. His name is Dr. Gary Leong, and he is wonderful. I really lucked out in becoming his patient – he was a new doctor at the clinic where I was seeing a Naturopathic Doctor because there were no other GP’s taking new patients in the city, not since Ray and I had moved to Victoria in June of 2013. I was seeing the Naturopath purely to get some nutritional help and when she told me a Family Dr. was joining the clinic, I made sure my name was on this list asap. Dr. Leong and I had an “interview” in order to ensure we would be a good fit – I mean, seriously….who would want to take on a complicated patient like me? But…he did, and I’m so blessed. Dr. Leong is a doctor who actually listens to what I have to say. He knows that I know my body, my symptoms, what’s normal and what’s not. He knows that I’ve weathered A LOT of stuff and that I’ve been in pain for a long, long time. He knows that I’ve been on opioid medications for a long, long time and that’s likely never going to change. He knows I’m smart, and he treats me that way. I can be honest with him about my feelings, when things have become too much when I’m ready to push forward on something when I’m ready to cut back on my meds to try and wean myself down from the narcotics…he’s been the perfect doctor for me.
So, once these TN flare-ups started becoming more frequent, I finally had to speak to Dr. Leong to start medication. We’ve tried a couple of things – I was taking Carbamazepine, which is the first line drug, but it stopped working fairly quickly, so now I’m on one called Topiramate. We have to be so careful with medications because of the other drugs I take for pain, etc. The Topiramate has been working up until recently, but it seems to me that I am getting flare-ups far more often than in the past. It might be time for a referral to a Neurologist, and possibly a discussion about one of the various surgeries that can be done. 
When I get hit with one of these flare-ups, it starts as a mild ache just under my cheekbone. It then starts to spread to the eye socket and sinus cavity, and completely under the entire cheekbone. The ache is gentle at first, almost teasing, and then becomes absolutely relentless. There’s no one place to pinpoint where the pain is….it’s just “there” and steady without a break. It begins to feel like tiny little hammers are hitting me…not quite enough that the actual hitting is painful, but the endlessness of it is instead. And because there’s no one place that hurts more, there’s no place to put ice or heat, etc. that helps. Neither helps the pain, and neither do much for distraction either. There’s also no rhyme or reason on how long it’s going to last. Sometimes it’s 30 minutes. Sometimes it’s 12 hours. However long it goes on for when it’s finally done, it feels like I’ve been punched in the cheek over and over and over but the bruises are all on the inside. The gentlest touch on my skin is agony, yet all I want to do is press my fist into my face as hard as I can at the same time. Yes…there is a reason it’s called the suicide disease.
As you can imagine, because this is an invisible illness, you would never know I was experiencing a flare-up unless I told you (or you were allowed to watch me if I let down my guard). So, stop for a minute. Think of the last time you were out for the day…shopping, working, working out, whatever. Think of how many people you might have run into or interacted with on that particular day. Do you think you could have picked out the one who was having a flare-up? I can almost guarantee you that somebody YOU interacted with on the day you chose was fighting some type of invisible illness, be it TN, Fibromyalgia, Arthritis in one of it’s many, many forms, or more. This is why I chose to start writing this blog – to help educate people on the fact that there are so many of us out there who are living in Chronic Pain from something, yet you might never realize it. We want so badly to be seen as “normal” i.e.: healthy, that we often push ourselves way past our limits, just to fit in. Or, you never see us, because we’re too unhealthy to get out in public much anymore, period.
I hate TN. I hate the invisible illnesses my dear friends suffer with (migraines, cluster headaches, Fibro, and more). I hate that we are living in pain with no end in sight. But I’m glad that more and more people are learning about us, and wanting to know more about these illnesses. I’m always happy to answer questions – just fill in the contact sheet and I’ll get back to you as soon as I can.
Until next time….remember…
there is always hope

0 thoughts on “The Pain In My Face Is A Pain In The @ss

  1. I’m so sorry you have to deal with such a terrible disease. I’m a pediatric pharmacist who rounds with the medical teams and I remember several years ago we had a young lady with TN inpatient. We just happened to walk into her room as she was starting to have an episode. Her screams haunt me to this day. I pray your are able to get relief from your medications and am glad that you found a good doctor!

  2. It’s a secret illness because we do not look sick but it’s agonising and lonely. My position is very similar to yours, right cheekbone and under the eye socket.

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