For the newly diagnosed

This is beyond excellent, Red. I am so glad you posted it here. I am sharing it with more than one person I know. Thank you.

Likewise, I encourage all of our members to download, print-out and FILL out our form titled "Attending Physician Advisory" for times when they need to be seen by a doc and can't communicate clearly or remember all relevant details. Links are in the Face Pain Info cluster on our menu above. I would also suggest a reading of "The Spoon Theory", in a different discussion thread. The thread can be looked up in our search window at the top right, but the original article is at http://www.butyoudontlooksick.com/articles/written-by-christine/the...

Go in Peace and Power

Red

To find a doc who understands face pain, you might start with our Find a Doctor Page from the Doctor's tab on our menus -- and through that page, to the medical providers' page at the TN Association.

Regards, Red

billn said:

How do you find a doctor who understands TN. My doctor(s) have prescribed antibiotics, prednisone and other drugs by assuming it is somehow sinus related. I have been to a dentist and endodontist in hope that it was tooth related. I live in a small town where there a few options when it comes to doctors. Any suggestions? By the way I live in Sequim WA

I have just joined this site and looking around it.

hi again, mine are not constant and it only hurts if anything hot or cold go that side. I get banging just for couple of mins then it go, but was confirmed as had mri scan, only recently diagnosed with this.

Great topic! All of the tips are wonderful.

Besides being able to find information that would help me in the precess of figuring out what I wanted to do to help my TN, this site was very helpful in helping me talk to others that are going through a similar experience. My family has always been great at listening to me when I have my bad days. Those days when I'm extremely frustrated and start having a pity party for myself. I love them and appreciate that they listen, but I know they don't understand completely. It makes me feel bad that I go on and on about these things. This site has shown me that there are other people out there like me and how therapeutic it can be to talk to others that understand what I am feeling.

This is why my tip for newcomers is: read other's stories and put something down yourself. By reading you will see you are not the only one in pain, confused, scared, emotional at times, proactive, etc. By writing something down you will see that this site is full of amazing people that can become an extra support group. They can help you find the answers to your questions, let you know what their experience was with certain medications or procedures, give you support when you are just having one of those really bad days, helps you with your jitters before a procedure, 'listen' to you when you just want to go off on a rant ... You will be amazed when you realize how good it is to just let it all out.

Thanks for the info and suggestions! I was diagnosed (finally) this past summer, and i've come to realize that the only person i can really count on to make sure i'm getting taken care of is me. Just because someone is a medical professional doesn't mean they know everything...(or that they don't have prejudices).

Anyway, i think the most important one on your list is #8. Hope. Sometimes it's really hard to have hope. I found a computer screen background that is a scrap of paper taped to a window. Written on it, in marker, it says "Every day may not be good, but there's something good in every day." I see that each morning when i turn on the computer, and on those hard days, it does help. So yeah, hope.

~Mistee

On that hope thing.... here's something from another recent thread:

http://www.livingwithtn.org/forum/topics/speeding-up-the-discovery-of-drugs

Regards, Red

Mimi, great discussion, I don't think you missed anything...yes, we all have similar but different types of this facial pain, not all will respond to the meds or be able to tolerate them, side effects. I have experienced an initial relief but it wanes and then the side effects from the meds I have tried are too overwhelming. Combinations of meds are helpful in lower dosages, that is where I am. Gabapentin, 300 mg. 3x, tegretol 50 mg. 1x, valium 5mg. 3 to 4x...going to be changed over to balcofen to give me break from this one, you build tolerance, and then I am using percocet 5 to 7.5 mg. as needed...trying not to build tolerance to a narcotic. It will work if you adjust the dosage lower when you can so the higher dosage will work if the pain hits one those high numbers 8 to 10. I do see my neuro next month, because I can not tolerate tegretol I know there are other meds, but oh my the side effects aren't worth it. I can not seem to tolerate anything with an anti-something, antidepressants, anticonvulsants and can't take a non-steroidal.

I am fairing as well as I can, sleep is so important to controlling this pain and reduce your stress.

Wishing this entire support group a very happy holiday season. I have been truly blessed finding all of you this year! Merry Christmas and Happy New Year too....Sharon

Thank you for all of the above I was diagnosed at a&e and then told to go home and read up on it. I was horrified by what was written on the internet and was convinced i would be wanting to commit suicide in a few years time.

Thankfully a talk with my understanding GP calmed me down and she explained she had other patients with it who led good lives.

Thanks Red for explaining the tic element I was also worried i would develop such a tic.

My early days were spent in fear, fear of what I had read on the internet. Not including this site of course, such a grateful day when I came across it and so important that we keep positive experiences going on hear as well as helping those in pain.

Mistee, you have it right where this all goes, HOPE...with so many ways to treat this damnable disease and the outlook is not always good, it is wonderful to read the messages of those who have gotten the relief from this thing whether it is meds or surgery. This thing has a thing called "remission" to it, so if all else fails know remission is possible. I was in remission for over 20 years, it behaved more like atypical facial pain but I also had tmj and did need surgery, I was only 29, now at 56, the neck pain, tmj maybe again and this facial pain has returned but this time the facial pain has taken on the characteristics of atypical trigeminal type 2, right side greater than left and it does come on like an attack of pain, eye, ear, head and jaw. I have had better results with controlling it with moist heat and stretching exercises for the neck muscles spasms. I just read on this site that MRI should be done but my neuro and most neuros don't do it, even if the scan does not show vascular involvement it doesn't mean it isn't there, they find it if they decide to operate. My type has less success rate and there is a chance surgery can make it worse. I have been through so many failed back surgeries I should know better than beg them to go in and make it go away...it has risks. So, I am really into this HOPE thing, hoping for remission again, I think it will exhaust eventually and stop. And, I do have hours of little or no discomfort so I am going to HOPE. Where do we get this HOPE? I get mine from believing in answers to my prayers and the constant prayers that are ongoing with the church family I have.....so, believing in the birth of our Lord, Jesus Christ, this Christmas season I am extending prayers of HOPE for all who suffer with this disease. Sharon

Mistee Humphreys Shelton said:

Thanks for the info and suggestions! I was diagnosed (finally) this past summer, and i've come to realize that the only person i can really count on to make sure i'm getting taken care of is me. Just because someone is a medical professional doesn't mean they know everything...(or that they don't have prejudices).

Anyway, i think the most important one on your list is #8. Hope. Sometimes it's really hard to have hope. I found a computer screen background that is a scrap of paper taped to a window. Written on it, in marker, it says "Every day may not be good, but there's something good in every day." I see that each morning when i turn on the computer, and on those hard days, it does help. So yeah, hope.

~Mistee

BUMP

Wow! Lots of great advice has been shared! Thanks everyone!
Hope more people add to this…

: )

hi

Can't tell you how much I have appreciated the posts here. As someone who is still struggling to accept the diagnosis and deal with the fear I welcome hearing that there is indeed hope that my life is not necessarily bound to be one of extremepain and depression. I know I am still somewhat in denial and each shock brings a bout of tears as it confirms it has not gone away. As someone who has taken pride in rising from some difficult beginnings and then raised children on my own this really is scary as it takes away my sense of control. Finding some positive things here for the first time made me think I might be able to influence the course of events rather than be in a victim mode. Thanks for sharing your stories I hope to hear more from people who feel that they have found ways to LIVE rather than exist with this horrible disease.

I'm very glad I found this site. I was just diagnosed yesterday (yeah, I had a GREAT New Year) after 12 years of wondering what was wrong with me. The doctor was absolutely sure it was TN and I think he's right, but I wanted to ask if anyone has had the same experience I have had over the years. I think the reason several other doctors have dismissed TN is that it does not effect my face, just my ears. And I have experienced it on both sides (not at the same time). Is this the case for anyone else? I call them the "episodes". Luckily it only flares up a couple of times a year, for a couple of days usually, but the episodes have gotten a little longer and a lot more intense. I think Mimi described it perfectly when she said "I was down on my knees begging for mercy." Yep. Also, my episodes mostly follow a cold or flu, another reason doctors have brushed it off as sinus related. But I'm curious if anyone else has the pain just in the ear. Thank you for all the great information in this thread. Nice to meet you all.

Hi jslowboat, I too have pain in my ears, achy, like a slap to the side of he head, right greater than left and they feel plugged, sometimes I have mild vertigo. I also have a history of tmj, surgery in '86 to repair the soft tissue between that small tmj joint, it helped a terrible screwdriver pain in my ears but my facial pain persisted, then I was dx'd atypical facial pain. Next was a herniated disk at c5-c6, surgery did not help, I failed on a pain pump that did help with the pain for 4 years because of a big problem with this pump, but my facial pain went into remission for over 20 years. Everything from 2000 to 2009 was all lumbar, many surgeries but they unable to correct this, then a year ago the neck pain and facial pain came back, only recently for about 4 months now I am presenting with atypical trigeminal neuralgia type 2. When I get an attack it feels like I have been slapped hard on the right side of my face, ear and head, my jaw aches, chewing is difficult and as I said my ear aches and feels plugged. Drugs have not helped, failed on lyrica, cymbalta, and tegretol. I use moist heat for ear and jaw pain, also do an exercise of plugging my nose and blowing until I feel like I have popped my ears. The pressure really is annoying. Can't and won't take antihistimines for this, can't take them with some of the meds I am on. So, I can get it to calm down with moist heat and get ears to feel unplugged with this exercise. I think the facial dx is aggravating my tmj again, or maybe it is tmj aggravating another facial pain syndrome again, or it could be coming from my neck, I am now fused at 3 levels. If I have a lot of congestion, which is usually an allergy it feel worse in the ears.

You may have some tmj too, all of this gets all mixed in together, the neck, the jaw and then this facial pain can make your ears ache and the pain is awful. I did have a trauma to the right side of my face when I was very young, 27, my husband slapped me so hard my eardrum was almost ruptured, I could not hear out of that ear for weeks, soon after the tmj started. Now I am almost 57, and unsure if I have a lot of arthritis in the tmj joint as I am riddled with arthritis now throughout my entire spine, cervical and lumbar from all the surgeries and fusions. That ear pain sometimes feels like someone is pinching my ears as hard as they can, they burn and ache and then it all refers to my face and jaw, cheek and eye pain. It is a combination of muscle spasm and nerve pain. I can get the muscles to respond to moist heat but the facial pain persists....I am different on one aspect, my face pain feels cold. It does burn and ache, and yes I get the jolting spasms of pain to the cheek and eye, the jaw locks up sometimes. I won't even entertain seeing an oral surgeon unless I start getting deep screwdriver pain in my ears, then it is the joint again. My brother-in-law is a dentist and has advised me to be watchful as this thing could gradually tear that joint up again. I know we all present differently with this facial pain, I guess that is why they call it atypical. Typical TN, is almost always the same for sufferers and surgery is usually successful but they do not do surgery for atypical trigeminal neurolgia as the success rate is low and my neuro says I do not have vascular involvement. I am going to ask for an MRI on my next visit to definitely rule this out...I have read sometimes it can not be seen on these scans but is found sometimes when surgery is done.

If I were you, I would see an oral surgeon to rule out tmj, the ears are always effected with this, but beware surgery for that joint is not always successful and may not relieve all your pain. Good luck to you, I should get into to see an oral surgeon again but am reluctant knowing the outcome for anything invasive can make it worse.

I am doing the first line of action for this, stretching exercises for the neck and back, swimming, moist heat, pain meds, not a lot, low dose of percocet. The exercise for the ears I learned from an ENT, plug your nose and blow 3 or 4 times, then keep your nose plugged, plug your ears, blow 3 or 4 times and then pop them. I did respond to some of those other drugs but the side effects were very negative. I see my neuro again this month, there are other meds but oh my the side effects are just too much. Again, I don't know if I have been helpful but I do hope you find a way to get some relief. Sharon



jslowboat said:

I'm very glad I found this site. I was just diagnosed yesterday (yeah, I had a GREAT New Year) after 12 years of wondering what was wrong with me. The doctor was absolutely sure it was TN and I think he's right, but I wanted to ask if anyone has had the same experience I have had over the years. I think the reason several other doctors have dismissed TN is that it does not effect my face, just my ears. And I have experienced it on both sides (not at the same time). Is this the case for anyone else? I call them the "episodes". Luckily it only flares up a couple of times a year, for a couple of days usually, but the episodes have gotten a little longer and a lot more intense. I think Mimi described it perfectly when she said "I was down on my knees begging for mercy." Yep. Also, my episodes mostly follow a cold or flu, another reason doctors have brushed it off as sinus related. But I'm curious if anyone else has the pain just in the ear. Thank you for all the great information in this thread. Nice to meet you all.

Sharon, I am so sorry you have had to deal with all that! I'm sure that you are overwhelmed sometimes.

I did see a dentist many years ago, thinking maybe I had a dying tooth, or possibly TMJ, but neither were found. My pain is much different, which is why I am questioning my diagnosis a little. Mine is only in the ear and it shoots out the back of my head. No face pain, or jaw, and it's not sensitive to touch. But it seems to center on my earlobe, which I think is strange. But it's like having my own personal taser. I get zapped. Some times it is tolerable but like this past episode, the pain level was a 10. And it's random. Sometime's it's every 30 seconds for a couple of days (like this past weekend) and it wipes me out. Then I might go a year before it happens again. It's been going on for 12 or 13 years.

Thank you for your insight. I see a neuro in a couple of weeks and am requesting an MRI. I'm glad this site is here!

Granny said:

Hi jslowboat, I too have pain in my ears, achy, like a slap to the side of he head, right greater than left and they feel plugged, sometimes I have mild vertigo. I also have a history of tmj, surgery in '86 to repair the soft tissue between that small tmj joint, it helped a terrible screwdriver pain in my ears but my facial pain persisted, then I was dx'd atypical facial pain. Next was a herniated disk at c5-c6, surgery did not help, I failed on a pain pump that did help with the pain for 4 years because of a big problem with this pump, but my facial pain went into remission for over 20 years. Everything from 2000 to 2009 was all lumbar, many surgeries but they unable to correct this, then a year ago the neck pain and facial pain came back, only recently for about 4 months now I am presenting with atypical trigeminal neuralgia type 2. When I get an attack it feels like I have been slapped hard on the right side of my face, ear and head, my jaw aches, chewing is difficult and as I said my ear aches and feels plugged. Drugs have not helped, failed on lyrica, cymbalta, and tegretol. I use moist heat for ear and jaw pain, also do an exercise of plugging my nose and blowing until I feel like I have popped my ears. The pressure really is annoying. Can't and won't take antihistimines for this, can't take them with some of the meds I am on. So, I can get it to calm down with moist heat and get ears to feel unplugged with this exercise. I think the facial dx is aggravating my tmj again, or maybe it is tmj aggravating another facial pain syndrome again, or it could be coming from my neck, I am now fused at 3 levels. If I have a lot of congestion, which is usually an allergy it feel worse in the ears.

You may have some tmj too, all of this gets all mixed in together, the neck, the jaw and then this facial pain can make your ears ache and the pain is awful. I did have a trauma to the right side of my face when I was very young, 27, my husband slapped me so hard my eardrum was almost ruptured, I could not hear out of that ear for weeks, soon after the tmj started. Now I am almost 57, and unsure if I have a lot of arthritis in the tmj joint as I am riddled with arthritis now throughout my entire spine, cervical and lumbar from all the surgeries and fusions. That ear pain sometimes feels like someone is pinching my ears as hard as they can, they burn and ache and then it all refers to my face and jaw, cheek and eye pain. It is a combination of muscle spasm and nerve pain. I can get the muscles to respond to moist heat but the facial pain persists....I am different on one aspect, my face pain feels cold. It does burn and ache, and yes I get the jolting spasms of pain to the cheek and eye, the jaw locks up sometimes. I won't even entertain seeing an oral surgeon unless I start getting deep screwdriver pain in my ears, then it is the joint again. My brother-in-law is a dentist and has advised me to be watchful as this thing could gradually tear that joint up again. I know we all present differently with this facial pain, I guess that is why they call it atypical. Typical TN, is almost always the same for sufferers and surgery is usually successful but they do not do surgery for atypical trigeminal neurolgia as the success rate is low and my neuro says I do not have vascular involvement. I am going to ask for an MRI on my next visit to definitely rule this out...I have read sometimes it can not be seen on these scans but is found sometimes when surgery is done.

If I were you, I would see an oral surgeon to rule out tmj, the ears are always effected with this, but beware surgery for that joint is not always successful and may not relieve all your pain. Good luck to you, I should get into to see an oral surgeon again but am reluctant knowing the outcome for anything invasive can make it worse.

I am doing the first line of action for this, stretching exercises for the neck and back, swimming, moist heat, pain meds, not a lot, low dose of percocet. The exercise for the ears I learned from an ENT, plug your nose and blow 3 or 4 times, then keep your nose plugged, plug your ears, blow 3 or 4 times and then pop them. I did respond to some of those other drugs but the side effects were very negative. I see my neuro again this month, there are other meds but oh my the side effects are just too much. Again, I don't know if I have been helpful but I do hope you find a way to get some relief. Sharon



jslowboat said:

I'm very glad I found this site. I was just diagnosed yesterday (yeah, I had a GREAT New Year) after 12 years of wondering what was wrong with me. The doctor was absolutely sure it was TN and I think he's right, but I wanted to ask if anyone has had the same experience I have had over the years. I think the reason several other doctors have dismissed TN is that it does not effect my face, just my ears. And I have experienced it on both sides (not at the same time). Is this the case for anyone else? I call them the "episodes". Luckily it only flares up a couple of times a year, for a couple of days usually, but the episodes have gotten a little longer and a lot more intense. I think Mimi described it perfectly when she said "I was down on my knees begging for mercy." Yep. Also, my episodes mostly follow a cold or flu, another reason doctors have brushed it off as sinus related. But I'm curious if anyone else has the pain just in the ear. Thank you for all the great information in this thread. Nice to meet you all.

the book Striking Back- by Dr. Ken Casey has become my new bible and 2nd dont hesitate to push back your Drs/neurologies or get 2nd opinions. You need to focus on the "root cause" of your pain.

Many Drs are not well versed, once you find a specialist who sees/knows TN extremely well you will know.

My lesson learned was that I wish I had gone for root cause and resolving from Day 1 as opposed to medicating it away or other shorter term less evasive remedies (such as the gamma knife and glycerol rhizotomy which note both work for MANY folks here). If the root cause is an artery compressing the nerve go for a final resolution such as MVD (I go in on Jan 15th 2013 for mine).

last advice POST ANY QUESTION OR CONCERN on this site, the people here are overwhelmingly helpful and can help be there for you every step of the way. Literally a lifesaver for me

A couple of cautionary notes, if I may.

JSSlowboat, et al -- sharp pain "only"deep in the ear or associated with a stabbing pain back into the rear of the head lines up pretty well with a combination of two neuralgias: Occipital, which affects the rear quardrant of the head, and geniculate or "nervus intermedius" which results from a compression of a nerve which branches between the 7th and 8th (??) cranial nerves. These variations on vascular compression syndromes are worth discussing with your neurologist or neurosurgeon. Both have been effectively treated with micro-vascular decompression, but from what I've heard and read from patients, neither variant is particularly responsive to Gamma Knife, Cyber Knife, or Glycerol Rhizotomy. That is something on which a neurosurgeon's experienced opinion will be important to obtain up front.

For Albee: GK, CK, and glycerol rhizotomy do have a place in treatment of pain in the face. Of the three, Glycerol is possibly the least damaging. It has an average persistence of between one and two years of pain reduction when it works, and it can be repeated. GK and CK can only be done twice in a lifetime. The published practice standards for GK indicate that pain recurs within three years for about half of all successful GK patients, with further recurrences after that. From sources other than the practice standard I have also read that these procedures are also "mis-labeled" as non-invasive. While papers in medical literature indicate that MVD can be performed as a second procedure after GK, in many cases it will be made more complex by lesions and adhesions on and to the nerve, which are produced by the GK.Cyber Knife is also less precise than Gamma Knife, with about four times the spill-over of radiation into areas nearby the nerve (within millimeters). When "nearby" is the brain stem, I would personally have profound reservations about safety of this procedure. It was originally developed for cancer treatment in situations where invasive surgery was not feasible. I believe both procedures should be reserved for such situations when the target disorder is TN rather than cancer.

My two Red cents, for whatever they're worth.

That is VERY helpful, thank you.


Great info on procedures. And I like the get to the root cause of this thing, I am asking for an MRI, failed on so many meds. Thanks, Sharon