Unknown stuff going on in my face ...help pls

Hello

(Please excuse my english , there can be some mistakes , i’m not native :s)

I read a lot of articles on the internet but still i cant rly figure out what is going on.

My name is Tomas and , I’m 24 for year old man from Slovakia and I have constant facial pain for over a year and i just want to ask if somebody can help me. („Hello Tomaas“) Like if somebody is dealing (or was dealing) with something similar to give me some hint or anything because i fell like i’m hopeless case. This message will be kinda longer because i want to explain everything from the beggining to the current situation in detail. I hope someone will read it :P.

It all started over a year ago when i’ve been seeing my dentist because he found that i have 7 caries on my teeth. He fixed first 6 caries and when he looked at 7th he said that the tooth is „dead“ so he has to do root canal. After that i was always feeling pain in this teeth so i was visiting him again and again. He kept doing root canal , i mean cleaning the teeth canals over and over. The pain didnt go away , so i decided to extract this teeth (because he didnt inform me about other options :S) , but unfortunately pain didnt go away either. After that it went worse , i was feeling pain at first in left side on my face and after that on both sides and this is my current situation. Constant 24/7 pain (except sleeping) on both sides of my face in he area of ,upper sided teeths,jaw,TMJ,cheeks,ears. Pain never stops , it just change intensity , sometimes it is little less painfull , sometimes it is really bad ( i would say in scale 1-10 , it goes between 3-8). Also sometimes pain in one side is dominant . Funny thing is there is no starter of this pain , nothing affects it . I mean for a year i didnt find anything that starts the pain , lower it , no condition , hot/cold , no weather effect , standing , siting , runing , happy , depressed – NOTHING , it is always the same , just changing intensity.

Only two maybe-useful things i realized are that when i’m in a bus/car and when it jumps or vibrate etc i think it lil bit irritate the pain but maybe its only in my head i dont know. Second one is that when i lie down and put one side on my pillow , the second side (one which is up) is painfull mostly in the cheek. I mean the epicenter of pain kinda change from upper jaw to the area of cheek bone. I really try to find some rules or regularity of this pain and this small things are what i found , but it’s just rly small probably pointless things.

After extraction of 3 tooth with no effect i was sent to maxilofacial department (dealing with facial pain , but mostly TMJ) where i was told my problem is TMJ disfunction , so i was using nightguard, done som ultrasonic treatment, using some relaxants medication , speak less , relax , not eating hard food for like 3-6 months with no effect. During this time i visited this department like 10 times and they always told me the same thing – TMJ – dont speak – dont eat hard food – no stress and it will go away. Well thanks a lot. Also it was weird for me because i have absolutely no pain when opening my mouth , speaking, no clicking jaw sound etc , nothing like other pacients dealing with TMJ. At the end i felt like they just dont want to deal with my case anymore. I was seen by ORL,Ortopedist,Eye doctor, Neurologist. I was at many X-Rays,head CT,blood control etc , but everything was good , without any issues they said.

Then totally hopeless i visited clinic which deal with various pain issues (i tis called algeziologist in my country or something like that) and he told me it could be „atypical facial pain“ and started to try different drugs on me. At first i was using analgetics , then Biston , Tegretol, Serlift and Tramal (every medication for a week+) with no effect.

Finally i visited neurologist second time (the better one i guess) and he told me it could be Trigeminal neuralgia V. So she gave me Gapapentin which i’m using right now like for a week with no effect. Also she told after that i will go to MRI (i quess its the only thing i wasnt at (i was at EEG before))Thats the current situation and i’m hopeless , i don’t know who can help me with that. I dont think MRI will show up something as everything other didnt aswell.

Summary:

Both sided constant facial pain with changing 4-8 intensity and occasional pain dominance of one side mostly in area of of upper jaw and upper sided tooth. (for a year )

Seen-

ORL,Neurologist,Eye doctor,Ortopedist,Dentist,Algeziologist

CT,EEG,X-Rays - nothing

Tooth Extractions ,Relaxants (Surgam,Dorsiflex etc), Biston,Tegretol,Tramal, Serlift, Analgetics,Gabapentin- no effect

(I’m 24 year old man which is another weird thing , because every doctor which treated me said that this kind of pain is typical for older people , especialy woman ... so i’m kinda rare ...yupi yey)

Anyone who helps me how to deal with this modafoking disease is my king forever!

Thanks a lot.

Tomas

Wow! Yes we are all rare - very rare.....

You have to try tegretol or gabapentin without other stuff for at least 2 weeks - have them pick one and get you on higher dose - this will sometimes be the diagnostic tool.

MRI does not usually show TN or atypical face pain--NOT a good diagnostic tool unless they find a tumor pressing on the nerve. So it's okay if it does not show the nerve being pounded to death! It sucks!

I don't know how good your reading English is --- but our GUIDE book here is "Striking Back" by Dr. Ken Casey == world renowned face pain doctor. Can you order books on Amazon.com?

Eventually, If meds don't work, you want to look into finding a surgeon anywhere you can drive or fly, who does MVD surgeries MUCH! Please let me restate --- do not visit a surgeon for MVD who has done one or two of them....you could be screwed for life!

No more teeth pulling - very common here! Keep coming here and read, ask, learn..... you must learn all you can to make good decisions. Not saying you will never need a tooth pulled, but NOT until face is under control if possible.

2 more things for now:

Get any doctor to get you a topical medicine to put on your face or in your mouth, lidocaine or ketamine are popular

Also, go to GOOGLE: IMAGES

type in Trigeminal Neuralgia - look at the pictures, does this look like your pain?

Go back to Google Images:

type in Atypical Face Pain-- look at the pictures, does this look like your pain?

if you could show doctor which pictures matches you best - treatment might go faster.

For today - go click on this link I made of meds that work for people here - some meds don't work for everybody...... I compiled a two year list - print off for your doctors.

http://www.livingwithtn.org/forum/topics/for-those-on-the-medicaion...

like before - try one med at a time at first, for a couple of weeks, then go up on it, or add a topical cream or mouthwash lidocaine or ketamine, then talk to doctor about other meds or MVD specialist in your area or any area you are allowed to get medical treatment. Don't let them start you on 3 or 4 meds all at once.

I gave a lot of info - try to get you out of pain sooner...... this disease is progressive, it gets worse over time.

It is also a disease that comes and goes if you have a kind of good med for you. But there is no cure.

You may want to copy this and print it - I don't mean to overwhelm you!

Glad you found us..... we are all same, but little differences in our treatments and our pain paths. Look on our member map tab above..... see if there is anyone here in or near your country!!!!! We are everywhere!

Kimberly

Tomas, I feel your pain and frustration in your post...I too am one that lost teeth, 5, all for no reason other than before diagnosis I was desperate to stop what I thought was tooth pain, with each root canal and extraction the pain got worse, but who knew, who had ever heard of TN! I am a woman, but was only 35 when this all started went almost 3 years without diagnosis. I am on Gabapentin, have had to triple dose to control pain,but have good days. Keep on in seeking doctors who know about this, everything Kimberely said was said so well! And most of all post, vent, let us all be there for you. This can be such a lonely, crippeling thing, but it doesn't have to be. We are here, we understand, we care. I am also a caretaker of my disabled husband, as I have posted, he is in a wheelchair, leg amputated, kidney failure, etc. only 52, but he gets the best of care, through his ordeal I lost insurance due to finances, hard, because somedays I hurt so, but I have to keep on and care for him, yes sometimes life seems unfair, but I refuse to ever quit, I can't. My dogs help, grin, sounds silly, but how I love them and their love for me gets me up and going everyday. Please keep us informed, Tomas and truly know you are not alone, share and share some more, it helps! Sending you a gentle hug.

Well thanks for support , it feels good that i'm not the only one with this weird mess on my face.

Also It would be rly great if i find someone with exact type of this "disease" or whatever it is , to tell me what exactly helps on this kind or how to deal with it. Because i read a lot of stuff on the internet , forums etc and i found many information helpful and found people with almost same stuff but never with exactly same pain (in exactly same area , changing intensity etc) as iam dealing with. I dont know if i can express myself correctly :P but i hope its understandable.

I've searched some images on the internet and i edited one of them to show you main area of my pain hoping that it can help in progress somehow , also i will probably print it out and show to my doctor(s) + i found some medication that helped other pacients with let say "similar" pain , so i will ask my doctors about this aswell ( like Lyrica, Ketamine or Armitryptiline) .

So this is the main area where this 24/7 bothsided evil is operating (mostly) xD

(Maybe another thing to consider is that when the pain becomes more aggresive i always massage this area with my fingers , i dont know why , i feel like i have to do it even though it doesnt help :P)


Hi Krayo,
It’s very difficult to find someone with the same pain presentation. Although we all share similarities, there are no 2 cases of TN alike.

It’s very important to stay on a medication like Tegretol or Gabapentin for a few weeks as it needs time to build in your system. You will need to slowly increase the dose if you still receive no relief from the pain.

Definitely have an MRI as this will show the doctors if there is anything else going on, and will help eliminate other illnesses or abnormal growths, bringing you closer to the right diagnosis.

Have you ever tried putting heat on your face where your pain is? I used a heating pad to help ease the pain and it really helped me, maybe you could try?

I hope you find pain relief soon. Know you are not alone!
(( hugs )) Mimi

Yes we all have a commonality but different variations…the lightning strike pics…that was me… Classic TN. if constant…on the 3rd branch as you have shown… Boring, burning, high level pain…then you have most likely TN 2. Which is now being renamed atypical face pain…cause it’s not typical…so do your research under those 2 labels and learn as much as you can!!! It’s 12 pm here… We are open. 24 hrs a day here!

Thanks for another responses , i really apreciate it that someone cares :P.

Well , yeah i tried something like hot/heat bottle putting on my face and it wasnt working :(

I will definitely go for MRI as soon as possible i hope they will find something, give me medication and BAAAM- out of nowhere- i'm freeeeeee xD.

(Now back to reality)

Another big problem ist that i'm traveling to study in Spain (Canary Island) for half a year so progress in finding the cure will be stoped because my insurance wont cover this kind of treatment in foreign country for sure :\ . I have only like 25 days till flight so i hope there will be some move forward :) . But anyway i'm living with this pain for a year , so another 6 months wont kill me i quess :P.

On the other hand i have small hope that pain will somehow magicly dissapear when i change the enviroment (you know , warm weather , sea etc:P ) , i know it may sound ridicoulus , but you never know :P.

and Yes' i'm doing research everyday , getting new info , reading as much as i can in my free time , thinking reading touching my face over and over again , and iam sick of it ... then i have like 15 minutes with this so called doctors giving me prescription for another random bulls*** which doesnt help at all and i'm in pain forever anyway aaaaaaaaaaaaaaaaaaaa.....

I know its rly hard to figure out what mess i have in my face but am rly sick sick of it , its been so long , and when i read these articles where people write that they are in pain for 5-10-30 years , im like whaaaaat? cmooon life , dont be so fokin cruel xD :S

I'm sorry but today pain is on higher intensity again so its the time for me to express my bad feelings about this whole annyoing , lifedraining bs.

But it rly help that there are people who understands my pain , not like my friends sayin "Clean your teeth MAaaan" (yeaaah , thanks bro ) ...

So thanks to everyone :P i will keep you informed about my progress :P

Tomas :)))

Topical meds are instant relief…like right now…try before you travel…may also get them in Spain I suppose… On member map…you will see at least one person who lives in Spain…might have name of clinic if you send her friend request here !

Can u tell me some common examples of this topical meds? maybe some which is able (and also affordable , iam student xD) to get in my country/europe? because when i googled equivalent in my native language it doesn rly says much about that.... And about "spain friend" - it will be kinda hard because i'm going to canary island but i will try , thanks for inspiration .....thanks a lot :)

Kc Dancer Kc said:

Topical meds are instant relief...like right now...try before you travel....may also get them in Spain I suppose..... On member map...you will see at least one person who lives in Spain...might have name of clinic if you send her friend request here !

Lidocaine, EMLA cream, Ketamine, Lidoderm patches,

a compound pharmacist or druggist can make a mix of Neurocain : contains Ketamine, Gabapentin, Lidocaine, Clonadine on the label. Doctor said it had pharmaceutical cocaine in it.

Biofreeze can be bought on Amazon ---

Depending on the country --- some are prescription some are not.....

I got this list started by googling : list of topical nerve pain medications

Keep it rollin!

Good luck Krayo, I hope that you are able to find something that works for you. I am on 2700mg of neurontin, it helps with the shocking/stabbing but I have lingering pain in my left ear jaw and lower teeth and lips. Drives me crazy!! Very frustrating I must say. It does take a long time to get a correct diagnosis. I really wish you the best.

sorry you are hurting! I have been doing lots of research for if and when the meds quit working and I am intrigued by the study I saw that TENS units can be effective. They are pretty cheap--but you do have to put electrodes on your face... check out the study.. http://www.jpma.org.pk/full_article_text.php?article_id=2771

worth a try i guess!! hope you find relief soon!!

well i've been doing some more research and when i read this wiki article it mostly describe my problem http://en.wikipedia.org/wiki/Atypical_Facial_Pain ...

Does anyones symptoms match with these? because it rly looks like my issue , constant pain (no shocks or anything, just changin intensity both sided sh**)

Gabapentin doesnt work at alllllll , i will suggest atriptyline to my doctor i quess ... also the topical meds you mentioned

This tens thing looks good , i will consider that aswell and topical meds

Thanks for advices

Gabapenin I don’t think works in a week…takes several…and maybe higher dose. I would keep taking it till it works, 3 weeks maybe…ask dr…and show graphics and article to dr!

Krayo,

I did a bit of investigating into topical meds in the CR a while ago. I contacted the Dr. Max pharmacist and here's what they replied (I imagine the options in Slovakia will be similar to those in my country):

v České republice si můžete volně obstarat Cathejell (gel v injekčních stříkačkách; 1 inj cca 52kč; 25 inj cca 1230kč). Je tedy určen k instalaci do močové trubice, ale jistě může posloužit i Vašemu účelu. Tradiční Emla krém (30g cca 750kč) obsahuje mixturu lidokainu a prilokainu a slouží k lokální anestezii před katetrizací, injektáží, povrchovými chirurgickými výkony. Speciální náplasti Versatis (tlumení posherpetické neuralgie) a Lidocain sprej (užíván v ORL či stomatologii) jsou vázany lékařským předpisem a zmiňuji je tím pádem jen okrajově. Každopádně Emlu či Cathejell Vám kterákoliv lékárna ráda v minimální časové lhůtě objedná. Nejde přeci jen o frekventovaný sortiment, který by zdravotnická zařízení měla přímo skladem. Jestliže budete chtít cokoliv doplnit, jsem zde pro Vás.

Oli

Krayo said:

Can u tell me some common examples of this topical meds? maybe some which is able (and also affordable , iam student xD) to get in my country/europe? because when i googled equivalent in my native language it doesn rly says much about that.... And about "spain friend" - it will be kinda hard because i'm going to canary island but i will try , thanks for inspiration .....thanks a lot :)

Kc Dancer Kc said:

Topical meds are instant relief...like right now...try before you travel....may also get them in Spain I suppose..... On member map...you will see at least one person who lives in Spain...might have name of clinic if you send her friend request here !

Gabapentin doesnt work at all.

Today i visited my neurologist and algeziologist , neurologist sent me to MRI , so in near future i will finally have this last thing done (ow god i hope they'll something and kill it :D) and doctor also said that if it will be "negative" then his work is done :P. It means that he doesnt have other ways to help me :S after all medication ive used etc , kinda weird but well thats what he told me.

Algeziologist looked like in the end with his options aswell , he mentioned opoids to be last chance for me but he isnt rly happy about this kind of medication. Is someone using these opoids? Well , i could give it a try , because nothing else worked so far and i want to be freee so baaaad :C

Thanks for info about topical meds etc i will give it a try, but it looks kinda more expensive and i'm low on money right now , iam student :P ... Its not easy for me to pay my study and all this medications and doctors and so on :/ ...but later i will totally buy it and give it a try ...

Some have to be on two meds. Here is a list of meds I compiled over 2 years here..... see what you've got there, maybe try one more in the gabapentin family like trileptal before going to opiates or both! Heres the list to print off for your doctor

http://www.livingwithtn.org/forum/topics/for-those-on-the-medicaion-merry-go-round-i-ve-compiled-a-list