What’s on your mind?

Author’s Note: Not to be read while you’re eating.

This time “What’s on your mind?” is not a fatuous question on Facebook, it’s a medical matter It started bugging me in April last year, and 14 months later it’s getting on my nerves. I need that like a hole in the head.

A gentle tickle in the face, not bad at all, escalated as the weeks went by. Why was I getting a sore sensation from the upper lip to the right temple? It’s like the pain you feel when a bad throat infection makes it painful to swallow, except it’s in the face. I consulted a dentist. Maybe I had a troublesome tooth? X-rays. Not.

Detailed view of the trigeminal nerve and its three major divisions (shown in yellow): the ophthalmic nerve (V1), the maxillary nerve (V2), and the mandibular nerve (V3) (Gray's Anatomy via Wikimedia Commons)
Detailed view of the trigeminal nerve and its 3 major divisions (yellow): the ophthalmic nerve, the maxillary nerve, and the mandibular nerve (Gray’s Anatomy via Wikimedia Commons)

The dentist suggested an ENT specialist, who quickly diagnosed the problem correctly. She introduced me to a neurologist who ordered an MRI to make sure it was not a brain tumor. Not, TG. A blood vessel could be seen pressing on the nerve, which is why the nerve is complaining. It’s called trigeminal neuralgia. Around 200,000 people in USA have this condition.

I looked it up on the internet and read that the pain gets worse over time. So it does. Six months ago the neurologist suggested surgery, or failing that, drugs. I said I’d try the drugs; I’m not enamored of invasive surgery. I haven’t had an operation since I had my tonsils out in 1944, aged 7, and I still remember heaving afterwards. Presumably anesthetics have taken a leap forward since then. I’m pretty sure today I wouldn’t have to climb onto the operating table and watch them put the stinking ether mask over my face while they hold me down. A happiness jab is more likely.

Over subsequent months, despite tripling the pills in stages, the pain came through the drugs every day. The medication makes me tired and unsteady on my feet. At one stage it began to affect my memory. I couldn’t remember whether I’d actually invited four friends for dinner or whether I’d merely thought about it. In fact I had entertained them royally the month before and a good time was had by all. Fortunately the pharmacist spotted that one of the drugs could be responsible, and after switching to another, memory was restored immediately. Phew. I wouldn’t want to give up entertaining.

Yesterday I consulted a surgeon neurologist at UVA. He said that over time it would get worse and that it’s known as “the suicide disease” because eventually the pain drives the subject to it. That doesn’t appeal to me; I’m having a good time. I asked about the procedure.

Here’s where the hole in the head comes in. They remove a piece of the skull behind the ear about the diameter of an American quarter. (I picture a circular drill bit.) Then they insert instruments inside your head to place a Teflon cushion between the blood vessel and the nerve, passing other bits of brain to do so. On the way out they fill the hole with cement. I had to laugh at that. “Cement” conjures an image for me of a builder’s cement mixer. There is no guarantee it will work, but it usually does.

The operation takes about three hours. These days they don’t shave ALL your hair off, they reassured me, just the necessary bit. Well, vanity has never been one of my vices and I can buy a wig. But I don’t like the idea of them fishing around in my brain for three hours. If it’s that hard to find, what else are they going to interfere with? Not my memory, he answered, but I could go deaf or be paralyzed. “OK,” I said, “but if I’m paralyzed I want you to finish me off. I don’t mind being dead but I need to look after myself while I’m alive.” He asked for a copy of my living will. No problem. “Think it over,” he said kindly,” take the weekend. We’ll schedule you for the week after next but you can always change your mind.” I asked if he would advise his mother to have this procedure? He explained that if I don’t, it will just get worse and it’ll be harder to operate as time goes by.

I turned to the internet again. Lots of people shared their pain. I watched a video of the actual operation, Teflon being inserted with a probe. That didn’t look too difficult, but what happens if the Teflon drifts around later? Can they remove the cement or do they make another hole? Could I end up like a colander?

All being well, I will only be in hospital about three days. It will leave me with a sore skull for a while. Presumably the only bit guaranteed not to hurt is the cement. “Don’t refuse the pain killers afterwards,” advised the nurse. “If you don’t start moving straight afterwards you’re in danger of a stroke or pneumonia.” “I’ll take everything you give me,” I said. (Why isn’t Chardonnay on the list?) I’m hazy about the brain’s geography but I really hope they don’t spoil the bits that speak Spanish and invent recipes.

I had a better day today. My two small grandsons came for lunch. I made them all their favorites and they said “We just love this kind of food.” Chicken, whole wheat pasta, green vegetables, melon. “Hey,” said 7 year old Jake, “What does a cow put on its hotdog?” No idea emerged from my wracked brains. “What does a cow put on its hotdog?” “Moostard,” he said with glee. Ten year old Connor asked, “How do you make a cow float?” “I dunno, tell me.” “Root beer, whipped cream, a cow and a cherry on top.”

I’m too old to die young, but after all those years of hard work I’m relishing spending my life and leisure exactly the way I want to. I keep thinking “brain surgery…of all my worries, that scenario never occurred to me.” But I feel curiously sanguine. I’m invoking the trust I put in the pilot every time I take off in an airplane, and placing it in the surgeon. I hope it isn’t a bumpy ride. I’ll let you know. Watch this space.

###
Eileen Dight

Eileen Dight

Eileen Dight is a retired British specialist on trading in Spain, now resident in Ireland. Spanish- and French- speaking, graduate (at 46) of International Politics and History; former editor, interpreter and fundraiser. Her five sons and twelve grandchildren live in four different Time zones around the world. She has lived in England, Wales, Spain, France and Virginia, North America for 11 years. In 2012 she self-published her memoir Plate Spinner and Only Joking, 200 pages of collected jokes categorized for easy reference, as well as What’s On My Mind, her first 50 essays published in Like The Dew. All available on Amazon.com.