Wednesday, July 23, 2014

My Journey through Pain

Pain is life--the sharper, the more evidence of life.
--Charles Lamb

I've been experiencing a lot of "life" lately. For the past year, I've struggled to get a diagnosis for pain that I've felt on and off, and almost daily for the past seven months. I first noticed the pain around my left ear, and then on the back left side of my tongue and sometimes along my left jaw, and more recently into my head and sinus area. I went to my dentist, who referred me to an oral surgeon, who referred me to an ENT. Next, I went to three different ENTs who could not find anything wrong with me. I subjected myself to many frightening medical tests, halfway hoping to find something, halfway not. I did not. I decided after my last disappointing ENT visit that I had nerve pain, possibly a neuralgia (this was based on meager suggestions from ENTs, and the Internet, of course). I went to a neurologist, who ordered more tests, just when I thought there were no more that could possibly be ordered. After talking to my dermatologist at an unrelated appointment, she mentioned I could have had shingles, without the skin rash, which would have left only the nerve pain, which can linger for a long time. Meanwhile, my neurology tests came back normal, so the neurologist, who thought I might have a rare type of neuralgia--glossopharyngeal neuralgia--prescribed an anti-convulsant medication, which is one of the ways nerve pain is treated, as well as a medication commonly prescribed for shingles (per my urging). After more than a week, I didn't really notice a difference. I felt doomed with this undiagnosed pain. I tried hard to manage the depression and anxiety that had gripped me during the past months, but sometimes they won out. I turned to more natural treatments.

A Possible Solution
After several weeks of intense massages in my neck and specialized cranial-sacral treatments, I was not really feeling any better. In the meantime, my regular dentist retired, so I was referred to a new one. This new, young, high-tech dentist did a couple of quick digital x-rays, noticed my wisdom teeth were still present, and said very matter-of-factly that "those need to come out." Now, I had already had a consultation with an oral surgeon about the teeth back in December, and he said they were definitely impacted and may cause problems later on, but if they weren't bothering me at that time, I didn't need to have them removed. (I also saw this same doctor about a week later when the left-side tongue and jaw pain flared up--and he referred me to an ENT.) So I called that same oral surgeon's office and inquired about having my lower teeth extracted (my uppers never descended--see below, near my nose ). The office staff reminded me of the exorbitant cost, and I reluctantly agreed to schedule the surgery that same week. I knew it may not solve my problem, but at that point I was desperate and would try almost anything.

Cheeese.

More Appointments, More  Meds
A couple days before my surgery, I had a follow-up appointment with my neurologist, who was a little skeptical of my decision to have my teeth extracted. She also thought that I may be suffering from migraines, without some of the the classic symptoms. It sounded a little wonky to me, but she's the learned one. So she prescribed more medication to treat me as though I had migraines. I only used the meds for a day or two because I knew I'd be going through the surgery soon, and I'd have yet more medication to take after that. 

On surgery day, I woke up with a massive headache that just felt like intense pressure squeezing my head from all around. But I wanted to get one more run in before I knew I'd have to take time off to rest, so I ran four miles despite the pain, and afterward I could not consume water because having any food or liquid in my system while under general anesthesia was a hazard. So on the way to my appointment, I felt awful, but I didn't care because I knew I'd be feeling nothing soon enough.

Post-Op Excitement
After I woke up from the surgery, I realized it had taken about 45 minutes longer than expected, and I could hear the doctor telling Tim that it had been a difficult procedure, which made me concerned. But I really just wanted to head home, pick up my prescriptions, and go to bed. Tim, by the way, was an angel throughout this process. He reminded me every 45 minutes to change my gauze (which I had to keep in my mouth to help the blood clot); he brought me my meds when it was time to take them; he prepared my food and helped me eat; and he changed out my ice packs that I had to keep wrapped around my jaw. I hadn't realized how useless I'd be that first day, and I'm so glad I wasn't on my own.

I'm only OK sharing this because I know how much uglier things got.

The next day, though, I was on my own, but I managed to do everything I needed to do for recovery. The third day, which I was warned would be my "puffiest" day, I decided to go out in public (I was not in the state of mind to make good decisions). I had a cranial-sacral massage, which I thought might actually help release fluids and decrease my puff, and then I had a haircut scheduled, which always makes me feel good, so I kept the appointment. But these appointments meant I had to drive myself around, so I didn't want to risk taking the narcotic (oxycodone) and operating a vehicle, per the prescription label's warning. This meant I was in a lot of pain. So by the end of the day, I really just wanted to knock myself out and sleep for many hours. So I took a double dose of the oxycodone and hit the sack.

Hours later, I still wasn't asleep, and my head was splitting again. I felt nauseated, and my body temperature kept fluctuating, leaving my skin clammy. Naturally, I called my mom, who does not live in Tampa, but she's a nurse (and a mom). I woke her up, as it was about 1:30 a.m., and frantically told her my symptoms. She told me very calmly that it sounded like I needed to go to the hospital. I said, "Are you sure?" despite knowing for myself that I needed to go. So I woke up Tim and told him I needed to go the ER. But just before leaving, I felt a strong bout of nausea and ran into the bathroom and knelt down by the toilet just in time to rid myself of the Chinese takeout I was only halfway able to consume anyway. Then we were able to leave for the ER.

We didn't have to wait too long before I got checked in, my vitals taken, and blood drawn for testing, but after that, we were sent back out to the waiting room until a bed became available. I was feeling rough. The headache would not relent, nor would the nausea. It seemed like we sat there for hours. Eventually a room was available, and as soon as we got in it, I knew I needed to make use of one (or two) of the blue bags available throughout the hospital for patients likely to vomit. I couldn't believe I still had that much left in me. When that episode was over, a nurse immediately hooked me up to an IV for fluids. Apparently I was pretty ghostly looking. Then the doctor came in and, after talking with me briefly and going over my recent meds, asked if I'd ever had a migraine. I said no. She treated me with what they call a "migraine cocktail" of medications through IV. And it helped very quickly. One of the meds made me very sleepy and loopy. After a while, the doc came back and told me that people who are migraine-prone sometimes react badly to certain narcotics, such as the one I took a double dose of earlier that evening. Ah. Good to know, but poor timing. Eventually I was released, around 5:00 a.m., and Tim drove us home so we could get some much-needed sleep.

Is It Over Yet?
I felt very unsettled after that experience, and what I wanted more than anything was to just feel normal again. I was still healing from the surgery--one side was healing a lot quicker than the other. I knew that if I didn't go into work the next day, Monday, I would just lie around the house feeling depressed, and in pain. Whereas if I went to work, at least my mind would be occupied while I was in pain, and I could start to get back to my normal routine. I got through the workday without any catastrophes, and I was really looking forward to the next day, when I had my follow-up appointment with the oral surgeon. I was almost sure something was wrong with my-left side extraction site. My fear was dry socket. So guess what I learned at my appointment? I had developed dry socket on the left side. I would venture to say that the pain of this condition is worse than the pain of having the tooth extracted. And I couldn't even take the narcotic. So I had to have a packing of gauze soaked in medicine placed down in the socket where my tooth once resided. That had to stay there until my next follow-up, two days later, when the packing was changed out for a new one. Then I had to keep that one in over the weekend until I could come back on Monday to have it removed. While the medicine helped immensely with the pain, it prevented the hole from closing because it had a foreign object in it. So I was glad to have the final packing removed so healing could finally commence.

Where I Am Now
You may be wondering whether the surgery in fact helped with the pain I had prior. Truthfully, it's hard to tell. I still have a good amount of pain from dry socket, which is in the same general area as the previous pain. But that will hopefully lessen throughout this week as I heal. Overall, though, I do feel better. I'm able to do more of my regular activities without being disrupted by pain or thoughts of pain or anxiety about pain. I think I probably had a combination of things going on. I learned that the left-side wisdom tooth was on the nearby nerve, which is what made the operation particularly difficult. So I think I had pain from that and just general pain that an impacted wisdom tooth can cause, and perhaps I am now susceptible to migraines, which can happen as hormones change throughout the years--especially in women. And perhaps I also have glossopharyngeal neuralgia, which may or may not continue to be a problem. But I feel like I have more tools to deal with what might come my way, and I'm relatively happy with the treatment I'm receiving from my neurologist. I'm pretty confident that once my dry socket heals up, I'll be feeling very close to normal. And it's about time. I have bigger and better things to concern myself with.

On a side note, throughout all of this I have been able to run (except for my week of recovery, post-surgery). I am proud of myself for keeping up with that part of my lifestyle, even when I felt too depressed to do much else. I am at the beginning of (although already a bit behind) my marathon training plan for the Marine Corps Marathon in October. I'm excited to get on track with that.

Also during this difficult time, I have had so much support from Tim, my family (and his), my friends, and coworkers. I realize how very fortunate I am to have such a supportive community around me. I can't imagine going through such a time without all of their love and concern.

Now, onward and upward (and more regular posting)!

1 comment:

B.o.B. said...

Good grief Lee! I had no idea you went through all this. I knew you had the pain but wisdom teeth removal totally sucks! I had mine removed in high school and was so sad & I also get sick from certain pain meds. (I almost passed out at the video store. Remember when video stores weren't Blockbusters? haha) Anyway, I'm so glad you are on the mend. Good job to Tim! He's a keeper!