Jul. 15—The pain comes on in fits—"episodic" is the medical term—shooting down the side of the face and jaw in bursts of shock.
"Never felt anything like it. It's like being electrocuted," said Marietta's Matt Flournoy. "Another analogy is if you were to take a screwdriver, and stick it in your teeth, and just have someone bang on it."
It started around three years ago, Flournoy said, with certain triggers: chewing, brushing his teeth, and most problematic for an attorney, talking.
Flournoy came to find the culprit is trigeminal neuralgia, a rare disorder caused by friction on a major nerve running from within the brain down the side of the face. Given the agony it can put Flournoy in, his wife Joanne has found her husband's stoicism remarkable.
"It's almost hard to know. Our friends don't even realize that he's had this problem. I barely even notice it. Sometimes he'll be eating, and he'll just stop," she said. "And I'll say, Are you having the pain?"
Hiding his suffering is no small feat. Mothers who've been diagnosed, said Dr. Raymond Sekula of the University of Pittsburgh's medical school, say the pain is worse than childbirth. In the old days, some called it the 'suicide disease' for the patients who took their own life rather than continue to suffer.
Flournoy, fortunately, lives in the era of modern medicine. On Tuesday, he'll go into surgery under Sekula's care for an operation that could cure him of the pain for good. Flournoy described the procedure thusly:
"They'll drill a hole behind my left ear the size of a quarter," he said, making a circle with his fingers to illustrate. "They drill through, cut through the dura (the membrane around the brain), and they pull back, retract, the cerebellum so they can see the trigeminal nerve."
From there, Sekula will insert a cushion around the nerve to protect it from the irritation causing the shocking feeling. If successful — and Sekula said he considers Flournoy a very good candidate — he'll be rid of the pain immediately.
The procedure is no small thing, being brain surgery after all. But Flournoy's had enough. Anti-seizure medications helped for a while, but made him drowsy and lethargic before eventually losing their effect. Prior generations of doctors, like the renowned neurosurgeon Walter Dandy, would simply cut the nerve, but the procedure wasn't always effective and often left one side of the patient's face completely numb.
"Over the last decade or so, I've really worked on making it a safer, gentler procedure so that the majority of the patients we operate on will leave the hospital the morning after surgery," Sekula said.
Flournoy should be in good hands. Sekula trained under Dr. Peter Jannetta, who pioneered the modern approach, and does the surgery about 225 times each year.
As Flournoy put it, "You do not want to go to a neurosurgeon who does only 12 a year."
His suitability for the procedure aside, Flournoy counts himself lucky in another regard. Many patients are initially misdiagnosed with a dental issue, subjected to unnecessary root canals and other such needless misery. He was fortunate to have a dentist, Dr. Jack Gentry of Marietta, who immediately suspected TGN.
"I'm very, very grateful to Dr. Jack Gentry ... he gets the credit for suggesting that it's not just a tooth problem," Flournoy added.
Though he was just days away from having a hole bored into his head, Flournoy was quite zen about the whole affair.
"I'm excited. I want the surgery. Being on that medication for the rest of my life was just not acceptable," he said.
Joanne Flournoy has done hours of research on the procedure and likewise was feeling calm — for the most part.
"I'm a little apprehensive, but then again, I've done a lot of reading and I've seen the surgery done. I'm not really nervous about it," she said.
"I guess maybe I'll be nervous when I'm sitting in the waiting room at the hospital waiting for the doctor to come out and tell me everything went all right. But I'm looking forward to having him get this over with."