He started me on a drug called Carbamazepine (Tegretol). My experience with this drug is mostly at the doses for my epileptic patients but in lower doses it's used to treat trigeminal neuralgia. Keith told me (after extensive googling on my way home) that trigeminal neuralgia was actually it's original use. The doctor also made me an appointment with a neurologist and booked me an outpatient MRI. I am really lucky to have such a great work buddy because Amy (my fellow fellow) stayed with me until we could take the train back together despite the fact that she paid her nanny overtime to do it).
Carbamazepine has really improved things so much for me. I don't have any attacks anymore. I sometimes can feel that there is some mild burning on that side of my face and take an additional pain medicine but that is getting even more rare. I truly think that people who hate Western medicine are people who haven't had a serious health concern. My trigeminal neuralgia isn't serious but if you google it (like my husband or my friends) - which I don't suggest - the top hits include phrases like "worst pain a human can experience" and "used to be called the suicide disease because people would kill themselves because of the pain". Mine wasn't that bad but I know I have a pretty decent pain tolerance with having lived through my 30cm ovarian cyst (if anyone didn't know about that - it was benign) so I knew this facial pain was probably pretty bad. I am truly thankful for people who have created medicine to alleviate human suffering. I think that we don't really think about that until we need it.
So my outpatient MRI was booked for today. I was the ridiculous patient that forgot the requisition (seriously doctors make the worst patients) but Keith sent me a photo of it and that worked. Being a patient is humbling. I know it's humbling for everyone but truly it makes me remember that I ask my patients to go for tests all the time and it's probably scary for them too and I have the benefit of understanding what's going on. I got on the MRI table and then they put a halo over your face with a bunch of foam to keep your head in a particular position. Years of medical training have taught me that artifact from movement is really annoying for radiologists so I stayed completely still. Everyone has told me how loud MRIs are but I live with Cian and Emily so it was relaxing and I think I nodded off a couple of times. The series for trigeminal neuralgia requires IV contrast and many series so I think I was in the MRI for 45 minutes. The series usually lasts up to an hour and mine was "fast" because I was very still. The receptionist who had been a little rude to me on the way in was a lot nicer to me on the way out when she found out I was a doctor. That is aggravating - maybe you should just be nice to people because they are going for a test so probably something is wrong and they are stressed - grrrrrr. They gave me my MRI pictures but I didn't look at them until I called back and they read me the report over the phone: NORMAL BRAIN!!!! This was a huge relief and the best Christmas present. This is always the part in the story where Keith doesn't realize I had previously been stressed. I explained to him (as I had explained before) that they were looking for Multiple Sclerosis or a brain tumour. His oblivion often shields him from thinking about those things. Doctors don't usually have that luxury. I had looked all the way down the tunnel of either path. What our lives might look like with either of those diagnoses. That's because I've seen patients with MS and brain tumours and the prologues to their stories are typically "I felt fine until...." and I think medical school often gives you the feeling that any moment the "health" shoe might drop.
This was the wake-up scare. The one that reminds you that there are worse outcomes in life than failing the exam I obsessed over last year. I've been slowly waking up over the course of this year - like I've been in a deep sleep of education these many years of medical school and residency and this was the jolt where you sit upright in bed. It's the reminder of how precious every moment is with my rapidly growing children - to be with them in the fits of laughter, the kangaroo jumping and the kitchen dance parties. My prayers changed over the last few days to "please Lord let me see my beautiful children grow up..." I am crying about this now and Keith is lovingly annoyed with me that I was so stressed and didn't tell him. I am so lucky that with either "fictitious illness lane" I walked down I saw him right there with me. If I lost my hair from cancer or couldn't walk with MS I knew he would be there and he was the only person I wanted there with me. That is a truly amazing thing to have - an always and forever partner in life. In this Christmas season I keep thinking of when Scrooge wakes up determined to be a better person and although I don't think I could ever be called a Scrooge I do feel like I've been reminded of what's really important to me. God bless us everyone.
"He became as good a friend, as good a master, and as good a man, as the good old city knew, or any other good old city, town, or borough, in the good old world. Some people laughed to see the alteration in him, but he let them laugh, and little heeded them; for he was wise enough to know that nothing ever happened on this globe, for good, at which some people did not have their fill of laughter in the outset; and knowing that such as these would be blind anyway, he thought it quite as well that they should wrinkle up their eyes in grins, as have the malady in less attractive forms. His own heart laughed: and that was quite enough for him." - A Christmas Carol by Charles Dickens.
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