Dr JP: The very aim of this surgery is to stop the life-disturbing pain as well as save the patient from the toxic chemical and the untold misery it brings with it. Due to carbamazepine’s side effects on body and mind, people have given up their jobs even when they were on smaller dosages. So surgery is not only indicated if the drug does not stop the pain. It is indicated even if it stops and causes side effects. The drug which is given to stop the pain brings other diseases in the form of toxic effects. Please try to understand this that the disease is increasing in intensity inside while you are delaying the surgical treatment. Secondly, carbamazepine treatment doesn’t cure the disease. So it is NOT comparable or an option for the surgery. At best it is a pathetic compromise. A person on carbamazepine treatment has severely altered quality of life and has the continuous feeling of impending doom if a dose is missed. He or she is drugging the brain on regular basis.
The other important aspect is that the surgery even cures the ‘side effects’ of TN itself.
That is interesting, can you elaborate?
Dr JP: I shall tell you one of my clinical experiences. As we have already discussed, TN has been described by the sufferers as the worst pain mankind knows and there is no exaggeration here. It is also called “the suicide disease” as in the absence of proper and timely treatment these people tend to have serious suicidal thoughts. And indeed there are instances of people have killed themselves. TN can disturb the patient’s mind and in some cases the effects are seen on the body too. So, coming to this case of a man from Jodhpur who had travelled all the way to Pune was in terrible agony. He also had severe psoriasis all over his face, scalp and chest.
Psoriasis is a skin disease and one of the causes and aggravating factor is severe mental stress.
This man was haunted by the pain and was under mental stress for many years. We operated on him. He had severe compression of his trigeminal nerve due a blood vessel deeply lodged in the root entry zone of his nerve. I had to perform the MVD surgery…and as expected, his pain vanished. For the first time in 12 years he was free of pain. He was duly discharged and returned to Rajasthan. When he returned after eight months for routine follow-up, I could not recognise him. You know why? His psoriasis was completely gone. You see, his pain and stress of many years were cured and this, in turn, treated his psoriasis. A glaring example of how the skin is, like all parts of our body is connected to the brain. I will go further in saying how the skin, like all parts of our body is an extension of our brain.