Thanksgiving Weekend

I have always had a tendency toward insomnia in my adult life that this methylprednisolone exacerbates.  Methylprednisolone is the prescription name of the steroid I am taking to calm the inflammation of the trigeminal nerve.  It helps, a lot.  Not only do I have the characteristic energy, but it is the first time since the surgery, without narcotic medication, that I have had relief from the pain. More important, it has confined the numbness, which has been spreading since the surgery.  Before the surgery I had numbness in my lips, chin, teeth, gums and progressively up my cheek.  In the weeks before the surgery I began to notice some slight mastication problems and an increasingly persistent dull pain along my ear canal.  I also felt an overall tension in my head on the right side.  

Immediately after the surgery all of these feelings intensified and the numbness spread up my cheek and even, to a lesser degree, in the area around my eye and up to my forehead.   Without the methylprednisolone, the earache and the pressure subsided a bit, but the new painful sensations hardly made those gains a cause of overall celebration.  The pre-surgical mastication problems increased significantly, to the point where post-surgically and as recent as yesterday afternoon not only has it been difficult to chew but even to open my mouth widely.   I also had some odd right eye problems, multiple vision.  (Although those symptoms have been erratic, and may in some part be a hang-over of a complication of lasix surgery a few years ago, I have written this entire blog by closing that eye.) By last night, on my first day of the methylprednisolone, I could start to open my mouth more widely and as I type this blog, between 3 and 4 in the morning, I feel my bite come together for the first time in two months.  

I decided, contrary to my earlier post, to wait until after company to begin this course of the drug.  Upon reflection, and at Denise's suggestion, I recognized that I did not know exactly what to expect and did not want any surprises while Denise and I entertained family and friends at our place on Keuka Lake.  It sounds like a house full, but it was not.  Denises beloved cousin Karen, Roz, Karen's husband and their 12 year old daughter, Deldar, drove 12 hours from Maine to be with us over most of the weekend.  On Thanksgiving Day Melanie May, from Rochester, Colgate Crozier Divinity School (where Denise works in addition to the Rochester Episcopal Diocese) and life partner to Brenda Meehan, erstwhile teacher and subsequent dear friend of mine (who passed away in 2006) together with David Smith, rector of St. Mark's in Penn Yan (where Denise had been the rector) joined Nikko, Sam, Denise, Bonnie and Rob (Denise's children) for dinner.   On Friday we also had some wonderful company from Penn Yan stop by for a lovely, early evening.  I enjoyed the time together thoroughly, but admit that I was in discomfort on Thursday and in pain most of the time on Friday.  I maintained on Thursday a continuous course of Advil, which kept something of the full-fledged pain at bay, but on Friday I decided to see how I felt without it.  Not good.  So first thing Saturday morning I popped my first two tablets of the 4 mg. dose of a total of 6 tablets taken over the course of the day.  No wonder I can't sleep!

The short, light dose of this drug begins its decent tomorrow and will taper off throughout the week.  Perhaps it is my penchant for anticipatory anxiety to already have concerns about going back to how I felt the day before yesterday but beneath my delight at feeling better is the concern that it is temporary.  Optimistically, I might expect that this course of the drug might bring the swelling down to pre-surgical levels, or perhaps even (wildly optimistically) control for the swelling of the nerve due to the amyloid to an appreciable degree.   Herein lies a number of questions I have for some doctor soon.  If the eventual outcome is atrophy of the nerve, would it have been better, had the surgeons known what they found when I was on the table, to remove the amyloid entirely?  What should I expect as a final outcome of the deadening of the nerve symptomatically?  Will this ache and pain remain as a constant or is it a feature of the transition to atrophy?  Finally, two questions: how might I prepare myself for this outcome pschologically and is there anything from the perspective of medical science through physical therapy to alternative medicines such as acupuncture that I can call upon for relief of symptoms or compensation for the motor and sensory deficients, especially in the expectation of returning to work and what otherwise I hope to be a "normal life" not only post-surgically, but post right trigeminally :-)

A minor digression on the subject of nasal care for any reader who inquires of this blog further information about the procedure itself.  Remember when last I said the stents were out and I could breath fully?  That was evidence of my optimistic side!  Relative to having the stents, not having the stents was an improvement, but it did not take me long to recognize, post posting, that I was still quite stuffed up nasally.  I continued to spray my nostrils with a saline solution administered originally in the hospital (somewhat unproductively so long as I had the originally packing in my nose, I might add, because it contributed to the incessant dripping, but it did establish the habit of so doing, which might have been the key idea to the practice while still under constant medical attention).  Post stents, I have taken up the habit of a nostril wash which I was told I must use a couple of times of day for three months until the nose hairs regenerate and do the job of sweeping debris automatically.  But speaking of debris, I spent about fifteen minutes every two hours of Thanksgiving Day discovering what lay in my sinus cavity.   Enough said.  I would still chose this surgery over the traditional post-cranial procedure, but in the interest of full disclosure in an era in which I expect more surgeons and centers will offer this route to the most interior locations of the skull and the brain generally, I should not sugar coat its impact.  I wonder whether that congestion might have contributed to my eye problems last Sunday, especially because, for obvious reasons, everything from the post-surgical black eyes to this expiation has been accentuated on the right side of my face.

Well, it is almost 5 now, (although the post will show up at Pacific Time) and I might try getting more sleep before morning.  Over this holiday I thought of the many, many people who have read the blog, written or called with good wishes, sent the absolutely beautiful flowers (truly, each and everyone has been a cause for celebration and cheers me enormously!) and the wonderful Italian food basket from my beloved Aunt Angel and Uncle Joe in Rochester and hoped for all a happy holiday.  Despite my aches and pains, I had the ultimate great fortune of getting to spend it with my immediate family, and while I might wish to enjoy still more extended family and friends, I could not ask for more happiness than to kiss my darling Denise and watch our beautiful children eat turkey.