The Challenge
James, a resident of Hot Springs, Arkansas, was enjoying retirement and spent most of his time with family, out on the golf course, and remodeling houses.
However, that all changed in 2019 when he began experiencing an extremely sharp pain above his right eyebrow. The attacks were very frequent, occurring multiple times a day and lasting anywhere from 30 minutes to an hour.
The intense pain affected his ability to complete daily activities, as once the pain hit, it was impossible to do anything but attempt to manage it in some way.
“To help stop the pain, I would hold my hand up to my head and put pressure on it. This provided temporary relief, but as soon as I removed the pressure the pain came back in full force.”
Concerned by the severity of pain, James saw three different neurologists in Arkansas and was ultimately diagnosed with trigeminal neuralgia, a condition in which a blood vessel compresses the trigeminal nerve creating sudden, severe, shock-like feelings of pain along the face.
He was prescribed medication to help control the pain. While the medicine alleviated some of the sharp pains, James was often described by his family as “not being fully present” in many of life’s moments.
James decided that there had to be a better way to manage the pain aside from medication, as the side effects were limiting his ability to engage with his family and reducing his overall quality of life.
The Path to UPMC
James’ brother was a spinal surgeon in Louisiana who often monitored surgeries. His brother had the chance to monitor a surgery of UPMC’s Dr. Georgios Zenonos, associate director of the UPMC Center for Cranial Base Surgery and assistant professor in the Department of Neurological Surgery.
James’ brother also encountered Dr. Zenonos once again at a medical conference. After listening to Dr. Zenonos’ presentation about surgical treatment of trigeminal neuralgia, James’ brother persuaded him to seek care with Dr. Zenonos at UPMC.
James eventually connected with Dr. Zenonos through a telemedicine appointment in which Dr. Zenonos reviewed a series of tests from James’ previous medical visits in Arkansas.
Dr. Zenonos recommended that James undergo a microvascular decompression, which is a minimally invasive surgery that offers the most long-lasting relief and minimizes risk of postoperative side effects like numbness.
“During our appointment, I felt confident in Dr. Zenonos and could tell he was definitely an expert and knew what he was talking about. I knew that if anyone was going to do this surgery, it had to be him.”
The Care
James underwent a microvascular decompression, which consisted of making an approximately 4cm incision behind the ear. Next, a window was made in the skull to gain access to the brain.
Dr. Zenonos then used a microscope to detect the area where the blood vessel was pushing on the nerve causing the pain. To separate the blood vessel from the nerve, Dr. Zenonos inserted a nonstick PTFE (polytetrafluoroethylene) "pillow" in between them.
James’ spent one day in the hospital following the procedure and was discharged the next day. He then stayed in Pittsburgh for a week after the surgery and visited with Dr. Zenonos for a follow-up appointment to review the results of the procedure.
The Results
James has made a full recovery since the procedure and is able to engage in his favorite activities such as golf and remodeling houses once again.
“As soon as I woke up from surgery, I could tell it was gone. As time continues to progress, I have never felt an onset of any symptoms or sharp pains like I once did.”
James has been fully weaned off the medications he was previously taking and finds that he is able to be fully present in all areas of life again.
“UPMC is the best hospital I have ever been to and the care I received from Dr. Zenonos was unreal compared to my other previous experiences.”
