Dr Ranj Singh’s ‘suicide pain’ condition he dismissed as tooth ache – trigeminal neuralgia
The general practitioner, who is also turning his hand to cooking in the latest series of ITV’s Cooking With the Stars, first noticed something was wrong when he started to experience pain in his mouth. After dismissing it as toothache after the pain subsided after a month, Singh then started to experience frequent “short attacks” twice a year until he was around 35 years old. With the symptoms in his mouth being triggered by seemingly simple things, soon his level of pain became unbearable that even so much as speaking would cause him a great amount of discomfort.
“I then started to experience this transient pain in my mouth that lasted for about a month then tapered off,” explained Ranj now aged 42, “so I dismissed it as toothache and got on with things.”
“The pain came back with a vengeance and was more severe and lasted for a couple of months at a time and was triggered by the tiniest thing. If something touched the inside of my mouth or brushed against my gums or a tooth, particularly on the left of my face, the pain started.
“Simply stroking the side of my face really gently would trigger an attack, which felt like an electric shock.
“Eating would provoke it, brushing my teeth, laughing or even talking, so I stopped speaking. I would get resentful if people started a conversation as the pain was so intense.”
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After seeking help from his dentist due to the source of his pain, the star underwent root canal surgery, which was able to fix some unrelated problems. However it did not bring Singh any closer to finding out the cause of his unusual “attacks”.
He continued to say: “Painkillers didn’t work, and it was happening 60 to 80 times a day at its peak, so I wasn’t sleeping properly and was permanently exhausted.”
Using his medical training to almost diagnose himself, Singh suspected that he was suffering from a form of neuralgia – pain in a nerve pathway. In “desperate” need of help he then sought the help of a neurologist at King’s College London who was able to order some urgent blood tests and an MRI scan.
“At that point I was desperate. I needed help rapidly and the pain was just relentless and brutal,” Singh recalled about the severity of his situation.
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“Sufferers often describe the pain as suicide pain because it makes some people feel so down, they feel like taking their own lives. I didn’t get to that point, but my existence felt like a living nightmare and I just needed answers urgently.”
After further tests under King’s College Oral Surgery specialist professor Tara Renton, Singh’s suspicions were proved right as he was diagnosed with trigeminal neuralgia, which occurs when the trigeminal nerve is compressed. This is the nerve inside the skull that transmits sensations of pain and touch from your face, teeth and mouth to your brain.
Going into detail about his diagnosis Singh added: “She [Renton] explained that the trigeminal nerve – when it’s coming out of the brain towards the back of the head – has a blood vessel that’s sitting on top of it.
“In my case that blood vessel was rubbing against the nerve, causing it to misfire, sparking the pain.”
As the NHS explains, one of the main causes of trigeminal neuralgia is damage by another medical condition, such as multiple sclerosis (MS) or a tumour. Something that Singh later found out to be true about himself as his brain scan displayed abnormalities consistent with multiple sclerosis.
“It was a massive blow,” Singh added. “I remember thinking, ‘I’ve gone in with a nerve condition that I thought could be treated relatively straightforwardly, and come out with a potentially life changing, debilitating MS diagnosis, which could leave me in a wheelchair.’”
A second opinion endorsed the fact that Singh’s abnormalities were consistent with MS, but several other tests were inconclusive and didn’t meet all the MS diagnosis criteria, leaving the star’s diagnosis unknown and ambiguous.
Nevertheless the doctor started to undergo treatment for his neuralgia which first consisted of anti-epilepsy medication and then a secondary prescription of pregabalin, which soon caused severe side effects such as weight gain, insomnia and low moods. Displeased with his treatment, Singh returned to his medical professionals.
He explained: “I’d got to the point where I couldn’t tell if my problems were the condition or the medication so in the end I went back to the consultant and said, ‘I’ve read that surgery is an option for trigeminal neuralgia, please can I give it a try, whatever the risks, as I simply can’t live like this anymore’.”
Desperate to have surgery, Singh had a procedure known professionally as microvascular decompression, which he explained involves surgeons opening a window in the skull using a special drill and accessing the nerve. From there they can stick a bit of Teflon between the nerve and blood vessel that is causing the irritation and replace the skull plate.
“It wasn’t quite like Hannibal Lecter, but I do have a 10cm scar behind my left ear,” Singh continued to say explaining the aftermath of his surgery.
“The impact was pretty much immediate. I felt groggy for a couple of days after the operation, but the symptoms then completely dispersed, and five years later I’m on no medication with no pain at all and I can now fiddle with my face to my heart’s content. I’m eating using both sides of my mouth, screaming, shouting, laughing, and talking a lot and – touch wood – that’s it.”
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