For many sufferers, the pain of TN attacks usually occurs during the day but for some people it can also occur during the night. When this happens, the effects of the pain combined with the loss of sleep and just the fact that it’s night-time, makes everything seem overwhelming.
No matter what the time is, there can be flare-ups so painful that the only option for some people is to go to A&E. Experience of various members has shown that, whilst staff at A & E are considerate, they may not fully appreciate the situation you are struggling with. Because TN is a rare condition, it is unlikely that nurses or even doctors will be familiar with the condition and consequently fail to understand just how much pain you are in.
By writing this article it is assumed that you have been diagnosed with TN and you probably know more than the person you are speaking to at A & E. However, when you are in so much pain, it may be difficult for you to communicate effectively just what is wrong and what sort of help you need. To that end, there are certain things that you can do to help the situation.
- If you are a member, take your alert card with you.
- If talking is difficult, take someone with you who knows about your condition.
- If that is not possible, take a pen and paper.
- Your doctor or specialist should have given you written confirmation of your diagnosis and this would be an excellent letter to take with you.
- If you are able, explain that standard analgesics and opioids will have no effect.
- Take a list of the drugs and dosages that you are currently taking for your TN.
- Many of the larger hospitals will, during the daytime, have an on-call dentist or maxillofacial person who can give you an injection of one of the following drugs:
- Various other nerve blocks/local anaesthetics
It should be noted however, that the use of nerve blocks is only a temporary measure but an injection of one of these drugs may be sufficient to break the pain cycle and give you some short-term relief. Should you be experiencing frequent extreme flare-ups of this nature then you should inform your GP or specialist who may decide to review your medication or discuss other options.
The experience of attending A & E for many people is associated with long waits. There are often good reasons for this – the main ones being a disproportionate ratio between patients and medical staff, admissions requiring urgent immediate care and, regrettably, queue-jumpers. Therefore, if your flare-up is during the day, it may be better to seek an emergency appointment with a dentist to give you a local anaesthetic.