Published on October 23, 2019

Alexandra's Story (Severe Facial Pain)

Relief after decades of trigeminal neuralgia

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“Pain is a full-time job,” recalled Alexandra Klein, resident of Greenwich, CT, and patient of Dr. Ofer Wellisch. “I’m glad to have someone in my corner who listens to me and respects my one wish: absolutely no narcotics,” she added.

Alexandra’s journey with pain began one day in 1996 after a car accident on a major highway. As a result of the accident, she suffered severe nerve injury and what she described as horrendous headaches. She recalled vomiting up to several times a day from these headaches. “I dealt with the pain. I did anything you could imagine—nothing worked,” Alexandra said.

The following year, Alexandra decided to have microvascular decompression surgery at a facility other than Stamford Health. Microvascular decompression is a type of brain surgery that decompresses the cranial nerves in order to treat trigeminal neuralgia, the medical term for severe, recurrent facial pain.

Alexandra, Pain Management Patient Story, Stamford Health Alexandra continued to have severe pain in her face despite the operation.

“The pain was [still] so bad,” Alexandra recounted. “I lost my independence. My hearing and left eye were affected. I could no longer be the serious athlete I once was. I needed to rebuild my life.”

“More often than not, surgery will achieve desired results but unfortunately, pain does not always improve with surgery,” Dr. Wellisch elaborated. “That’s why the neurosurgery team at Stamford Health will have patients work with the Pain Management Center to exhaust all conservative options prior to proceeding with surgery. Alexandra’s journey has indeed been exceptionally challenging – a journey often traveled by patients with severe trigeminal neuralgia.”

Life went on for Alexandra. Over the decades, she had additional procedures and surgery in an attempt to relieve the pain. Some treatments worked for a certain period of time while others did not. She even moved to Arizona as an attempt to lessen her pain by living in a different climate (she ultimately settled down in Connecticut to be with her family). Despite the many treatments and integrative approaches that provided only temporary relief from her pain, she had two healthy kids throughout her journey. Although she had created a new life for herself, she was still unwilling to resign to a lifetime of significant pain.

“I refused to accept this as a permanent condition. I refused to accept permanent anything,” Alexandra said. “I knew there had to be another way,” she added.

There was another way.

Alexandra meets Dr. Wellisch who offers a new solution to her chronic pain.

In 2016, Alexandra’s primary care physician referred her to Dr. Ofer Wellisch of Stamford Health's Pain Management Center.

“I was honest with Dr. Wellisch and told him I had had no luck with most of my prior treatments, and continued to suffer,” she recalled. “He immediately listened to me and actually cared to know what had worked in the past and what didn’t.”

After considering a few different treatment options for Alexandra’s pain, Dr. Wellisch decided the best course of action was a minimally invasive SPG block. The SPG (Sphenopalatine Ganglion) is a group of nerve cells close to the brain stem and to the brain’s covering or meninges. The SPG block is a targeted local anesthetic nasal spray that numbs this group of nerves and therefore prevents them from transmitting pain signals passed on by surrounding nerves.

In regard to Alexandra’s SPG block treatment, Dr. Wellisch said, “People with this level of facial pain may develop glaucoma-like symptoms due to increased intraocular pressure. When you relieve pressure from the eye, symptoms and pain often improve. In the 1800s, doctors injected cocaine behind the nose to relieve these ocular symptoms. The idea of a trans-nasal SPG block is similar, obviously without the cocaine,” he elaborated.

Alexandra’s pain has improved, as well as her vision and the appearance of her eye. “Alexandra has coped with her condition exceptionally well,” Dr. Wellisch added.

Alexandra visits Dr. Wellisch for her SPG block every two-three weeks and also meets with an ophthalmologist. While the treatment is not a permanent cure, she’s pleased with the results. “There’s a significant difference, especially psychologically,” Alexandra affirmed. “I count down the minutes until my next appointment. Life is about perspective and I’m fortunate to have the gift of not being able to give up.”

Dr. Wellisch added, “Alexandra and I have tailored a plan that meets her needs and beliefs. I’m glad that because of our work together, Alexandra is more able to enjoy life. My hope is that she will only improve going forward.”

Alexandra spends her free time with her two children. She attends every track event, something she hadn’t been able to accomplish before. “You could look at me and never know I was in pain,” Alexandra said.

To anyone going through what feels like an unmanageable level of pain, Alexandra advised, “Do not give up on finding a doctor you trust and that respects your opinion. You have to be your own advocate. There is someone for everyone.”

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