This is an amazing account of what happened to a trigeminal neuralgia patient in agony, suffering severe pain after one CyberKnife treatment session. The neurogeon asks radiation therapist Bill Vogel, “What did you do to my patient”? I immediately asked why, what was wrong. He said she woke up early this morning and has been asking if she could eat breakfast. The pain was completely gone, and she wanted to eat. In less than 12 hours the pain had been entirely eliminated.
Story By Bill Vogel: Director of Clinical Excellence at Accuray the manufacturer of CyberKnife technology
I am a Radiation Therapist by trade who originally worked on CyberKnife® number three prior to making the leap to the world of industry and joining the Accuray team. Initially I began in training as there were only six systems in the United States at the time, having the opportunity to show others what I know seemed a natural fit, so I spent my first few years with the company doing onsite training to healthcare professionals at hospitals. One of the first sites I visited had a trigeminal case.
Trigeminal neuralgia is a non-cancerous condition that affects the trigeminal nerve which causes intense pain to the face and jaw. The pain can be unbearable for some, and this was certainly the case with the patient scheduled for treatment that day.
The patient was in-house, and the treatment was scheduled for the end of the day when an anesthesiologist could be present. She was brought down on a stretcher and couldn’t have weighed more than 85 lbs. She was hooked up to a feeding tube since the pain made it impossible to eat, and hooked up to an IV that I am sure contained pain medication although it seemed to do no good as the continual moan could be heard the moment the elevator doors opened.
That sound is one I will never forget for the rest of my life. She was in pure agony as she was writhing on the gurney.
The treatment itself is done in a single fraction to a dose that falls between 70-90 Gy to a target that is usually in the 3-5 mm range. The purpose is to damage the trigeminal nerve enough to block the pain signals to the brain while not doing any damage to any other structures. And considering this is a treatment deep inside the brain to a non-cancerous region, to an area generally covered by two to three CT slices, accuracy is of the utmost importance.
The patient was placed on the table with a mask for immobilization, the sedation was started and for a treatment that took over an hour, she laid there moaning loud enough to be heard from the treatment console while under total anesthesia and completely unconscious.
The hour seemed to go on for days, as we all watched the console meticulously, while also keeping an eye on the monitors; one focused on the patient and the other on the devices monitoring her.
As the treatment completed sighs began, she was returned to her room as we all silently contemplated what just took place.
The next morning, I showed up to continue the training process and started with a review. While speaking to the staff the Neurosurgeon called down to the department and asked for me specifically. As I picked up the phone, my heart went cold when the neurosurgeon said to me, “what did you do to my patient”? I immediately asked why, what was wrong. He said she woke up early this morning and has been asking if she could eat breakfast. The pain was completely gone, and she wanted to eat. In less than 12 hours the pain had been entirely eliminated.
I had treated many spine lesions in the past and had personally seen situations I could only describe as miraculous, but hearing those words from the neurosurgeon was confirmation that I had made the right choice leaving the clinic to show others how to do what I knew how to do.
I have seen many incredible treatments and application of the CyberKnife system since and must admit I still choke up a bit when I see the robot move with the patients breathing, but will never forget the sound of that moan, and the jubilation of the words that came shortly after.
*The statements on this site are my own and do not represent Accuray opinions or positions.” Bill Vogel
Trigeminal Neuralgia is treated often at the CyberKnife Center of Miami with excellent results. Go to our website now and see how, and call our team at 305-279-2900 for a consultation. They are among the leading experts in CyberKnife therapy worldwide.