It wasn’t quite like Hannibal Lecter, but the al Lecter, used a drill to remove a piece of my skull
After five years of relentless pain, TV medic Dr Ranj was left with only one option to curtail his misery, he tells
Three years before making his TV debut on the CBeebies show Get Well Soon, NHS clinician turned Strictly’s dancing doctor, Ranj Singh, could have done with some of his own advice. “Until that point, the only thing I’d ever had removed was my appendix as an 11 year old,” explains This Morning’s resident doctor. “I then started to experience this transient pain in my mouth that lasted for about a month then tapered off,” says Ranj, 42, “so I dismissed it as toothache and got on with things.” Ranj’s intermittent discomfort continued in short attacks, once or twice a year, until he was 35, when the symptoms escalated. “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,” he says. “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. “So I went to the dentist, who did a root canal procedure, which happened to be coincidentally necessary but didn’t resolve the problem.” By now, Ranj’s pain had skyrocketed. “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. “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.” Ranj, who specialises in emergency paediatric medicine, began to suspect the problem might be a form of neuralgia, and his dentist referred him to a neurologist at King’s College London. “At that point I was desperate. I needed help rapidly and the pain was just relentless and brutal. “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.” King’s College Oral Surgery specialist professor Tara Renton ordered blood tests and an MRI scan, which confirmed suspicions that Ranj was suffering from trigeminal neuralgia. “She explained that the
‘‘ I said please try surgery, whatever the risks as I can’t live like this any more
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.” But Ranj’s relief at his diagnosis was diluted by a secondary discovery that his brain scan displayed abnormalities consistent with multiple sclerosis. “It was a massive blow,” says Ranj. “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 Ranj’s abnormalities were consistent with MS, but several other tests were inconclusive and didn’t meet all the MS diagnosis criteria, leaving everything ambiguous. But, determined not to be hamstrung by his health issues, Ranj ploughed on with his neuralgia treatment. The anti-epilepsy medication he was prescribed, oxcarbazepine, was effective in the short term but stopped working within a year. This pattern was echoed with his secondary prescription, pregabalin, which sparked significant side effects including weight gain, insomnia and low moods. “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’.” Shortly afterwards Ranj was under general anaesthetic, undergoing a procedure known as microvascular decompression. “In layman’s terms they stick a bit of Teflon between the nerves and the blood vessel that is irritating it, so that they can’t interfere with each other,” explains Ranj. “The surgeon opens a window in the skull using a special drill, takes that plate out, accesses the nerve, then once they’ve completed the procedure, they put the skull plate back and stitch it all together again. “It wasn’t quite like Hannibal Lecter, but I do have a 10cm scar behind my left ear. “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.” Ranj was told the reason he contracted the condition was anatomical randomness – just pure bad luck. But the episode changed his perspective. “I’ve realised that life is short, and you can’t control it. None of us know what’s going to happen in 10 years so you have to make the most of life now. “The whole experience has driven me in so many directions I might not have gone. I probably wouldn’t have done Strictly without my operation, and generally I’m so much more willing to give things a go now. “It’s made me braver, and I fully intend to grab every opportunity that comes my way and make the most of it.”
‘‘ It changed my perspective, I’ve realised life is short so make the most of it