Patient Stories

Victor Balancia - Surgery saves him from silence

Story courtesy of Tampa Bay Journal, By Jodie Tillman

HUDSON - One autumn, Victor Balancia spoke hardly a word. This was not by choice.

"I love people. Love people," he says. "I get to talking and geez ... Ask my wife."

Marion is his wife.

"I tell you," she says. "We'll go to the supermarket and he's right with me. I'll look down and before I know it ... he's at the other end talking to someone else."

Even his stories feature dialogue for which he supplies a range of voices. Here he is talking about a party in Queens nearly 55 years ago. He was 19 years old and had just spotted two girls from across the room. He turned to a pal.

"I says, 'Lou, who are those two?'

"He says, 'A couple of sisters from a couple of blocks away.'

"So I got up, walked over and said, 'Hi girls, how you doin'? You look like twins. One of you older than the other?'

"And they say, 'Yeah, Marion's older.' And I said, 'Well, Marion, do you want to dance?'

"Well, they happened to have a rumba on. And we did the rumba and he claps his hands I fell in love with her over the course of one rumba!"

But back to the silence. About 15 years ago, the retired insurance salesman started getting a terrible pain in his jaw. It felt like a constant electric shock. No doctor had an answer for the tortuous episodes, which might recur frequently for a few days but then go away for six months or a year.

Until October 2005. The pain came - and rarely left. He could barely eat; his wife made mashed potatoes and soup and pureed everything, including sweet-and-sour meatballs.

He could barely sleep; he held his hand to his face all night. He could barely do his old activities without certain accommodations; he tied a wool scarf around his face when he went for a walk or to the movies. Even the slightest breeze or rush of air-conditioning would spark an episode of pain.

But worst of all, he could barely talk. He took a notepad and pencil wherever he went. His wife became his spokeswoman. He was lucky when someone could understand his whimpers.

"My thinking at that time was not happy," Victor, 75, says. "I was not thinking happy thoughts."

By Christmas 2005, Victor had still not found relief. Even so, he and his wife decided to go see their children and grandchildren in New York. Driving took his mind off the pain.

"Driving up to New York, I wouldn't talk to her (for) five, six hours straight," he recalls. "Not one word."

"Well," says Marion, "I read."

This being a big, traditional Italian family, they had planned to attend a big, traditional Italian meal - the seven-fish dinner. But when it was ready, when the coconut shrimp and lobster tails were on the table and the grandchildren and in-laws around it, Victor slipped off to the kitchen.

"I heated a can of soup, and he ate it in there," says Marion. "He grimaced so badly when he ate that he looked terrible. He didn't want people seeing him."

Victor contorts his face to demonstrate and then shudders at the memory. "Murder," he whispers.

His doctors diagnosed him with a disorder called "trigeminal neuralgia." For reasons he still does not know, one of Victor's cranial nerves - the trigeminal nerve - was being compressed by an artery.

The result: "one of the most painful afflictions known to adult men and women," according to the Trigeminal Neuralgia Association.

Treatment includes medication and a number of surgical options. A dentist told him about the newest noninvasive procedure called Gamma Knife radiosurgery.

More often used to treat brain tumors, the Gamma Knife's beams of radiation can also pinpoint the nerve. It isn't clear what exactly happens, but it seems the radiation "injures" the nerve so that it isn't radiating as much pain, says Dr. George Gade, the Morton Plant Mease neurosurgeon who treated Victor.

No scalpel is required. In January 2006, Victor went to Morton Plant Mease Hospital in Clearwater, donned an aluminum halo and a helmet with 200 tiny holes for the beams of radiation. He was placed headfirst into the machine, similar to a CT scan. From a control panel, doctors sent precise doses of radiation through the holes of the helmet.

Gade told him before he went in not to expect a miracle. But Victor had hope that he'd come back out his old self.

That took time. The relief was far from immediate.

A few weeks after the surgery, he was driving back from Tampa and stopped for coffee. Somehow, the hot drink set off the pain.

"I screamed at the top of my lungs for 35 minutes and cried like a baby all the way home," he says. "I got in the door and said to her, 'Marion, this damn operation did not take. It's no good.' I said, 'I'm going to cut my head off!' "

But after that the pain started subsiding, a tiny bit at a time. He started at 1,200 milligrams of daily prescription pain medication. Now, he is down to 200 milligrams and doesn't think he really needs that anymore.

Sometimes he worries about the pain coming back. But mostly he's just happy to eat his wife's homemade cheesecake and angel hair pasta, go to the movies without a wool scarf in his pocket, and, of course, talk and talk and talk.

"Well," he says, "that's the story."

Click for our next patient story - Bill Sawyer

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