After the Proton Beam Radiation treatment I quickly jumped back into things.  It was about a month later,  that I was on a gig playing my sax when I got this excruciating pain in my face.  It was a sharp pain that was in my jaw.  I had to stop playing my solo and I just held my jaw for a second and then it went away.  It happened a few more times that night and would last a few seconds and then go away. The next day it happened some more and I noticed that my tongue was numb and tingling. Sharp face pains and a numb tongue make it difficult to play the saxophone in case any of you are wondering.

My wife and I headed back to the Proton Beam  doctor to talk about these new symptoms.  He listened intently and responded that he thought the radiation treatment was affecting my cranial nerves.  Now if you have read “Part 10″ you will remember that this was my one and only question that I had asked this doctor.  Could this radiation affect my cranial nerves?  Remember that?  Well, I did!   I was a bit bewildered  by his analysis and brought up that he had told me this would not happen.  He replied that in a small amount of cases it does (You would think he would have mentioned this before before when he told me it never affects the cranial nerves!).  It was at this time that I started to believe that if a doctor told me that the prognosis was 99% good but there was a 1% chance it would be bad that I would fall into that 1 %. I didn’t really have a strong faith in the percentages by this point.  If the bad thing had a greater than 0% chance of happening that was enough to include me.

The doctor prescribed Nuerontin to me to help me with the face pain.  Within a few days I started getting a rash on my chest and he took me off of that drug and decided to give me Tegretol instead.   I started taking Tegretol and it really seemed to help I wasn’t having the face pain as much and my face wasn’t tingling as much.  About 3 weeks into taking Tegretol, I came out of the shower one morning and my wife exclaimed “Why is your chest so red?”  I said I didn’t know why but it had been getting red over the last few days.  By this point my whole torso  had a sunburned look to it.  My wife being a nurse correctly diagnosed that I was allergic to the Tegretol and to call my doctor.  I called the doctor and he said to  stop taking the Tegretol ASAP.  My wife went to work that night as I sat at the computer.  I was curious so……..I did some searches for “Tegretol” and “allergic reaction”.   I found a whole bunch of interesting reading on the subject.

Now the internet is an incredible tool.  It can give you the right information for you to make the right decision or it can give you so much messed up information that you are scared out of your mind  and it’s not based on facts.  Then there are those times that it can give you all the right information, scare you out of your mind and the lead you to the right decision.  This was one of those times.  As I was searching around the internet,  I kept gravitating to the worst case stories.  By this point in my path in life I had come to assume I had the worst case scenario so that is what I was drawn to.  The two terms that kept coming up were Toxic Epidermal Necrolysis (TEN) and Stevens-Johnson Syndrome (SJS).   It might be just me,  but having the words “toxic” and “necrolysis” in the title of a condition is not a good sign!  Basically, I learned that some people that have allergic reactions to Tegretol get this condition.   The condition causes your skin to redden and  peel similar to if you get a very very bad sunburn.  This happens all over your body.  Your skin then can separate from the lower layer and large sheets of skin slide off the entire body at pressure points (they call it sloughing) similar to a 3rd degree burn all over your body. Nails and eyebrows can fall off also.  People with this condition go sterile, lose their eyesight, have multi-organ failure,pneumonia,pulmonary edema, and die( mortality may reach 40%) If you want the full list of possible side effects you can go to this site and read about them. (Don’t do it on a full stomach)

As you can imagine, I had a hard time sleeping that night.  I called my wife about 4 hours later at work because my heart was racing like crazy and now I had a temperature of 102.    She suggested I drop my one year old at a neighbors house and  that I go down to the emergency room at MGH.  The neighbor’s wife stayed with my daughter and the husband ended up going down to the ER with me.  It was about 4AM when we arrived at the  MGH Emergency Room.  After waiting forever, we were finally seen and after some tests and blood work the doctor informed us that I was just having an allergic reaction to Tegretol and to just go home and take some benedryl and I should be fine.  Now, this is the point where I used my vast knowledge of medicine and the internet to impress the young intern.  ”Could I have Steven Johnson Syndrome?” I asked.  He looked at me with a look of admiration that you would only get from a peer who considers you his intellectual equal.  There was a brief moment where we locked eyes and he knew I would be a worthy adversary……….”Where did you hear about that?” he asked. “The internet” I responded proudly.  At 4 AM the young intern in all honesty looked quite tired.  He did his best to offer a polite smile, sighed,  and told me that the chances were low that I would have “Steven Johnson Syndrome” and that I should go home, take benedryl and rest (maybe even implying that I stay off the internet).  If by chance the fever continues or goes up, then I should come back.  I went home just as my wife who hadn’t slept was getting home from her overnight shift at another hospital. (Did I mention she was 7 months pregnant)  When I got home, I took some benadryl and went to bed.

I woke up later that day sweating like crazy.  My sheets were soaked. I got up and looked in the mirror and believe it or not my chest was even redder and my face was now beat red and everything was looking a bit swollen and puffy looking.  I woke my wife up and we went off to the hospital.  This time a good friend of mine also came with us.  Now I have to say that this trip to the hospital was quite different than the 4AM trip we had made earlier.  The place was “hoppin”.  There were doctors and nurses every where and we were seen pretty quickly.  We didn’t play around this time.  I quickly mentioned my research into the Steven Johnson Syndrome to the first doctor we met.  It helped that my knowledgeable registered nurse wife was there who knew what she was talking about  as opposed to me who had surfed the net and was mis-pronouncing words ( I think I was telling  the staff I thought I had Toxic Thermal Hydrolysis).  I remember getting a whole bunch of other tests but in the end they came back and said that yes, it looked like I had TEN (Toxic Epidermal Necrolysis).

A bunch of doctors came in and talked to me but basically they all said the same thing.  All they could do was put an IV in, hydrate me, and wait to see how far it would progress.  I thought that just because I stopped the drug I would immediately get better but that wasn’t the case.  Once the symptoms started all they could do was wait and see where it went and give me pain medication to help.

I stayed in the hospital and sent my wife home.   She needed to pick up my 1 year old and she needed sleep herself.  I wasn’t sure where this was all going but to be honest I was reaching the end of my rope here.  I started to have a mix of feelings like I was  really starting to lose it.  I had mentioned earlier that I had a strong faith in God.  Well at this particular moment,  I felt like I had a lot of anger boiling up inside of me.  Brain Tumor…….OK.   Meninigitis…….OK.  Cancer……….Well, I’m not happy about it but OK. Return of brain tumor……………..AhhhhhhhhOK!  Side affects from radiation……..OOOOOOOKAY!.  Now severe allergic reaction that could end with my skin sliding off my body and then organ failure and to top it all off death!   I  GIVE UP!   AHHHHHHHHHHHHHHHHHHHHHHHH!   I went to bed that night silently screaming! You have to wait until Part 12…………..

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