Fanta’s Story: 'Life After CyberKnife Is a Life Worth Living'

The first time that Fanta Richardson experienced the searing facial pain that would plague her for months, she had just bitten into a crab leg and cracked her tooth. Initially, she hoped that dental care would alleviate her discomfort. She had a root canal, but it didn’t dull the pain. Extracting the affected tooth didn’t help, either. “I never experienced pain like that before,” Fanta said. “In cartoons, when the lightning bolt hits one of the characters and they have an out-of-body experience, that’s what it feels like.”

After the tooth extraction, she consulted with a series of dentists to determine the cause of her pain. After more painful months without success, one dentist diagnosed trigeminal neuralgia and sent her to a neurologist. Trigeminal neuralgia is a chronic pain condition that arises when the trigeminal nerve – which sends signals from the brain to the face – becomes compressed. The extra pressure causes the nerve to misfire, resulting in painful jolts. When the mouth is affected, ordinary activities like chewing, talking or smiling may cause excruciating pain.

“It was so bad, I ended up in the emergency room two days in a row because I couldn’t talk, eat, drink or open my mouth,” Fanta said. She met with the recommended neurologist, who prescribed medication. It dulled the pain, but the side effects were worrisome. She didn’t want to take the medication forever. Seeking a permanent solution, she met with a surgeon who wanted to perform a craniotomy, opening the base of her skull to reach the offending nerve. It would have involved shaving a section of her hair. “That didn’t sit right,” Fanta said. “Cutting the skull never got to me, but shaving my hair? Not shaving my hair! I asked if there was any other option, and he told me about Dr. Shah at ChristianaCare.” Radiation oncologist Sunjay Shah, M.D., mainly treats cancer, but one of the treatments that he uses, CyberKnife, can also relieve trigeminal neuralgia. During a CyberKnife procedure, a robotic arm delivers pinpointed radiation therapy to a precise location. It can be aimed at the trigeminal nerve to help disrupt abnormal pain signals. Despite the term “knife,” there is no cutting and there are no scars.

“CyberKnife has been proven to eliminate trigeminal neuralgia pain, and Fanta was an ideal candidate,” Shah said. “She was interested in the procedure because of its track record, and because it’s painless and noninvasive.” Typically, the CyberKnife treatment is done in one fraction (or dose). Shah pioneered a three-fraction treatment to minimize the risk of facial numbness complications and recently published an article in the journal Cureus.

Fanta had three CyberKnife sessions over the course of a week. She said it was the easiest part of the medical journey she had been on for more than nine months. “You just lie there for 30, 35 minutes, while the machine is travelling around you,” she said. “I am so grateful. ChristianaCare took very good care of me.” After the final treatment, Shah asked Fanta to stop taking pain medication to see if the procedure worked.

“I was nervous about stopping,”  she said. “On a scale from one to 10, the pain was a one or two with the medication. I worried that it could go back up to 10.” With Shah’s guidance, she gradually weaned off the medication. “I waited to feel that electric shock of pain, but it never happened,” she said. Fanta has resumed activities that were impossible to do with trigeminal neuralgia. She can once again eat her favorite spicy foods and drink through a straw. She’s ushering at church, which she’d stopped because the medication made her stumble. She’s also singing in her church choir again. “When you sing, the vibration of your vocal chords can trigger the pain,” Fanta said. “My faith is important to me, and not being able to serve the way that I love to serve was an issue for me, but now I’m back to it.” She is also working full-time again and socializing. “I didn’t participate in a lot of things that I enjoyed because of the pain,” Fanta said. “Life after CyberKnife is a life worth living.”