Published January 5, 2018, Authored by Dr. Adam Lowenstein

A young lady was in my office recently, and like so many patients with pain from migraine headaches and/or occipital neuralgia, she had been too many many doctors before me.  We discussed the possibility of doing Targeted Injection Mapping, and she became very emotional.  She had been through so much over the past three years of pain since a small accident that involved hitting her head.

As I asked her to explain why she was so emotional, it became apparent that she was tired of seeing doctor after doctor, and also tired of repeatedly being told that some or another therapy may or may not help.  Worse still, however, she was anxious about hearing the same from me and distraught that I might not be able to help her either.  She was hesitant to get the nerve block injections for fear that they would not work and she would remain helpless.  (Spoiler alert… she decided to get the nerve blocks, they worked, and she was pain-free for the first time in three years.)

Chronic pain is one of the most difficult things to have, to treat, and to manage from every point of view.  Not only is there a pain issue that is often overbearing, but the hopelessness and loneliness that each patient can feel is nothing short of horrific.  Seeing doctor after doctor can make things even worse, and repeated false hope and subsequent failure can wear on even the strongest patient.  In this particular case, this young woman was accompanied by her mother who just wanted to do anything to make her daughter feel better.  As a father myself, I can imagine how difficult this must be for her as well.

It is so very important for migraine headache and occipital neuralgia patients to try to stay positive.  As my peers and I are doing what we can to provide information about surgical options to patients of these dreadful conditions, we hope to be able to help many improve their chronic pain symptoms.  Even though migraine surgery can help so many, even those who are not surgical candidates should do what they can to keep their head up.  Join online discussions.  Seek out support forums and groups online or in person in your local area.  You are not alone, and there are those out there that understand. 

With this young woman I saw, I explained that as a migraine sufferer myself, I knew how the pain can be erratic sometimes, hard to explain, hard to localize sometimes, and how difficult it was never knowing when a headache was going to worsen.  I’m lucky enough to be able to control my pain with medication, but for many many years even I as a surgeon did not know that medication such as this existed, and I just continued on in a somewhat hopeless situation myself.

As I spoiled above, this young woman did decide to have nerve blocks.  Her crying from the anxiety actually made her pain bad enough to push her toward trying the nerve blocks, and they worked.  Seeing her go from anxious and crying to smiling and telling me this was the first time she was pain-free in three years… it is the best part of my surgical practice.  It turned out to be a great day for us both (and her mother as well), and I’m looking forward to working with this very sweet family going forward.

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