Neck position and aura migraines

Thanks, Laurie 

The nerve block injections are good and I am sure you will handle them ok, just be strong.  Whether they will help you long term you will have to see.  They only stopped my cluster headaches for a few days.  I now have Botox injections for Hemiplegic migraine which are way better for me.

Good luck and I hope they resolve your migraines

I am sorry to hear you have been in so much pain. You said you are scheduled for an occipital nerve block? Usually there are two reasons they do a nerve block, either to determine if one specific nerve is causing the pain, as a trial for possible later radiofrequency ablation, which is a much more permanent procedure OR the nerve blocks are done often using a combination of numbing medications such as lidocaine, marcaine, etc. and steroids to

(1) attempt abort pain currently in progress as a means of immediate but temporary relief. (2) Give some relief with repeated blocks in order to allow time for new preventative medications to take action and provide relief. (3) The numbing medication can provide some temporary relief and the steroid therapy with repeated injections hopes to reduce inflammation around the nerves that may be causing continued pain. If you aren't sure of which reason they are doing the block I would recommend you discuss with your doctor their intentions and expectations so you know what to expect.

I have experience with nerve blocks for reason #3.

My background and what led me to these treatments:

-migraines since 2009 became increasingly worse and med resistant.

-diagnosed in 2014 with idiopathic intracranial hypertension (IIH); one symptom is severe headaches which are treated the same as migraines.

-Past two years migraines escalated lasting 9-15 days per episode, with lesser headache until my next episode a week or two later.

-At home therapies provided partial relief for a few hours, still requiring bed rest. After meds wore off pain came right back.

-Current abortive therapy is DHE infusion cocktail at the ER. My neuro calls it in so they don't give me the whole drug seeker thing. -Referred to a headache clinic for additional treatment ideas.

-Finishing headache calendars for possible botox approval (yes, I suck started & then forget a few days, a week or more so I'd stary over. In hind sight I feel like crap all the time, could have marked that j/k.

The headache clinic is 110 miles away, one way, but desperation will make you do things. My husband always drives me because I barely trust myself to drive because of how bad my symptoms have gotten.

The headache clinic doctor made the usual suggestion; lose weight, which we all know is simple when you are in excruciating pain on a daily basis! IIH with also makes many people exercise intolerant because exercise increases the pressure in your head = pain.

He also wanted to clean up some of the many medications I take, Effexor XR was the first. My GP prescribed it for anxiety & depression immediately following my separation from an abusive husband in 2009.

The doctor wanted to clean up unneeded medications that may cloud true migraine headache from side effects from my taking SO many meds. They were obviously not doing me any favors on the headache side. Next med to go Propranolol, after I return to normal from the Effexor cessation.

He recommended a series of 6 sets of trigger point and nerve block injections, one set every two weeks. Ijust completed my 4th set of injections. The injections I receive are a combination of Lidocaine, Marcaine, and Decadron. I get anywhere from 40-60 injections in my head, face, and neck during a session. You will not receive that many if they are only doing the occipital nerve block. I am receiving 12 different nerve blocks done bilaterally so automatically 24 injections without adding any to trigger points. My doctor does these with no imaging guidance, I do not receive any local anesthetic injections prior to the blocks and trigger point injections, I've read both are possible so you may want to ask your doctor how they do it . The occipital nerve injection goes right above where your neck and head meet, there is a bump on each side of your head in your hair, so just below there is what it feels like to me. My doctor also does some other injections, not as bad as the actual block, though they feel very sharp, up through my hair above where the nerve follows up toward the top of your head. So what you'll experience is obviously some pain, sometimes sharp due to nerves involved. You'll probably also feel a pressure with a good amount of discomfort as the solution is going in. Afterward the area will feel numb but it wears off. They say different amounts of time for different people, me personally it has been anywhere from 30 minutes to 4 hours, time the lessened pain lasts seems to increase as I receive more injection sets. I've read some people get relief for days, or a week or two. Due to my getting so many injections I've figured out ways to combat feeling like crap. I take 5mg valium about 30 minutes to an hour prior, and a Zofran 2 hours before. I was getting what I call my shot reaction where I get the sweats, dizziness, nausea, where I had to stop the procedure and take a break sometimes 2-3 times. I am quite used to shots, my regimen was previously giving myself injections of imitrex, if that failed off to the doctors for shots of toradol, magnesium, and reglan. Maybe the number of injections is what was doing it, but if you get nervous and have valium, ativan or xanex I'd take it. After the blocks my doctor told me to ice my head. I keep gel ice packs since they help me deal with the daily pain, so I ice for 12-24 hours after depending on my pain level. You may also experience some neck stiffness.

So is it worth it? I'm not sure yet. I have had four sets of these injections and still have severe pain, enough where I need to lie down at some point almost every day. I have been encouraged to lay off the pain medications (triptans, fioricet, nausea meds), but still HAVE to medicate about 8 days a month. I have been on leave from work since April when I started all of this with the headache clinic shortly after a ER visit for NSAID induced colitis (too much toradol so no more of that) then I had to go to the ER for the DHE infusion cocktail about a week later. With the combination of being away from work, the injections, coming off of meds, and, increasing the lamotrigine I take as a preventative I just recently recognized a positive. Though I have daily severe pain right now, I did wake up with a terrible migraine 12 on a scale of 10, and took my DHE nasal spray, 2 fioricet, and a reglan, and passed out. When I woke up I didn't feel 100% (when's the last time that happened? lol) but I was able to get up, sit on the back porch in late afternoon, and have dinner with my family like I normally would, it didn't last for weeks! So something or a combination of is making a small improvement, which is kind of a big deal around here.

Best of luck in your treatment! If you have further questions I'm glad to talk.

Jenn