Thursday, 20 November 2014

Occipital Nerve Block for Migraines

I have worked my way through a lot of preventatives to try and cure my migraines and none of them have worked.  In fact most of them had an adverse effect on me.  I heard about the occipital nerve block a few years ago when it was being trialled in Leicester but didn't manage to get on the trial.  But now here it is, available to all and sundry (via a referral of course).  Thankfully, my neurologist seemed happy to tick the box and sign on the dotted line during the 5 minute consultation that I manage to get with him or one of his team every 4 months.  Not a lot is ever discussed, so I am lucky that he is prepared to sign me up for pretty much anything that I suggest, as long as it is available on the NHS.

So what is an Occipital Nerve Block?  Let's start by describing the occipital nerves as that is what we are planning to block.  Without going into too much medical technogigery, they start in that nice massageable part at the back of your neck.  They then work their way up through the back of your head, branching out multiple times, until they reach the top of your head and above the ears.  Think of it like painting a tree on either side of the back of your head and that is pretty much it.

The theory behind blocking them is that you stop the pain temporarily and that will fool your body into forgetting about the headaches.  Reprogramming your mind.  The question is, will your mind be so easily fooled?

I get 80% of my migraines on the right and 20% on the left, so the neurologist suggested that I have both sides injected.  The more the merrier as far as I was concerned!  So off I trotted (after waiting for the appointment to come through which, to be fair, was remarkably quick) to the local hospital, ready for anything.  Needles aren't my favourite thing in the world, but it's amazing how a round of botox (approx 30 injections given in about 5 minutes) can help you overcome your fear.  The nurse advised me that I should start with one side and then maybe make another appointment to get the other side done.  The side effects would be numbness in the head, which didn't sound too bad.  But as the neurologist had suggested doing both sides as the same time I persuaded her to go with that option.

The first injection was done in the bottom of my head on the right side.  I always get a rush of adrenalin when pierced with a needle which make my hair stand on edge.  But other than that, it wasn't too bad.  The second injection went in the top of my head and that hurt a bit more as there isn't any fat to absorb the needle up there.  But on the whole it wasn't too bad.  I did start to feel a bit wobbly, but a mig had started to appear so I put it down to that pre mig feeling that nobody every talks about.  The nurse suggested again that I only have the one side done, but my male bravado kicked in.  Of course I was ok, absolutely nothing wrong at all.  On with the show and inject away!  The bottom injection on the other side hurt but I grinned and bared it.  The top injection also hurt, a lot more than any of the others which is when the bravado started to slip slightly.  I cringed away from the needle.  But the nurse wasn't having any messing around.  Almost in defiance of my male preening she made sure that the needle stayed in for the maximum time to make sure that every ounce of local anaesthetic got into my head.

To be fair, the nurse was very nice and told me to sit down for a few minutes until I felt ok to go.  There was no need to see her again unless I needed to.  The mig was trying to win.  I could feel it on the inside, but strangely not on the outside of my head.  So maybe it was working already.  My head did feel a bit strange though, sort of cold and clammy.  But other than that I felt fine, so after a few minutes I shrugged my shoulders and got up to go.  As I rose I placed a hand on the top of my head to see if I could feel it (either the hand or the head)...

And then I sat down again rather fast as the room started to spin at an alarming rate.  My head was going numb, that's for sure and boy was it a strange feeling.  What seemed an eternity later, but was probably only about 3 or 4 minutes, the nurse walked by, so I called out to her to explain that I was feeling rather wobbly and perhaps leaving now wasn't the best thing to do.  She escorted me to a nearby bed and very kindly told me to rest for as long as I needed.  They tested my blood pressure which was understandably a bit low, but nothing a few minutes rest wouldn't cure.

By this point the whole of my head was numb including the all of my hairline and even the back of my tongue had started to go numb.  About 20 minutes and a glass of water later, I was able to sit up without the room spinning.  I gave it another few minutes just in case and then was up and back to work!

So did it work?  In a very simple word.  No.  Not a thing.  Not an ounce of difference did it make.  Of course, that was just for me, so don't be put off trying for yourself and do let us all know how you got on.  But for me, I think that is it for injection based treatments.  Botox and Occipital Nerve blocks are not for me.  Time to wait for my next 5 minutes appointment in a few month time and boy did I have a surprise waiting for me (ok, to lessen the excitement slightly, it wasn't a cure but a new enthusiastic neurologist)!