Sunday, May 23, 2010

Occipital Nerve Block

On Friday I had my first occipital nerve block. *Update - I'm referring to the procedure described below as an "occipital nerve block" which is what the doctor who performed it (an anesthesiologist), called it. If you read the comments below, you'll see that "occipital nerve block" could mean different procedures to different doctors. As always, please talk to your doctor and do not make medical decisions based on my blog posts. Thank you!* If you're not familiar, here's a description in Q & A format (note that I do not go to this medical provider; it was simply the best description I found via google). Forgive me if this explanation is not entirely medically accurate - it was difficult to tell what exactly was going on during the actual procedure because my head was turned away; plus the pain clouded my thinking!

My husband had to take me to the appointment because I wasn't allowed to drive home. Once I got there, my vitals were checked and I went to the first room. I filled out a general headache questionnaire and then a nurse (not certain about the title) inserted an IV in my hand "in case" they needed fast access in case something went wrong. Nice. Then the anesthesiologist came in and had me sign a consent form. I had to replace my shirt with a lovely hospital gown, and then they had me go to the procedure room.

Talk about intimidating! In the procedure room were three different people with surgery masks, aprons and hair covers. A tech had me put my hair up and she put a hair cover over me. Then she had me lie down on the exam table in the middle of the room and turn my head to the left because I was having my right side done. The door and all the action was on the right, so the only thing I saw the whole time was the X-ray tech making adjustments to the machine above me. After what seemed like forever, the anesthesiologist came in the room and I couldn't turn to see him because they already had me positioned properly. He marked the spots on my neck with a marker and then covered the entire right side of my face and neck with a sheet of plastic, I'm guessing so germs wouldn't get in the area during the procedure.

Finally, the shots began. The first was Lidocaine which numbed the skin. Then the real pain began. I couldn't feel a lot on the surface, but from what I could tell the anesthesiologist inserted three needles into the appropriate spots, which hurt pretty bad - not from the needles penetrating the skin but from them going into my neck muscles where many of my headaches seem to start. The sudden stabbing pain plus soreness made me want to groan in pain but held it in. The tech (not the X-ray tech but another one) was holding my hand the whole time, and at this point I gave it a slight squeeze and took a deep breath. Next the anesthesiologist said it was time for the injections. The pressure was also fairly painful, but it was quick. Finally it was over, and I was helped into a wheelchair and taken to a recovery area.

One of the nurses gave me a soda (I asked for Sprite since I've eliminated caffeine and aspartame, which ruled out the other options. I've added citrus back to my diet and found that it is not a migraine trigger, thank goodness). After sitting a few minutes and changing back into my shirt, the nurse removed my IV and walked with me to the waiting room where my husband was patiently waiting. I was dizzy and my balance was thrown off because the right side of my head/neck was numb, so I asked him to stay close to me. We were out of there in an hour-and-a-half, but I'd guess the actual procedure took no more than five minutes.

So has it worked? Well, I'm not sure yet. On Friday it hurt to move my head at all, and yesterday I felt like I had whiplash. I've been icing it and resting, and it's not nearly as sore today. I still am having slight headaches on and off, and they still seem to be all over my head. The effects of the steroid are usually felt three to five days following the procedure, so I'm patiently waiting.

Here's a picture of my neck. Note that the purple is the marker, or at least that's my guess since there was some purple on the band-aids when I took them off.

I'll do an update soon on whether or not my headaches have improved. Here's hoping they do!