Peled Migraine Surgery Blog

Information and knowledge about migraine relief surgery.

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Ziv M. Peled, M.D. on The Doctors!

Ziv M Peled MD on The Doctors

I was proud to appear in today's episode of The Doctors, where I discussed my patient Ronny's surgery and recovery, and how peripheral nerve surgery had helped eliminate his migraines.

With more than 37 million migraine sufferers in the United States, you probably know someone who is suffering from debilitating headaches.  Ronny was one of these 37 million Americans until he came to see me.  He shared his story with The Doctors and let the show into the operating room with us as he had his peripheral nerve surgery to rid him of migraines.

Ronny's migraines had been steadily worsening since 14, and had pain coming from the back of his neck that would spread to the front of the forehead and to his eyes and his temples.  He also suffered from extreme nausea, leaving him unable to get out of bed and having trouble working.

After trying many different meds and therapies, like acupuncture and massage, Ronny also went through changes to how he went about his regular life.  Even stress management and diet changes brought no relief.  After seeing over 15 doctors and dentists, he was at the end of his patience.  Then he came to our office.

The most common misconception about migraines is that an abnormality inside the brain is the cause.  This is not always true.  They can also be caused by nerve compression outside of the brain, where scar tissue, abnormal blood vessels or spastic muscles can impinge on the nerve.  This was what Ronny was dealing with.

I operated on Ronny to release the nerves at the back of his head and get them away from the spastic muscles.  We showed this procedure in the video that was shared with The Doctors as I operated on the nerves in the front of the head and the temples.

We then joined the studio panel for The Doctors, where Ronny shared his story, and that he is nearly 100 percent pain-free after the surgery.  I was asked by Plastic Surgeon Dr. Andrew Orton why Ronny was such a good candidate for this surgery.

To me, the ideal candidate:

  1. Has been diagnosed with migraines by a board-certified neurologist or headache specialist
  2. Has failed conventional therapies including various drugs and injections
  3. Has a good physical exam that shows there's a peripheral nerve that is casing the headaches
  4. Has responded well to an injection of a numbing agent or a local anesthetic in the office.  For example, the headache goes from 9 to 1 on the pain scale

When the patient has been numbed in the office, I can identify the problem nerves and the patient also gets the chance to "test drive" their results, to see where they would be numb if we did cut those nerves.

While Ronny was afraid of having his nerves cut prior to the surgery, the pain was awful enough that he felt he had no choice but to undergo the procedure.  He does report some numbness behind his ear and in his forehead, but says he hasn't had any really noticeable side effects form the surgery, and in fact, doesn't even think about it any more!

If you're dealing with migraines and want to know if migraine surgery can help you. here's how to find the right surgeon for you:

  1. Look for someone with specific training in peripheral nerve surgery during either a residency or fellowship.
  2. Use a surgeon who has done nerve surgery not just in the head and neck but all over the body
  3. Preferably find a surgeon with specific training in this headache operation 
  4. Utilize a surgeon who could provide patient references, ideally from several years out, to show the results are lasting
  5. You can use the American Society for Peripheral Nerve to look for members

While Medicare covers migraine surgery, many insurance policies don't because the surgery is new.  Always discuss insurance with your surgeon's office because they will help you understand the costs, what is covered and what is not. 

 
We then joined the studio panel for The Doctors, where Ronny shared his story, and that he is nearly 100 percent pain-free after the surgery.  I was asked by Plastic Surgeon Dr. Andrew Orton why Ronny was such a good candidate for this surgery.
 
To me, the ideal candidate:
 
  1. Has been diagnosed with migrianes by a board-certified neurologist or headache specialist
  2. Has failed conventional therapies including various drugs and injections
  3. Has a good physical exam that shows there's a peripheral nerve that is casing the headaches
  4. Has responded well to an injection of a numbing agent or a local anasthetic in the office.  For example, the headache goes from 9 to 1 on the pain scale

When the patient has been numbed in the office, I can identify the problem nerves and the patient also gets the chance to "test drive" their results, to see where they would be numb if we did cut those nerves.

While Ronny was afreaid of having his nerves cut prior to the surgery, the pain was awful enough that he felt he had no choice but to undergo the procedure.  He does report some numbness behind his ear and in his forehead, but says he hasn't had any really noticeable side effects form the surgery, and in fact, doesn't even think about it any more!

If you're dealing with migraines and want to know if migraine surgery can help you. here's how to find the right surgeon for you:

  1. Look for someone with specific training in peripheral nerve surgery during either a residency or fellowship.
  2. Use a surgeon who has done nerve surgery not just in the head and neck but all over the body
  3. Preferably find a surgeon with specific training in this headache operation 
  4. Utilize a surgeon who could provide patient references, ideally from several years out, to show the results are lasting
  5. You can use the American Society for Peripheral Nerve to look for members

While Medicare covers migraine surgery, many insurance policies don't because the surgery is new.  Always discuss insurance with your surgeon's office because they will help you understand the costs, what is covered and what is not. 

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Friday, 19 July 2019

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