Thanks, I think I will pop on over soon. I've been thinking about
it but I've focused my attention here because I know a lot more about
headache disorders than I do about
chronic pain--though I've learned a lot in doing research to find a link between the CRPS that I experienced when I was younger and my persistent headache now. I appreciate the invitation.
Unfortunately I don't have any contacts in Ottawa. But there are some good treatment centers in Massachusetts and New York which are less of a hike than coming to Philadelphia.
Regarding specific treatment: Well... Four hours isn't nothing. I've had nerve blocks, oh, I don't know, 4 or 5 times at least and it's fair to say that they did nothing (the very first time I experienced some relief for almost an hour, but it didn't happen again). I'm assuming that you did actually have the blocks in the temporal area (you know, between the eye and sideburn area), yes? And how much relief did you actually experience? A lot or just a small improvement?
My thinking is that if you experienced significant relief for four hours, there are several possibilities (I'm drawing from experience and logical deduction here, not necessarily medical fact).
<1> The local anesthetic blocked signaling from the temporal nerve that had been causing neuralgia. It's short duration could be due to:
(a) the anesthetic not being potent enough to fully block an overexcited or damaged nerve
(b) the anesthetic did block neuralgia from the temporal nerve, but that turned out to not be the only source of your head pain
<2> The anesthetic, being localized, but only to a point, partially affected other nearby problem areas, possibly:
(a) another nerve group proximal to the injection site, such as the supraorbital nerve (centered behind the ridge of your eyebrow, really a branch of the ophthalmic nerve), the maxillary nerve (its infraorbital branch innervates the area below the eye and across the area of the cheek), or even as low as the mandibular nerve which innervates the jaw as low as around the chin and up to the temporal-mandibular joint (TMJ)
(b) Tense/strained muscle areas or trigger points in your face (have you tried biofeedback training? sensors can monitor your muscle tension in potentially problematic areas and you will learn to be able to control that)
So you may have more options
open to you among those possibilities.
In regard to IV infusions, they are "short-term", though in a very relative sense. As I mentioned Jefferson does 3 day outpatient IV treatment (bodine infusion) as an intermediate to a full admission. In a full admission you'd be looking at being treated continuously for at least 7 days. By nature of the fact that the treatments are administered over a short period of time, they can be called "short-term". But the same can be said of any treatment that isn't used continuously. The goal, frequently achieved, is long-term benefit though. Sometimes just breaking the pain/headache cycle can give long-term relief. But in most cases, with their discharge goal being one pain-free day, breaking a cycle of headaches provides an
opening in which longer-term treatments can be administered. Cyclical or persistent headaches can make the brain very treatment resistant. Preventative treatments work much better when they are preventing
, as opposed to stopping, controlling and then preventing. Typical daily headache medications work by regulating the balance of important excitatory and inhibatory neurotransmitters in the brain. They function much more effective in maintaining the necessary balance than when they are used to try to reestablish that balance when it is already quite out-of-whack. I've been trying to think of a good analogy for this. Imagine trying to earthquake-proof a building. You'd have much better luck reinforcing the structure before an earthquake than you would trying to protect the building during
an earthquake, as the building falls apart. (okay, not the best analogy, I know)
I have tried all of these treatments. They did not work for me. But my headache has been wholly treatment-resistant. Knowing others who have found relief from these treatments, and knowing that they are the correct way to approach chronic headaches (from logic and many research studies), I do highly recommend trying them. If you're not finding relief from other types of treatment then this is
the next intelligent step in trying to find relief. And I really hope it works :)
DX: NDPH, Recovered(?) CRPS
RX: Lamictal, Namenda, Wellbutrin XL, Oxycodone, Oxycontin, Concerta (Methylphenidate), Clonazepam, Rozerem, Magnesium (1200 mg/d), Riboflavin (400 mg/d).
PRN: Ketamine nasal spray
, Toradol IM, Celebrex, Haloperidol, Lodine, Zofran, Phenergan, Ambien CR
rarely: Migranal, Thorazine, DHE IM, Droperidol IM, Reglan, Provigil, triptans (Imitrex, Maxalt, Relpax, Zomig, Axert, Amerge)I can be contacted personally via email at email@example.com.
Post Edited (korbnep) : 11/20/2009 8:53:38 AM (GMT-7)