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Monday, June 29, 2009

Grrr!!

I'm having problems getting the programming/options on this thing figured out. Saturday I felt fantastic. Didn't have the stimulator on all day. It was the best I've felt since I've had the thing in. But Sunday I woke up with a headache and couldn't get it to go away. It was painful enough to lay me out for a good part of the day and make me nauseous. I was really frustrated. I finally got the programming tweaked properly and started feeling better around 6:30 pm...just in time for the day to be over. I went to bed with the stimulator turned on, and feeling decent, but then was awoken by the pain at about 2 am. I tried to tweak the settings as much as I could but I just couldn't seem to get it right. I ended up having to get up for about an hour in the middle of the night to play with it and whatnot because the pain was too bad to just lay there. The pain lessened for a little while from 3:30 until 4:30, then I had to change the programming again. Got back to sleep, but was awakened around 6:30 (time to get up anyway) with pain. I got up and changed settings one more time. I guess I finally got it right because then the pain started to ease up (slowly) and I was able to get to work, albeit a few hours late. And as of right now, I'm pretty much pain free. Go figure.

I haven't figured out what types/levels/locations of pain call for which settings yet. I didn't realize this stimulator would be so complicated. But, the good news is that when you do get it right, it does work. It just takes some figuring out, which is frustrating.

The other thing I'm grumpy about today is that my battery incision site has been hurting the last couple days. Not a lot, but more than it did last week, for whatever reason. It's not infected or anything like that, just a bit sensitive. And the hematomas by my head incisions are still there. I think they are a bit smaller but I'm not really sure. I think I'll give them another week and if they are still there I'll go to my GP and see what he has to say. Maybe if I'm really lucky he'll stick a needle in them and suck all the blood out. *shudder*

Friday, June 26, 2009

Set-Backs and Tweaking

Yesterday was 3 weeks post-surgery...and I had a bit of a set-back, I suppose you could say. It seemed like this week I felt pretty good in the mornings, then in the afternoons my head would start to hurt. I'd turn on the stimulator but it wasn't helping as much as I hoped. I was starting to get nervous and really disappointed because I thought this stimulator was so great and then it began failing me. So Thursday morning I woke up with the most pain I've had since this thing was implanted...enough pain that I kind of just wanted to stay in bed. So I got out the remote and turned up the juice. It didn't help. Then, being the genius that I am, I remembered that the wire actually crosses the main nerve in my head in 3 places, and that when the Medtronic rep programmed my unit for me, she made it so that I could change where the stimulation is, not just how strong it is. Since she programmed it for me 2 weeks ago, I'd never changed anything but the stimulation strength (they call it "amplitude" in their fancy scientist terms). So I changed it to a different setting and voila, it hit the exact spot where the pain was coming from. It still took about 2 hours for the pain to really go down to an acceptable level for long enough that I was comfortable going into work. But in the afternoon and evening I felt really good. And today I don't even have my stimulator on, so I must have done things right yesterday.

Unfortunately it looks like I have a lot to learn about my stimulator and its capabilities still. I think part of the problem is that I had it stimulating the same area for too long. Sometimes I think this irritates the nerve. When you are over-stimulating, it causes pain, just like a headache but there's also a bit of a different element to the pain, which I'm starting to discover. I hope that someday I will be able to accurately tell the difference between pain and over-stimulation and get the stimulator turned off or switced to a different area before I actually cause myself pain. So I guess there is still a lot of operator error involved and the learning curve is still rather high.

Thursday, June 25, 2009

Three Weeks Post-Surgery

Today is officially three weeks since surgery. I started back to work this week--jumped right in and started going full time. Monday was a bit rough. My head really started hurting in the afternoon and I had to crank up the stimulator, but I still had a bit of a hard time keeping the pain controlled. I'm sure it was just the massive stress of coming back after being away since February. I was fine the next morning. I was also really tired when I got home that evening. I guess I'm not used to doing anything productive for that span of time!

Wednesday was rather warm, and I was driving around in a truck most of the day for work, and for some reason I had another day where I could feel the wire in my neck a lot. Mostly on the right...it's definitely tighter on that side. It doesn't restrict my movement or anything...it just feels kind of weird. I thought I'd be used to it by now, but I'm not, which makes me think it's a little tighter than it should be. I think the next time I go to Chicago (which won't be anytime soon) I might ask about getting a wire extender put in on that wire. I'm afraid that if it's too tight I may over time end up compensating for that and screwing up my neck or posture or something dumb.

"I may walk around looking like this, but at least I don't have headaches anymore!"

Yeah...not so much.

My scalp is still a bit more sensitive than I'd expect, but only really on the left side (the side I had the trial wires put in on). And the battery site is still a bit tender too. Sometimes I forget about it and do something that hurts it a bit, which is annoying. BUT I don't seem to feel it as much as I used to...I'm definitely getting used to it, which is positive. I'm not taking the painkillers anymore...I weaned myself off them during the week as I hated that "junkie" feeling I had this weekend and I seem to be fine now.

All in all, things are going well. Sometimes I feel like I'm not as far along in my healing as I wish I was, but at least I'm back to a sense of normalcy. I even have social plans for the weekend for the first time in months. Yep, I'm just that popular.

Sunday, June 21, 2009

Home Sweet Home!

I apologize for taking several days to respond to some of your comments...I was traveling back home to Wyoming during that time. It's been 14 1/2 weeks since I've been home and it's good to be back. There was snow on the ground when I left and now the grass is green and the flowers are blooming. It's weird, I feel like I just missed a big chunk of time/life being somewhere outside of my usual daily life.

But I feel good! The last day I took my painkillers was on Thursday. I get a pang of pain here and there but it's not bad...not enough to take the pills. I spent yesterday spraying weeds, grocery shopping, doctoring my horse's eye (he decided to poke it on something just a few days before I was going to be home...big dummy), etc. I got really hot (it was 85 degrees out) and had a small spell where I could really feel those wires in my neck and it made me feel a bit claustrophobic, but as soon as I cooled off a bit I was fine. I think after time I won't even feel those things anymore. The battery may be another story. I'm always kind of aware of it because it just seems so big and so obtrusive. It doesn't bother me very often, it's just sort of an annoyance sometimes, like I want to say to it "will you just go away already?" But of course that's silly...I'd rather have that battery there any day than have the pain.

I have had one issue in the past few days...anxiety. At first I thought it was because I was home and had all this stuff to do to get my life back in order. Friday night I took 2 anti-anxiety pills to be able to sleep. But last night was 10 times worse. Took 2 more anti-anxiety pills and they did nothing. It was one of the most horrible nights ever. Even this morning I couldn't just relax. I feel like I'm breathing really quickly and shallowly. To be honest, I'm having a hard time sitting still to write this right now. Then I realized what it probably is...lack of pain pills. The ones I was taking were morphine based. I was on them for 2 weeks, and then just suddenly quit taking them. I imagine they made me rather calm and now that that's out of my system, I feel like I've got ants in my pants. Now...how do I remedy this? I got lots of exercise yesterday...in fact I was rather exhausted last night, but my body just wouldn't cooperate. So now I'm just annoyed. I've taken all these pills over all these years and this is what it all comes down to...no headaches but I'm as jittery as junkie. Awesome.

Tuesday, June 16, 2009

Damage Assessment


Here it is...pictures of the damage. Today is day 12 after my surgery. My staples were removed from my head, which hurt, but not terribly. Just about as much as you'd think getting staples removed from your head would hurt! I also got the bandage taken off my chest incision (where the battery is). Turns out there aren't any stitches there to remove. He put in some internal stitches and then just used surgical glue so I think it will heal up nicely.

So here you go...the debut of my bare chest on the internet!

Obviously that's where the battery is on my right. It's still bruised and a bit swollen but it really is feeling better every day. I'll take another photo in a couple weeks to show you how it's healing up. Look up on my neck as well. There is a little bump on each side. The one of the right (my right) is kind of high, the one on the left is low. That is where the wire extenders are. There will always be bumps there, because the extenders do stick up a little, but they should get less red and obvious over time. There were little incisions there (no stitches, just glue) but you'll barely be able to see them I'm sure.

Here's another one...a profile shot to show you how the battery sticks out.


I think this picture makes it look worse than it is...but maybe not. It's still a bit swollen and whatnot, but not too much. So yes, you can see it if you look from the side, but you can't see the outline of it or anything from the front. Also, you can't see the bump through clothing or anything like that. I think it'll feel more obvious than it actually is. I'm making sure to keep scar ointment on the scars to help them heal and be less obvious. I know they'll never disappear but I'm sure it won't hurt to minimize them.

So...I don't have much of a swimsuit body anymore, although to be honest, I'm not sure I had one before! And I'll have to chose fancy dresses a bit more carefully in the future to try to de-accentuate (is that a word? I doubt it) the scars and bumps. But it's all worth it. I feel so much better. I don't feel like just laying in bed anymore, I feel like going out and doing things again. I feel like going back to work, having a regular schedule, being a productive member of society again. I feel like riding my horses and going camping. Heck, I even feel like having a drink! I'm not scared of that sending me to bed for the next 3 days. So scars and all, life is good.

I also got the okay from the doctor to go home today! WOOHOO! So I'm headed back to Wyoming at the end of the week, and will be back at work on Monday. It's been 14 weeks now that I've been away (15 by the time I actually really get home) and I am SO glad to be done with all this and get on with my life. The last few months have been a struggle but what is it "they" always say (actually I think it was Thomas Jefferson but whatever)? "Anything worth having is worth fighting for." I've fought for my health and now I have it. Or maybe "what doesn't kill you makes you stronger" fits a little better. Eh, you know what I mean!

Monday, June 15, 2009

I Can Feel It

Today was a rough day. I'm still exhausted for no apparent reason, which is not good because I have only a week before I go back to work. But worse than that, I seem to be very aware of my neurostimulator. This morning it kind of freaked me out. I could feel all the wires coming down the sides of my neck and felt like they were just closing in on me. I wanted to rip them out but of course I couldn't. And I'm always aware of the giant battery in my chest. It makes me wonder if I will ever get used to it. I can just feel it in there, pressing against my skin on one side, and my chest muscles on the other. It doesn't inhibit my movement much, but I'm more aware of it when moving that arm, and it does inhibit movement a little bit, which I notice particularly in the shower for some reason or when I try to turn my head really far to the right. I'm not sure if that's something that will change since I'm still healing or if I'm stuck with what I've got. The whole thing freaked me out and I had to take an anti-anxiety pill...glad I have those. I cut back on my painkillers quite a bit this weekend so I bet the increased awareness of everything is due to my nerves not being so de-sensitized by Vicodin. But still, I can't take Vicodin for ever so I'd better get used to this. It's just weird to be so aware of a foreign object that's in your body all the time and you can't get rid of. I should probably try not to think about it too much!

Saturday, June 13, 2009

"Comments" tool should be functioning now.

I heard from several people that they were not able to post comment on this blog. I think I fixed it now, so if anyone wants to be the guinea pig, comment away! Sorry about that...I don't really know much about computers, I just pretend.

Thanks!

Take It Easy

On Thursday I was so exhausted that I slept all day. Literally. I didn't get out of bed until 4:00 p.m. and still went to bed that night before midnight...and slept for a good 8 hours. Yesterday (Friday) I took a 4 hour nap in the middle of the day, and last night I slept 12 hours as well. I seem to forget that surgery was only a week ago, and that it really takes it out of your body. I have to keep reminding myself to take it easy. Otherwise I seem to be exhausting myself...apparently. Not a very good idea!

I'm also still taking pain meds. Sometimes I think "I feel so good!" and then I over-do it and end up hurting, or I think I don't need my pain meds anymore, and then once they wear off completely I realize that was stupid. I guess I'm having a hard time realizing that I'm still recovering, but I definitely am still recovering...my body is telling me so. So, if you have surgery, just remember that it'll probably take a few weeks or a month to be back up to par, even if it is what they call a "simple outpatient procedure." What's simple to the doctor is not simple to your body. Although I find it hard to believe that hooking up all these wires and tunneling them under my skin is a "simple" procedure since it's hard to find a doctor that actually does these ONSTIM implants. I guess it's not as hard as, say, open heart surgery, but I'd say it's a bit more complicated than maybe an appendectomy. But who am I to classify surgeries as simple or hard?

Friday, June 12, 2009

One Week Post-Surgery

It's been a week since surgery. Well, actually a tad more but close enough. I went to the doctor today and thought he was going to take my staples and stitches out but he decided to leave them in a few more days and I have to go back on Tuesday to get them removed. Which is fine with me. I'd rather make sure everything is closed up tight before all that stuff comes out. He said everything looks to be healing well though. He also gave me the g0-ahead to have a shower and wash my hair! WOOHOO! I'd had a couple baths this week, so I wouldn't completely stink, but my hair hadn't been washed since the morning of my surgery. It was dirty and had all the blood from the surgery still crusted in it. My scalp was really starting to itch terribly too...I wouldn't have been surprised to find some bugs hiding in that mess. Not really, but it sure felt that way.

A Medtronic rep was also at my appointment to help program my stimulator. I felt like one of the wires wasn't in the right spot, but she reprogrammed it so that the stimulation came a bit further down on the wire and it seemed to work like a charm. I didn't know they could do that, but apparently they can, which is good to know. She also gave me a few other things to tweak on my own remote, like pulse width, which can give me better coverage as well. They didn't have all that kind of stuff available on the trial stimulator so it was a learning experience for me. They are also going to set me up with a Medtronic rep in either Wyoming or Montana to help me out when I am back home, if I need it. Glad I won't have to travel to Chicago any time I need anything adjusted. If it's surgical I will, but not for adjustments to the stimulator programming.

I'm still tired, my head is still sensitive to sleep on, and I'm still taking my pain meds. But every day seems to get a little easier. Hopefully in another week I'll be able to go home! *Cross your fingers!*

Tuesday, June 9, 2009

If this doesn't make you feel like Frankenstein...

There's nothing like some good ol' metal staples in your head to make you feel like Frankenstein. I finally took a photo to share. Both sides of my head look virtually the same so I figured I just needed one picture. There are 7 staples on each side of my head. I'm guessing they used staples because it is in an area that doesn't have to be stitched nicely since it will be covered by hair because they used stitches on the incisions in my neck. I've never had staples before...I can only imagine how fun it will be to have them removed on Friday.

I was worried about them shaving off a bunch of my hair. Dumb, I know, but I'm attached to my hair, and with all the other scars I'm going to have, I didn't want to have half my head shaved too. Luckily my surgeon was pretty conservative when it came to shaving my head, as you can see. When I put my hair down (which I haven't done yet since surgery since they won't let me have a shower yet, grr), you probably won't even be able to see the shaved patch, unless you are looking for it. That's what I'm hoping anyway! Cute hair-dos like ponytails and braids and all that fun stuff will be out of the question for probably 6 months but c'est la vie.

Honestly, the whole thing looks worse than it is. When I look at pictures of people with hair shaved off and staples in their head, it freaks me out. This was one of the things that gave me massive anxiety before surgery. But it's really not bad. They don't hurt and I really can't even see them unless I look. So although it looks scary and gross and might make some people run away from the idea of an occipital nerve stimulator, I can tell you that it's not nearly as bad in reality as your imagination makes it out to be. I promise!

I haven't taken photos of the other incisions yet because they still have the steri-strips on them, which I am not allowed to take off until Friday, so taking a picture of them now would be pointless...you can't see anything. I'll take photos once I get all that junk off them. And if you're really lucky, I'll even let you see the awesome hematoma on my chest incision too.

Monday, June 8, 2009

Post-Surgery

I got home from the hospital on Friday afternoon. The first couple days were a bit rough, although not as painful as I expected. I had laproscopic surgery on my abdomen a few years back, and that was much more painful than this procedure. Then again, I have stronger painkillers this time and the incisions aren't as deep or in an area that moves all that much. But it's a pleasant surprise when you end up being in less pain than expected!

I felt really good on Sunday...good enough to get on the computer, although the angle of my arm when I'm moving the mouse doesn't feel great so I was not on there very long. But of course I think I overdid it that day because on Monday I slept most of the day and was in noticeably more pain. Oops.

Sleeping is difficult because it's hard to find a comfortable position for my head since there are incisions/staples on both sides. I also tend to not sleep well on pain meds. They knock most people out but they get me all crazy, and they make me itch. With all the tape and bandages, it's hard to get at those itches so it's kind of a never-ending cycle of craziness. I'm still taking the pain pills regularly but the pain isn't bad at all. The incision sites are more achy than sharp now. Where the leads were tunneled under the skin just feels like a bruise (it felt like that from the beginning, there was never sharp pain there). I just have to remember to take it easy or my shoulder starts to hurt because I think I'm moving it too much.

I'm a bit worried that the wires on the left side of my head are not in the right place. The front wire seems to be about an inch too far forward, and the back wire seems both too far up and too far to the left. I can't tell if they will work where they are or not because during surgery the doctor put a lot of local anesthetic in my head, and it hasn't worn off yet...my scalp is still numb. So I haven't had the headache pain come back yet to be able to try the stimulator out. In fact, I really haven't even had the stimulator on at all since I had the surgery. Between the pain pills and anesthetic, I haven't needed it yet. Keep your fingers crossed that I'm wrong about the wire placement because if they do need to be moved, that means opening my head up again on that side...something I will not be happy about. I'm ready to be done with surgery, pain, and medications and move on with my life!

I haven't been able to shower yet, which is kind of gross since my hair is crusted with blood, but the doctor told me not to shower until after I'd seen him on Friday to get my stitches/staples out. I think that's a bit ridiculous but I guess I better listen to him. I had a bit of a sponge bath yesterday but my hair is starting to drive me nuts. I've been camping for periods longer than this without a shower but I think it's just the idea that there is all that blood on my hair that's driving me crazy. A bit of dirt and grease is one thing, blood is another. Yuck.

Implantation Complete!

My cyborganization is complete...I had my permanent nerve stimulator implanted on June 4, 2009. Surgery was schedule for 3pm, which was a terrible time because then I had all day to worry and be anxious...plus I couldn't eat or drink at all after midnight so it made for a long day. All went well though, as far as I can tell. I had wires put in on both sides of my head this time (there were only on the left for the trial). I had to have some hair shaved off near my ears on both sides but my surgeon was as conservative as he could be about that. Both of those wounds have 7 staples holding them closed. I'll get some photos up here soon. There is also a small wound on each side of my neck, kind of in the front so more on my throat than neck. I think that is where the wire extenders were put in. Then of course there is the huge incision where my battery is. I'm just supposed to leave it all alone until I go in on Friday to get the stitches and staples out, but some of the adhesives were irritating my skin so I changed the bandages. Shh, don't tell! My sister is a nurse, and she did it for me and said it would be okay so I'm not worried about it.

The procedure was supposed to be outpatient, but I was in too much pain that night to go home. The worst pain was on the left side of my head...the side I'd had wires in and out of just a few weeks ago for the trial. The doctor only prescribed Vicodin for me, and it just wasn't strong enough. So while I was in the hospital he gave me something strong via IV...one of the good ones where you get to press the button whenever you need it. And he prescribed stronger drugs for when I went home too. Once I left the hospital, the pain has been manageable...that first 24 hours was just a bit rough.

A Medtronics rep was also present during my surgery (apparently I talked to him during the surgery, although I don't recall that at all. I thought I was fully knocked out, but he said I was under conscious sedation for the first part of the surgery, just like I was for the trial, so they could talk to me when they turned the stimulator on to make sure I felt it. I have zero recollection of any of this. I don't even recall seeing him in that surgical room! I hope he didn't ask me to reveal my deepest darkest secrets because he could have some really good blackmail info right now and I'd be none the wiser!), and visited me in the recovery room to make sure I was doing okay and to see if I had any questions. He sent me home with a bag full of info and gear related to my neurostimulator.

I will take some photos of the incisions later this week when I get a chance so you can have an idea of where everything is and what the surgical process entails. Typing is still a bit hard though, the angle bothers my shoulder, so that's all for now.

Wednesday, June 3, 2009

What IS an Occipital Nerve Stimulator?

I guess I haven't given a very good explanation of what an occipital nerve stimulator is. I'm going to try to do that, but pictures are worth a thousand words, or so they say, so I'm going to put a few pictures with this too for all you visual learners.


The word "occipital" refers to a nerve in your head. It controls sensation in the scalp. The "nerve stimulator" obviously refers to the device put in you and what it does. Therefore there are more than one type of nerve stimulator. There are peripheral nerve stimulators, spinal stimulators, trigeminal stimulators, etc. They are all basically the same device...they are just named for the nerve they work on.

The nerve stimulator is made up of a battery and some long wires (called "leads"). The battery is 2" x 2", and about half an inch thick. So it's about the size of an Oreo cookie (well, the cookie part anyway, not all the filling and the other cookie). The battery is implanted somewhere in your body. For occipital nerve stimulators, it's usually implanted in the pocket of fat right below your collarbone, so that you're really lucky and get to be a 28 year old with a pacemaker-type scar. Oh wait, that's just me. They can be put in your back, but the chance of lead displacement is higher then because there is a higher amount of movement through your back. Personally, I'd rather not have the leads move and have to deal with that so I'm okay with the pacemaker thing. The battery lasts anywhere from 10 to 25 years, depending on how much you use the stimulator. I figure that by the time I need my battery changed they'll have developed one the size of a paperclip. I wonder where they'll put that. The leads are placed in your head via a small incision, between your scalp and skull. Then they are tunneled under the skin with a hollow needle and adjusted to cross the proper nerves. They send an electrical signal that your nerve senses...it's a tingling sensation. This sensation blocks the nerve from sending a pain signal. Pretty straightforward concept, if you ask me. Apparently the stimulator can have up to 4 leads attached to it. There are two places to connect to the battery, and you can join two wires together via a connector (as shown in the photo at left), for a maximum of 4. From the incision site, the other end of the lead is tunneled under the skin on the neck and shoulder down to the battery in your chest. So everything is just under the surface, and is fully embedded in your body.

To control the stimulator, you have a remote control, which I hear are very expensive to replace if you lose yours. You only get one with your implant. It's a bit bigger than an average cell phone. With this remote you can turn the stimulator on and off, control stimulation strength and speed, and control all these things on the individual wires. Unfortunately you have to hold the remote control right over the battery to get it to function, it's not exactly like a TV remote that you can point and shoot from across the room. But then again maybe that's a good thing, in case it gets in the wrong hands. This is also another reason to have the battery placed in your chest as opposed to your back where it would be quite hard to reach.

The battery is rechargeable. Recharging frequency again depends on how much you use the stimulator, but typically it's a good idea to recharge every other day. The charger has to be held over the battery as well, just like the remote, but only takes about 20 minutes to recharge. So if you just sit/lay and read a book or watch TV while you do it, it's not a big deal. Maybe I can tell my boss I need to "recharge" every day around 2pm and get a nice medically excused nap everyday. Hmm, I might be on to something.

As for restrictions, well, they are about the same as anyone with a pacemaker. You'll set off metal detectors, but they give you a medical card to carry for that reason. You can't go in an MRI. No ultrasounds in the vicinity of the stimulator (my doctor said nothing above the waist), no muscle stimulators (like some chiropractors use). You have to stay away from welding machines (not sure why but my experiences with welding are limited to watching my boss weld together some rebar in a garage about 5 years ago so I'm not exactly a leading expert on the subject). I also know a gal who has a spinal stimulator and says she sets off the burglar alarms in Wal-mart, but I don't think of that as a restriction, I think of it as retribution...a way to annoy Wal-mart the way it annoys me. See, there are many benefits of a nerve stimulator...probably more than you even thought!

Monday, June 1, 2009

Things I Have Tried to Treat These Headaches

I thought it would be good to include a list of things I've tried over the years to treat my headaches...both treatments and tests. When I tell people I suffer from headaches, everyone seems eager to repeat something to me that they've heard about headaches and their "cure." I try to take their comments graciously, even though honestly, when I've suffered this long, I've tried pretty much everything mentioned. I suppose that sounds snotty but it's the sad truth. So anyway, I'll make a list of my trials, in case it might help someone else figure out a new treatment for themselves. This is in no particular order. (This list may be edited in the future as I remember more things.)

Treatments
  • Diary--tracking foods, weather, hormones in an attempt to define headache triggers
  • Diet changes--reduced or eliminated foods to see if there was any improvement, including caffeine, sugar, wheat, dairy
  • Daily "preventative" drugs--anti-epileptics, anti-depressants, beta blockers, calcium channel blockers, steroids, NSAIDs
  • "Rescue" drugs (i.e. triptans)--tried them all, the only one that worked was Zomig
  • Herbs--I went to an herbalist who recommended things for the particular needs of my body
  • Supplements--potassium, magnesium, lecithin, calcium, vitamin D, vitamin B-12, CoQ10, butterbur, fever few, etc., and a few herbal mixes designed specifically for migraine treatment
  • Biofeedback
  • Chiropractic
  • Cervical traction
  • Massage
  • Acupuncture
  • Oxygen therapy
  • Physical therapy
  • Exercise
  • Wisdom teeth removal
  • Dental biteguard (NTI--supposedly particularly effective on migraneurs)
  • Nerve blocks

Tests
  • MRIs--head and neck, on several occasions over the years
  • CT Scans
  • Discography--one of my MRIs showed a bulging disc in my neck; this was to rule it out as a source of pain
  • Blood tests
  • Hormone level tests