tag:blogger.com,1999:blog-61747106223175519842024-03-05T09:25:04.260-07:00Adventures in Occipital Nerve StimulationAfter years of suffering from headaches, I decided to try occipital nerve stimulation to control my pain. This blog is to document my process to try to help educate others about the process and results.Bannerhttp://www.blogger.com/profile/10411396685109840881noreply@blogger.comBlogger65125tag:blogger.com,1999:blog-6174710622317551984.post-24345217628682427512018-08-30T09:11:00.000-06:002018-08-30T15:31:27.342-06:00Battery Replacement<div dir="ltr" style="text-align: left;" trbidi="on">
This post is embarrassingly overdue but I'm going to write it anyway because I think it's worth writing.<br />
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<a href="http://shauntee.com/wp-content/uploads/2012/08/lowbat.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="301" data-original-width="500" height="120" src="https://shauntee.com/wp-content/uploads/2012/08/lowbat.jpg" width="200" /></a>If you have a rechargeable battery, how long will it last? When I got mine in 2009 I was told it would last 10-20 years, depending on how much I used it. I have mine off more than I have it on (not because it doesn't work but because I don't need it that much anymore!) so I expected mine to last somewhere in the 15-year range. Yeah. Wrong.<br />
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Last fall when I went to charge one day, a message popped up. I looked it up and it turns out it was telling me my battery life was nearing its end. My doctor checked it out at my next appointment and verified that it was time for replacement. We scheduled it for November (2017). That means my battery lasted about 8 1/2 years. I had expected it to last twice that long! So I was a bit disappointed but there's nothing to be done but replace it.<br />
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The good news is that the battery replacement surgery was a breeze. I debated whether to go back to my original surgeon in Chicago or to have my local pain doctor in Colorado do it. My CO does NOT do stimulator for headaches but does a ton for back pain and he was very confident the battery swap was well within his skills. He was right. He did it in his surgical center (i.e. not a hospital) and it took all of 30 minutes. He cut the battery pocket open along the original incision as to not make a new scar. The battery I got was the exact same size as the original so he didn't have to alter the pocket or anything. He literally just had to disconnect the old battery, take it out, put the new battery in, reconnect it, and close me up. He usually staples battery sites but I persuaded him to to staple mine because it's so visible being in my chest. He did internal stitches and then a bit of surgical glue. He was so happy with how it turned out that he said he might have to start using that technique on all his patients!<br />
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Recovery was all of a few days. Sure, it was a bit sore for maybe two weeks but not enough to require more than some Advil.<br />
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While he was doing the replacement, he did notice that one of my leads had some damage right where it plugged in to the battery. He said it wasn't terrible and since it had been working fine, he decided to leave it. But if I have any problems, it will need to be replaced. The good news is he said the whole lead wouldn't need to be replaced. He could do it himself and would just have to open the battery pocket again and replace the end section of the lead. He said it wouldn't be any more invasive than than the battery replacement. Probably less, actually.<br />
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So...how long will your battery last? Who knows! But don't fear the replacement. It's truly no big deal.<br />
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Bannerhttp://www.blogger.com/profile/10411396685109840881noreply@blogger.com0tag:blogger.com,1999:blog-6174710622317551984.post-71640250579397950902016-09-20T14:17:00.003-06:002016-09-20T14:22:30.539-06:00We've Joined Google+<div dir="ltr" style="text-align: left;" trbidi="on">
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The success of the Facebook group, <a href="https://www.facebook.com/groups/232392623486874/" target="_blank">Occipital and Peripheral Nerve Stimulation</a>, has been great, with a current membership of 1700+. That's way beyond what I ever expected. While I expect that to remain the most popular social media platform, I've also created a Google+ community for those who prefer the Google+ platform or don't want to join Facebook. We'll see how it goes. If it isn't popular, I'll probably shut it down in time...one less thing to keep up with.</div>
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<a href="https://3.bp.blogspot.com/N-AY2XwXafWq4TQWfua6VyjPVQvTGRdz9CKOHaBl2nu2GVg7zxS886X5giZ9yY2qIjPh=w300" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://3.bp.blogspot.com/N-AY2XwXafWq4TQWfua6VyjPVQvTGRdz9CKOHaBl2nu2GVg7zxS886X5giZ9yY2qIjPh=w300" width="200" /></a>So join me at the new <a href="https://plus.google.com/u/0/communities/107838776219149387607" target="_blank">Occipital and Peripheral Nerve Stimulation Google+ Community</a>! (Clicking that name will take you there.)<br />
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Bannerhttp://www.blogger.com/profile/10411396685109840881noreply@blogger.com0tag:blogger.com,1999:blog-6174710622317551984.post-8443942826220139512014-01-31T14:24:00.001-07:002014-01-31T14:24:41.919-07:004+ Years With My Peripheral Nerve Stimulator<div dir="ltr" style="text-align: left;" trbidi="on">
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiMgr6nMa3W12ugrV3o7IWmd2AU8pVyMBRt9U68XGZQiBiXd28HWW5CK8dc-gAVmDb0RT1PafK9SJLA8-2OTPMw7mS1OW-AkTyvRveR-i8URbE0KzbfmXpx0YKurNvp2fjRE6LBWDcMNxU/s1600/update3.png" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiMgr6nMa3W12ugrV3o7IWmd2AU8pVyMBRt9U68XGZQiBiXd28HWW5CK8dc-gAVmDb0RT1PafK9SJLA8-2OTPMw7mS1OW-AkTyvRveR-i8URbE0KzbfmXpx0YKurNvp2fjRE6LBWDcMNxU/s1600/update3.png" height="189" width="200" /></a>My stimulator is great. I feel bad that I don't post much anymore, but there's no need to rehash subjects on which I've already written,
continuing to say "I'm doing great." I really have no complaints and I forget I have it most of the time, to be honest! </div>
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That being said, I figure I might as well give an update as I've now had this thing for over 4 1/2 years.</div>
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<u>Success</u>:</div>
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If I had to give my stim a number, I'd say it has reduced my pain by 80%. I still have a baseline daily pain level of a 2 or 3, but that's completely acceptable. It's small enough that it doesn't slow me down and I can ignore and/or forget about it. Sometimes, my pain is actually gone entirely and that is an amazing thing. </div>
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Was the stim worth it? ABSOLUTELY. My only regret is that I didn't get it sooner! If I had to go through it all again, I wouldn't change anything. This has by far been the most successful treatment I've ever tried my pain and it is an overwhelming success.</div>
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<u>Medications</u>:</div>
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I'm no longer on any daily preventative medications for headaches. No more heavy neurological drugs that have terrible side effects and make me feel like a zombie. No more worrying about if/when my liver and kidneys will be affected. I do still have rescue meds (Zomig and Cambia) for days when the stim doesn't quite cut it but those days are much less often than they were before the stim, and their severity is greatly reduced. I can't tell you the last time I had a headache bad enough to make me vomit or send me to the ER.</div>
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<u>Activities</u>: </div>
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Since my leads are fully scarred in, I really do not have any restrictions on my activities. I've resumed my favorite activities including horseback riding, skiing, and swimming. I also get weekly chiropractic adjustments and massages. However, in the spirit of honesty, my doctor does not like that I get adjustments. She does not recommend it to stim patients and I'm aware of this. I really shopped around for a chiropractor before choosing one, which was very important. The one I chose is excellent and I trust her absolutely. That cannot be said of all chiropractors I've ever been to though so if you do choose to risk chiropractic adjustment with a stim, <i>go to the best, not the most convenient or the one you've known the longest</i>. Personally, the relief I get from the chiropractor (for occipital and neck issues) is worth the risk. But that's a decision everyone has to make for themselves, of course.</div>
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<u>Surgery</u>:</div>
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Besides the one optional revision I had several months after the initial implantation, I've had no need for any revision. All my wires and anchors have stayed in place, which I attribute to my wonderful surgeon but also to giving things a good long time to heal. At this rate, I think the next surgery I'll have for the stim will be to replace its battery, and thankfully that's still quite a few years down the road (knock on wood).</div>
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<u>Reprogramming</u>:</div>
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I've not had a lot of need for reprogramming either. I think I've been reprogrammed three times ever, and I've always waited until I go to Chicago to have it done there. I've never had to see my rep in Wyoming. To be fair, I'm not sure this is actually normal. Most people need quite a bit of reprogramming in order to get the most out of their stim. But most of that programming will probably be within the first year or two. Once you get it set right, you should be able just to leave it alone.</div>
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If you have any other questions, drop me an email or a comment on this post and I'm happy to answer. I think this post covers most of the most frequently asked questions.</div>
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I may not update this blog much, but I'm on the PNS/ONS Facebook group daily. We have over 600 members (!) from around the world. It has become an <i>amazing </i>resource. Plus then you can hear experiences and opinions other than mine! If you or someone you know is considering getting a nerve stimulator to treat headaches, I highly suggest you join the group. It's much more active and comprehensive than this blog. But as always, I'm available via email. I may not post much on this blog anymore but I still check the email address attached to it regularly.</div>
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<a href="https://www.facebook.com/groups/232392623486874/">https://www.facebook.com/groups/232392623486874/</a></div>
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Bannerhttp://www.blogger.com/profile/10411396685109840881noreply@blogger.com0tag:blogger.com,1999:blog-6174710622317551984.post-17815875074601429522013-08-30T15:09:00.000-06:002013-08-30T15:09:01.968-06:00MRI Compatibility?<div dir="ltr" style="text-align: left;" trbidi="on">
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<a href="http://2.bp.blogspot.com/-i32kYcbBRrc/UiEJZ4rpwtI/AAAAAAAACsc/ZILH_tt9cJQ/s1600/nomri.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="http://2.bp.blogspot.com/-i32kYcbBRrc/UiEJZ4rpwtI/AAAAAAAACsc/ZILH_tt9cJQ/s200/nomri.jpg" width="200" /></a><span style="font-weight: normal;"><span class="messageBody" data-ft="{"type":3}"><span class="userContent"><span style="font-size: small;">I've heard rumors of an MRI compatible battery floating around for awhile now but have not met anyone that has one or been offered one. I was visiting with my Medtronic rep today and decided to ask him about it. It turns out there <u>are</u> MRI compatible
batteries...but they are more for pacemakers or pain pumps. I can get an
MRI compatible battery but it won't help because the <u>leads</u> are not MRI
compatible. If I were to need an MRI, they'd have to take the entire
system out. And there are currently no MRI compatible leads on the
market or even in development. This was excellent clarification for me so that I can set the record straight and move past the idea of getting an MRI compatible system.</span> </span></span></span></h5>
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Bannerhttp://www.blogger.com/profile/10411396685109840881noreply@blogger.com0tag:blogger.com,1999:blog-6174710622317551984.post-79287014043985525352013-07-02T10:49:00.001-06:002013-07-02T10:55:21.307-06:00What's in a Name?<div dir="ltr" style="text-align: left;" trbidi="on">
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<a href="http://ww1.prweb.com/prfiles/2012/01/18/9981677/reedprocedure_lrg.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="154" src="http://ww1.prweb.com/prfiles/2012/01/18/9981677/reedprocedure_lrg.jpg" width="320" /></a></div>
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<span style="font-size: x-small;"><a href="http://ww1.prweb.com/prfiles/2012/01/18/9981677/reedprocedure_lrg.jpg" style="margin-left: 1em; margin-right: 1em;">Image from ReedMigraine.com</a></span></div>
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As occipital and peripheral nerve stimulation for headaches become more popular, doctors and companies are rushing to put their name on the process. This can be a bit confusing as it seems some procedures now have several different names.</div>
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Technically, an occipital nerve stimulator covers only the occipital nerve. A peripheral nerve stimulator covers any nerves, particularly smaller unnamed branches. But doctors are finding that a combination of these seems to be the most successful, placing leads on both the occipital nerve (at the base of the skull) and on the supraorbital nerve (across the forehead). This particular placement has been coined as the "<a href="http://www.reedmigraine.com/procedure" target="_blank">Reed Procedure</a>," the "<a href="http://www.advancedmigraine.com/chronic-migraine-treatment/transforma-procedure/" target="_blank">Transforma Procedure</a>," and the "<a href="http://migrainecenters.com/omega-procedure/" target="_blank">Omega Procedure</a>." They are all essentially the same thing.</div>
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Hopefully one day a single name will stick and be used to avoid confusion but for now be aware that there are several names floating around which all mean the same thing. </div>
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Bannerhttp://www.blogger.com/profile/10411396685109840881noreply@blogger.com0tag:blogger.com,1999:blog-6174710622317551984.post-27238287816389205592013-02-19T15:59:00.000-07:002013-02-19T15:59:17.741-07:00Updated Doctors List<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: Times,"Times New Roman",serif;"><span style="font-size: small;"><span style="font-family: "Times New Roman","serif"; font-size: 18.0pt; mso-fareast-font-family: "Times New Roman";">I have finally updated the list of doctors that do ONS. I've made a "page" out of it. You can find it by clicking on the page title "List of Doctors" just under the blog title and description. The list has gotten long (which is a good thing!) so I've divided it up into regions of the United States, as well as a section for Canada and "other," which currently only includes Australia. If you would like your doctor added to the list, please email me at onstim@gmail.com or leave a comment for this post. I spent all day combing my emails and other resources but I'm sure I've missed a few here or there.</span></span></span></div>
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<span style="font-family: Times,"Times New Roman",serif;"><span style="font-size: small;"><span style="font-family: "Times New Roman","serif"; font-size: 18.0pt; mso-fareast-font-family: "Times New Roman";">I've also updated the links section with a few things people might find helpful.</span></span></span></div>
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<span style="font-family: Times,"Times New Roman",serif;"><span style="font-size: small;"><span style="font-family: "Times New Roman","serif"; font-size: 18.0pt; mso-fareast-font-family: "Times New Roman";">I'm posting the updated list of doctors below, just because I thought it might be helpful.</span></span></span></div>
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<a name='more'></a><b><span style="font-family: "Times New Roman","serif"; font-size: 18.0pt; mso-fareast-font-family: "Times New Roman";"></span></b><br />
<b><span style="font-family: "Times New Roman","serif"; font-size: 18.0pt; mso-fareast-font-family: "Times New Roman";">List of Doctors for Occipital Nerve Stimulators</span></b></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">This is a list of doctors involved
with headache treatment using occipital and/or peripheral nerve stimulators.
The list is not comprehensive; there are many more doctors out there. I would
encourage you to contact a stimulator manufacturer (i.e. <a href="http://www.medtronic.com/">Medtronic</a>, <a href="http://www.sjmneuropro.com/">St. Jude</a>, <a href="http://www.bostonscientific.com/" target="_blank">Boston Scientific</a>)
to locate a doctor near you.</span></div>
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<i><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">NOTE:
I cannot, and do not, vouch for any of these doctors, except Dr. Elborno as he
is the only one I personally have any experience with.</span></i></div>
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<b style="mso-bidi-font-weight: normal;"><u><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt;">Northeast</span></u></b>
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<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Elliot Pain Center</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"> </span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">185 Queen City Avenue <br />
Manchester, NH 03101</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(603) 663-6730 </span></div>
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<b>Dr. Mark Thimineur</b><br />
Comprehensive Headache & Pain Center--Griffin Hospital</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">130 Division Street</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Derby, CT 06418</span></div>
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<a href="http://painandheadache.com/"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">http://painandheadache.com</span></a></div>
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<b>Dr. Linqiu Zhou</b><br />
730 N Broad St #205</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Woodbury, NJ 08096</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(856) 202-5331 </span></div>
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<b>Dr. Ashwini Sharan</b><br />
Jefferson Medical Center</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">909 Walnut St</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Philadelphia, PA 19107 </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(215) 955-7000 </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><br />
<b>Dr. Didier Demesmin </b></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr. Jeffery Gehret</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><br />
University Pain Management Center</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">33 Clyde Rd., Suites 105 and 106<br />
Somerset, NJ 08873</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(732) 873-6868</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(Offices in Somerset, Monroe, and
South Plainfield, NJ )</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><a href="http://upmcpainmedicine.com/" target="_blank">http://upmcpainmedicine.com/
</a></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><br />
<b>Dr. Sukdeb Datta</b></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">90 Park Avenue</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">17th Floor</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">New York, NY 10016</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(212) 430-0312 </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><a href="http://www.laserspinepaininstitute.com/" target="_blank">http://www.laserspinepaininstitute.com/
</a></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(Works with Dr. Ken Reed of Reed
Migraine Center, Dallas, Tx)</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(Also has a New Jersey Office)</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr. Brian Grosberg </span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Montefiore Medical Park/Headache
Center</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">1575 Blondell Avenue</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Bronx, NY 10461-2660</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(718) 405-8360</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><a href="http://www.montefiore.org/" target="_blank">http://www.montefiore.org/ </a></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr. Roger Ng </span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">400 Red Creek Dr #120</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Rochester, NY 14623</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(585) 334-5560</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><a href="http://www.rochesterhealth.com/" target="_blank">http://www.rochesterhealth.com/
</a></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr. Alon Mogilner </span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">865 Northern Blvd #201</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Great Neck, NY 11021</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(516) 570-4477 </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr. Brian Snyder</span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman";">Neurological
Surgery, P.C.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span class="ad1"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">Multiple
locations in New York</span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;"> <br />
(800) 775-7784</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">(516)
300-1281</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<a href="http://nspc.com/index.html"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">http://nspc.com/index.html</span></a></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b style="mso-bidi-font-weight: normal;"><u><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt;">Southeast</span></u></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b style="mso-bidi-font-weight: normal;"><u><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt;"><span style="text-decoration: none;"><br /></span></span></u></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr. William Witt</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><br />
Cardinal Hill Rehab Hospital</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">2050 Versailles Road</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Lexington, KY 40504<br />
(859) 254-5701</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(800) 233-3260</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><a href="http://www.cardinalhill.org/">http://www.cardinalhill.org/</a></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><br />
<b>Carolinas Pain Institute</b></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Multiple locations in North Carolina</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><a href="http://www.carolinaspaininstitute.com/index.html">http://www.carolinaspaininstitute.com/index.html</a></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr. Thomas Yearwood </span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">4105 Hospital Street</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Suite 112</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Pascagoula, MS 39581</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(228) 938-0700</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<a href="http://www.nopaindr.com/"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">http://</span></a><a href="http://www.blogger.com/blogger.g?blogID=6174710622317551984" target="_blank">www.nopaindr.com</a></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr. Jose Sarria</span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Moffitt Cancer Center</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">12902 Magnolia Drive <br />
Tampa, FL 33612</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(813) 745-820</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><a href="http://www.moffitt.org/">http://www.moffitt.org/</a></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">Migraine Treatment Centers of America</span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">Locations
in Dallas, Houston, San Antonio, Lubbock, Phoenix, Nashville, and New Orleans</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">(855)
300-6822</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<a href="http://migrainecenters.com/"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">http://migrainecenters.com/</span></a></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr. Robert Levy</span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">University of Florida, Department of
Neurology</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">580 West 8th Street </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Jacksonville, FL 32209 </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(904) 244-9646</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<a href="http://hscj.ufl.edu/neurosurgery/"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">http://hscj.ufl.edu/neurosurgery/</span></a></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr.
Erich Richter</span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">West
Jefferson Medical Center<br />
1101 Medical Center Boulevard <br />
Marrero, LA 70072 <br />
(504) 347-5511 <br />
<a href="http://www.wjmc.org/" target="_blank">http://www.wjmc.org/</a></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">Dr. Eric Royster</span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span class="street-address"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">2700 Napoleon Ave. Suite # McFarland Building, Suite
540</span></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span class="locality"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">New
Orleans</span></span><span class="adr"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">, </span></span><span class="region"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">LA</span></span><span class="adr"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">
</span></span><span class="postal-code"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">70115</span></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span class="tel"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">504-899-9311</span></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<a href="http://www.ochsner.org/"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">http://www.ochsner.org/</span></a></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b style="mso-bidi-font-weight: normal;"><u><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt;"><span style="text-decoration: none;"><br /></span></span></u></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b style="mso-bidi-font-weight: normal;"><u><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt;"><span style="text-decoration: none;"><br /></span></span></u></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b style="mso-bidi-font-weight: normal;"><u><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt;">Midwest</span></u></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b style="mso-bidi-font-weight: normal;"><u><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt;"><span style="text-decoration: none;"><br /></span></span></u></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr. Ahmed Elborno</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><br />
Midwest Academy of Pain & Spine<br />
2867 E. Ogden Ave. <br />
Lisle, IL 60532</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(630) 420-8080</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><a href="http://controlchicagopain.com/">http://controlchicagopain.com/</a><br />
<br />
<b>Mayo Clinic</b><br />
</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">200
First Street SW<br />
Rochester, MN 55905</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">507-284-2511</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;"><a href="http://www.mayoclinic.org/rochester/">http://www.mayoclinic.org/rochester/</a></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b style="mso-bidi-font-weight: normal;"><u><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt;"><span style="text-decoration: none;"><br /></span></span></u></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr. Nagy Mekhail</span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr Andre Machado</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><br />
Cleveland Clinic</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">9500 Euclid Ave</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Cleveland, OH 44195</span></div>
<table border="0" cellpadding="0" class="MsoNormalTable" style="mso-cellspacing: 1.5pt; mso-yfti-tbllook: 1184; width: 100%px;">
<tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0; mso-yfti-lastrow: yes;">
<td style="padding: .75pt .75pt .75pt .75pt;" valign="top"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(216) 444-2200</span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><a href="http://my.clevelandclinic.org/default.aspx">http://my.clevelandclinic.org/default.aspx</a><br style="mso-special-character: line-break;" />
<br style="mso-special-character: line-break;" />
</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr. Peter Pahapill</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><br />
United Neurosurgery Associates</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">225 Smith N Ave Suite 200</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Saint Paul, MN 55102 </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(651) 241-6550</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr. Ramsin Benyamin</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><br />
Millennium Pain Center<br />
1015 S. Mercer Ave</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Bloomington, IL 61701</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(309) 662-750</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><a href="http://www.millenniumpaincenter.com/">http://www.millenniumpaincenter.com/</a><br />
<br />
<b>Dr. Hammam Akbik</b><br />
UC Pain Management Center</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">7759 University Drive<br />
Suite C<br />
West Chester, Ohio 45069<br />
(513) 475-8282</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><a href="http://www.universitypain.com/" target="_blank">http://www.universitypain.com/
</a><br />
<br />
<b>Dr. Joseph Atallah</b></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">University of Toledo Medical Center</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">3000 Arlington Avenue</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Toledo OH 43614</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(419) 383-4000</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(800) 321-8383</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><a href="http://utmc.utoledo.edu/index.html" target="_blank">http://utmc.utoledo.edu/index.html
</a></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr. Wade Cooper</span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">University of Michigan</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">325 Eisenhower Pkwy., Suite 100</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Ann Arbor, MI 48108</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(734) 615-7246</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><a href="http://www.uofmhealth.org/">http://www.uofmhealth.org/</a></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b style="mso-bidi-font-weight: normal;"><u><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt;"><span style="text-decoration: none;"><br /></span></span></u></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b style="mso-bidi-font-weight: normal;"><u><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt;"><span style="text-decoration: none;"><br /></span></span></u></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b style="mso-bidi-font-weight: normal;"><u><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt;">Southwest</span></u></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b style="mso-bidi-font-weight: normal;"><u><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt;"><span style="text-decoration: none;"><br /></span></span></u></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr. Miles Day</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><br />
3601 4th Street</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"> </span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Lubbock, TX 79415</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(806) 743-7246 </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Mayo Clinic</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><br />
</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">13400
E. Shea Blvd.<br />
Scottsdale, AZ 85259</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">480-301-8000</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><a href="http://www.mayoclinic.org/arizona">http://www.mayoclinic.org/arizona</a>/</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b style="mso-bidi-font-weight: normal;"><u><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt;"><span style="text-decoration: none;"><br /></span></span></u></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">Migraine Treatment Centers of America</span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">Locations
in Dallas, Houston, San Antonio, Lubbock, Phoenix, Nashville, and New Orleans</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">(855)
300-6822</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<a href="http://migrainecenters.com/"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">http://migrainecenters.com/</span></a></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr. Louis Whitworth</span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">UT Southwestern Medical Center, NSG </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">5303 Harry Hines Blvd</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dallas, TX 75390 </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(214) 648-2300</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><a href="http://www.utswmedicine.org/">http://www.utswmedicine.org/</a> </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr. Jack Chapman</span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman";">Advanced
Migraine Relief & Treatment Center</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">7501 Fannin Street</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Houston, TX 77054</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman";">(832)
532-3344</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><a href="http://www.facebook.com/l.php?u=http%3A%2F%2Fwww.chronicmigrainehelp.com%2F&h=_AQGgytpO&s=1" target="_blank">http://www.chronicmigrainehelp.com/</a></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr. Kenneth Reed</span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr. Kelly Will</span></b><br />
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr. Robert Bulger </span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Reed Migraine Center</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">11970 North Central Expressway,
Suite 510</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dallas, TX 75243</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(972) 707-2800</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><a href="http://www.facebook.com/l.php?u=http%3A%2F%2Fwww.reedmigraine.com%2F&h=iAQGjmC8W&s=1" target="_blank">http://www.reedmigraine.com/</a></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b style="mso-bidi-font-weight: normal;"><u><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt;">West</span></u></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b style="mso-bidi-font-weight: normal;"><u><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt;"><span style="text-decoration: none;"><br /></span></span></u></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr. Robert Narotzky</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><br />
Central Wyoming Neurosurgery</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">6600 E 2nd St</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Casper, WY 82609 </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(307) 266-4000</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b style="mso-bidi-font-weight: normal;"><u><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt;"><span style="text-decoration: none;"><br /></span></span></u></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr. Giancarlo Barolat</span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">721 E 19th Ave # 434</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Denver, CO 80218<b> </b></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(303) 865-7800</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><a href="http://barolatcares.com/" target="_blank">http://barolatcares.com/</a></span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Swedish Pain and Headache Center</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><br />
Multiple locations in/near Seattle, WA</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><a href="http://www.swedish.org/Services/Pain-and-Headache-Services">http://www.swedish.org/Services/Pain-and-Headache-Services</a><br style="mso-special-character: line-break;" />
<br style="mso-special-character: line-break;" />
</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr. Kim Burchiel </span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Neurological Surgery--Oregon Health
Sciences University (OHSU)</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">3181 SW Sam Jackson Pk Rd - CH8N</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Portland, OR 97239</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(503) 494-4314</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">http://<a href="http://www.ohsu.edu/neurosurgery">www.ohsu.edu/neurosurgery</a></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b style="mso-bidi-font-weight: normal;"><u><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt;"><span style="text-decoration: none;"><br /></span></span></u></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr. Shane Brogan</span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">University of Utah Pain Clinic </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">50 N Medical Dr<br />
Salt Lake City, UT 84132</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(801) 581-6393</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><a href="http://healthcare.utah.edu/">http://healthcare.utah.edu/</a>
</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b style="mso-bidi-font-weight: normal;"><u><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt;"><span style="text-decoration: none;"><br /></span></span></u></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr. Mazin Al-Tamimi</span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">20 W Dry Creek Cir Suite 310</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Littleton, CO 80120 </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman";">(720)
388-1027</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b style="mso-bidi-font-weight: normal;"><u><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt;"><span style="text-decoration: none;"><br /></span></span></u></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr. Yogesh Patel</span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman";">Coastal
Pain and Spinal Diagnostics</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">6221 Metropolitan St, Carlsbad, CA
92009 </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">760)
753-7127 </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><a href="http://www.coastalpaingroup.com/">http://www.coastalpaingroup.com/</a></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr. Christopher Uchiyama</span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Scripps Clinic</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">10666 N Torrey Pines Rd</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">La Jolla, CA 92037 </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(858) 554-8877</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<a href="http://www.scripps.org/"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">http://www.scripps.org/</span></a></div>
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<b style="mso-bidi-font-weight: normal;"><u><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt;"><span style="text-decoration: none;"><br /></span></span></u></b></div>
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<b style="mso-bidi-font-weight: normal;"><u><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt;"><span style="text-decoration: none;"><br /></span></span></u></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b style="mso-bidi-font-weight: normal;"><u><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt;">Canada</span></u></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr. Andrew Parent</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><br />
</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">London
Health Sciences Centre<br />
University Hospital<br />
339 Windermere Road<br />
London Ontario Canada<br />
N6A 5A5</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">(519)
663-3707</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<a href="http://www.cnsuwo.ca/"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">http://www.cnsuwo.ca/</span></a></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<i style="mso-bidi-font-style: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">According
to Medtronic, other doctors also available in Montreal and Vancouver</span></i></div>
<br />
<br />
<br />
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b style="mso-bidi-font-weight: normal;"><u><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt;">Other</span></u></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b style="mso-bidi-font-weight: normal;"><u><span style="font-family: "Times New Roman","serif"; font-size: 14.0pt;"><span style="text-decoration: none;"><br /></span></span></u></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Precision Neurosurgery</span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman";">Multiple
locations in Victoria, Tasmania, and NSW</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><br />
</span><b><span style="font-size: 12.0pt; font-weight: normal; mso-bidi-font-weight: bold;">http://www.precisionneurosurgery.com.au/</span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dr. Ralph Mobbs</span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman";">Prince of
Wales (Private) Hospital</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">Suite
7a, Level 7<br />
Barker Street,<br />
Randwick NSW 2031</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">Australia</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">(02)
9650-4766</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<a href="http://www.neurospineclinic.com.au/index.html"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">http://www.neurospineclinic.com.au/index.html</span></a></div>
</div>
Bannerhttp://www.blogger.com/profile/10411396685109840881noreply@blogger.com2tag:blogger.com,1999:blog-6174710622317551984.post-52025305323502036992013-01-31T13:00:00.002-07:002013-02-19T16:00:22.917-07:00Occipital Nerve Stimulation versus Peripheral Nerve Stimulation<div dir="ltr" style="text-align: left;" trbidi="on">
<div style="text-align: justify;">
I apologize for not posting on this blog much anymore. I have been spending most of my time on the <a href="http://www.facebook.com/groups/232392623486874/" target="_blank">Occipital and Peripheral Nerve Stimulation group on Facebook</a>. We now have almost 250 members, most of them very active and willing to help others. To me that is a more valuable resource since there are multiple opinions and experiences provided instead of my one-sided story. It is a closed group so any Facebook friends outside the group cannot see what you post (your medical issues are kept private) and the group itself has been amazingly helpful and supportive.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
However, I think what I have learned in the past year or so is important to post here for those who stumble across this blog looking for information. I have always called my stimulator an occipital nerve stimulator. Turns out, it is really a peripheral nerve stimulator. Although the terms are often used interchangeably, when it comes to surgery, there <i>is</i> a difference. The difference is in which nerves the leads of the stimulator are placed on. Everything else is basically the same...the device, choice of battery placement, how the leads are put in etc.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b>Occipital Nerve Stimulation (ONS):</b></div>
<div style="text-align: justify;">
This is more common. The surgeon places the leads on the main branch of the occipital nerve, which is located in your neck, around your C1-C2. This is where the incision will be made. Also, if necessary, many doctors are finding it more effective to put wires in the front of a patient's head as well, usually on the supraorbital nerve. This, however, means they often make an incision on your face, usually by the temple. The idea is that with leads in both the front and back, the whole head will be covered. For some people this is the case and is great. For others (like myself), peripheral nerve stimulation is a better option.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b>Peripheral Nerve Stimulation (PNS):</b></div>
<div style="text-align: justify;">
This is a less common option. There are fewer surgeons who do this type of surgery because it's tougher. PNS involves placing the leads on any peripheral nerve...generally any nerve at all that is giving you pain. This could include the trigeminal, auriculotemporal, or any branch of the occipital nerve, for example. Incisions are made close to the nerve being stimulated, wherever that may be. Surgeries like this are harder because there are many blood vessels in the head and not a lot of room to work. So just because a surgeon says he does occipital nerve stimulation does not mean he does peripheral nerve stimulation. I just want to be clear about that.</div>
<div style="text-align: justify;">
<br /></div>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEheIQnSZHIYnMRpl3JpajYjpHYPSSIl26v1Dr8uVt7uqzwdscdkNpFLAMl3CAstH_biAVt-uylDVxgRwiCb1-jMuE0bMTdeHLf5BL6L7WBBY4HatmOxP8jkOyaNANO91NhPIco4YKG5yGpN/s1600/face-and-head-nerves.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="191" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEheIQnSZHIYnMRpl3JpajYjpHYPSSIl26v1Dr8uVt7uqzwdscdkNpFLAMl3CAstH_biAVt-uylDVxgRwiCb1-jMuE0bMTdeHLf5BL6L7WBBY4HatmOxP8jkOyaNANO91NhPIco4YKG5yGpN/s400/face-and-head-nerves.jpg" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Image from RahulGladwin.com</td></tr>
</tbody></table>
<div style="text-align: justify;">
This is by no means proved by any research and is nothing other than my opinion, but from talking to people that have many kinds of pain and have had many different surgeries in many different states and countries, I'm comfortable saying that peripheral nerve stimulation seems to be more successful in managing pain than occipital nerve stimulation...if, of course, your pain is not on your occipital nerve. It really only makes sense. If you have pain from your trigeminal nerve, put the lead on the trigeminal nerve.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
I thought this was a topic worth clarifying for anyone researching surgeons for one of these stimulators. That was you can use the proper terminology to make sure you and your doctor are on the same page. If your surgeon only does ONS but you think you'd be better off with PNS, <u>find another surgeon</u>. People seem to have a loyalty to their doctor(s), often based on nothing substantial, and you have to give that up to do what is best for yourself. If you're going to get something implanted in your body, you might as well get one that does you the most good.</div>
</div>
Bannerhttp://www.blogger.com/profile/10411396685109840881noreply@blogger.com0tag:blogger.com,1999:blog-6174710622317551984.post-79286466822083730352012-01-19T16:20:00.002-07:002012-01-19T16:21:59.016-07:00Tips for insurance appeals<div dir="ltr" style="text-align: left;" trbidi="on"><h6 class="uiStreamMessage" data-ft="{"type":1}" style="font-family: inherit; font-weight: normal; text-align: justify;"><span style="font-size: small;"><a href="http://0.tqn.com/d/healthinsurance/1/0/h/0/-/-/claims_denial.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="133" src="http://0.tqn.com/d/healthinsurance/1/0/h/0/-/-/claims_denial.jpg" width="200" /></a></span><span style="font-size: small;"><span class="messageBody" data-ft="{"type":3}">I want to share some tips for insurance appeals. I'm not sure if they all help but I'm sure they can't hurt.<br />
<br />
First of all, I don't know if this is true, but it seemed true for me. I was told that an appeal coming from a patient is often more successful than a doctor appeal. Your doctor should be able to appeal 3 times, and if all of those are denied, it becomes the patient's turn to appeal. What I did with mine was just overwhelm them with info. I wrote like a 6 page letter giving them a history of my headaches for the last 15 years, telling them all the things I tried,how it had affected my life, and why the stimulator was the last option. I wrote it as an essay so maybe it would make them think of me as a person instead of a number.<br />
<br />
I also included references to current research a<span class="text_exposed_show">rticles. I suggest using <a href="http://scholar.google.com/" target="_blank">Google Scholar</a> to look for professional articles. I have a list of them that I'd be happy to share but I'm sure there are some more up-to-date articles available as well.<br />
<br />
I also did a simple cost-benefit workup. I'm not much with numbers but I basically added up my costs for the past year, and estimated how much of that could be cut out if the stimulator works (75% of prescriptions, ER visits, urgent care visits, etc.) and compared it to the stimulator to show that them paying for the surgery would be to their financial benefit within as short as a year.<br />
<br />
And lastly, I'm also it's told the diagnosis and procedure codes are important. For example, if your diagnosis is coded as "migraine" it won't be as successful as if it's coded as something more specific like "occipital neuralgia." I already posted the codes that were successful for me on here somewhere but if you can't find them, I would be happy to post them again.<br />
<br />
Those are my tips. I hope they help. If anyone has anything to add, please do!</span></span></span></h6><h6 class="uiStreamMessage" data-ft="{"type":1}" style="font-family: inherit; font-weight: normal; text-align: justify;"><span style="font-size: small;"><span class="messageBody" data-ft="{"type":3}"><span class="text_exposed_show"> Also, as previously posted, we've got a great group going regarding occipital nerve stimulation on Facebook so please join us! <a href="http://www.facebook.com/groups/232392623486874/%20" target="_blank">http://www.facebook.com/groups/232392623486874/ </a></span></span></span></h6></div>Bannerhttp://www.blogger.com/profile/10411396685109840881noreply@blogger.com0tag:blogger.com,1999:blog-6174710622317551984.post-50513547071348704782011-10-24T19:58:00.000-06:002011-10-24T19:58:31.276-06:00Facebook<div dir="ltr" style="text-align: left;" trbidi="on"><div class="separator" style="clear: both; text-align: center;"><a href="http://radar.oreilly.com/facebook-logo.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="66" src="http://radar.oreilly.com/facebook-logo.jpg" width="200" /></a></div><div style="text-align: justify;">Yeah, I'm a nerd, I'm on Facebook a lot. As I was browsing around, I realized there are several groups for migraines and nerve stimulators in general, but none specifically dedicated to occipital nerve stimulation. I've found these groups to be great sources of information and a great way for people to communicate. Blogs are good too but they are obviously rather one-sided. So please consider joining the group. Sometimes the discussions are a little slow to get going but feel free to invite friends or anyone you know who may be interested.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">Here is the link to the group:</div><div style="text-align: justify;"><a href="http://www.facebook.com/groups/232392623486874/">http://www.facebook.com/groups/232392623486874/</a></div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">Hope to see you there!</div></div>Bannerhttp://www.blogger.com/profile/10411396685109840881noreply@blogger.com1tag:blogger.com,1999:blog-6174710622317551984.post-29261878028739395212011-07-26T22:10:00.000-06:002011-07-26T22:10:54.409-06:00Two New Blogs<div dir="ltr" style="text-align: left;" trbidi="on"><div style="text-align: justify;"><a href="http://styleandsteel.files.wordpress.com/2010/09/blog.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="150" src="http://styleandsteel.files.wordpress.com/2010/09/blog.jpg" width="200" /></a>I have two new blogs to share with you related to occipital nerve stimulators.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">The first is from Tara who has been diagnosed with hemicrania continua and is looking into getting a stimulator to help manage her pain. You can find her blog at: <a href="http://hemicranialady.blogspot.com/">http://hemicranialady.blogspot.com</a></div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">The second is from "Ms.J" who has been diagnosed with occipital neuralgia and although she's been suffering for years, she is just starting her journey into the world of ONS. You can find her blog at: <a href="http://on-neurostim.blogspot.com/">http://on-neurostim.blogspot.com</a></div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">I'm still way behind on getting my list of doctors updated, although since I've heard it has actually helped people find a doctor, I know it's an important thing to do. I also need to update my links and labels. I've been pretty lax about keeping up with this blog lately but updating it is at the top of my list, I swear!</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">If anyone has a blog that relates to occipital nerve stimulation that you want to have linked to on this site, let me know. As always, my email is always open.</div></div>Bannerhttp://www.blogger.com/profile/10411396685109840881noreply@blogger.com0tag:blogger.com,1999:blog-6174710622317551984.post-5356755736097542352011-05-06T22:06:00.001-06:002011-05-06T22:26:02.265-06:00New ONS Blog<div dir="ltr" style="text-align: left;" trbidi="on"><div style="text-align: justify;"><a href="http://www.geardiary.com/wp-content/uploads/2010/02/blogger.png" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="150" src="http://www.geardiary.com/wp-content/uploads/2010/02/blogger.png" width="200" /></a>I don't often have much to post anymore since my stimulator is in and working well. It's hard enough to find the info that people want on this blog so I've vowed not to bog it down with a bunch of useful posts just to keep it active. Consequently, I now go months without posting. But even if I'm quiet, I'm still here and check my email daily so you can get in touch with me.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">A fellow headache sufferer and blog reader has decided to blog about her experience getting a stimulator. I want to share it so that people can hear a more current and different story than mine. Because resources regarding occipital nerve stimulators seem to be so hard to come across, I'm really excited that "nutmeg04" has decided to document her experience.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">Her blog can be found at:<br />
<a href="http://stimulationsurgery.blogspot.com/">http://stimulationsurgery.blogspot.com/</a> </div><div style="text-align: justify;"></div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">She just got her trial stimulator put in TODAY so show her some support and have a look!</div></div>Bannerhttp://www.blogger.com/profile/10411396685109840881noreply@blogger.com0tag:blogger.com,1999:blog-6174710622317551984.post-79279441284806980692011-01-23T23:47:00.000-07:002011-01-23T23:47:42.713-07:00List of ONS Doctors--Updated<div dir="ltr" style="text-align: left;" trbidi="on"><div style="text-align: justify;"><a href="http://patricpeake.files.wordpress.com/2009/12/pencil1.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="http://patricpeake.files.wordpress.com/2009/12/pencil1.jpg" width="200" /></a>I have just updated the list of doctors that are known to use occipital nerve stimulators for headache treatment from names readers have submitted to me. If you have any to add, please <a href="mailto:onstim@gmail.com">e-mail me</a>. And thank you everyone for helping me compile this list. I've been told by several people that it has been a great resource for them.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">This list can always be found on the righthand side of the blog for easy access (you may have to scroll down a bit to see it). Also, as one reader suggested, you can try contacting your local university pain management center. Most of them implant nerve stimulators for many indications, possibly including headaches. But in the meantime, here is the current list:</div><div style="text-align: justify;"><br />
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</style> <![endif]--> </div><em>NOTE: I cannot, and do not, vouch for any of these doctors, except Dr. Elborno as he is the only one I personally have any experience with.</em><br />
<div class="MsoNormal"> <br />
<strong>Dr. Ahmed Elborno</strong><br />
Midwest Academy of Pain & Spine<br />
Chicago, IL<br />
<br />
<strong>Dr. Robert Narotzky</strong><br />
Central Wyoming Neurosurgery<br />
Casper, WY<br />
<br />
</div><div class="MsoNormal"><strong>Dr. Miles Day</strong><br />
Lubbock, TX<br />
<br />
<strong>Swedish Pain and Headache Center</strong><br />
Seattle, WA<br />
<br />
<strong>Mayo Clinic</strong><br />
Scottsdale, AZ<br />
<br />
<strong>Elliot Pain Center</strong><br />
Manchester, NH<br />
<br />
<strong>Dr. Thimineun</strong><br />
Comprehensive Headache & Pain Center<br />
Derby, CT<br />
<br />
<strong>Dr. Nagy Mekhail</strong><br />
Cleveland Clinic<br />
Cleveland, OH<br />
<br />
<strong>Dr. Linqui Zhou</strong><br />
Woodbury, NJ<br />
<br />
<strong>Dr. Peter Pahapill</strong><br />
United Neurosurgery Associates<br />
St. Paul MN<br />
<br />
<strong>Dr. Ashwini Sharan</strong><br />
Jefferson Medical Center<br />
Philadelphia, PA</div><div class="MsoNormal"><br />
<strong>Dr. William Witt</strong><br />
Cardinal Hill Rehab Hospital<br />
Lexington, KY<br />
<br />
<strong>Dr. Ramsin Benyamin</strong><br />
Millenium Pain Center<br />
Bloomington-Normal, IL<br />
<br />
<strong>Dr. James North</strong><br />
Winston-Salem, NC<br />
<br />
</div><div class="MsoNormal"><strong>Drs. Didier Demesmin and Jeffery Gehret<span style="font-weight: normal;"><br />
</span><span style="font-weight: normal;">University</span><span style="font-weight: normal;"> Pain Management Center</span></strong></div><div class="MsoNormal">Somerset, NJ<br />
<br />
<strong>Dr. Hammam Akbik</strong><br />
UC Pain Management Center</div><div class="MsoNormal">West Chester, OH<br />
<br />
<strong>Precision Neurosurgery</strong><br />
Melbourne, VIC--Australia<br />
<br />
<strong>Dr</strong><strong>. Andrew Parent</strong><br />
London, Ontario--Canada<br />
<br />
According to Medtronic, other doctors also available in Montreal and Vancouver<br />
<br />
</div><br />
</div>Bannerhttp://www.blogger.com/profile/10411396685109840881noreply@blogger.com0tag:blogger.com,1999:blog-6174710622317551984.post-27505696853204461732010-12-29T11:05:00.001-07:002010-12-29T11:10:29.497-07:00Residual Effects<div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; text-align: justify;"><a href="http://www.whatisneuroplasticity.com/images/Axons%20firing%20in%20a%20neural%20cell.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="122" n4="true" src="http://www.whatisneuroplasticity.com/images/Axons%20firing%20in%20a%20neural%20cell.jpg" width="200" /></a>I've had my stimulator for a year and a half now, and I find that as time goes on, I use it less and less. When I initially got it, I had it on all the time. Now I only turn it on when I need it. My surgeon's head nurse told me that this is pretty common, and in fact some people get to the point where they no longer need the stimulator. She said they removed a woman's this fall because she no longer used it! I still find it hard to imagine getting to that point, but the idea that it is possible is so uplifting. Now, I have zero medical background, but I'll try to explain it the way the nurse explained it to me.</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; text-align: justify;"><br />
</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; text-align: justify;">She said when people have chronic pain, the nerves get used to firing at a certain location. The more they do this, the more that becomes almost like a normal process for your body. Part of breaking the pain cycle is to block that "easy" path that your nerves have gotten used to. The stimulator helps to disrupt this pain path and make your nerves sort of re-circuit. If there is a bigger problem causing the pain, your body may find new paths to use. However, if the pain is partially caused by nerves that are damaged from so much firing, the stimulator may help to give them a break and allow them to heal (yes, nerves can/do regenerate). I'm sure it's all much more complicated than that, but that was a basic explanation that I got that I thought was worth sharing.</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; text-align: justify;"><br />
</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; text-align: justify;">I hope everyone had a wonderful holiday season. Best wishes to all for a pain-free (okay, let's not get greedy...pain-reduced) New Year.</div>Bannerhttp://www.blogger.com/profile/10411396685109840881noreply@blogger.com0tag:blogger.com,1999:blog-6174710622317551984.post-56214996276069659692010-10-28T11:55:00.000-06:002010-10-28T11:55:49.375-06:00Breakthroughs<div style="text-align: justify;"><a href="http://t2.gstatic.com/images?q=tbn:ND7elZi3yiu5NM:http://xtrahealth.com.au/home/images/stories/clinicaltrial.jpg&t=1" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="http://t2.gstatic.com/images?q=tbn:ND7elZi3yiu5NM:http://xtrahealth.com.au/home/images/stories/clinicaltrial.jpg&t=1" /></a>There are a couple of exciting breakthroughs I want to mention for anyone who is interested. The first doesn't have to do with occipital nerve stimulation, per se, but it's a breakthrough in migraine treatment. The FDA has recently approved the use of Botox for migraine treatment. My excitement from this approval is that it shows that there IS hope for new treatments to be approved!</div><div style="text-align: justify;"><br />
</div><div class="separator" style="clear: both; text-align: justify;"></div><div style="text-align: justify;">But more importantly, supposedly there will be a nationwide medical trial conducted on nerve stimulators in regards to headache treatment in 2011. What this means for you: If you can't get your insurance to cover the stimulator, you can get it paid for under the medical trial if you get accepted. I, unfortunately, do not have much information regarding the trial. I do know that the Mayo Clinic has accepted several people but am not sure if the opportunity is only being offered through specific doctors/clinics, or is available all over. I asked my doctor about it, and she hadn't heard anything about it. She said she'd do some research and get back to me. My suggestion would be to discuss the possibility of joining the trial with your doctor ASAP. If any of you readers have more information regarding this trial, please let me know so I can share it with everyone.</div>Bannerhttp://www.blogger.com/profile/10411396685109840881noreply@blogger.com0tag:blogger.com,1999:blog-6174710622317551984.post-4668092230722606832010-08-19T21:47:00.000-06:002010-08-19T21:47:31.665-06:00Itching!<div style="text-align: justify;">So, I've had this stimulator in for nearly 15 months now, and sometimes the thing still itches like crazy. Initially I thought it was just healing, but after this long I'm pretty sure it will always do this. It itches under the battery box, where I can't scratch, of course. To keep my sanity, I had to find a solution. It seems that a soft bristled brush does the trick...you know, the kind you use in the shower. You can find one just about anywhere; I got mine at Walgreens. It doesn't reach beneath the battery of course, but for some reason scratching it lightly over the battery site eases that itching. Just thought I'd share my tip if any of you with a stimulator have the same problem.</div><br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://www.bodecare.com/site/components/com_virtuemart/shop_image/product/Detox_Body_Brush_4afca4d9bf05e.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="111" src="http://www.bodecare.com/site/components/com_virtuemart/shop_image/product/Detox_Body_Brush_4afca4d9bf05e.jpg" width="200" /></a></div><br />
<div style="text-align: justify;">We have been busy busy busy this summer, with lots of weddings and out-of-town guests. Thanks to my stimulator I've been able to attend and participate in all planned events. I have to be a bit pickier about the dresses I choose, as I want them to cover my scar, but other than that, I feel like a normal person! I've been not only working regular hours, but working extra hours, saving up some vacation time for a long trip in the future. It's good to be living mostly free from pain, even if I am itchy sometimes.</div>Bannerhttp://www.blogger.com/profile/10411396685109840881noreply@blogger.com0tag:blogger.com,1999:blog-6174710622317551984.post-90923891238231163772010-05-28T16:00:00.002-06:002010-05-28T16:03:15.149-06:00Winning...and Losing<div style="text-align: justify;">I finally heard back from the insurance company...and I won my appeal! Hooray! The final $12,000 of bills should be paid by them this month. What a relief. Their letter said they reviewed my case and found an "inconsistency in payment history." I don't really care what they call it, I'm just glad they are paying it.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">My submission to them included a 6 page letter that outlined my struggles with headaches over the past 14 years, how I came to choosing a nerve stimulator, and how it has changed my life. I also included an outline of the documents I had received from them and how they were incosistent. Altogether I submitted about 20 pages of documentation. I guess that did it. I was told that appeals received from patients (as opposed to medical professionals) are taken more seriously. That's something to keep in mind if/when you ever deal with an appeal of this sort.</div><div style="text-align: justify;"><br />
</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; text-align: justify;">On a separate note, I also wanted to apologize to those of you that have contacted me recently that I have not gotten back to. My oldest dog was sick the last few weeks and I had him in and out of the vet every few days. Last Thursday he lost the battle and we had to put him to sleep. It was very hard but the vet came to the house and made the experience as minimally traumatic as possible, I think. It's amazing how deeply animals can touch our lives. That dog was my companion for the last 12 years and although everyone thinks their dog is the best, he was truly exceptional. It's been a long time since I've lost anyone or anything close to me and I forgot how hard grief is. Anyway, I haven't been much in the frame of mind to be social but I will get to your emails this weekend.</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><br />
</div><div class="separator" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhSLOI1kSpmzvpJlUmD03UHSPVERH0iaiD5IpVC43XiZCqtiXQDzuGlKe2mhQaMV7KZF7pfGf4RTlwsmH75JZWgPFRygoRrKc1lBC65kNO4jjP3vtXUkx65bvh-_soYh0PSh854NQ37r8nY/s1600/Boo.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" gu="true" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhSLOI1kSpmzvpJlUmD03UHSPVERH0iaiD5IpVC43XiZCqtiXQDzuGlKe2mhQaMV7KZF7pfGf4RTlwsmH75JZWgPFRygoRrKc1lBC65kNO4jjP3vtXUkx65bvh-_soYh0PSh854NQ37r8nY/s320/Boo.jpg" width="320" /></a></div>Bannerhttp://www.blogger.com/profile/10411396685109840881noreply@blogger.com0tag:blogger.com,1999:blog-6174710622317551984.post-4128371423760960042010-04-27T12:45:00.000-06:002010-04-27T12:45:53.020-06:00Chatroom!<div style="text-align: justify;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhwyf-P2PE5BPTnWfiVUP1ibhUcNj6LEXAv_f93zX-_c85xlpB-yuEq3F3wb449CtkHIob-2TSljkMO7hgkJg26bZFCNXXtMBqbw72kIs8qQTgUmfB2LFARmNaxfn1ofsmcijs9LaWkkOvM/s1600/chatroom.bmp" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="170" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhwyf-P2PE5BPTnWfiVUP1ibhUcNj6LEXAv_f93zX-_c85xlpB-yuEq3F3wb449CtkHIob-2TSljkMO7hgkJg26bZFCNXXtMBqbw72kIs8qQTgUmfB2LFARmNaxfn1ofsmcijs9LaWkkOvM/s200/chatroom.bmp" width="200" /></a>I've added a chatroom to the blog...finally! I hope this will allow some of my readers interact with each other and share their stories instead of just me blabbing at you about my story. Originally I had wanted to add a forum where conversations could be saved and users wouldn't have to be online at the same time but that's not an option with blogger.com. There are, however, archives kept of anything anyone types in there so I think that may serve the same purpose.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">To find the chatroom, just scroll to the bottom of the page. It should appear below the posts. You have to make an account with chatroll.com to use it (sorry!) but it's free . I think the easiest way to use the chat is to make it a pop-out. That way you can stay on there while you surf other websites. To do that, just click on the icon in the bottom right corner that looks like this a box with an arrow coming out of the corner. You can also go to the chatroom page, which takes you to the chatbox in a webpage layout, if that makes sense. To do that, click the icon that looks like a blue circle with a green dot in it. This chatroom web page is also where you can find the chat archives.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">Enjoy!</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">Also, on a separate note, if anyone wants to do a "guest post" about their ONS experience, please let me know and we can certainly arrange that.</div>Bannerhttp://www.blogger.com/profile/10411396685109840881noreply@blogger.com0tag:blogger.com,1999:blog-6174710622317551984.post-68477139916405816722010-04-12T22:21:00.003-06:002010-04-12T22:22:55.121-06:00Battery Placement<div style="text-align: justify;"><div class="separator" style="clear: both; text-align: justify;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhHaqRAej_rw6SM_8-o39XzWJiSss9KzD_z1uaxyKRQAMPwcXm1wQO09_V_0I_55CPf3cRePMUJ_lzRitN1N8bEmssT31a12ugIBdtI8qN-Q3GU_-hwp1Z2qPdTvwnp0xwD5ERLuM65JCYn/s1600/battery.bmp" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="161" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhHaqRAej_rw6SM_8-o39XzWJiSss9KzD_z1uaxyKRQAMPwcXm1wQO09_V_0I_55CPf3cRePMUJ_lzRitN1N8bEmssT31a12ugIBdtI8qN-Q3GU_-hwp1Z2qPdTvwnp0xwD5ERLuM65JCYn/s400/battery.bmp" width="400" /></a></div>I want to talk a little bit about battery placement as I've had quite a few discussions with people about that recently.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">My battery is in the right side of my chest, just below my collarbone. When I was discussing the stimulator with my surgeon we talked about battery placement. I didn't really want it in my chest, as I thought the battery would be very obvious and the scar would be more visible. I suppose this is true, but he told me that having it in my chest is better than having it in my low back/upper buttocks where a lot of surgeons place them for the following reasons, which all made sense to me:</div><ol style="text-align: justify;"><li>It takes about 3 times more wire to run the battery down to your lower back, as opposed to your chest. More wire means a longer surgery, more disturbance to your body, and a longer healing time.</li>
<li>When they put the wires down your back, they go through muscle. When they go do your chest, they don't go into the muscle, or if they do, it's very minimally. If you know anything about muscle, it takes a <b>long </b>time to heal, which means having wires runs through it increases your recovery time <b>substantially</b>.</li>
<li>There is a lot more movement through your back than there is through your shoulders/chest so with the rear battery placement, the potential to pull your wires loose is much greater, which of course leads to one (or more) revision surgery(s).</li>
<li>Charging the battery and using your remote is awkward as it is...having that battery in a place that is hard to reach and hard to see makes using it that much harder (in my opinion).</li>
</ol><div style="text-align: justify;">Speaking to people that have had their batteries placed in their lower backs, I find all these things to be true. Yes, I have a more visible scar but my recovery was easy compared to what some others have been through. I've also heard of doctors wanting to put the battery under your arm, but that was a discussion I never had...it was never brought up as an option for me. I can't imagine having it there...I think it would be terribly annoying! Therefore I think discussing battery placement options with your doctor is very important. And if the scar on your chest is the biggest thing holding you back, just remember that it becomes a conversation piece, a way to educate others about headaches and the available treatment options. Or it can make you look like a badass if you make up a story about how you got in a wicked bar fight. </div>Bannerhttp://www.blogger.com/profile/10411396685109840881noreply@blogger.com1tag:blogger.com,1999:blog-6174710622317551984.post-19393231621943768162010-03-26T10:38:00.001-06:002010-03-26T10:39:09.673-06:00Relief<div class="separator" style="clear: both; text-align: center;"><a href="http://jennroth.typepad.com/selftalksoultalk/images/2007/10/15/stress_relieved_womanjpg.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="132" nt="true" src="http://jennroth.typepad.com/selftalksoultalk/images/2007/10/15/stress_relieved_womanjpg.jpg" width="200" /></a></div><div style="text-align: justify;">I'm happy to report that I'm feeling much better now. Monday was the last of the really bad days. Between the stimulator, ibuprofen, and caffeine, I've been able to keep the pain to a minimum all week. I went to work (and was productive!) and rode my horses. The only weird thing is that I'm completely exhausted. I don't know if it's from battling pain or from the medications I pumped myself full of last weekend. Oddly enough, I think it's the medications. It sure makes me wonder how I ever got through YEARS of taking all those drugs.</div>Bannerhttp://www.blogger.com/profile/10411396685109840881noreply@blogger.com3tag:blogger.com,1999:blog-6174710622317551984.post-88521259151734131112010-03-22T18:52:00.001-06:002010-03-22T18:52:50.465-06:00The Worst Week Yet<div style="text-align: justify;"><a href="http://www.beverlydoc.com/Portals/0/headache2.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="150" src="http://www.beverlydoc.com/Portals/0/headache2.jpg" style="cursor: move;" width="200" /></a>This past week has by far been the worst one since I got my stimulator last June. A headaches suddenly came on last Monday afternoon. I thought it was because I hadn't really eaten all day or because I hadn't had any caffeine after drinking a lot more of it than usual the week before (I was at a meeting all week...had to stay awake somehow). The stimulator didn't work so I went home, took my Zomig, and went to bed. Thought it would be okay but I was down all the next day, taking more Zomig along with ibuprofen, which often helps. I felt a bit better on Wednesday, went to work but still ended up taking my Zomig halfway through the day. Same story the next few days. Yesterday (Sunday) I got to the point where I dug out the Vicodin I still have stashed away and took some of that just to try to break the pain cycle. It worked for a few hours but that's about it so that idea didn't work either.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">I know I really shouldn't complain too much because the pain really is nothing compared to what it was last year at this time. I mean, I'm still able to work for the most part, and I was able to go do a few things this weekend. But I guess I've just gotten so used to not having pain that I'm now spoiled...if living without pain can really be considered spoiled. I think it's sad that it is. Anyway, I've had a few bad headaches (about one a month) since I got the stimulator but I've never had one drag out like this so it's frustrating, and honestly a bit scary. My mind starts playing that "what if" game: What if the stimulator doesn't work for me anymore? What if I go back to all those medications and doctors? What if I have to have more surgery and more wires? I try not to do that, but sometimes it's hard not to.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">Maybe it's time to go back to some physical therapy...massage, acupuncture, etc., to try to keep these headaches under better control. Or maybe I just need to move somewhere that has more consistent weather! Sometimes I think all these spring storms moving in and out affects me. I hear Costa Rica is nice...</div>Bannerhttp://www.blogger.com/profile/10411396685109840881noreply@blogger.com3tag:blogger.com,1999:blog-6174710622317551984.post-40096414292675037622010-03-16T03:51:00.000-06:002010-03-16T03:51:07.626-06:00Insurance Update<div style="text-align: justify;"><a href="http://api.ning.com/files/fcDO4mhZsmyvUm8dYs8FANLHY9196q9HkOq0RjkgpvHAcBENhiT59xly7yTziO4YD1usve06OxI-awpr7m-sKMcy6dPbohuj/FIST.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="150" src="http://api.ning.com/files/fcDO4mhZsmyvUm8dYs8FANLHY9196q9HkOq0RjkgpvHAcBENhiT59xly7yTziO4YD1usve06OxI-awpr7m-sKMcy6dPbohuj/FIST.jpg" width="200" /></a>After my post last month regarding the insurance issues (to put it nicely), I made a LOT of phone calls. Surprisingly Medtronic, the company that makes the stimulator, jumped right on it and said they would start an appeal case for me. I didn't even have to do anything! Talk about good customer service...that company is tops. I hadn't heard from them in weeks and decided that no news was good news, but then they called the other day. The rep told me that they had tried to appeal my case but since my other doctor (surgeon) had already appealed it 3 times unsuccessfully, appeals had been exhausted and there was nothing Medtronic could do, so they put the issue back in my hands. However, the insurance company did tell them that I could submit an appeal myself, and that personal appeals from patients usually weigh in a bit heavier than appeals from doctors (yeah right). So I am supposed to write them a letter and put everything in it...my history, prior treatments, stimulator experience, and of course why I feel they should pay, including any paperwork I have. This all seems silly and redundant to me, since I had to give them most of that to get the darn thing approved in the first place but whatever, I guess it's better than dealing with a lawyer.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">Being long-winded as I am, I decided that if they want everything, I'll give them everything. I've already begun writing my appeal and have 5 pages. I have a feeling it'll be at least 10 by the time I'm done. They want paperwork? They'll get paperwork. I have a lot of it. Plus I'm a government employee and we are masters of paperwork.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">I have a feeling this might turn into a long battle, but I'm ready to fight it. I still stand by my assertion that $12,000 is nothing to an insurance company, but it's a lot to me and therefore this is worth the effort.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">And people think we don't need healthcare reform in this country...</div>Bannerhttp://www.blogger.com/profile/10411396685109840881noreply@blogger.com1tag:blogger.com,1999:blog-6174710622317551984.post-54418201637868451652010-02-18T15:56:00.000-07:002010-02-18T15:56:43.930-07:00Insurance Woes<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEic9Gj-jmBBkipI2BMUkm1_pGttmTo0w_hhWLCXwLMP86ee4Am-2W2iOYt66ppEbw9JVzrux6mfVAZlBtBJdWWbrWOYPoRdRFBqZ0VqwwgIJPmvNsphO5E6OXxjphB5KNfp2BB2QzZfP7LS/s1600-h/denied-721524.png" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" ct="true" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEic9Gj-jmBBkipI2BMUkm1_pGttmTo0w_hhWLCXwLMP86ee4Am-2W2iOYt66ppEbw9JVzrux6mfVAZlBtBJdWWbrWOYPoRdRFBqZ0VqwwgIJPmvNsphO5E6OXxjphB5KNfp2BB2QzZfP7LS/s200/denied-721524.png" width="200" /></a></div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; text-align: justify;">One of the most common questions I get from readers is regarding insurance and how to get coverage for your stimulator. Mine was easy enough...my doctor's office did all the pre-approval work. But it looks like I jinxed myself by bragging about how lucky I have been to have great insurance to cover my stimulator. Last week I got a letter in the mail from the insurance company saying they were denying over $12,000 worth of claims. I had no idea what they were talking about so I just set it aside. On Tuesday I got a letter from the surgeon's office saying they'd tried submitting my claims several times but the insurance company refuses to pay so it is now my responsibility. Fantastic.</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; text-align: justify;"><br />
</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; text-align: justify;">The charges they don't want to pay for are specifically for the stimulator. They already paid everything else, including all the hospital costs, as well as many of the surgical costs. I don't understand how you can pay for 90% of a surgery but not the other 10%. Don't they do hand-in-hand?</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; text-align: justify;"><br />
</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; text-align: justify;">I'd like to know why I sat around waiting for pre-approval for 6 weeks when that approval apparently means nothing. On the positive side, I have all the paperwork to back up what I say. On the negative side, I'll have to get a lawyer and go to court to fight this. $12,000 isn't much to an insurance company so I am hoping they will settle out of court but still, it's going to be stressful to deal with.</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; text-align: justify;"><br />
</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; text-align: justify;">I guess I should be happy they covered ANY of the surgery, since it seems like so many companies won't. But still...the whole thing is really pretty annoying. I haven't even seen or paid any medical bills in months; I thought this was all resolved. Grr.</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; text-align: justify;"><br />
</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; text-align: justify;"><br />
</div>Bannerhttp://www.blogger.com/profile/10411396685109840881noreply@blogger.com5tag:blogger.com,1999:blog-6174710622317551984.post-91863073717532983532010-02-03T22:11:00.000-07:002010-02-04T16:25:36.822-07:00Chronic Pain: Hitting Rock Bottom<div class="separator" style="clear: both; text-align: justify;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhRvdg_AJh5zgmnm6NuM_HfXXWg_W5Jx3vTY5FsXT-m9KbAfP6fM0Nbsxf_pJGQGxZ6MyTuCv4R-Sd8ch5E_cFxDghq7O9wgDA1rgTGln0EA7dKCbheuSKVFIgKjJQTYFfqDXux_SQ2iYO6/s1600-h/depression_3.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="157" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhRvdg_AJh5zgmnm6NuM_HfXXWg_W5Jx3vTY5FsXT-m9KbAfP6fM0Nbsxf_pJGQGxZ6MyTuCv4R-Sd8ch5E_cFxDghq7O9wgDA1rgTGln0EA7dKCbheuSKVFIgKjJQTYFfqDXux_SQ2iYO6/s200/depression_3.jpg" width="200" /></a></div><div style="text-align: justify;">I usually try to limit blog posts to things related very closely to occipital nerve stimulation, but I'm now faced with a situation that I want to discuss. It's not directly related to ONS but I think it's important to talk about.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">I was informed on Tuesday that my supervisor killed himself this weekend. He suffered from chronic back pain. He only moved here last January, so I don't know his history, but from discussions with him last summer I know he's been to many doctors and tried many things. He had a metal rod implanted in his back at some point so he has more of a history than I can begin to imagine, I'm sure. His condition deteriorated quickly at the end of last summer. He got to the point where he could no longer sit or stand for more than about 5 minutes at a time, so he was essentially a prisoner of his bed. He was taking a lot of heavy-duty painkillers just to get through each day. He was not married and did not have any family in the area. Someone from work would go over once or twice a week but they wouldn't stay long so I think part of his downward spiral must have come from feeling isolated and alone. I guess he decided it just wasn't worth it anymore.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">However, I do think he gave up on himself a long time ago. We had a discussion last summer about a doctor's appointment he'd been to and the doctor has said something along the lines of "you need to get something figured out. If you feel this way now (he was in his 40's), how are you going to feel when you are 75?" And my boss said "I hope to god I don't live to be that old." I know people made suggestions to him of where to go for treatment, and offered him transportation but to my knowledge he didn't accept much help.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">The moral of this story to me, and why I wanted to share it, is this: <i><b>no one can help you if you don't help yourself</b></i>. I understand chronic pain. I've been there. Last winter I myself was feeling extremely low and got to the point where I couldn't envision a future for myself because every day was just filled with pain. I was not suicidal but I certainly was depressed. But I (luckily) got to the point where I got mad, not to the point of giving up. I refused to "live" this way and realized that I had to go find help for myself, whatever that took. That's why I traveled 1000 miles and spent 4 months away from home. And if it would have taken 4 times that long, I still would have done it. I had been to "experts," and no, they didn't help. You have to keep searching until you find the right doctor for yourself. Just because someone is labeled as a specialist or has been treating "your kind of case" for 30 years doesn't mean they can help <i><b>you</b></i>. You don't have to stick with a doctor that isn't helping you. I wasted way too much time doing that. If they don't help you, move on and try the next one. But if you just sit around wallowing in misery and self-pity, you will never feel better. No one will come knocking on your door saying "I think I have a solution for you."</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">Wow, I guess this turned into a bit of a lecture but it's just something that I feel very adamant about. I'm very sad for my boss. In all honesty, I didn't know him very well at all, but it still makes me sad that he felt death was the only way to end the pain. I hope to inspire people to take a different path than that, to give them hope, because you don't have to just give in. But you do have to be willing to help yourself.</div>Bannerhttp://www.blogger.com/profile/10411396685109840881noreply@blogger.com7tag:blogger.com,1999:blog-6174710622317551984.post-38940012770210393082010-01-11T09:04:00.004-07:002010-01-11T09:12:57.969-07:00A Good Surgical Summary<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh3N0kRLdbAXV9hp_-7Y0Z5F8wfomRjtidzyeAbw0UvLDoOx8LM6DoLQSrhrD17_884Aci5y5_x0pxuElhH59ZaolX0RMczj7Cc2xj6UNEo718jgvALoVsSRBd9MB1XKGLb6UEltGKmnMQo/s1600-h/cliffsmakesshort_small_m9rt.jpg"><img style="margin: 0pt 0pt 10px 10px; float: right; cursor: pointer; width: 134px; height: 200px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh3N0kRLdbAXV9hp_-7Y0Z5F8wfomRjtidzyeAbw0UvLDoOx8LM6DoLQSrhrD17_884Aci5y5_x0pxuElhH59ZaolX0RMczj7Cc2xj6UNEo718jgvALoVsSRBd9MB1XKGLb6UEltGKmnMQo/s200/cliffsmakesshort_small_m9rt.jpg" alt="" id="BLOGGER_PHOTO_ID_5425514723421179746" border="0" /></a>I stumbled across <a href="http://www.precisionneurosurgery.com.au/html/surgical_occipital.htm">this</a> site recently and thought it was a very good summary of the surgical procedure involved with occipital nerve stimulation. Much easier to get through than this entire blog since I'm so long winded :) This is from a neurosurgery center in Australia, but it's still pretty much spot-on with what goes on here in the States.Bannerhttp://www.blogger.com/profile/10411396685109840881noreply@blogger.com1tag:blogger.com,1999:blog-6174710622317551984.post-30477478995015127642010-01-06T11:36:00.012-07:002011-01-23T23:16:46.338-07:00List of Doctors for Occiptial Nerve Stimulators<div dir="ltr" style="text-align: left;" trbidi="on"><div style="text-align: justify;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhdSHchGij64G9UD6FL-VzT0GUDAygE1RfDWyVBlW5u5DcQYoxFF_UInoAEGv5akw1jCE_NZDe00qoO2T_C2EbCMaPrIBSlc91gEUpOvEdCzo9DG0muMmpJ4AkWtbN8d56C23n9qKWj1Nw6/s1600-h/list.jpg" onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5423699962103568498" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhdSHchGij64G9UD6FL-VzT0GUDAygE1RfDWyVBlW5u5DcQYoxFF_UInoAEGv5akw1jCE_NZDe00qoO2T_C2EbCMaPrIBSlc91gEUpOvEdCzo9DG0muMmpJ4AkWtbN8d56C23n9qKWj1Nw6/s200/list.jpg" style="cursor: pointer; float: right; height: 200px; margin: 0pt 0pt 10px 10px; width: 176px;" /></a>Here is the list I have complied so far. I know there are a few others out there, I'm still waiting on a few responses from people as to those names. I will add to this list as I collect more names. Some people have also found it beneficial just to call Medtronic (one of the companies that make the stimulators) directly and ask if there is a doctor available in their area. Please let me know if you have anyone to add to the list! And thank you to everyone for your input and help! </div><div style="text-align: justify;"><br />
<div style="text-align: justify;"><span style="font-weight: bold;">NOTE:</span> <span style="font-weight: bold;">I cannot, and do not, vouch for any of these doctors, except Dr. Elborno as he is the only one I have any personal experience with.</span> </div></div><br />
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</style>Dr. Ahmed Elborno <br />
Midwest Academy of Pain & Spine <br />
Chicago, IL <br />
<br />
Dr. Miles Day <br />
Lubbock, TX <br />
<br />
Swedish Pain and Headache Center <br />
Seattle, WA <br />
<br />
Mayo Clinic <br />
Scottsdale, AZ <br />
<br />
Elliot Pain Center <br />
Manchester, NH <br />
<br />
Dr. Thimineun <br />
Comprehensive Headache & Pain Center <br />
Derby, CT <br />
<br />
Dr. Nagy Mekhail <br />
Cleveland Clinic <br />
Cleveland, OH <br />
<br />
Dr. Linqui Zhou <br />
Woodbury, NJ <br />
<br />
Dr. Peter Pahapill <br />
United Neurosurgery Associates <br />
St. Paul MN <br />
<br />
Dr. Ashwini Sharan <br />
Jefferson Medical Center <br />
Philadelphia, PA <br />
<br />
Dr. William Witt <br />
Cardinal Hill Rehab Hospital <br />
Lexington, KY <br />
<br />
Dr. Ramsin Benyamin<br />
Millenium Pain Center<br />
Bloomington-Normal, IL<br />
<br />
Dr. James North<br />
Winston-Salem, NC<br />
<br />
Drs. Didier Demesmin and Jeffrey Gehret<br />
University Pain Management Center<br />
Somerset, NJ<br />
<br />
Precision Neurosurgery <br />
Melbourne, VIC <br />
Australia<br />
<br />
Dr. Hammam Akbik <br />
UC Pain Managment Center <br />
West Chester, OH <br />
<br />
Dr. Andrew Parent <br />
London, Ontario <br />
Canada <br />
<br />
Medtronic also has doctors available in Montreal and Vancouver, although I don't know specific names at the moment. </div>Bannerhttp://www.blogger.com/profile/10411396685109840881noreply@blogger.com6