July 30, 2019: Occipital Nerve Decompression Surgery

We arrived bright and early at the surgery center and went through all the pre-surgical paperwork, etc. I was brought back to pre-op where I got my IV, was given a Scopolamine patch for nausea, spoke to different nurses, the anesthesia team, my surgeon, etc. My surgeon (Dr. Perry) is so particular about everything that he made the pre-op nurse change the direction the IV tubing was taped to my hand. The surgical nurse (who has been working with him for years) smiled and said he has this down to a science. 

  

Shaun gave me a kiss and watched me walk to the operating room with the OR nurse.  She told Shaun that she would call him every hour with an update.

I spent 6 hours in the OR.

 

I woke up with my hair shaved from the top of my ears down, 3 incisions in a "T" formation, a drain, and a pump giving me a continuous dose of pain medications that I will have for a week. I don’t remember much when waking up from anesthesia other than feeling pretty nauseated. Shaun and my dad were there with me, and they took some flattering pictures of how swollen my face/lips/chin were from laying on my stomach so long. They said I answered all the questions the nurse asked, even the ones that were directed at Shaun. 

 

I went home about 6pm and snuck upstairs without my kids seeing me. I made myself comfortable in a reclining chair in my room, put a compression device on my legs, and put on a cooling mask on my head that I rented from my surgeon’s office for the next week.  The cooling mask is like an icepack for your entire head, but it is attached to a device that continuously delivers cold water at a perfect temperature to reduce swelling and give comfort, but not cause any damage that an ice pack could cause. The danger of ice packs after this surgery is that your head is completely numb, so you could cause a burn from the ice and have no idea.  If you use an ice pack on your head, they want you to also put one on your leg so that when your leg starts to burn, it means the skin on your head is also burning. Plus getting new ice packs every hour would be very inconvenient. Renting this machine made recovery so much more bearable. 

 

The rest of the day is pretty fuzzy, I don’t remember a lot other than feeling groggy. I wasn’t in any pain, my head just felt “tight”. I just had some difficulty finding a comfortable position. 

Dr. Perry called Shaun to give him an update on what he found during surgery. He said I had exactly the anatomy he expected, and that he had to decompress 25 nerves. That means there were 25 places along my occipital nerves that were pinched or damaged that needed to be fixed. He said I definitely needed this surgery.

(I will explain more about what it means to decompress a nerve after my 1 week post-op appointment with Dr. Perry where he explains things in greater detail)

Pre-operative Assessments

Before my doctors will operate, they require additional testing to be done beforehand. A cardiovascular assessment and a psychological evaluation. 

I had an ECG and a stress test done by a cardiologist. From what I understood, there are two reasons for this. The first is to make sure my heart can handle the anesthesia and laying on my stomach for 6 hours as the surgery can be fairly long. The other reason is to make sure my body can handle all the hormone changes and ups and down post-op. When a person lives with chronic pain and then suddenly that pain ends or decreases, your body and your hormones go crazy and can impact several body systems.  

I also had a very long, very thorough pre-surgical psychological evaluation done with a psychiatrist.  My doctors started requiring every patient prior to surgery have an assessment done because they were finding that a certain group of people were not having as much success after surgery compared to others. They found that people who have depression, anxiety, or are dealing with an underlying mood disorder can feel physical pain, and unfortunately many chronic pain sufferers struggle with depression and anxiety due to how the pain causes such high levels of stress and severely disrupts your life. My doctors want to see which patients are experiencing this as they can fix the physical issue, but this alone its not enough for success. It also may affect the patient’s ability to cope with expected post-op sensory changes. Basically, they want to make sure the patient has all the support and tools they need to maximize the surgery’s success. 

My results for the psychological evaluation revealed that I don't suffer from anxiety or depression, however I do respond to stress higher than a "normal" individual does.  Because my body runs at a constant level of stress due to chronic pain, my baseline is higher than it should be. So even if there is something small that is causing me stress, my body responds a lot more aggressively because it already has a head start. With this knowledge my doctor explained to me the importance of deep breathing, meditation, etc to keep stress under control in order to avoid severe pain flare ups.   

I also had bloodwork done and had to stop any injections (nerve blocks, botox, trigger point injections) in surgical area. I had to watch what I ate to make sure I didn’t take any medications, herbal supplements, or eat any foods that could increase bleeding and bruising.

"Oh you get migraines? Have you tried....?"

Let me see...

- Chiropractic Therapy
- Active Release Therapy
- Graston Technique Physical Therapy
- Gua Sha Massage Technique

- Massage Therapy
- Physiotherapy
- IV Therapy
- Craniosacral Therapy
- Neurosomatic Therapy (NST)
- Oxygen Therapy
- Chinese Cupping Therapy
- Herbal Remedies from a Chinese Doctor
- Traditional Acupuncture
- Dry Needling
- Botox Therapy
- Occipital Nerve Block Injections
- Sub Occipital trigger point injections
- Yoga
- Strength training
- TENS
- Cervical Traction Device
- Essential Oils
- Magnesium Supplements (Both pill and powder form)
- Vitamin Supplements
- Numerous medications
- Neuropsychological evaluation
- ALCAT Bloodwork to assess allergies
- Drastic diet changes ex) removing refined sugar, decreasing dairy, meat, and gluten consumption, organic foods, 100+oz  daily water intake.
- Cervical support pillow. All the pillows.
- Pregnancy

- MRIs
- CT scans
- Angiograms
- Consulted dentist for a nightguard even though they stated unnecessary.
- Consult with ENT specialist and had Septoplasty to correct deviated septum
- Consult with a Pain Management Specialist
- Consult with an Oral and Maxillofacial Specialist for TMJ assessment (nope)
- Cervical Spine Xrays done and analyzed by Orthopedic Surgeon
- Cervical Spine Xrays done and analyzed by The Mayo Clinic
- Several Neurologists in both Canada and the United States
- Migraine Specialists and Migraine Centers
- Mayo Clinic Department of Neurology
- Naturopath
- Chinese Doctors

- Future plans: Occipital Nerve Decompression Surgery – July 30, 2019

Thank you for the suggestion, but chances are I have tried it.