Migraine Surgery Recovery Month 1: Any Headaches?

How did migraine surgery effect my chronic migraines during this first month after surgery?  

On December 2, 2017 I had migraine surgery with Dr. Ziv Peled. He decompressed my left and right greater occipital nerves, and cut out my left and right lesser and third occipital nerves. Today is January 3, 2018. How have my headaches been this first month?

Migraine Frequency and Severity Drastically Reduced

Pre-Surgery Headache Frequency

The statistics are as follows: prior to surgery I had an average of 3-4 migraines per week, with “migraine” defined as any headache-like pain above 0/10 in the area of my neck, eyes and temples.

I had an average of one 10/10 full-blown migraine episode each week, characterized by one-sided pain in the neck, eyes and temples that was so severe I could not keep open the eye of the effected side and had to nurse the pain all day with massage and could not function normally in any activities.

These 24-hr or more episodes were also characterized by a full-body sense of crumminess, depression, and repeated bouts of vomiting (even on an empty stomach). 

Postop Headache Frequency

Since surgery on December 2, I have had a total of 7 migraines with the average pain being about 4/10, and have had zero 10/10 episodes with vomiting.

I have been waking up with these headaches, just like before surgery. But instead of becoming worse after waking and lasting all day and through the night, these headaches have all dissolved completely before noon time, with two of them fading completely within an hour of rolling out of bed.

Only Pain in the Eyes and Temples Remains

Before surgery, the neck was the epicenter of all of my headaches. Although the pain often spread to my eyes and temples, the occipital region is where the pain began and was always most severe.

It’s the area I would massage most while in episode.

But all of my headaches since migraine surgery have been in my eyes and temples primarily, with four of them involving just a hint of greater occipital nerve sensation.  

Prior to surgery, it was as if I had constant pain in the area of my lesser occipital nerve (especially on the right side, where I suffered an injury throwing a football in 2011). Now that pain is gone completely.

At all times, whether I had a headache or not, I used to be able to press my index finger into a quarter-sized spot along the route of the lesser occipital nerve behind my ear and trigger a zingy burst of migraine-like pain. 

Dr. Peled performed cut out my lesser occipital nerves, so there is no more sensation at all in this spot. When I first pressed into trigger point in the days after surgery and realized that the zingy sensation was gone, and all that remained was numbness, I was brought to tears of joy.

I believe that this lesser occipital nerve irritation served regularly as the tossed cigarette that sparked the forest fire of my full-blown 10/10 migraine episodes, so the severing of this nerve has brought great relief.

New Pains Relating to the Surgery Itself

A handful of times each day I’ll have an odd zing or twitch in my neck, which are new sensations that I've never before experienced. They are almost certainly related to the surgical manipulation itself, which involved burning muscle and scar tissue off of the greater occipital nerve, and severing and implanting into muscle the lesser and third occipital nerves. 

These sensations haven’t bothered me because they are just short zings of pain and are infrequent.

In Conclusion

I cannot remember the last time I went a month without a severe migraine episode.

As Dr. Peled says, we cannot draw any firm conclusions about the effect of the surgery before 3-6 months have passed and I have healed completely.

But at the moment I'm feeling very optimistic that migraine surgery has addressed many if not all of the structural issues that were causing my headaches, and that it at least partially cured my chronic migraine condition. 

Learn more about how I managed my incisions and post-operative limitations during the first month of migraine surgery recovery.