ANA Discussion Forum
Treatment Options => Microsurgical Options => Topic started by: Captain Deb on November 22, 2009, 12:30:04 pm
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Please talk to your doc about head positioning during your surgery, especially if you have occipital headaches or a bad neck. Talk him into positioning your head FIRST, before you are put under. I firmly believe that the hyperextension of my neck during my surgery is a leading contributor to my 7 year long headache nightmare. At the Symposium, Dr Ryzenman spoke on his new protocal at one of the headache workshops. He makes sure the patient is in a comfortable position before he anesthetizes them.
Please do this!!! You do NOT want to go through what I have gone through for the past 7 years!!!
Capt Deb(http://i235.photobucket.com/albums/ee60/Captdeb_photos/skull_sword_through_head_lg_clr.gif)
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I agree 100% with Capt Deb especially if you are having retrosimiod. This approach is the one that puts your neck in the most exaggerated potentially out of normal range postioning. I have headaches and neck issues still at 1 1/2 years post op that my dr attributes to this positioning during surgery. While I have figured out how to manage my neck pain and headaches it sure would have been nice not to have to learn to manage them!
Erin
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I agree also....I am 1/12 yrs post op n still have neck pain n headache.I had such a bump for like 2 months where my head was so tight in the vice.
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Thanks for that excellent advice, Deb.
Although I underwent retrosigmoid approach AN surgery, my neurosurgeon - who had decades of experience with AN removals - must have known to position my head correctly prior to the surgery (I recall it being somewhat elevated) and I haven't experienced the headaches that plague you other AN surgery patients. Still, your caution to potential surgery patients have their head comfortably supported prior to the anesthesia being administrated is a very worthy tip for AN pre-op patients. You've done many people a huge favor by posting this warning. Thanks again.
Jim
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Hmmmmmmmmmmmm .....
I'm wondering if this is why I had terrible headaches following my retrosigmoid surgery in 1994 and absolutely no headaches following my retrosigmoid surgery in 2008 ..... (different neurosurgeons in different states and I am quite sure in different surgical positions)
Clarice
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Excellent info Deb. You would think something as basic as ensuring patient comfort would be a given! Maybe because the patient is heavily sedated there was less (or no) concern during surgery.
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Captain Deb,
Do you think that the sword going through your head has something to do with it? :P
Thanks for the great advise as I continue to W&W.
LisaP ;D
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Hi Captain Deb,
Thank you so much for this advice...I've been "collecting" info and questions for my surgeon and this is one I didn't have and NEVER would have thought to ask! THANK YOU SO MUCH!!! :)
Bren~
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Captain Deb,
Do you think that the sword going through your head has something to do with it? :P
Thanks for the great advise as I continue to W&W.
LisaP ;D
Sword? What sword? There's a sword?
Capt Deb(http://i235.photobucket.com/albums/ee60/Captdeb_photos/skull_sword_through_head_lg_clr.gif)
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My surgeon, Dr. Bartels, told me that he believed the positioning of the neck was very important in minimizing the risk for post operative headaches. He was telling me about how when he was in training (years and years ago), he was surprised at how far the neck was "cranked" in order to perform retrosig. That said, I still get some headaches, but they are not at all debilitating and easily controlled with OTC's.
Thanks for sharing this important information, Capt Deb!
Ernie
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Oh geeze I never would have thought of that! One thing I do know, is my right hip *still* hurts 2 months after my 10 hour retrosig.
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For me, the pain in my neck was waaaay worse than the incision pain. I talked to Dr Friedman about it and he said I may have some soft tissue damage from the "splint." I had my first of many major migraines 2 weeks post-op. What I have is some major nerve damage. I hope all prospective surgical patients read this and pass it on to their docs and fellow patients. I have been doing lots and lots of reading on occipital neuralgia and how symptoms can arise from injuries like whiplash.
Capt Deb(http://i235.photobucket.com/albums/ee60/Captdeb_photos/pirate-smiley-12.gif)
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Deb
I'm sure that you have had this done but...the Dr that I go to for my neck and headache issues is sending me for am MRI of my cervical spine because he feels in my case there is probably some damage there. Not that I'm thriiled about going in the MRI again but I'm hoping it will pinpoint exactly what the heck is going on! Like you, my neck pain has always been way worse than the incision pain. I actually got the idea for the MRI from one of the cd's from the conference. I gave it to my Dr, who after listening to the cd, concurred that this could very well be the source of my issues and ordered the MRI right away.
Erin
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I have had a cervical spine MRI and they found some disc degeneration. I believe I have some scar tissue left from muscle tearing pressing on my occipital nerves--but don't know if that shows up on an MRI. An X-ray of your neck, if you are having neck pain before your surgery, might not be a bad idea. Dang! I wish I'd thought of that before my surgery. I've had a wonky neck for years.
Capt Deb
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At the Symposium, Dr Ryzenman spoke on his new protocal at one of the headache workshops. He makes sure the patient is in a comfortable position before he anesthetizes them.
Wonder how new this protocol is for Dr. Ryzenman - and if he learned it while at the Ear Institute of Chicago where he used to practice. My neurotologist is from Chicago Ear and I haven't experienced any headaches post op.
Jan
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I’ve had headaches all my life, usually 3 to 4 times a week. Now it has been 8 months since my Retrosigmoid surgery, and I have had headaches and neck pain every day! I never thought to question head position with the doctor and it certainly makes sense that the way you are positioned would contribute to headaches and neck issues. I was controlling the headaches with Ibuprofen, but have recently gone to see a specialist to see if there was a way of controlling them without taking so many OTC pills. I am currently taking Gabapentin. I’ve only been on it for two weeks so it’s still too early to tell if it will help me. Fingers crossed!
As a side note: I still have hip pain when I lay on my side for too long too.
Scarlett
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Scarlett,
I'm considering nerve blocks, but because mine is so easily controlled with otc meds, I have been a bit lazy about pursuing it. You may want to ask your physician if this could work for you.
Ernie
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Nerve blocks are great if you have occipital nerve damage--I've had 5-6 of them but the NB doc says I'm done. Too much steroid can cause even more damage. This topic should be in the headache thread but I wanted to give pre-ops the warning!
Capt Deb
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Thanks for the head's up Capt Deb,
I emailed my doctor to ask him his opinon on this. I am scheduled for retrosigmoid on December 28th. I do hope they take all precautions to help the headaches from happening.
Gingerbread6
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Here's an article I googled up on precautionary surgical methods used in retrosigmoid surgery--it is long and has lots of medspeak but worthwhile reading if you are considering surgery.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1151675/ (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1151675/)
Capt Deb
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I'm going o keep bumping this up to the top just to make sure all you pre-ops read it and discuss head position with your docs!
Capt Deb
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Thanks for the info!
I was recently diagnosed and am undecided on treatment.
I have been experiencing headaches daily and mentioned it to the doctor who gave me Ibuprofen 800mg to take 3 times a day for one month! He did however order neck xrays and said all looked good. I have a concern about post op headaches given that I have them already!
I will discuss this info with the doctor next time we meet.
Arrrggghhh!
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You are the best Capt Deb. I saw a pain specialist the other day and he injected the occipital nerve with anesthetic. I had some relief so it is another injection on Wed with an anesthetic and cortisone. He feels my trigeminal nerve is a major problem also. I've weaned myself off the gabapentin, I needed to clear the fog if you know what I mean. The Dr is talking about putting me on lyrica, he said I would take less medication and it is more effective. I'm thinking about it when my head doesn't hurt too much.
Thank you for all of the articles.
Anne Marie
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Interesting post. I also suffered debilitating headaches after sub occipital surgery. When I first saw a physiotherapist who specialized in headache treatment, she put me in a neck brace (the kind one wears after neck injury in a auto accident). I couldn't believe the difference this made for me but, of course, I couldn't stay in this for life. I was weaned off this thing slowly after wearing it for about six weeks or so. My headaches were much better after her treatments and after wearing this support. Perhaps it just gave my neck some time to heal with this support?
Cecile
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After reading this post I decided to get my neck in the best possible shape I can before surgery. My neck on a good day has a tendency to be rather stiff and sore. I made an appointment with a gal that does acupuncture & massage therapy. Hope it makes a difference for me. I am also taking this info with me when I meet with my Doc for pre-opp.
Thanks so much for all the valuable info.
Lynn
Life Is Good
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Bump up for newbies! (is that forumspeak or what!!!)
Capt Deb(http://i235.photobucket.com/albums/ee60/Captdeb_photos/emoticon___pirate_by_anya1916.gif)
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I am floored reading Captain Deb's post and all your replies. I had my surgery (retrosigmoid) in Feb '09 and had my first killer headache/neckache while still in the hospital. I have had headaches, neckaches and major cramps in my neck/shoulder ever since my surgery. My doctor told me I was just stressed out and I should relax ~ It's really annoying getting the pity look from your doctor when he just thinks your a whiner!! Once again, you've made me see that I'm not crazy and am not alone. xo ~Kathy ;D
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Wow! Thanks for posting this thread. I always had PMS headaches, but just now realize that since my surgery my neck is constantly stiff. I can tell if I'm going to get a headache from the tightening in my neck. Will have to look into this more.
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Captain Deb,
Because of your post I had acupuncture & some work done on my neck prior to surgery. I also spoke to the Dr. about it. I really want to thank you as I have had NO headaches & my neck is better than it has ever been. I have had acupuncture since surgery & she has also worked on my neck. I was not a big believer in anything that wasn't black & white but I am becoming a believer in the gray, acupuncture, alternative treatments.
Thanks Again,
Lynn
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If your surgeon is going to change the way he does your surgery because of something you saw on the internet its time to find a new surgeon quick. Find a (or 2-3) surgeon(s) who has lots of experience both current and previous and ask him what he likes to do. Do not try to tell your surgeon what to do, either let him do his job or dump him and find a surgeon you like. If you are not an M.D. you are not qualified to tell a Doctor what to do. I can only imagine the frustration good, experienced doctors suffer whenever somebody "discovers" something and tries to tell the pros what to do. To each his own and I certainly have some minor pain and suffering but I am glad I spoke to every Dr. as a patient not as an expert. Good luck to all and if anyone near the northwest edge of Chicago ever needs help please let me know. I have survived so far so I owe help to anyone
who needs it.
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Thanks for your advice about neck position in surgery. Wish I had seen this in time for my Jan 12 surgery. I had 2 cervical disks removed back in 1989 so have a long history of neck problems. It didn't have headaches prior to surgery but am woken up by them every night and am managing them with Motrin and Topamax. I just hate to be in this position to be taking all this medicine and experiencing these killer headaches. It's downright scary. You think you're going to be found one day on the floor from a stroke. I don't want that.
Anyway, Capt Deb...You've done us a service for posting this. Keep it up!
Thanks...
Mei Mei
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All the things we wish we know ahead of time. I hope one day you wake up and there are no more headaches. I also heard that bone dust left behind is another way that people experience headaches. I DID speak to my doctor about that and he assured me that he would take extra care once I was sawed open (yikes) to clean up well. No headaches but my massage therapist says I have great range of motion in my neck and maybe that's why? Who knows, I was sleepin'
Michelle ;D
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If your surgeon is going to change the way he does your surgery because of something you saw on the internet its time to find a new surgeon quick. Find a (or 2-3) surgeon(s) who has lots of experience both current and previous and ask him what he likes to do. Do not try to tell your surgeon what to do, either let him do his job or dump him and find a surgeon you like. If you are not an M.D. you are not qualified to tell a Doctor what to do. I can only imagine the frustration good, experienced doctors suffer whenever somebody "discovers" something and tries to tell the pros what to do. To each his own and I certainly have some minor pain and suffering but I am glad I spoke to every Dr. as a patient not as an expert. Good luck to all and if anyone near the northwest edge of Chicago ever needs help please let me know. I have survived so far so I owe help to anyone
who needs it.
I actually got the information about head position and related headache from attending 2 AN symposium workshops lead by specialists in the field. The two who clarified this issue for me were Dr Ryzenmann of the Ohio Ear Institute and Dr Leonetti of Loyola. Dr Ryzenman now positions the head prior to anesthesia as a protocol. Anyones surgeon can probably contact either of these Drs for more information on this issue, particularly if you have a bad neck to begin with like I did. If I had had this information prior to my surgery, you bet your butt I would have discussed it with my surgeon!
Capt Deb
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If your surgeon is going to change the way he does your surgery because of something you saw on the internet its time to find a new surgeon quick. Find a (or 2-3) surgeon(s) who has lots of experience both current and previous and ask him what he likes to do. Do not try to tell your surgeon what to do, either let him do his job or dump him and find a surgeon you like. If you are not an M.D. you are not qualified to tell a Doctor what to do. I can only imagine the frustration good, experienced doctors suffer whenever somebody "discovers" something and tries to tell the pros what to do. To each his own and I certainly have some minor pain and suffering but I am glad I spoke to every Dr. as a patient not as an expert. Good luck to all and if anyone near the northwest edge of Chicago ever needs help please let me know. I have survived so far so I owe help to anyone
who needs it.
I actually got the information about head position and related headache from attending 2 AN symposium workshops lead by specialists in the field. The two who clarified this issue for me were Dr Ryzenmann of the Ohio Ear Institute and Dr Leonetti of Loyola. Dr Ryzenman now positions the head prior to anesthesia as a protocol. Anyones surgeon can probably contact either of these Drs for more information on this issue, particularly if you have a bad neck to begin with like I did. If I had had this information prior to my surgery, you bet your butt I would have discussed it with my surgeon!
Capt Deb
Dr. Leonetti was one of my surgeons, I guess I had a good feeling about him from the beginning for a good reason. I go in tomorrow to have my stiches removed and my 4 week post-op checkup. I will be back to work tomorrow if I get the O.K.
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My surgeon explained to me that I was operated on in almost a sitting position (retrosigmoid), like in a dentists chair. That way he could also sit relaxed beside me while operating 7 hours, and he hardly had to turn my head to operate. I had no headaches after surgery and only a slightly stiff neck for 3-4 days.
Dan in Germany