After COVID-19 travel restrictions were lifted, one woman traveled 330 miles to continue treatment at Westchester Medical Center.
By Melissa F. Pheterson As seen in the September 2020 Issue of Advancing Care.
Lynne Schicker was tired of breaking plans and promises because of her chronic migraines.
Often seized with nausea and throbbing pain at 2 a.m., she knew with a sinking heart that the whole next day would be ruined. The 68-year-old from Rochester had suffered excruciating headaches nearly every day since she was 18 years old.
“I tried every medicine and remedy out there, and some had very bad side effects,” she recalls. “I tried Botox and acupuncture; I went to the chiropractor; I wore mouthguards and a device that pulsated on my head.”
She even had a hysterectomy, at 46, when her local doctor suspected hormones might be the cause of her migraines. But the debilitating headaches persisted.
In 2019, she learned about Kaveh Alizadeh, MD, MSC, FAC, Chief of Plastic and Reconstructive Surgery at Westchester Medical Center, the flagship of the Westchester Medical Center Health Network (WMCHealth).
Schicker and Dr. Alizadeh met first through a telehealth video visit. “The first step in identifying the correct treatment was to learn as much as I could about her 50-year history of chronic headaches and pain,” says Dr. Alizadeh, also the program director and cofounder of WMC Headache Specialists.
Then, he posed a question that Schicker says no other doctor had asked before: Had she suffered head trauma at age 18, the year the migraines started? “Yes,” Schicker replied, astonished. That year, she’d been in two car accidents, with a brain bleed that had created scar tissue. A third car accident, at age 26, had sent her head smashing against the windshield. “My right forehead always hurt during a migraine. Dr. Alizadeh was the only one to make the connection.”
Dr. Alizadeh suspected the scar tissue had entangled around the nerves running from the base of Schicker’s neck to her scalp, causing constant pressure and discomfort. He believed she would benefit from a surgical approach to addressing migraines. “Think about carpal tunnel syndrome, where people have tingling and chronic pain in their hands,” he says. “This is a similar concept with the nerves that provide sensation to your head. If nerves are under chronic compression, then disease of the nerves and pain can occur. We decompress or relieve those nerves, so people can get their lives back.”
Migraines By the Numbers
Three times as many women suffer from migraines than do men.*
4 to 72
Number of hours a migraine typically lasts.*
Percentage of the population that suffer from migraines.*
Dr. Alizadeh’s estimated percentage of patients who’ve stopped medications entirely after migraine surgery
Number of patients treated by WMC Headache Specialists since the center opened in October 2017
*Source: World Health Organization/Migraine Research Foundation
Lynne traveled five hours to Dr. Alizadeh’s office to receive a nerve block. If this technique eased the pain, Dr. Alizadeh would be able to identify the impacted nerves and confirm that Schicker would be a good candidate for surgery. After two sessions, Dr. Alizadeh had the confirmation he needed. He performed the neuroplasty surgery in October 2019.
Schicker has been migraine-free ever since — able to honor her commitments, attend weddings, take care of her disabled son, aging mother and 94-year-old mother-in-law, as well as spend time with her three grandchildren. She’s even returned to see Dr. Alizadeh during the pandemic, after travel restrictions were lifted. And most importantly, she is able to do it all without pain.
What to Expect
Before: Dr. Alizadeh’s team will use methods such as ultrasound, MRI or CT scan to pinpoint the location of the nerve and create a “road map” as it crosses the brain and skull to provide sensation to the head. During. “Surgery can take two to four hours. In that time, the goal is to find, isolate and decompress the nerves with precision tools and fine sutures,” says Dr. Alizadeh.
After: “Discomfort lasts up to a week. Most patients are back to their routines within a week and fully recover within a month. Patients have follow-up appointments at the three-month, six-month and one-year mark.”
The Future of Migraine Surgery
In addition to its potential to cure patients and change lives, migraine surgery has a broader impact. Dr. Alizadeh cites mounting evidence that it can mitigate the opioid epidemic, a major public-health crisis in America, by breaking the cycle of dependence on opiate pain medications.
“Like Lynne, patients move from one medication to another. All these drugs affect the whole body. This surgery helps them get off these lifelong medications.”
“People hear ‘surgery’ and ‘anesthesia’ and get scared,” Dr. Alizadeh adds. “The reality is, migraine surgeries can be as simple as most outpatient surgeries — but with outcomes as significant as we saw with Lynne. So, the most important question for patients in pain to ask is ‘Is my treatment enough? Am I getting the result I need?’”