Patient Success Story: Finding My Migraine Puzzle Pieces

At Georgia Vascular Institute, we love to hear stories of success from our patients.

In our latest testimony, patient Susan McManus tells her story of suffering from migraine for 18 years before visiting with Dr. Sendil Subramanian.

I was officially diagnosed with migraine about 18 years ago, but believe I have been suffering since I was a teen. Originally, I just thought I had bad sinus headaches. I was episodic for many years, and migraines did not really impact my life. I called myself a highly functional migraineur.

That began to change about four years ago. I slowly crept from episodic to chronic and, finally, to daily.

I discovered what I would call my first migraine puzzle piece in the Spring of 2015. I was diagnosed with sleep apnea. I started sleeping with a CPAP (Continuous Positive Airway Pressure) mask, and it really made a difference. Currently, I use a sleep apnea mouthguard made by my ENT, who is also a dentist. I find it much easier than wearing an octopus on my face every night.

My second puzzle piece actually relates to the first piece. I was sleeping on my back while wearing the CPAP mask, and this ended up exacerbating an issue going on in my neck that I did not know about at that time. I had degenerative disc disease that caused spinal stenosis. When we discovered this with a neck MRI, my neurologist said I was probably experiencing cervicogenic headache that I thought was migraine. This was in addition to the migraines we knew I was having.

So, in June of 2016, I had ACDF surgery (anterior cervical discectomy and fusion) on vertebrae’s 4/5 and 5/6. The recovery from this surgery is tough, because it actually causes more headaches! I then found myself in MOH (medication overuse headache). Otherwise known as rebound headaches.

My third puzzle piece was to get off the MOH carousel. I spent 5 inpatient days at the Jefferson Headache Center in Philadelphia where they pumped me up with all sorts of drugs. Most importantly, IV lidocaine. It took exactly 24 hours for me to become pain free.

The experience was much tougher on my body than I expected. They had me on Cymbalta for two months prior to my inpatient stay. It took about 45 days when I got home to totally detox from everything I had been on. That took me into early 2017.

I became episodic again with an average of about 10 migraines per month. Compared to what I experienced previously, I was happy with this and feeling really good. I rejoined Weight Watchers and have now lost over 30 pounds. My outlook was certainly better. When you are in chronic pain every day, for two years, it is good to feel good!

Fortunately, my story doesn’t end here. I slowly felt more chronic pain again as the year went on. At the end of January this year, 2018, I began what would be a 50-day migraine. I hit a very low point emotionally, because I thought I had fixed myself with finding these three previous puzzle pieces.

That brings me to my fourth, perhaps most, important puzzle piece. SphenoCath. This is a procedure that inserts a catheter up your nose, deep into your nasal cavity where lidocaine is then delivered to your SPG nerve (Sphenopalatine Ganglion). I have known about this procedure for a couple of years but could only find it being done in chiropractor’s offices. Unfortunately, my neurologist was unable to do this for me.

During my 50-day migraine, I found through research the procedure being done by an Interventional Radiologist, a doctor that works on varicose veins and uterine fibroids. I found a fabulous doctor, Dr. Sendhil Subramanian.

I went to his out-patient treatment center for the procedure where he uses x-ray guidance and contrast to see where he is placing the catheter. This is why a chiropractor’s office, or even a neurologist’s office, cannot perform this procedure. They would be going in “blind” without the x-ray and contrast.

It took all about 20 minutes, and I drove myself. When I say that this has been life changing, I am not exaggerating. I am 60 days out from my first treatment and I have had 2 migraine days. Only two!

For the SphenoCath procedure, you receive three treatments that are two weeks apart. I am now over 4 weeks from my last treatment. The doctor has scheduled a “maintenance” treatment for August. But, if I feel like I’m falling back into the migraine rabbit hole, I can go sooner. Since it is lidocaine, I can get it as often as you need it.

The SPG and the Trigeminal Nerve start to learn how to only fire their pain cylinders. The lidocaine gets in there and settles things down. It “reboots” the circuit.

I am feeling the best I have felt in years. I haven’t gone so many days without a migraine in ten years! It has actually been a strange adjustment to feeling good when you keep feeling like the other shoe is going to drop! If the other shoe finds it’s way out, I will just go earlier to get another treatment!

In closing, I want to say that I do not take any daily preventatives. My pain-free status right now is all because of this treatment. Don’t give up researching to find your migraine puzzle pieces. It is a very slow process, but hang in there and be your own best advocate. And, go see Dr. Subramanian!

If you or someone you love is experiencing similar migraine pains, schedule an appointment or a telemedicine appointment with one of our migraine experts today!

Written by Patient Susan McManus