Peled Migraine Surgery Blog

Information and knowledge about migraine relief surgery.

9 minutes reading time (1769 words)

Real Patient Stories: Eleanor

RPS Eleanor 2

What is your name?

Eleanor Thaler.

Where are you from?
I am from Eugene, Oregon, but currently live in Minneapolis, Minnesota.

What was happening in your life before the headaches became chronic?
I started having migraines at age 14. At that time, I was a typical, young student heavily involved in both music and dance. Outside of school, I took lessons in piano and violin as well as ballet and pointe.

How long ago was that?
At first, the migraines occurred every other day, beginning when I was 14, and I would plan my life and schoolwork around this schedule. Throughout high school, my headaches increased in frequency until I was having 5-6 headache days per week. When I started college at age 18, my migraines became constant and more intense. I had two procedures with Dr. Peled--one at age 20 and one at age 21. I am now 22.

Describe a good day with chronic pain.

On a good day, distraction from pain was possible. When I was able to adequately manage my pain with medication, I spent time with friends or studied in the library rather than my dimmed room. If I had enough energy, I could go to the gym or for a short run, although my energy was limited.

Describe a bad day. What does/did the pain feel like.

During college, my pain was constant. Pain was always there, waiting for me, when I woke up in the morning, and it would increase steadily throughout the day. It felt like a stake had been driven through my right eye and was being continuously hammered into my skull. I would take naps for 2-4 hours daily, as focusing during morning classes while struggling against mounting pain was utterly exhausting. As the day wore on, I would become dizzy and nauseous as the pain worsened, and eventually, my hands would start to shake, making it difficult to write or study. More than once, I had to wear sunglasses to my afternoon classes to tolerate even the dim fluorescent lights in my lecture halls. After school, I would drag myself home and collapse in my darkened room, and I counted the hours until I could sleep again.

A social life was not an option. It became too painful to watch friends become disappointed and frustrated with me when I was no longer able to attend social outings; most of my friends fell away over time. Focusing my attention on school, in an attempt to distract myself from pain, was what made it possible to endure the suffering. I dreaded the time that I had to spend awake each day. At my lowest point, I only kept myself going for the sake of my parents.

ET Before painWhere did you experience the pain?

My pain was located just above my right eye with occasional radiation to my right temple.

What meds were you taking?

I had run the gamut of available medication, both prophylactic and abortive, for migraine pain. For prophylactic management, I had tried topiramate, lamotrigine, gabapentin, propranolol, indomethacin, nortriptyline, amitriptyline, Fioricet, duloxetine, riboflavin, and magnesium. For acute management, I had tried Toradol injections, sumatriptan, naratriptan, eletriptan (my personal favorite), rizatriptan, and zolmitriptan. I had prescriptions for two triptans at a time and would cut tablets in half to ration them throughout the month. I knew I was giving myself rebound headaches by taking medication too frequently, but I didn’t know what else to do

Did you have any success with other pain relief methods besides medication?

I tried trigger point injections and Botox injections. My first round of Botox gave me significant relief, but I did not get any relief from the second round. Trigger point injections only helped for a few days at a time. I also tried massage therapy, physical therapy, acupuncture, meditation, and dietary changes without much relief.

How did you hear about Dr Peled?

After six years of worsening pain, I often felt forgotten by my providers after the first few treatment attempts were unsuccessful. I got the sense that my providers did not understand just how much my pain had taken from me. I began to feel invisible. Desperate for relief, I began conducting my own research into treatment options and clinical trials. I found Dr. Peled’s work through a database of clinical trials. I followed the study for a year and a half before I reached out directly to his practice.

What inspired you to speak with him?

After being told several times by other providers that I was out of options, I decided it was time to take the initiative and reach out to Dr. Peled’s office myself. I had followed the clinical trial for over a year and a half, and I knew it was time to trust the research that I had done and be my own advocate.

Tell me about your surgery, including when you had it, what happened.

I have had two procedures with Dr. Peled. My first procedure was in May of 2016. I arrived on a Friday and had diagnostic nerve blocks that significantly reduced my pain. Surgery took place the following Monday. At that time, branches of my right auriculotemporal, zygomaticotemporal, supraorbital, and supratrochlear nerves were cut and embedded into the surrounding muscle. In addition, my right supraorbital notch was widened to relieve the compressive pressure on my supraorbital nerve from a nearby blood vessel. I saw Dr. Peled two days post-op for a follow-up appointment and flew home to Oregon later that day. He continued to check in periodically throughout the year by phone.

About one year after my first surgery, my pain returned. I again tried conservative pain management without significant relief. I reached out to Dr. Peled’s office again and scheduled a second trip to see him. This second procedure was in January of 2018. I again arrived on a Friday for diagnostic nerve blocks. During my second surgery, Dr. Peled found that a separate branch of my right supraorbital nerve was embedded/encased in my frontal bone. He chiselled off small slivers of my frontal bone to free the compressed supraorbital nerve and then used fat from my eyelid to pad the nerve and protect it from further damage. By doing so, he was able to salvage the nerve. I flew home following my post-op appointment two days after surgery. In January of 2019, I had my final follow-up call with Dr. Peled one year after the second surgery.

Do you remember how you felt in the first few days after surgery?

I woke up from my first surgery without pain. I did not need any post-operative pain medication,  and was working full-time one week after surgery.

My second procedure was more extensive, and thus recovery was a little slower. Still, I only required pain medication for two days following surgery. I had intermittent swelling in the right supraorbital region (which was expected) over the first several months, but this decreased in both frequency and severity over time.

ET After outside on the beachHow are you feeling now?

Since my recovery, I have had the privilege of watching my limitations fall away. I now live a life without pain, and only get occasional tensions headaches (once or twice per month) that respond to Excedrin. Prior to surgery, my headaches could not be managed by OTC medication.

How has your life changed as a result of this surgery?
I am able to work a full-time job with a variable schedule, including overnights, without pain. I can drive places without being afraid that I will be in too much pain to get home. I don’t need to nap during the day, and I don’t need to make sure I have triptans in my pocket every time I leave the house. Most importantly, I can be more present in my life and engage fully in the things that interest me. I certainly live more courageously now that pain is no longer a looming presence in my life. I am able to have closer relationships with my friends and family now that I have the bandwidth to do so. For a long time, pain was in the driver’s seat of my life, but now I am in control and get to choose how to use my time and energy each day. After eight years of merely surviving, now I am able to really live.

What is next for you?
After a relatively non-linear path through school due to pain, I am so excited to be starting medical school in the fall. My journey through pain (and the opportunity to help other patients feel supported during their own journeys through illness) was largely what drew me to a career in medicine. The relief I have gotten from my surgery is what made the pursuit of this dream possible.

What would you say to anyone wondering whether to meet Dr Peled?

I hardly have words to describe how grateful I am for having met and been treated by Dr. Peled. He is truly at the top of his field. There is no better time than now to take control of your story and reach out for help – there are so many wonderful things to be a part of in the world when your experience isn’t overrun by pain! My experience with Dr. Peled gave me my life back, and I will forever be grateful for him and his incredible team for taking such good and thorough care of me.

Describe your overall experience with Dr. Peled and his office.

Dr. Peled was the first provider to validate my experience and make me feel seen.  Not only did he listen, but I felt that he truly heard my story and my experience. I felt 100% supported by him every step of the way, even when I required a second procedure a full year after my first, and this meant more to me than I can express. Dr. Peled never gave up on me nor hope for improvement in my pain, and I am so incredibly lucky to have been under his care.

As a young student traveling to the practice from far away, I was nervous leading up to my initial consultation, but Cary-Anne set me at ease and answered all of my questions. She made me feel so comfortable and welcome when I arrived for my appointment, and I am very grateful for her support along the way.

Do you have any advice for prospective patients who are thinking of coming to the practice?

Now is the time to make a change and take your life back – go ahead and call!

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Thursday, 25 April 2019

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