Headache 360 – A Severe 15-Year Headache: A Prolonged Recovery and a Light at the End of the Tunnel

00:01 — Announcer:

Welcome to the Headache 360 Podcast, a place to listen and learn about the diagnosis and treatment of chronic headache and migraine pain. Because information can be the best medicine.

00:17 — Dr. Lowenstein:

Hey everybody. We’re going to be doing this both by video and as our next episode of the Headache 360 Podcast. And we’re going to talk today. I’m going to talk today, and you’re gonna hear directly from, for the most part, one of my most difficult patients. And I mean that in the sense that she is one of my favorite patients, an absolutely lovely woman with a spectacular family, but she is the most difficult patient that I’ve had to deal with as far as her post-op course for both of her surgeries has been very difficult.

And I kind of wanted to let you all know about like a worst-case scenario. There’s so many, you know, on my website you’ll see testimonials of people who like right in the recovery area, they didn’t have a headache again. And that happens a lot. It happens that way much more often following headache surgery that people get an immediate improvement of some type, either complete or significant improvement in the weeks or months following their surgery.

But occasionally it takes a long time. It can take up to six months to recover from the surgery and really see the benefits. And that can be hard. It can be hard for the patient, it can be hard for me, it can be much harder for the patient.

And in this particular case, Christa, who you’ll hear from, she had a tremendously difficult situation before I took her on as a patient. Car accidents and multiple head traumas, hospitalizations, Lyme disease, malaria, just a tremendous amount of systemic problems that left her, I guess, somewhat debilitated, with severe headaches all the time for about 15 years.

She’s seen a tremendous number of physicians. She’s actually from rural and very beautiful Canada, which you’ll actually get to see that too. But she’s from British Columbia, and man, the story she told me, she’s told me about the difficulties that she’s had are really moving.

And we did two surgeries. I did two surgeries on her. She came in with constant occipital headaches. We did an occipital nerve release.

And the first video you’re gonna see, which you can also find on my website, is kind of her, I hate to say the word testimonial, but a testimonial after her first surgery and shortly before her second surgery.

So her second surgery was done about five months after her first surgery, and she came in, she flew back from Canada to have her anterior nerves released, the nerves above the eyes, which were constricted.

And again, this is a little on the advanced side of discussion. I’m not going to go into the mechanisms and whatnot of nerve release and headache surgery, migraine surgery, these issues, but you can find all of that on headachesurgery.com on our website.

But the point of the story is she had debilitating headaches, and we did migraine surgery, migraine surgery, headache surgery, and nerve release surgery, all the same thing, on her occipital region and protracted difficult recovery.

And then we did the operation for her frontal headaches because frontal headaches are mediated by nerves in the front, and occipital headaches are caused by nerve compression in the back.

So we fixed her back, then we fixed her front, and she again had a really protracted, very difficult recovery.

And so between those two surgeries, we did a small discussion here in the operating room, actually in the office, which is on the website, but I’m also including it here as the first video that you’ll see.

And then we did our second surgery about five months later, which is about seven months, six, a little over six months from today.

And today is June 4th, and the significance of today is nothing, the significance of yesterday is that it’s a year out from her first surgery.

And so last night she sent me a video, so it’s not an interactive discussion, it’s just her talking about her journey and the recovery.

And I want people to understand that sometimes it goes great, most of the time it goes great, sometimes it takes a long time, and for those few patients that it takes a long time, I hope you can find inspiration in this video that it gets better.

But first thing you’re gonna see here is the video from after the first surgery before the second surgery.

And you’re going to see me kind of interject in different parts of her videos, so I can do a little bit of discussion and tell you things about what’s been going on.

So I hope you enjoy listening to her. She’s a wonderful young lady, and she’s been through a lot.

Alright, so we are here with Christa.

07:07 — Christa:

Hi, I’m Christa.

07:10 — Dr. Lowenstein:

And so let’s see, Christa, you had this is your second visit to us, right? Because we did your occipital surgery how long ago?

07:22 — Christa:

Five months ago.

07:23 — Dr. Lowenstein:

Five months ago, okay. And you’ve had not the easiest go of it, which is why we want to make this video so everybody sees that there are a couple different ways this can go. But we’ll skip to the end. It ends good.

But why don’t you tell me about how things were after the surgery and subsequent to that?

07:48 — Christa:

Yeah, for sure. It was definitely a bumpy recovery for about the first four months post-op. I actually had some of the old pain I had experienced for almost 15 years, plus some new pain. It was perplexing and

07:48 — Dr. Lowenstein:

Unnerving.

07:48 — Christa:

Unnerving. And yet, and yet right around the four-month mark, some massive changes started to happen and they’re lasting.

And so something really encouraging too is that even with the consistent old triggers, it didn’t make the back worse, i.e., dental appointments, barometric pressure changes, things like that. So that was super encouraging.

08:31 — Dr. Lowenstein:

And you’ve, I mean your particular case is worse than many. So I mean like just talk about what life was like before you had the first surgery.

08:40 — Christa:

Yeah, so basically in 2007 I was in a rollover car accident off a cliff and quite a lot of head trauma from that accident, and then a year later, another rollover car accident, avoiding an elk on the highway, and that also had some impact to the head.

08:55 — Dr. Lowenstein:

And I just, I mean it wraps a little bit, because we don’t have elk here in Santa Barbara. I don’t want to, so where are you from?

09:01 — Christa:

I’m from Canada, yes. I know if it was a moose that would be even better.

09:05 — Dr. Lowenstein:

That’s true.

09:06 — Christa:

But around the same time I was bitten by a tick and was infected with Lyme disease and sister to malaria. So it was sort of a perfect storm with a lot of adjutants potentially to the nerves, right?

And so, and then with the Lyme came seizures and I would often fall and hit my head quite hard. Back, side, front, all over.

And so it’s, yeah, it’s been 15 years almost of, you know, trying everything. We’ve tried every, I mean, even our Canadian system said I exhausted the Canadian conventional system, tried lots of natural things as well.

Nothing offered more relief than honestly hours or at most a couple days, and so yeah, it’s been a long journey.

09:46 — Dr. Lowenstein:

You were spending a lot of time in bed.

09:46 — Christa:

Yeah. We have been blessed with three little boys, but often I am not able to tuck them into bed. I can’t participate in family gatherings sometimes, and even meals, you know, just the day-to-day enjoyment of life isn’t always possible to participate in that.

It’s heartbreaking. It doesn’t get easier actually, it gets harder.

Yeah, but it’s been amazing the last while that the back has been so much better that I find I’m even able to get out of bed a little sooner in the mornings, and some, yeah, like I said, the old triggers are not causing the aggravation that they were.

So my baseline head pain for almost 15 years has been between a four and seven over the whole head. And slight triggers like smelling perfume or cigarette smoke or whatever, lighting, barometric pressure, flying in an airplane, all those things would send it skyrocketing to an eight or nine out of ten, and that’s where I couldn’t push through anymore.

So right now, the front is at about a six or seven right now that I’m just pushing through. But I look forward to when that goes down too.

10:53 — Dr. Lowenstein:

And so what’s the back now?

10:56 — Christa:

Like a two.

10:56 — Dr. Lowenstein:

Yeah.

10:57 — Christa:

Yeah.

10:57 — Dr. Lowenstein:

Okay. That’s great.

So, and you know, just from a surgeon’s standpoint, I always love it when right after the case, people don’t have any pain anymore, and it’s all wonderful.

But, you know, we always talk about how this can take three to sometimes six months for things to equilibrate and get better, and it is as hard. No, it’s probably not as hard for me as it is for you, but it is very hard for me as well.

Just, you know, those phone calls that we did for follow-up, where you know, you can’t comb your hair, you can’t touch the back, you know, the pillow, yeah, all of those things.

And you know, that was, it was hard for me to listen to as well. Yeah, but we kept on saying the same thing, you know, we know this can happen, and it can sometimes take up to six months.

And it just, that follow-up call that we had at four months where you’re like, yes, I can go to church and I can do stuff again.

And that was just, yeah, I mean, it was as wonderful.

So, but we knew going in that you had some issues with the nerves in the front as well as the occipital nerves. So first round we took care of the occipital nerves.

12:10 — Christa:

Yeah, because that one never ever let up, whereas the front can sometimes ebb and flow a little more. So I’m still thankful we did the back first.

12:17 — Dr. Lowenstein:

Okay.

12:17 — Christa:

And I’m just so grateful for your compassion, like that you were always very efficient and realistic and practical, but also compassionate.

I think that’s a pretty, I’ve seen more doctors than I can count over the last 15 years, and I really appreciate that from you. There’s the professionalism, but also compassion, and I think that’s a real blessing. So I’m grateful to God for you.

12:35 — Dr. Lowenstein:

Well, I’m grateful that you’re here and grateful that I’ve got such great patients. So it’s good.

So we’re going to go and do some injections.

12:45 — Christa:

Yep, this I think everyone watching understands the value of real support, and this man’s been with me from the very beginning.

12:52 — Dr. Lowenstein:

He’s been fantastic. It’s the real deal.

Yeah, it’s just this, from again from a doctor’s standpoint, it’s what you really hope for in somebody.

A support system is super important, and it’s not easy. You are very lucky to have that support.

13:03 — Christa:

I think they suffer almost more sometimes, right?

13:08 — Dr. Lowenstein:

So next time, next time we bring your kids. Hopefully, sadly, I’d like to see you another time, but that may be just to visit because we did a part of our last operation.

So we’re going to do our nerve blocks today, and then we’re scheduled for surgery in two days to do the front.

Yeah, but we wanted to get this video in because I’m not going to pull you back down from Canada through a canceled flight in San Francisco just to make another video later about how the front went.

Thank you very much for your time.

13:29 — Christa:

God bless, and do not give up. Those who are watching, I was you at one point watching Dr. Lowenstein’s videos, and I’m so glad I did.

13:52 — Dr. Lowenstein:

Oh, that’s all. Alright, so you heard of, that’s the video that we did after her first surgery.

And so her first surgery was for the pain in the back of her head, and that was, you know, again, these chronic migraines that she’s had.

And she’s had so many diagnoses, and you know, this is, we gotta, I gotta do another video about how so many different diagnoses are actually tied into the same cause, which is irritation of peripheral nerves.

And so she had really problematic occipital nerves. And at her first surgery, I went down to those occipital nerves and I released them from the surrounding tight irritating tissues.

And her nerves in particular looked terrible, and we released them and they, it took a while to heal.

And so what you’re going to hear now is about her second surgery.

So after what you just heard, she still had anterior nerve compression and nerve irritation, so that was providing pain up here.

And so, you know, this is from years and years of head trauma and systemic disease, and it’s, it was just, it was problematic.

She had in the front, you have your supraorbital and supratrochlear nerves that are usually what are causing the pain that is right here behind the eye.

And one of her nerves was traveling through bone, and so that bone had to be taken away to decompress the nerve so there wasn’t so much compressive force irritating the nerve.

But there’s also muscular issues and things like that. We had to dissect the nerves away from the muscle.

And again, remember these are all sensory nerves, nothing, there’s no motor nerves, there’s no risk of paralysis, there’s nothing like this.

The biggest risk is actually what you’re seeing here, which is a just a protracted, difficult recovery.

But she fortunately is one of the 93% of people who at the end you’ll hear has found significant life-changing improvement from headache surgery.

And so I hope you learn a lot from what she has to say.

Okay.

16:36 — Christa:

Thanks for watching this in advance.

Today is the 3rd of June, which marks exactly one year since the first surgery.

So Justin and I thought that we might give you a little update.

We haven’t connected in quite a while. I think the last time we talked live was right before Christmas. Is that right?

Anyway, thank you for always being available and willing to connect, but part of the reason I didn’t reach out is because it has been such a brutal recovery again.

And I think I was just feeling such a weight of, I’m just really overwhelmed and didn’t want to disappoint, you know, one more person.

And I know it’s not my fault and I know all that, but just saying it out loud to one more person how awful it was, just I didn’t want to do that.

And I just wanted to wait till I could share good news with you.

16:36 — Christa:

Thanks for watching this in advance. Today is the 3rd of June, which marks exactly one year since the first surgery.

So Justin and I thought that we might give you a little update. We haven’t connected in quite a while. I think the last time we talked live was right before Christmas. Is that right?

Anyway, thank you for always being available and willing to connect, but part of the reason I didn’t reach out is because it has been such a brutal recovery again.

And I think I was just feeling such a weight of, I’m just really overwhelmed and didn’t want to disappoint, you know, one more person.

And I know it’s not my fault and I know all that, but just saying it out loud to one more person how awful it was, just I didn’t want to do that.

And I just wanted to wait till I could share good news with you.

Anyway, I know you have your own life, and it’s not like you would lose sleep over it or anything, but I know you deeply genuinely care for each of your patients.

And it’s been a long road. It’s been 15 years now.

So anyway, thank you though for always being willing to chat.

Two main things. I just wanted to give you a bit more of an update on what happened through the winter and early spring, and then tell you where things are at now.

Okay.

I believe it’s been 12 months to the day. I don’t know, I’m feeling a little bit just emotional about it.

Not necessarily in a crying way, but just really stirred and like this is just so incredible that a whole year has gone by and what a year.

But anyway, so yeah, basically the recovery initially was quite rough and it was essentially the same as before the surgery, plus a lot of new uncomfortable, horrible sensations.

So I was still getting almost daily migraines and constant head pain, plus a lot of the new nerve sensations.

And I was developing, I was hardly sleeping, like two to four hours a night on average, which just was insane.

But God really did sustain me and keep surrounding our family with so much support.

19:17 — Dr. Lowenstein:

So, here again, what I want you to take away is that while a lot of patients get immediate relief that’s either complete or partial, sometimes migraines come back.

And sometimes, yeah, they can even be worse.

And you have these sensations from the actual nerves that are irritated from the actual surgery.

So they’re irritated from potentially years of irritation, but also when I manipulate them and free them from the surrounding structures that are squeezing on them and causing them to send these distress signals to the brain, which is what is actually causing the headache.

So while they’re recovering, they can do some weird things.

And Christa, she had these wasp stinging pains, and sometimes there’s itching, and sometimes it feels kind of creepy crawly, and sometimes it’s kind of just like the area is that numbness feeling.

And there are some drugs that we can prescribe to help to some degree for those kinds of feelings called gabapentin, which I’m sure several of you have been on.

Some people tolerate it well, some people don’t, and Christa hates it, and you’re going to hear a little bit about that in a little while.

But again, you know, when what we’re doing is freeing the peripheral nerves from the surrounding compressive forces that are irritating them, and that is causing those irritations that are causing distress signals to go to the brain, and that is causing the headache.

So we’re cutting the headache off before it starts by freeing these peripheral nerves.

But the peripheral nerves, they let you know that something’s going on sometimes when in the post-operative period.

And so some people do struggle with ongoing migraines and sometimes even motioning pain, as Christa did.

21:32 — Christa:

But anyway, it was rough, it was brutal.

Lots of those wasp stingy things and zigzag electric sensations and jolty sort of zappy feelings and crushing, you know, like vice feelings a little bit more than usual.

And violent, violent migraines, lots of vomiting, lots of visual disturbances, and a lot of extra pain around this eyebrow, which I’m not sure which side you chipped away or rubbed away or whatever you do, some of the shaved away some of the bone or whatever.

I’m guessing it was the left side, but anyway, you can correct me if it was the right.

22:10 — Dr. Lowenstein:

So again, here she’s talking about the area where I had to take bone away from the supraorbital nerve because sometimes the supraorbital nerve comes through a little notch and there can be some connective tissue that’s pushing on the nerve at the bottom of that notch that we can release.

But a lot of times the nerve is actually coming through what we call a foramen, so a hole in the bone.

And so that bone is tight around that nerve, and I actually have to take some of this bone away to allow the nerve to be a little more free in that canal, and that’s what that’s what she’s talking about here.

22:52 — Christa:

That was really, really difficult. I had not struggled in that way since I was sick with Lyme disease, malaria, and mold-related issues.

22:52 — Dr. Lowenstein:

Here again, she is referring to those systemic diseases.

Now so many different people have so many different reasons to have headaches, and people are just born with compression of their nerves.

And I saw two patients actually yesterday, and both of them have had headaches since they were a child, and I tell them it’s just, it’s how you’re built.

You know, you’re this tall, your hair is that color, and your nerves happen to be irritated because there’s tight tissue around them, and it’s just the way you are.

Other people have head trauma, other people have just systemic disease that causes nerve problems.

Unfortunately, Christa had some of both trauma and long-standing disease.

So, anyway, here’s more.

23:58 — Christa:

I’m thankful that is behind us.

Okay, so about around Easter, which is exactly when you predicted that I would maybe start having some relief.

Do you remember saying that? I’d forgotten. And yeah, Justin remembered.

So, right around maybe a week before Easter, I started to notice the wasp sensations were diminishing and becoming less severe and less frequent, and every day it would just get better and better.

And it took about three weeks for them to fade away completely.

And I’ve literally only had, I can count on basically one hand, well maybe not one hand, two hands, how many times I’ve had sort of episodes of that again since then.

And there was always a reason. There was always a reason, like maybe I had a cold I was fighting off, or maybe around my period or something.

But anyway, what is so encouraging to me is the last three or four cycles with my menstrual cycle have not looked at all like what it looked like before the surgeries.

So for 14 and a half years-ish before, sometimes during and for sure afterwards, menses, I would have crushing, debilitating migraines where I couldn’t even move my eyeballs in my head.

I would be, I’m in our bedroom right now, and I’d just be writhing in bed, literally having to think about each breath, or I couldn’t breathe.

It was vomiting, not eating for days, not being able to walk really.

I would have to have help walking to the bathroom. Every step would just make the nine out of ten pain even worse.

And super dizzy and crazy visual stuff.

So it was like all the usual painful sensations were just way worse.

You know, I’ve been used to living with a four to seven out of ten.

I just don’t want to keep using the word pain, agony, torture, extreme discomfort, pretty much 24-7.

But consistently there would be certain triggers, right, that would make it way worse.

Anyway, let’s just, I’m trying to be concise, but you know me, I’m not very good at that.

So that’s been incredibly encouraging.

That is no joke to have that part of my hormone cycle come and go for the last three to four cycles.

I think it’s been four cycles actually.

26:28 — Dr. Lowenstein:

So with menstrual migraines, you know, again, it’s suspected that the hormones cause changes in the tissues, as you know, all women would be able to tell you that you sometimes retain water, etc.

And those things are global in the body.

So as muscles swell around the time of menses, you know, again, more compression can happen on the nerves, thus more headaches, more severe headaches, and so I think that’s what Christa was experiencing.

27:15 — Christa:

Because yeah, we’re June now, and I just finished. Yeah, I know you’re a doctor, so it’s not like it’s grossing you out.

But anyway, I’m technically day like seven of my cycle, and that would be the worst every single month.

I would like I was describing to you, that’s what would be happening.

So it would happen before menses, sometimes during a little bit, and certainly afterwards for at least 24 to 72 hours, sometimes longer.

And yet, yeah, the last several months have not been the case, and yes, I have a bit more discomfort around that time and even mild migraines, but taking a couple Motrin or Aleve or whatever significantly helps, which was unheard of before the surgeries, unheard of.

27:15 — Christa:

Because yeah, we’re June now, and I just finished. Yeah, I know you’re a doctor, so it’s not like it’s grossing you out.

But anyway, I’m technically day like seven of my cycle, and that would be the worst every single month.

I would, like I was describing to you, that’s what would be happening.

So it would happen before menses, sometimes during a little bit, and certainly afterwards for at least 24 to 72 hours, sometimes longer.

And yet, yeah, the last several months have not been the case, and yes, I have a bit more discomfort around that time and even mild migraines, but taking a couple Motrin or Aleve or whatever significantly helps, which was unheard of before the surgeries, unheard of.

Okay, other triggers.

We drove to the nearby city close to us called Kelowna, and you guys have to come up and visit. You seriously do.

We’ve got a little guest cottage and you have to come and stay in it.

But anyway, we drove to Kelowna, and no joke, the last 15 years, every time we would drive to Kelowna and go through the elevation and then back down again, I would get a migraine on top of either already a migraine or just the regular pain.

And I’d always have to have a vomit bag with me.

Yeah, nothing would help.

I tried, you know, taking naproxen or whatever before we would do the drive. Never touched it, never helped.

And so I just planned for it. I just would know that that would happen.

Well, we just went last weekend to visit my brother and his wife there, and didn’t even feel the elevation changes.

No visual disturbances.

Sometimes I would get numbness on the left side of my face, the nail driving into here, the horrible like temple discomfort, all the, no yeah, just the nose area, just all of it.

Everything would just feel it, you know, super bad.

And that didn’t happen.

I can’t wait to fly and see if there’s a difference when I fly, because I’ve, anyway, flying’s been a nightmare for these last 15 years, so I actually look forward to flying again.

And what else?

Weather changes have been way less dramatic.

Still, you know, sometimes it makes it worse for sure when it’s sunny and high pressure.

I’m a high pressure kind of headache girl, which is way more rare.

I remember over the years seeing pain specialists and neurologists and all this, and even some natural doctors and doing, you know, craniosacral stuff or whatever, and all of them would just say that’s so rare.

Usually it’s people get headaches more on days like today. It’s cloudy and rainy today.

But anyway, yeah, even on the super sunny, high-pressure days, my head holds its own really well.

I am participating in life more without having to sneak away from events early or gatherings early.

I’m able to eat dinner.

Like, first I’m able to make dinner more consistently, make lunch more consistently, and then sit and actually enjoy meals with the family.

Often I would have to choose, like, I will push through and make the meal, but I can’t sit and enjoy it with you guys because I’d be in way too much pain, and I’d just back in bed, curtains closed, all of that.

But now I can make the meal cheerfully and enjoy it without pushing through these thick walls of pain, and also sit down and enjoy the meal, which is just incredible.

I mean, you know what a gift it is to be with our loved ones, and there’s just no comparison to the joy of being less hindered and being able to just witness the day-to-day life.

That’s the most precious part.

And we are still meeting together with our church family, and we host in our backyard.

And I’m able to sing most Sundays up front, sort of helping lead the singing, and so not only can I sing without it triggering crazy migraines, but I am able to stay outside and enjoy the rest of the get-together.

And we have potluck lunch together every week.

There’s usually about 50 to 75 people that come, and just to be able to interact and mingle with everyone afterwards, and I’m staying outside now until the last family leaves, like around two o’clock.

People are usually here from 10-ish, helping set up until 2-ish or even 3-ish, and I’m able to be out participating the whole time, fully on, fully engaged, and fully feeling like myself and not having to smile through.

And that’s surreal, that’s incredible.

Yeah, things like crying, laughing, talking a lot are not causing the same devastating agony that I would pay for literally days sometimes after.

34:41 — Dr. Lowenstein:

So, just for information, Christa has three beautiful children and Justin, her husband, and you can see a picture of them here.

And just a really lovely family, but I’ve got a boy and a girl, and I can’t tell you randomly my son is a feature.

Three boys, a tremendous amount of energy, and it can be so difficult when you’ve gotta do stuff for the children, but you’re in such severe pain.

So I’m really glad things are better enough from that standpoint for her whole family.

35:28 — Christa:

And it’s not anymore at all.

And yeah, our boys are eight, six, and four now, and just such a huge help and such compassionate, amazing, hardworking, cheerful little guys.

And they’ve learned so much from having a mama who’s been so limited physically.

We went to Walmart the other day, which I know that sounds like such a simple thing, but it was a huge deal to be able to go with all three boys.

And you know, yes, I would run errands with them over the years when I could push through.

But again, it was immense pushing through and literally trying to breathe differently while we’re out running errands and just praying we wouldn’t run into anyone so I would not have to use more of my energy.

And not that I would get tired, but just literally it’s like the pain is sucking so much life out of you all the time, right?

I’m sure you understand that with your head stuff when it’s bad, or you know, during residency and stuff.

So that was not the case.

I actually get excited to run into people.

Adam, I’m not joking.

I realized the other day I was going to visit, drop off a birthday card for my auntie, and my parents said, “Oh, she’s already out of town, her and her hubby are going camping or whatever,” and so I thought I’ll just drop it off at the door.

Okay, so I pull up near to their house and their big camper is still there, they haven’t left yet.

And I’m not joking, for all the last 15 years, I would have this sense of dread and massive panic, thinking if I had to be around someone unexpectedly and just knowing what it would, how it would, you know, the talking, the smiling, the even moving my eyes too much, all these things would make my head way worse.

Like it was just signing up for so much more agony and worse migraine stuff.

But this time when I saw their camper, I was excited to see her.

I was excited they were still there, and I hopped out of the van.

I was like, boys, I’ll be right back.

They were just, we were just parked on the curb and ran up and couldn’t wait to see her and hug her and talk with her and listen to her.

And that was a huge shift for me, and it just made me realize how much better my head is.

Man, and there’s so many other stories, but basically, I guess I just wanted to communicate how you were right.

Remember when you were hesitating about operating here and here, and I said, “Doesn’t matter, let’s do it anyway, even if it’s the worst recovery ever.”

And you were just hesitant because of how brutal the occipital recovery was.

Well, as I’m like, oh, my death back there.

Oh, that’s why I wanted to start this video.

Sorry, I’m doing those squirrel things.

One sec, I want to show you something.

But anyway, it was wonderful to see her.

There’s something else I was gonna say.

Okay, this is what I want to show you.

I was going to start the call with my hair up in a bun to show you that my hair can mostly stay up.

And it’s not, it’s not that it’s about the hair, it’s about the length of time that has passed.

Okay, see there’s a little bit coming out, but yeah.

I remember so vividly when you shaved it and just how real it made everything feel, you know.

38:36 — Dr. Lowenstein:

So now here I want to be clear, we don’t shave your head. When we’re doing posterior surgery, different people do it different ways.

I do it through a single midline incision, a single incision that’s about four or five inches long that is in the hairline.

So I don’t know if we can pull this off, but I shave just a strip of hair right here.

And so for people like Christa who have long hair, you can’t even notice it unless your hair is up.

People with short hair, it grows back faster though, so there’s plus minus to both sides.

So, but from the sounds of that, it sounds like I shaved her whole head, which I categorically I don’t do.

So there you go.

39:30 — Christa:

Okay, the scars are looking amazing. Can I show you?

Oh, and I do have something to say, it’s a little bit gross. Maybe this happens, maybe it doesn’t happen. I don’t know if it’s because I, I don’t even know why.

But basically, after the first surgery, I would get these blemishes, like these sort of pimple-type sores all around the scar area, way after the scar had healed.

Like it was white and closed and totally great.

So it’s, yeah. I don’t know if it’s toxic type, like toxin type stuff. I don’t know. That sounds weird. I don’t even know.

But anyway, it happened again after the first surgery. Like I got these dot-like bumps around here.

40:13 — Dr. Lowenstein:

These kinds of sores are not usual.

I did not get to see them because she was in Canada.

Sometimes people have reactions to antibiotic ointment that can cause irritation, but what she is describing is not a usual occurrence.

40:33 — Christa:

They hurt, and I cannot really touch them.

Oh, and that’s the other thing, I still can’t quite touch firmly around here, but look, I can do this and I can do this.

Which I couldn’t do that for the first five months after the surgery, no joke.

Putting in contacts every day, brutal, but it’s always been brutal for the last 15 years.

Anyway, check these scars out.

40:53 — Dr. Lowenstein:

For those of you listening on our podcast and can’t see the video, she’s showing the incisions that are in the upper eyelid and on the side of the neck.

And some people do have some sensitivity there after surgery.

It usually goes away in a couple weeks or a couple months.

It’s a little more protracted with Christa, but her scars healed up very nicely.

41:20 — Christa:

So even after you had to, when I pulled down, obviously you can see them more, but amazing.

Obviously, no makeup on there. That’s just me.

And here, look, you can’t even see them.

And here, and just amazing.

And everyone always comments on how incredible they can’t believe how minimal the scars are, and I always brag about you, how you’re the best.

And what else was I going to ask you or tell you about that part of the healing?

Itching has sporadically been an issue, but not too bad.

I never took gabapentin again.

I just couldn’t. I can’t even explain to you how horrible it makes me feel.

42:04 — Dr. Lowenstein:

So, here again is what I was referring to earlier.

Gabapentin is a drug that sometimes calms nerves.

And so when we have these closed things or weird feelings, we call those paresthesias, and gabapentin can help with those.

But they also can make you feel very wonky, tired, lots of different symptoms, and some patients just don’t tolerate gabapentin very well.

42:34 — Christa:

Just yeah, awful.

And it’s not worth it for me to feel, I don’t like feeling altered or fuzzy or anything like that.

And it made me feel exhausted and dizzy and nauseous.

So, anywho, I did try a few natural things, nothing very extreme.

And I, yeah, I don’t know how you feel about natural alternatives.

I’m guessing you’re not a fan. I’m just going to guess that.

43:00 — Dr. Lowenstein:

Not true. I am a big fan of natural approaches.

My attitude toward headaches is to try whatever you would like, and if it works, that is great.

Some people find that daith piercings work well. Some people benefit from craniosacral therapy, and some get help from acupuncture.

Unfortunately, a lot of people don’t, and so, you know, those are the people that I’m happy to help.

But I am in favor of anything that works, and so I just want to clarify that I think a holistic approach is great.

Sometimes surgery is the only option.

43:47 — Christa:

And I wasn’t before, but when I got Lyme and malaria and everything, it opened my eyes to other options, shall we say?

I like integrative medicine. I think that there’s a place for both, and I’m very grateful to The Creator for both options, obviously.

Surgery, hello.

Yeah, I am very grateful. That is putting it lightly.

I’m overwhelmingly grateful to you, and that God has made you such an excellent surgeon.

And I never really put pressure on you, to be honest.

I trusted you and had confidence that you more than knew what you were doing.

But ultimately for me, the responsibility or the outcome rests in the hands of the Great Physician.

And so there was a long time there in the recovery for both surgeries that I thought, here we go, this is just one more thing that I’ve tried and it hasn’t worked.

Not even in a negative way, just kind of resigned and just thankful that I have heaven to look forward to.

I know that sounds probably kind of morbid or not morbid, but just yeah, fatalist or whatever.

But truly, I kind of just let go of putting expectations on anything in this life.

I know that again might sound crazy. I’m only 33, but after 15 years and trying so many things and nothing helping the head and neck issues for longer than a matter of hours, maximum like a day or two.

I just kind of thought, you know, I don’t know.

I don’t know what could possibly help if this won’t help, you know, and maybe it is anyway.

There’s a little bit of a fluid component for me, so that’s why Diamox or acetazolamide does seem to help that a little bit.

It doesn’t help the pain, but it helps some of the other sensations that I get from, yeah, MRIs have shown that there is some not obstruction, that’s a strong word, but just narrowing and a bit of compression around the brain stem.

And some, a little bit like the, what are they called, cerebral cerebellar tonsils are herniating a little bit down into the foramen magnum.

And there’s some stenosis along the upper neck area or whatever, and very minor bone spurs and things like that.

So I just was thinking, well, maybe I was wrong.

Maybe it’s, maybe the nerves, yeah, they were not looking great when Dr. Lowenstein opened me up, but maybe the real issue has more to do with fluid and pressing on the brain stem, and that’s causing all the issues.

I don’t know.

But guess what?

No, the majority of the pain-related issues clearly are nerve related.

And I’ve had more relief in the last month, six weeks, when was Easter?

Basically, I’ve had more relief since then than I’ve ever had in the last 15 years.

And it is surreal, and I’m thankful, and I’m fully expecting things to just keep getting better and better.

The nerves don’t feel to me as if they’re done regenerating, like not at all.

I still get these random, like numbness that is extra numb, and then these fuzzy feelings and a bit of zinging and all that.

They just feel sometimes like they’re still temperamental and they’re still prone to, like they’re just sensitive still, it seems to me.

So that again makes me feel super hopeful that they’re just going to continue to improve.

So thank you, thank you for taking me on and yeah, welcoming me into your clinic and even just everything with the second surgery.

47:35 — Dr. Lowenstein:

Man, I will never forget all those details with your dear mother-in-law and with Elizabeth being away and you caring for the kiddos and your son getting sick and all of that.

And so what she’s referencing here is that unfortunately during the time for second surgery, my mother-in-law was very, very sick, and so my wife was on the east coast, and we’re on the west coast, and she was away for much of that time.

And I was single parenting my two kids at the same time, and also trying to manage my patients, and her surgery was right in the middle of that.

And so that’s, that was an unfortunate time in both of our lives.

But I’m really happy that such great things came out of it for her, and so anyway, that’s the backstory there.

48:35 — Christa:

Like, oh my word, Adam! Like it was, it was crazy, right? It was crazy.

And again, I didn’t put pressure on you because I live my life with the ultimate faith and expectations in the one true God, and so that’s why there was quite a deep peace about all of it.

Like, even if we flew there and it didn’t work out, I just, you guys were going through a harder time, and yes, I live in agony, but you guys had more going on, you had more cause for stress and need for, yeah, just what’s the word?

These things to just resolve, you know.

So I just knew like if God has it planned that I’m to get this second surgery, it’ll happen, and if not, it won’t.

And I just trusted that His timing is impeccable, albeit perplexing sometimes.

Yeah.

49:25 — Dr. Lowenstein:

So here again, for perspective for those of you who are not from Santa Barbara, Christa’s about to discuss Butterfly Beach, which is a local beach that a lot of patients enjoy during their stay.

49:40 — Christa:

Our favorite beach, Butterfly Beach.

And I don’t know if you know this, but the day before we flew down to Santa Barbara the first time, I, oh, see, I just had a funny zingin’ up here.

So interesting.

Nerves are fascinating to me, and I’ve really enjoyed doing a bit of reading and learning a little bit more, tiny bit more, about the way God fashioned our nerves.

It’s so fascinating to me.

Obviously, I know a microscopic amount compared to you, but it’s fun to learn what we can.

Anywho, we loved that beach, and being at Butterfly Beach was special.

A, because it was gorgeous, and B, yeah, the day before we said goodbye to our three boys.

Whew, that was emotional, not going to lie.

Here on our property there was a monarch butterfly that flew and landed right with us while we were all sitting on the grass.

And actually our first born, Preston, our oldest, he’s eight, and he picked up the butterfly and held it, and we just got to study and get our magnifying glasses out and bring out all our nature books and learn more about butterflies.

And then follow on a map where they fly to, and how in fact they do fly from Canada here on the West Coast, down to the West Coast, down in the states in California and down into Mexico.

So that was just really special and neat for the boys to see this butterfly and know, hey, mummy and daddy are flying the same path that the butterflies do.

And I mean, hello, just the fact the butterflies are so incredible, right?

How they start as a caterpillar essentially and the transformation they go through.

I feel like that’s how significant this change has been for me.

I feel like a new person, and I’m excited to just, yeah, pace myself and ask God what He has for me in this new chapter of life where I’m not as hindered and held back and where I don’t have to muscle through every little thing.

And I’m enjoying gardening more than ever.

When I planted a lot of the seeds in April, I did not have the usual tremendous agony that I’ve just grown accustomed to over all these years, and it was incredible.

Just yeah, and it still is.

Like going out, I’m already harvesting, you know, like the lettuces and radishes, everything’s just thriving because we’ve had a very chilly spring and the plants all love it.

But anyway, to do these things that I so enjoy, like baking bread, I love making sourdough from scratch and being able to be creative.

52:03 — Dr. Lowenstein:

So here I take a little opportunity, I thought, to give a little insight into my world because I am, I’ve got a sourdough fetish too.

So when she shared this, I sent, we’ve been sending back dueling versions of our sourdough loaves.

So anyway, you know a little bit more about your doctor.

52:28 — Christa:

And being able to be creative, like make bouquets for people from the flowers I grow and from doing hand lettering gifts for people, putting together parcels, reading.

I lead a ladies’ Bible study every week and I had to stop that for a while over the last two years.

I mean, yes, there were restrictions, but we’ve been rebellious and we’ve still been seeing people and within reason we’ve been respectful and taking care of our elderly and those who are vulnerable.

But anyway, I was able to start hosting that again, and it’s just been amazing, it’s been surreal.

And even Justin, he’s like, I can’t believe you’re functioning after hosting Bible study every week.

Like, usually he’d have to come and help me walk to bed, and it would just be game over.

So I’m only scratching the surface, and yet here I have been talking for so long.

But anyway, I just, and this Dr. Lawrence Dean is where I’ve spent so much.

Yes, it says tonight. We got this for our wedding. I was 19 and we got married, and everyone was very, had fun teasing us.

Anyway, yeah, this is where I’ve had to spend many hours.

But not anymore.

And I just had to say too, that when I, when my head starts to hurt and get a little bit worse and worse before surgeries, there’d be no point of return.

Like I said, nothing ever would help.

But now sometimes I don’t take anything, not even anything natural, and it’s as if the nerves just course correct and they calm right down again.

So just because it starts to hurt doesn’t mean it’s game over for the whole rest of the day.

I’m just giving you a little tour.

I’m just going to show him one of my gardens.

Look who it is.

54:13 — Justin:

You are looking productive.

54:13 — Christa:

It is just the two of us here.

My parents have our boys.

Here is the vegetable garden.

There is our little barn.

Someday we would love to have animals.

You can tell us what to expect with chickens, okay?

54:32 — Dr. Lowenstein:

Okay, and again, a little, you know your doctor.

I do have chickens that we get eggs from, and Christa and I have had these conversations about our gardens and our animal husbandry, I guess, or yeah.

Point is, yeah, your doctor has chickens.

54:58 — Christa:

There is the little vegetable garden.

It is thriving.

Anyway, thank you for changing our life.

God bless you.

55:11 — Dr. Lowenstein:

And so I want to just, you know, I want to say that I’m guessing that a lot of what you’ve heard here resonates with a lot of you who are suffering from headaches.

And Christa had a really terrible time of it.

And I’m so thankful that we were able to make her better.

And I also want to thank her so much for sending an unsolicited update of her story and allowing me to share that with you.

I just think as she does, the more people who understand what people with head pain, migraine, headache, migraine headache, whatever you want to call it, status migrainosus, tension headache, occipital neuralgia, all of these different headaches that are having different manifestations but similar root causes being nerve compression.

It’s such a difficult thing to live with, and making people better is the best part of my practice.

But again, I want to thank Christa for allowing us to share her story with you.

And again, you know, the details of the surgery and the information about headache surgery and nerve decompression and migraine surgery, and again, it’s all the same thing with different names, can be found on our website.

I strive to make our website as educational as I can.

You know, the surgery’s not for everybody, but with a 93% success rate, we love making people better.

I hope you enjoyed this video and this podcast, however you’re getting this.

And again, please, as always, if you have questions about the surgery or want to discuss your particular situation, call our offices and be happy to do that.

Have an appointment with you and discuss what’s going on in your world.

56:34 — Dr. Lowenstein:

Hey everybody, this is Dr. Lowenstein once again, and I have two last things to ask of you.

Firstly, the thing you can do for fellow headache sufferers is to please remember to subscribe and rate our podcast.

The more ratings and subscriptions that we get, the more visibility that we’ll get, and the more listeners will be able to find us.

And the more help and information we’ll be able to provide to the huge population of people who suffer from headache pain.

Secondly, please remember that the treatment of headaches of all types is very individualized.

The purpose of this podcast is not to give medical advice, so please use the information here on this podcast and elsewhere that you’re hearing on the internet to broaden your knowledge.

But consult with your physician before acting on any information that you hear on podcasts or see on YouTube or read anywhere on the internet.

I, as a physician, don’t necessarily endorse the opinions or practices of my guests.

And if you have particular questions that you’d like to consult with me directly about, please call our headache surgery center.

Our phone number is 805-969-9004.

Or you can email us at info@headachesurgery.com and my staff will set up a consultation and we can discuss your specific case over the phone or in person.

Our website is filled with information as well, and that is headachesurgery.com.

Thanks and best wishes from all of us here at the Headache 360 Podcast.