Life without migraines - surgery now viable long-term option in fight for happiness

HEALTH AND MEDICINE
Posted: July 25
By Mechele Cooper mcooper@centralmaine.com


Melinda Brawn suffered from searing migraine headaches for more than 20 years.

RELIEF FROM PAIN: Melinda Brawn suffered debilitating headaches until she underwent surgery recently. The 43-year-old Chelsea resident says she now no longer suffers from migraine headaches.

She said she missed days of work and family functions and was forced to lie in bed for days in a quiet, dark room until the pain subsided.

Brawn, 43, of Chelsea said she tried everything imaginable -- shots, patches, pills and more. But she said drugs gave her major stomach problems.

So her physician recommended surgery.

"They're debilitating ... they're crippling," Brawn said of her headaches. "But now I get up and face the day pain-free."

David Branch, a Bangor hand and plastic surgeon, relieved Brawn's pain using temporary injections of Botox, a widely used lifestyle drug used mostly to smooth wrinkled skin, to weaken the muscles impinging on nerves in Brawn's head.

The injections were a temporary solution. Once she proved to be a good candidate for the surgery by responding well to the injections, he removed parts of muscles that impinge on those nerves.

Botox injections are expensive, between $250 and $800 a session, and people may need them for many, many years to preserve the pain relief, Branch said.

But surgery, he said, eliminates the problem "for good."

"Patients who have had this surgery and no longer have migraines are simply the happiest patients I have ever seen," he said. "People are busy and they don't have time to be burdened with migraines. Well, now that burden has a chance to be eliminated.

"I typically inject people with Botox to see if they are candidates for the surgery. I've been doing the surgery for many years and it works very well."

Brawn agreed.

"I would do it again tomorrow," she said. "I was not able to function. I missed out on a lot of fun times with family because I was so sick, and now I'm not. I am so grateful to Dr. Branch and his staff for helping me get my life back."

Common ailment, uncommon treatment

Migraine headaches affect 36 million people in the United States, according to the National Migraine Association. The ailment can cause intense throbbing in one area of the head, commonly accompanied by nausea, vomiting and hypersensitivity to light and sound. Symptoms can also include swallowing and breathing difficulties that, if extreme, can be life-threatening.

Russell Katz, director of the U.S. Food and Drug Administration's Division of Neurology Products, said chronic migraines are one of the most disabling forms of headache. Patients with chronic migraines experience a headache more than 14 days a month, he said.

"This condition can greatly affect family, work and social life, so it is important to have a variety of effective treatment options available," Katz said.

Branch said migraines are a neurological disease associated with changes in the size of arteries inside and outside the brain.

He said the likely cause of a migraine headache occurs when muscles surrounding the nerves become tense or irritated, causing the nerve branches, or "trigger zones," to become more excitable.

Branch said he discovered the benefits of botox therapy for migraines studying under Bahman Guyuron, chairman of plastic and reconstructive surgery at Case Western Reserve University School of Medicine in Cleveland, who discovered the outpatient procedure.

In a double-blind study conducted last year, Guyuron found 80 percent of patients who had migraine surgery using Botox in one of three "trigger zones" significantly reduced the number of headaches.

http://www.kjonline.com/news/eliminating-migraines_2011-07-24.html