Surgical solution for migraine headaches offers relief, hope

Highly successful procedure performed in Madison
Surgical solution for migraine headaches offers relief, hope

The pain came daily, relief was fleeting and Brenda Haney lived day to day at the whim of her migraine headaches.

“I would hold my head in my hands, and a lot of times, I would just cry,” Haney told WISC-TV in an interview at her DeForest home. Describing the pain as “so intense that it feels like someone is just taking a hammer and hitting you in the head.”

After years of seeing specialists, trying different medications, and finding no long-term relief, Haney somewhat by chance found herself in Dr. Ahmed Afifi’s clinic. A nurse had told her the plastic and reconstructive surgeon at UW Health might be able to surgically ease her pain.

“These are patients that have been forced to retire, patients who can’t plan any vacations because of the migraines, patients who are missing so many days from work, they are school teachers who have to work through the pain,” Afifi told WISC-TV.

In Haney’s case, she was a Dane County Sheriff’s deputy who had to fight through the pain. Each day began with a handful of Aleve and quiet time, before she could get the headache to calm down just enough to get through the day. Heavy medications came with major side effects, so while some helped for a short time on days off, they weren’t an option on duty. If the surgery worked, relief could be permanent.

“Surgery is simply to take the muscles that are compressing the nerve, to cut them, and release the pressure on that nerve,” Afifi said. “The most common of these nerves being one in the eyebrow, two in the temple, and [one in] the upper neck.”

In December, Haney underwent the procedure. On average, it lasts just two hours, though she spent a little longer in the operating room where Afifi worked on several bundles of nerves around her head.

To determine if a patient is a good candidate, Afifi uses the dermal filler Botox on the common migraine nerve sites. If a patient sees a level of relief, it is generally a sign that surgery could make a difference.

The discovery that led to the modern procedure happened by accident 15 years ago. A Cleveland plastic surgeon noticed a pattern of patients reporting their migraine pain had improved or disappeared after a cosmetic brow lift.

Today, select surgeons are performing the researched, refined procedure across the country with a success rate between 75-90 percent.

“It’s so flattering when patients tell me after the surgery not that this has had a great impact on my pain, but rather this has had a great impact on my life,” Afifi said as he operated on a patient in April.

Now several months post-op, Haney hasn’t had to take her migraine medication at all, and only tips her bottle of Aleve into her palm on rare occasions.

“I think there’s a little more spark,” she said. “Every once in a while I’ll wake up in the morning with just a little bit of a pressure, but its not pounding like it used to be, so for me, I’d say it’s a 90 percent difference.”

Procedure relieves migraine pain

A difference that’s allowing her to enjoy retirement on her on schedule, but also give back when disaster strikes. Since the surgery she’s begun volunteering with the American Red Cross and has been dispatched to the storm zones of Hurricane Sandy and the Moore, OK tornado.

“Now I can take off on deployments and not have to worry about if I’m going to come down with a migraine, and worry if I’m going to effect somebody else, or if someone’s going to have to take care of me because of my headaches.” I’m in a better place right now.”