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C2 Nerve Block

Hello to the group. Next week I am schedule to have a bilateral C2 nerve block, my first in a short series, at Chelsea Memorial Hospital in Chelsea Michigan. The procedure is being performed by the physician that heads up the Pain Program at the Michigan Head Pain and Neurological Institute in Ann Arbor.
I have a long history of Migraine and Chronic Migraine and have worked through many different treatment options over the years with MHNI. I am excited to have something to try that I have not tried before. And, I am curious to hear others' experiences with C2 nerve blocks. I have had Occipital and Supraorbital nerve blocks. Neither of those were too painful as they were not "deep" blocks. I understand C2 is a deeper block. From what MHNI told me and what my research finds, it may involve some sort of radiological or ultrasound guidance.
I would to hear from those who have had this type of block.

Thanks!
MB

  1. Hi MB,

    Welcome and thank you for sharing your story with us! I've not had this done, but do have information I can share with you.

    This link will take you outside Migraine.com to the Today Show where Doctor Saper (who is wonderful!) is doing what I think is the same procedure. Yes, it is under fluoroscopy. This should help; http://www.today.com/health/block-migraine-pain-back-head-injection-8C11440964.

    Good luck and let us know how it goes!

    Nancy

    1. Hello to the group. I thought an update would be in order as I had my second round of nerve blocks earlier today.

      The blocks I had today are the same as the blocks I mentioned in my original post here. Although effective, the first bilateral C2 block lasted only two days. For me two days without migraine is a miracle. I have had daily migraines of varying intensity for a very, very long time.

      So, the good news is that a treatment interrupted the migraine. The bad news is that two days is not enough relief!

      The physician and I had discussed the idea that there may be a need for multiple blocks before things get into a state of better control. I am hopeful that this will indeed be the case.

      Today's block went just like the first. I cannot say enough about the staff and the care I received. The procedure itself is a non-event as there are sedatives given before the real fun begins. I experience some mild soreness later in the day and into the next day, but nothing more severe.

      As I write this update I am trying to stay positive even though I have a migraine. I know the block was not necessarily going to make this particular migraine go away. After the first block I had a migraine the next day and then the two migraine free days began. Perhaps this time I am getting the migraine out of the way today so that tomorrow can be a better day!

      If, as I hope, this block also brings about some relief I will be discussing next steps with the physician. Do we do a third block? Do we try to get my insurance carrier to pay for radio frequency nerve ablation? Are there other viable options, like implants...

      All I know is I need to find some relief that lasts longer than a couple of days. I feel worn out, beaten down, drained, tired, etc., etc....

      I continue to infuse these thoughts with a more positive and hopeful voice. In the midst of a migraine (like now) of significant intensity it is hard to be positive.

      Expect another update tomorrow.

      Thanks to the group.

      MB

      1. Good Morning MB!

        I came across this post and I wanted to let you know that I hope you are feeling better and that you got some relief. It is hard going through this process-- the pain, the procedures, the insurance. They don't make it easy.

        I had a similar block at Chelsea Hospital with MHNI in April of 2014. Mine was a Facet C2-C5. I had two while I was there, and I've had one here in Georgia. I am scheduled for Radio frequency Ablution but am scared. Anyway-- i can empathize.

        Thinking healing thoughts!

        1. Hello again to the group.

          Please allow me to provide an update. After my second bilateral C2 block I spoke with the physician, via his nurse by phone (six hour round trip for me to get to the clinic or to Chelsea). In both the first and second blocks I had periods of time where I was either at a pain level around one or two, or completely pain free, that lasted between one and two days. For me to get a full day of low level or no pain is absolutely miraculous! Needless to say I was anxious to talk about something as a next step that might be longer lasting in the way of relief.

          I shared all this with the nurse during our phone conversation. She seemed excited about the progress and mentioned radio frequency ablation as a possible next step. At least two other team members at MHNI have also mentioned this procedure as a likely next step for my treatment path.

          A few days later the nurse called back and said that the physician wanted to do one more, a third, nerve block. With this series of three, she said, we could go to my insurance company to get approval for the ablation procedure. It all made sense.

          Then I waited for the scheduler to call. That happened last week and I was lucky enough to grab a cancellation slot for last Friday. If I had not taken that slot I would have had to wait for another month!

          So, Friday I went for my third bilateral C2 block. The procedure itself was pretty much the same as the first two. The only exception is that I "woke up" a bit during the procedure. They do not put me completely out, but do pump some pretty good meds through the IV to deal with the pain of the large needles. There is also an amnesia agent that puts one in a state where one does not recall much. I came up out of this fog to feel some pretty intense pain on the right side of my neck as the needle was going in, or was progressing or something. I mumbled to the team that it hurt pretty bad and I presume they put more meds in the IV because after that I recall nothing until being in post-op / recovery.

          This third block followed a very similar course in relationship to the migraine. I went into the procedure with a fairly decent migraine in place (7 on a one to 10). The physician, when I shared this with him prior to the procedure, said, "Oh you are doing pretty bad today huh?" I told him 7 was not really all that bad for me. A 10, and I am dead in the water, but I have developed some coping techniques that allow me to function, temporarily and in short bursts, at pain levels near (not at) the top of the scale. In any event, he noted the level and off I went. Post procedure the migraine stayed about the same. Later that evening it started to move upward and topped out in the late evening at 9. The next morning, Saturday, the migraine was still at a 9. I pursued my normal path with some abortive medications. For several hours the migraine continued.

          By mid-day yesterday the migraine was down to a one or two on the pain the scale. By evening the migraine was completely gone! This morning, Sunday, the migraine is still gone! Some odd sensations seem to indicate that something, maybe the migraine, is really still there, but I am not feeling it, or sensing it as pain. Whatever is going on, I will take the pain-free time!

          The second block followed a very similar path. A migraine going into the block, that got worse after, with relief coming later. If this block follows the path I should expect to have a great day today (odd to think or write something like that!). Unfortunately, the pattern to this point would suggest that the migraine may return tomorrow. I am hopeful that this third in the series might help to extend the relief.

          Regardless of whether I get any more relief I am confident that we have established a grounds for insurance approval of the ablation procedure. Three blocks with three migraine-free periods of time after each block. We have finally found an actual spot/location and specific treatment that can completely disrupt the migraine! To this point (after two decades of working with physicians and healthcare providers) I have never found anything that could so effectively and reliably impact the migraine like this!!!!

          It would seem this is nothing short of a turning point in the war!!! My experience with migraine, and my low energy and depressed mood, however, keep me from getting too excited. I am not jumping up and down. I am not on the roof screaming and shouting. I am, as years of living in chronic pain have taught me, keeping it low-key... I guess fearing the next migraine. Yet, there is a voice, rising and becoming more insistent, that has more to say than, "migraine, migraine, migraine, migraine..."

          Next steps... I expect the nurse to phone me tomorrow. I have my migraine log and notes ready. She will, I expect, pass along my experience to the physician. Unless something changes I expect he will want to proceed with getting insurance approval for the ablation.

          The idea of more than two consecutive days without migraine is such a foreign concept. I am not sure I can wrap my head around that!

          I will continue to update this thread / post.

          MD

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