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Omega Procedure

  • By Melissa

    I have struggled with migraines for 19 years now and have tried everything from chiropractic, acupuncture, physical therapy, counseling, meditation, preventative meds, abortive meds and pain meds with no results and the migraines have now progressed to daily and never end. Has anyone heard about the Omega Procedure? Have you had it, did it work, would you recommend it or should I run?

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  • By Nancy Harris Bonk Moderator

    Hi meh422,
    I’ve not had this procedure but do know there is plenty of conversation about the validity of it. In 2012 The American Headache Society issued a statement regard surgery for treating migraine. You can read that statement in this link: http://www.americanheadachesociety.org/american_headache_society_urges_caution_in_using_any_surgical_intervention_in_migraine_treatment/.

    Many of us feel like we have tried everything out there to treat migraine. Even though it feels like it, that’ just not the case. The thing is it would take 25 years to try all the medications that are used for migraine prevention when used at the proper dose in the correct manner, so try not to lose hope! Let me share information with you on migraine prevention; https://migraine.com/blog/migraine-management-essential-4-preventive-treatment/. Something to note is that when we start new medications, it can take up to three months as our body adjusts to it before we see a reduction in our migraine frequency and severity. It’s important to give each medication a fair trial because if we don’t, we may never know if that would have been the pill that would have worked for us. Does that make sense?

    How are you doing on trigger identification and management? One of the problems with triggers is they can change over time. If you haven’t kept a detailed migraine diary in a while you may want to do so. Here is information on keeping a migraine diary:https://migraine.com/blog/keeping-migraine-diary-basics/.

    Not to beat a dead horse, but I don’t think enough time is spent on lifestyle changes and trigger identification and management. Because the brains of people with migraine tend to be very sensitive it’s important to maintain a regular sleep schedule and stay hydrated among other things.

    Do you by any chance take something every day to relieve your pain? A big problem many of us can run into is called medication overuse headache, moh formerly called rebound. If we take migraine abortive medications and/or pain relievers, whether they are over-the-counter or prescription, more then two to three days a week we can create moh. The important thing to note is that if we have moh, our migraines will be more difficult to treat and we can end up in a DAILY cycle of pain that is hard to break. Here is information on moh for you; https://migraine.com/blog/help-how-can-i-not-overuse-migraine-medications/.

    I hope this information is helpful,

    Nancy

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  • By MaFixIt

    I have tried numerous medications, diet, exercise, acupuncture, massage, chiropractic, osteopaths, I meditate, do yoga, etc., but still have chronic daily headaches. Nothing I take controls the pain in any way unless it knocks me out. There is no pattern, no triggers. They come and go at will like a monster and are there EVERY DAY of my life. I can’t live like that. I have to work – I have bills to pay. I have to play – I have a life to live.

    I had a consult for this Omega procedure last night and am going to try it. They hook you up for 5-7 days in a trial and if it works, then they do the permanent implant. They take whatever my insurance pays even though they are out of network – out of pocket is minimal to me.

    Who the heck wants to live 25 years with headaches while they try every medication that is out there? You try a new one – wait three months – that one doesn’t work, so you try another, wait another 3 months – and the cycle continues. Before you know it, 5 or ten years of your life has gone by while still trying to find relief.

    So why not try this procedure? It’s minimally invasive, is reversible, and doesn’t involve drugs of any kind. Mayo Clinic is starting a clinical research trial, so there must be something to it. I have spent thousands and thousands of dollars and have the outstanding medical bills to prove it, and am no better off than I was before I started seeing all my doctors for these headaches. These drugs have horrible side effects, can make you stupid and tired, and who knows what else.

    I am going to try it and will let you know the results.

    Karen from Arizona

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  • By The Migraine Girl Moderator

    Karen (mafixit),

    Definitely keep us posted! We’ll be thinking positive thoughts for you and hope you have a break in your headache pattern.

    Fingers crossed,
    Janet G.
    “The Migraine Girl”

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  • By Brittany

    If any of you are thinking about doing the trial I say go for it! I just finished the trial on Monday and will be getting the permanent implant in a few weeks. It worked amazing, its the first time I’ve had a week without pain in almost 5 years. Contrary to what has been said above there is a lot of research supporting this procedure. It has been used with great success for back pain and occipital neuralgia which is similar to migraine. I will continue to update following the permanent implant! Good luck!

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  • By MaFixIt

    BrittanyR, it is so good to hear that your trial went well. I am having a consult with a laser spine surgeon for next week for possible correction of a compressed nerve and herniated disk that *could* be causing my headaches. I wanted to find the cause of the problem and if this is it, then fantastic. If not, I will schedule the trial for the Omega unit.

    Best of luck. Can you elaborate on some details on how it went and what you experienced? Where did you have it done?

    Karen from Arizona

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  • By Sunnynshare

    I, too, am going for the Omega Procedure. I have had the 25 years of every type of treatment out there that Nancy talked about. I am a 58 year old RN that has struggled with the migraines and chronic daily headaches my entire adult life. I lost my job 5 months ago after working for the same hospital for 34 years. The reason they gave me for my termination, I truly believe, is for health reasons, even though I had an intermittent FMLA. I was blamed for a mistake a physician made and I was not even in the same room with him. It absolutely makes no sense. I gave 150% of myself ever day I went to work to the point that I had no energy for the rest of my life and losing a job I loved has crushed me. I’ve always had excellent evaluations. My family believes that this is the best thing that could have happened to me, as they are seeing me looking at options to treat my pain that I have never would have considered. I am not ready to give up. Part of my identification is being an RN but I am not physically able to learn another job at this point.

    I had my initial consultation last week with the physician from the MTCA (Migraine Treatment Centers of America), which is based out of Dallas, Texas. I believe MTCA is the only place where the Omega Procedure is done. Does anyone know if there is any other place that this is available? I talked it over with my pain doctor who is frustrated that he hasn’t been able to help me more and I have his support. One of his partners could do 2 separate neurostimulators, one for frontal headaches and the other would be an occipital area. The Omega Procedure would cover both areas so I wouldn’t have 2 separate battery packs.

    Because I don’t live close to a MTCA, I did my first consultation with a physician over the phone. The second step will be a psychological evaluation, and that, too, will be a phone consultation. This is a last resort treatment and they require you to have tried all other options first. If I qualify and get insurance approval (I am currently paying for COBRA insurance), I will have the procedures at the Detroit branch. If you look on the MTCA website, there are 5 centers across the country where they do the Omega Procedure. I was told the trial procedure cost is $12,800 and the implantation procedure is $48,000. The physician told me that 92% of people who go through the trial get such great relief that they go on to get the permanent neurostimulator. I have high hopes because I bought a Cefaly over the summer and when I use it for the recommended 20 minutes, it is the only time I don’t have a headache. When I remove it, the headache comes back within a few minutes.

    I will keep you posted and am praying that I am not in the 8% that it does not help. I will be thrilled to get off all the medications I am on. I have hope that I have not had in a long time!

    By the way, meh422, since you opened this conversation in February 2014, did you get the Omega Procedure? If you did, what are your results?

    Wanda from Michigan

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  • By MaFixIt

    I am approved for Omega but decided to hold off. My cost out of pocket would be around $1700 for trial and permanent. My problem with this was that it didn’t fix the reason why I get headaches, just try to stop them or slow them down.

    I just had surgery for a compressed nerve at C5-C6 this past Friday. The pain this issue caused was in my neck and shoulder, and what I feel progressed to many of my headaches.

    I am 3 days post-op with no real migraine. I am only on Tylenol and a low dose of Valium at night. I am hopeful, as were my doctors at the surgical spine center, that this procedure will help get rid of many of my headaches.

    I will keep you all posted as to my progress. So far, so good. My pain in there, but it is different. Tylenol is taking care of most of it.

    Karen from Arizona

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  • By Sunnynshare

    Karen from Arizona,

    I am happy for you that you may have gotten rid of the cause of your headaches. I have compression from bone spurs between C-5 to C-7 but the neurosurgeon talks about fusions, which have a low success rate. I think it could be referred pain but I don’t have any doctors that agree. I definitely wouldn’t want fusions.

    Do you live near a laser spine institute? How did you get approved for surgery? Keep me posted on your results. I haven’t done anything out of network my insurance yet nor anything permanent. I agree with you that the Omega Procedure doesn’t ‘t fix the problem but neither do medications.

    I really hope it continues to get better!

    Wanda (Sunnynshare)

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    • By Nyki1323

      I am from Arizona also. I moved here almost 3 years ago. I have been suffering from migraines for years. I have tried over 12 different preventives. I have tried many abortives. I have a RFA done on my C2 thru C 5 to help with migraines. I am looking into the Omega procedure. It has really interfered with my life. I had to stop working 5 years ago from a job I loved because of them. Keep me posted if you end up getting it done. I need something to improve my migraines last for days some as long as 10 days. I wish you luck.

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  • By MaFixIt

    SunnynShare (Wanda),

    I do live near the Laser Spine Institute – about 20 miles away. I went in for a free consult and they checked with my insurance and got the procedure approved. I felt SO mentally good on Saturday and most of Sunday. I wish I knew why. If I could feel like that every day life would be perfect. I was able to tolerate the surgical pain, had no headache and felt like I had a new lease on life.

    Yesterday I started to go back into headache mode, but then again, I am still in pain from the surgery, so I would expect a headache based on the neck stiffness and pain I have. I am trying to be patient. Tylenol has stopped working. I am also experiencing some depression. Today I just want to lay my head on someone’s lap and have them pet my head while I spill my guts.

    I can’t use my usual array pain relief like my TENS unit or my Yoga, so I am trying to live with this and think positive thoughts as I heal. Either way, the issue needed to be fixed as the nerve was quite compressed.

    I saw a new headache doctor yesterday who wants me to also try Lisinopril because she feels my blood pressure is too high (it’s only borderline at times upper 120’s on the top end and mid 80’s on the bottom end). So I started that yesterday, 5mg per day for 1 week and then 10 mg per day.

    We’ll see how that goes. This will take some time to heal and the spine surgeon told me before the surgery not to get discouraged if I still have headaches for several weeks. He told me specifically “we don’t do surgery for headaches”, but felt this all could have been a contributing factor because of muscle tension.

    I will keep you posted.

    Karen from Arizona

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  • By Sunnynshare

    Karen from Arizona,

    I’m sorry I didn’t respond sooner but I got a nasty virus which put me down (at one point, I think I slept for 2 days). Now down to just a dry cough but the ever changing weather in west Michigan, the headaches have been really bad. It is one good thing about not working right now.

    I have been on Lisinopril for a long time but put on it for high blood pressure. I know many people struggle with side effects. I have a friend that finally went off it because she developed a chronic cough. It’s also a medication they want you off prior to surgeries. It is a high risk med for uncontrollably low blood pressure that there isn’t any treatment to give you with anesthesia (even for something like a colonoscopy).

    I still would like you to keep me posted with your progress. We are not quitters and you are strong and brave! Don’t try too many new drugs at once. You won’t know what is helping and what isn’t.

    I am now just waiting for insurance approval for the Omega Procedure. The trial cost is $12,800 and the actual implant is $48,000. Both are done under conscious sedation and is an outpatient procedure. I’m just praying if the door closes because of insurance that I can accept that it is not my answer. I do believe God is in control and He doesn’t always say “yes” to our prayers. But it has just given me renewed hope of some normalcy in my life. The psychologist told me that I may be still needing some of headache medications, that it may not take all the pain away.

    I will also let everyone know if I go through with it, what my response I get. I hope you feel better soon and you will see positive results.

    Wanda from Michigan (SunnynShare)

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    • By MaFixIt

      Hi Wanda from Michigan,

      I am 3 weeks out from my surgery and am still getting daily headaches, although now they have switched more to tension-type. The left side of my forehead (the subocciptal nerve) hurts and makes my head hurt when I press on it or rub it. I am hoping this is still a result of the irritation from the neck surgery. My surgeon did tell me don’t be surprised if I still have headaches 3-4 weeks out.

      I am trying not to use the painkillers (Ibuprofen and Tylenol) and Valium (for muscle relaxation), but I am thinking it is too soon to stop. I am also still on heavy movement restrictions as far as sitting too long, lifting, etc.

      I am going to wait a couple of more weeks and see how things progress. I see my headache doc just before the holiday. Most of the surgical pain is gone, but I still can feel my neck muscles tighten up, and that feels like where my headaches are coming from.

      I will post again later with my progress.

      I do still have the approval for the Omega, I think until 12/31/2014. So I can fall back on that if necessary.

      Karen from Arizona

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  • By Sunnynshare

    Well, I got bad news yesterday. My insurance company denied my getting the Omega Procedure. I am praying for the next step. Does anyone have suggestions how to get you insurance company to change their decision? They denied it based on that is “an experimental treatment. Because it is so expensive, it is not an option to pay for it.

    Anyone out their have any ideas and how you have handled the denial?

    Thanks!

    Sunnynsahare

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    • By Emm

      I was looking around today online and found the omega procedure and then this thread (and this website) and while looking at a few different links and reading through found this on a differant site and though it might be helpful to you sunnynshare
      “I wanted to clarify a few things. This is definitely a confusing topic. I do not have an implanted nerve stimulator, but did a trial of one for a few days awhile back (where they did not implant the battery but inserted leads and let the ends hang out and connect to an external battery). The Omega and Reed procedure are done by different doctors/clinics, although they appear to basically be the same thing.
      They use leads to simulate the occipital and supraorbital regions with an implanted nerve stimulator. The addition of the leads to the supraobrital region (front of the head) in addition to the occipital region (at the neck) is an advantage when treating headache/migraine, where often a single problem nerve branch can’t be identified through procedures such as nerve blocks, vs. occipital neuralgia, where only the occipital nerve is involved.

      The battery (pulse generator) itself is not experimental and is FDA approved. These batteries are the same ones they use in spinal cord stimulation techniques. It is however not FDA approved for peripheral stimulation (ex. foot, hand, head), which is why it would be considered experimental for headache conditions. Therefore often they need to be creative to get it approved by insurance, such as only submitting it for neck pain, not headache.

      My doctor had to do this just to get my external trial approved. This is also the reason he could only do the trial at C1/C2, not an leads to the front of my head. Doctors who do these procedures are well-versed in getting it approved. However, the bigger issue with insurance approval / affordability for a lot of folks is that they travel to get the procedure done, and it ends up being out of network, so they have either reduced or no coverage. ”

      I don’t know if it helps much but though you might find it useful…

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  • By Tammy Rome

    Every insurance company has an appeals process. Find out what your options are and then try to get them to change their minds. You will need your doctor’s participation to get this done. Talk to his/her staff to get it going.

    Tammy

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  • By Chief

    BrittanyR can you share a bit more about the trial. How invasive was it? How long was it? Also when I’d your procedure scheduled? I would appreciate it if you can share you experience with us. I am actively looking at the Omega procedure but I am on the fence about such an invasive procedure without FDA approval. Also the clincal results have been inconclusive and benefits have only been identitied in posthoc analysis of sub populations. I am always wary of posthoc analysis but granted the clinical design may be part of the issue.

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  • By Sunnynshare

    Hi Tammy and tototoocutee,

    Thank you for your response to my request for suggestions with the appeal process. I did not realize it is considered experimental for nerve stimulation for outside of the spinal stimulators. I actually had an occipital nerve trial about 15 years ago but did not proceed with the implanted one. It was very new at that time and I actually got a severe jolt when my kids or husband used the garage door opener when I had it turned on, which we laugh about it now but it wasn’t funny at the time. The occipital area alone does not seem to be a major contributor to the headaches. However, my pain clinic doctor added the supraorbital pain block to the occipital block my last visit when I told him that the only time I don’t have a headache is when I used my Cefaly (a TENS unit for the forehead). The supraorbital along with the occipital block worked very well until the local anesthetic wore off but didn’t help much when the steroids took over.

    I have a appointment next week with my neurologist and she has been very supportive so maybe she would be able to write a letter on my behalf. I can get separate neurostimulators for the occipital and supraorbital areas separately from my pain doctor’s partner but then I’d have 2 battery packs. I wonder if my insurance would cover the separate procedures if done locally.

    Thank you for your suggestions. I’ll keep you informed on this forum. God bless and hope you have a good (no migraine) day!

    Sunnynshare

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  • By MaFixIt

    Update on me – the nerve decompression surgery at C5 was of no help and I am back to square one, headaches worse than ever, everyday.

    I fear I may be having rebound headaches now and am needing stronger meds to kill these headaches, which come right back the next day.

    I have called the Migraine Treatment Center and have been re-approved for the trial and the implant.

    In the meantime, I am trying Zonisamide. I have never been on a preventative med long-term as they never agreed with me. This one, so far, has few side effects, but I am only on day 4. I tried Sumitriptan for the first time this weekend and felt like I was having a heart attack – AND it only took the headache down to a 2-3.

    Took a Zipsor this morning – a new pain killer prescribed. No real help there either.

    I will update as I have more news.

    Karen from Arizona

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    • By Katie M. Golden Moderator

      @maxfit,
      Thanks for giving us an update. I’m so sorry the procedure hasn’t helped.
      I went on Zonisamide after tapering off of Topamax. They work similarly, but Zonisamide doesn’t have as many side effects as Topamax. I hope it helps you.

      Also, Imitrex shots is known to give patients horrible pain in their chest that feels like a heart attack. If you suffer from any heart disease issues, Imitrex can exacerbate those issues and is not recommended to be used. Even if you don’t have heart issues, the feeling of having a heart attack is serious. I know you’re not taking it now, but next time you see your doctor, please mention this as it could affect other drugs he may want to try with you. Here’s some info on extreme side effects of Imitrex (not all people will experience any of these symptoms).

      https://migraine.com/migraine-treatment/imitrex/special-warnings/

      The main ingredient in the other drug you mentioned, Zipsor, is potassium. It’s also marketed under the name Cambria as well. Here’s some info on it:
      https://migraine.com/migraine-treatment/natural-remedies/potassium-for-migraine-headaches/

      With any new drug treatment, it can take up to 3 months to start getting the full effects, so I encourage you to stick with it before changing up your meds. Unless, of course, you are having adverse reactions (like the Imitrex) and then you should notify your doctor. This process can take a long time to find the right mix of drugs that help you to manage and prevent your Migraines, but it’s definitely worth exploring.

      Let us know if you have any other questions. And best of luck to you!
      -Katie
      Migraine.com Moderator

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  • By 2ajqdhr

    Karen, looks like we live in the same state! I moved to Arizona a little over a year ago. My headaches and health were a lot better from July to March. I don’t know if it was allergies or stress, but my headache cycle kicked back up and although overall it isn’t the worst it has been, I have had 3 of the worst headaches I’ve ever had.

    I get daily headaches and migraines. I am wondering if the Omega procedure will be effective for daily headaches or if it is designed more for migraines. I am interested in getting more information on it. I have tried a litany of medications, biofeedback, chiropractic, massage, acupuncture. None of the medicines have ever worked enough to tolerate the side effects. Massage and acupuncture does help, but more so to lessen the severity of a headache.

    I need to get established with a doctor in Phoenix. I’d given up on going to Drs because none of the medicine or treatments ever help. I haven’t tried Botox or nerve stimulation, so those sound the most promising to me at this point.

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  • By Nancy Harris Bonk Moderator

    Hi 2ajqdhr,

    Thank you for your comments. You are in luck – there are over 30 doctors in AZ who are board certified in headache medicine! If you’ve not seen one of them, I would encourage you to seek one out. Here is a list of doctors who are board certified in headache medicine; http://www.ucns.org/globals/axon/assets/10300.pdf.

    Migraine and headache experts are different from neurologists in that they treat one disorder all day, every day – migraine and headache. Neurologists may be fine doctors, but have a hard time being experts in one area because they treat so many other conditions such as stroke, epilepsy, multiple sclerosis, Parkinson’s and more. For more information on how different these doctors are continue reading this article; https://migraine.com/blog/how-are-migraine-specialists-different/ and https://migraine.com/blog/really-find-headache-specialist/.

    Good luck and keep us posted on how you are doing,
    Nancy

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  • By Nancy Harris Bonk Moderator

    Hi Nyki1323

    Thank you for your comments and questions. I know many of us feel like we have tried everything, but I wanted to let you know there are over 100 medications that can be used for migraine prevention. If you add up the combinations that number goes up considerably. Let me share that information with you; https://migraine.com/blog/migraine-management-essential-4-preventive-treatment/.

    You mentioned you live in AZ, where there are a number of world class “true” migraine experts. Before moving forward with this procedure, I would encourage you to seek out their expertise. This link has all the doctors who are board certified in headache medicine, which is different than being certified neurology; http://www.ucns.org/globals/axon/assets/10300.pdf.

    Let me know what you think,
    Nancy

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