OITNB: Occipital is the New Block

Occipital nerve blocks. Somehow, I got 11 years into my migraine journey without ever having had any. It was basically my new migraine specialist’s first suggestion (after putting me on Propranolol as a daily preventative medication.) I have had needles in most areas of my body. However, I was still anxious about this new treatment. But I puffed up my chest and told myself that, if I could handle 31 injections during each round of Botox, I could handle this. My Dad and I trekked the 2.5 hours to my migraine specialist’s office and, all told, my appointment probably lasted a bit longer than an hour. My specialist is very thorough and so is the resident that works with him so I never leave with any unanswered questions. However, the portion of the appointment that was taken up by the occipital nerve block injections (of which there were 10) lasted less than 5 minutes. Basically, I sat in a chair in front of the exam table and laid my head down with my hair flipped up to expose the base of my skull and my neck. The doc wiped each injection site with an alcohol towelette and said “A little scratch and then a little sting.” It made me smile that he said “A little scratch” when he was injecting me with a needle but it also sounded much more soothing than “a little poke” or “a little prick”. He informed me that he was using the smallest possible needle gauge. He told me that he was injecting a numbing agent called bupivicaine. The shots essentially went as follows “Ouch! Sting, sting, sting, NUMB.” The pain was over with quickly not much worse than Botox. In the interest of being totally honest, I will say that the ones that hurt the most were the two he gave me in my forehead, right above my nose. It’s the place that would crinkle when I frown had I not had six rounds of Botox. Those two HURT but it was nothing I couldn’t stand and, if these blocks help me, I will definitely do them again without all of the agonizing anxiety beforehand. The bupivicaine feels very strange; it’s like the novacaine they give you at the dentist but it’s in your face. It wasn’t scary, just odd, and it wore off before the night was over. I haven’t experienced any real side effects except for some tenderness at the injection sites (which is different from the tenderness you get with Botox though I’m not sure I can put into words how) and very slight bruising on my forehead. (I suppose I might have bruising on the back of my neck but, well, I can’t see the back of my neck!) All told, I am hopeful that this could be a new addition to my migraine toolbox!

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