Announcer (00:01):
You are listening to Head On with your host, board certified plastic surgeon, Dr. Bahman Guyuron, the pioneer of a life-changing surgery for permanently eliminating migraines and a specialist in plastic surgery of the face, head and neck.

Eva Sheie (00:19):
Thanks for listening to Head On. My name's Eva and I am Dr. Guyuron's podcast producer. And I'm here today to talk with a patient who's had migraine surgery and has an incredible story to tell. And her name is Tabatha. Welcome to the podcast, Tabatha.

Tabatha (00:34):
Thank you for having me.

Eva Sheie (00:35):
Tell us a little bit about yourself and what you do.

Tabatha (00:39):
Yeah, I am a beautician and a social worker. So my migraines probably started when I was 22 and they would start off maybe once here or there in the week. I would have maybe a couple and within the week, and then it started becoming every day. And then at some point it turned into, I don't even remember what age it was. I want to say probably maybe 25. I was having migraines pretty much every day I would wake up with migraines, I would go to bed with migraines. Pretty much my whole day would be a migraine. And I went to family doctors who then would be like, here, try this medicine and that medicine and this medicine. And then finally they were like, oh, we'll send you to this neurologist. And then I got sent to another one and then they couldn't help me and so they sent me to another one. I think I seen five neurologists total. And the one I'm currently at was kind of, it would've been two years ago that he was like, there's nothing else I can pretty much do for you besides refer you to Botox. And the Botox, you have to be committed for a year. And that's something that when we were talking about it, they were very like, oh, you have to, regardless of the side effects, you had to be committed, which was scary to me. I was like, I don't know what that entails.

Eva Sheie (02:04):
So how many years was it between when you started having headaches and when you had surgery?

Tabatha (02:10):
At least 10 years for sure.

Eva Sheie (02:14):
What was your life like with the headaches? What kind of things could you do or not do because of the migraines?

Tabatha (02:21):
So I would always have this big purse or this big bag full of headache medicine and oils and creams and everything. And I would use them daily and I would wake up every day and I would maybe have a headache, maybe not, just depends by pretty much 11 o'clock, I would probably get a headache and then I would have to like, I would smell like a peppermint ball. Everyone could smell me and they would be like, I can smell Tabatha. And I'd be like, awesome. They know me as the peppermint ball because I would have headaches all the time and I would just have peppermint on me to try to get rid of it. There would be days that maybe I would have some that was maybe less severe. Some the days that were really bad, I would have to get picked up from work from my boyfriend or from my family members, whoever would be available to me.

(03:25):
I couldn't drive because I couldn't focus on the road to even drive because my headaches were so severe it would be hard to do my job. So as a social worker, as a beautician, it's very hard to concentrate when you have a chronic migraine and all you can think about is the pain that is providing you. There'd be days when I would find a dark room and I would just sit in it praying that my headache would just stop or the medication would, I don't know, work. And sometimes it didn't. Honestly, a lot of the times it didn't. I just had to be strong and just manage it, deal with it. I lived with managing how to live every day in pain, which was kind of sad to be honest with you. But I did learn how to, alright, I got a headache, oh, well let me make sure I don't go outside when it's humid because that would make me have more of a headache or let me not do A, B or C because that could increase my migraines. So just kind of not doing things that I really wanted to do or could do just to try to limit that trigger for it.

Eva Sheie (04:40):
The weather would make you have a headache?

Tabatha (04:44):
If it was too humid, it would increase. It would be too much pressure. So then it would give me headaches. I would hate the summer. Hate it. I mean, despise it. I mean I wouldn't go outside barely. And if I did, if it was really humid, I could feel it and I would be miserable. So miserable. So I would always be praying for the wintertime. I'd be like, there's no humidity in the winter. But yeah. And now since the surgery, I can go outside, I can walk around in the zoo, I can do whatever I want to do and I don't have that fear of oh my gosh, this heat's going to give me a headache or not.

Eva Sheie (05:29):
Could you point to the spots on your head where the triggers were? Could you actually feel them?

Tabatha (05:35):
What's really crazy is for the 12 or whatever, 10 years that I went to neurologists, not one of those neurologists cared about the trigger points at all. In fact, they only cared about what you ate or what you were doing. I mean, I did multiple different eating or what you were doing. Were you stressed? They swore up and down. It was like caffeine induced or stress related. I mean I had neurologists telling me I needed to have an airplane pillow because that was what was, or I needed to get massages because I was too stressed or that I should stop drinking. I dunno, coffee or whatever. And I would be like, that's not it. I know that's not it. And they just wouldn't listen to me. And the neurologist that I have is good, but he never asked me, where's your trigger at with where it started? And when I started doing that journal for Dr. Guyuron, I was like, oh my gosh, why didn't no one tell me to do this? This is so important. Why isn't this being done? Because I mean, ideally that is where it starting, right? I mean it's brilliant. But the five neurologists that I went to go see, never even considered to do that type of trigger pressure point thing or that recording for it.

Eva Sheie (07:08):
Can you tell me more about the journal? What does he ask you to write down?

Tabatha (07:12):
Dr. Guyuron has a sheet that just has you track your headaches. And so what it does is it narrows down the point of your head that it starts beginning, where does it start at? And then what can increase that? Is it sun, is it humidity? Could it be menstrual cycle? I mean there was other things that you could write on what's affecting it to increase it, but the pinpoint for the area is to determine where he would go in for his surgery. So if you have multiple different sites that keeps reoccurring that it starts off, that's where you would have multiple surgeries ideally. But that lets you know, hey, because when you have a migraine, your head just hurts, right? You might think it starts at your eyes, but it doesn't necessarily really begin in your eyes unless that is really where it begins.

Eva Sheie (08:06):
How many trigger points did you have?

Tabatha (08:10):
I had four.

Eva Sheie (08:13):
And were they symmetrical?

Tabatha (08:15):
Yeah. I only had surgery done for one of the sites that he recommended. When I went down there to do the consultation with him, he did say that there was three areas, which would be six sites total. That was trigger areas. But when we were talking, the way he made it sound was he would like to start. He was very honest, I want to start with this area because it could result in taking care of the problem and then if it doesn't, then you could come back in and do the others. He was very respectful about what would be beneficial financially and what made sense medically to do so. We did start with the areas of when we went into surgery, when I ended up going into surgery, he was like, I'm going to add these two different ones in there. You're going to get the best out of your surgery this way. I mean he was clearly doing it because he wanted to have success.

Eva Sheie (09:32):
What part of your head were they?

Tabatha (09:35):
So they were my temples and then right above my ears.

Eva Sheie (09:41):
And so did it take a long time to recover from that or was it pretty smooth sailing?

Tabatha (09:46):
I will say I recommend taking three weeks off. I tried to go back to work a couple days after because I was like, I could do this, it's fine. I'm not bruised up or anything. I mean, I was kind of tender in the areas, but I wasn't like my face wasn't swollen, so I was like, I'm fine. And your body internally is tired and that is something that you don't see. And so it does need rest and it does need to heal. So you might have a little boost of energy for a couple hours, you're going to get tired. So I think take the three weeks off if you can. I mean definitely I would say three weeks. I think the hardest part for me was having restrictions. So you can't lift under over 10 pounds and you can't bend over. I mean, 10 pounds isn't a lot, to be honest with you. That is a lot of, I mean, most things are over 10 pounds, so being restricted to a lot of things can be hard. I think that was something I struggle with because I wanted to continue doing the things that I did before. And the more you strain, the more you get exhausted and it affects you and it hurts because you're, the blood pressure where that blood flow is going is pulsating and it's definitely harder for it to heal.

Eva Sheie (11:13):
How quickly did you know that the headaches weren't going to come back?

Tabatha (11:19):
I don't think I really knew. I had pain, which was not a migraine, but it was like my head hurt, which was so weird. I couldn't explain my head hurt, but it wasn't a migraine, but it was an area of my migraine. It was a weird feeling. And so for the first couple of weeks, I remember when we did a checkup with Dr. Guyuron, I was just like, I feel pain still. I feel pain in my head. How do I know this is not going to be a headache? I don't know what to know. And he was like, if you haven't really had a migraine, then it's going to keep getting better. And I was like, what do you mean it's going to keep getting better? He was like, it'll keep improving. And I mean it did. And I want to say probably after, because I still had to take, so I was taking Emgality the shot every month and I had to still take the Emgality after my surgery because I had to wait to see my neurologist, for me to stop it and get off all my, I was taking medicine every day, the monthly shot every month.

(12:29):
And so I had to wait a month to really know and a month even after that because it takes over a month to get out of your system. So I probably would say six months when I wasn't having anything, I was like, huh, this is different. And now that it's been over a year, I feel pretty confident that the surgery was successful.

Eva Sheie (12:53):
And so no migraines since surgery.

Tabatha (12:56):
I get 'em during my menstrual cycle. I do. I do, but it's not every month. It's so weird. It's like maybe one month every other or something. And it's just that. Nothing else. Yeah, nothing else.

Eva Sheie (13:15):
Did any of the neurologists ever suggest the surgery or know about the surgery? Did they even consider it's just not existent?

Tabatha (13:26):
Nope. When I went to, so I actually never told my neurologist I was going to see Dr. Guyuron. I did not let him know. I don't know why until after I did the surgery. Honestly, I didn't even know. I didn't even know if I would be a candidate. I didn't know what the doctor would say. And then it happened so quickly. We had the appointment with Dr. Guyuron on Friday, and then he was like, we can get you in on Monday for your surgery. And I was like, okay. So then I want to say after the three weeks, I ended up having a follow-up with my neurologist. So I mean, it was kind of weird. It all happened that way. But when I told him about it, he had no idea about it. He was asking me questions. He was very intrigued about the surgery. He wanted to tell people, even was like, can people have your number to tell them about it? And I definitely was like, yeah, I'll definitely talk to anybody. And he did kind of say during our appointment, he wasn't sure how it would fix it and that he would be worried that it came back, that the blood flow continues to regrow and that I would get my migraines. But it's been over a year and I mean, I'm still off all my medicine and I don't have them, so.

Eva Sheie (14:48):
Do you have any regrets about it?

Tabatha (14:51):
No. No. I would do it again. I would do it every year if it meant a year without headaches. Not saying the awake surgery was fun because that was definitely not like the dentist's office.

Eva Sheie (15:05):
Oh, you were awake.

Tabatha (15:06):
Like I was trying to be patient. Yeah. Yeah.

Eva Sheie (15:13):
Do you remember how you heard about the surgery?

Tabatha (15:17):
Yeah. I had a new client who lived in Chicago that came into Ohio where I'm from, at our salon and got her hair done by me. Never met her before. I've never seen her again in my life, honestly, besides that one time. And she came in, we were talking about why she was living in Chicago and she was telling me that she went to go search for someone to help her with her migraines. And I was like, okay, tell me about this. And she said that she moved to Chicago and then later found out this doctor in Cleveland that took care of him for her. And of course I was very intrigued by this because I had no idea this was a thing. And she said that she did the surgery and it was a success for her and that, I mean, she was over a year without having a headache. So she gave me the contact information and I was right on it to call.

Eva Sheie (16:15):
She was actually an angel. She wasn't just a regular client.

Tabatha (16:19):
It was something because I was like given up hope. I mean, neurologists was just telling me, this is your life now. I was told if you were a male, usually if you were a male at a certain age, your headaches would go away, but because you're a female, you have to live with them forever. And I was like, awesome. That's awesome.

Eva Sheie (16:43):
They were every day and you're being told they're going to be there forever.

Tabatha (16:46):
Forever. It would get so bad where I was wanting to pull my hair out, they were hurting so bad. I mean, I remember one time going to the hospital, it was probably six years ago, I went to the neurologist or I went to the hospital. I had such a bad headache that I was like, I can't do this. And the hospital really didn't know what to do. They were like, I'm giving you all this and it's not helping you. And I'm like, okay, so I'm just going home. And they're like, yeah, I'm sorry. Follow up with the neurologist. And I'm like, okay.

Eva Sheie (17:21):
Yeah, go back to the same people who can't help you either.

Tabatha (17:26):
Yeah. Yeah. It was an experience. I will say probably the first five, six years, when I first started getting migraines, it was a battle to advocate for myself that I had headaches, migraines. I think a lot of doctors, I don't know if they thought that I was seeking pain meds or something, but I mean, I would go in there, I don't want your pain meds. I want you to just get rid of my headaches. And doctors were just telling me, you're fine. This is all the things I would get told. I was like, are you kidding me? Why did I pay this money to come to you for you to tell me that I'm not even taking me seriously? I think that was probably the biggest challenge. And then once I found doctors that believed me, my blood pressure was too low, so I couldn't do certain medications because it would bottom out my blood pressure and then, or they would be side effects where you would be sleepy because it makes you sleepy or you would decrease your hunger. I mean, there would be always something, a catch 22 with the meds.

Eva Sheie (18:35):
If you ran into somebody who had migraines like yours, what advice would you give them now?

Tabatha (18:42):
I just tell 'em, just check it out. What do you got to lose? I mean, I tell everybody, everybody. I talk about it a lot because I think people have migraines all the time, but I'm like, what do you got to lose to just call and talk to 'em? You got nothing. You make the decision. Why not? I will say that I think maybe people might be scared of the surgery. I mean, it's scary. I think if I would've wasn't in so much pain, I probably would've been scared of the surgery. I was So I don't care what you do, cut my brain open and take it out for all I care. I was in so much pain that I did not care what they did to me, but people around me were really worried, you're having surgery on your head. And I was like, it's fine. It's fine. It's fine. So I'm sure people that are normal and isn't like me, that would be who caress. If you come into my brain. I'm sure they could be scared or worried or have fear, but I mean definitely it is.

Eva Sheie (19:47):
He doesn't cut into your brain, your being funny. <laugh>

Tabatha (19:49):
No he doesn't. <laugh>

Eva Sheie (19:50):
Okay. I was just making sure.

Tabatha (19:54):
Cutting into, like, your head area. But it is a small procedure. It's nothing. I mean, it's a minor procedure. You go home afterwards depending on the type of surgery. And the staff is really supportive too.

Eva Sheie (20:11):
Well, thank you Tabatha, for sharing your story with us. We really appreciate it.

Tabatha (20:15):
Yeah, thank you for having me.

Announcer (20:18):
Links to learn more about Dr. Guyuron and anything else mentioned on this podcast are available in the show notes. Head On is a production of The Axis, THE AXIS.io.