Migraine Cure Nerve Block | Auburn Medical Group

oh my gosh he announced but it’s like it’s like gone Rebecca who some of you remember from an earwax cleaning video has been having headaches and does have migraine and this particular headache you’ve been having now for the last three weeks just a block 11 mostly on little off maybe a couple hours of a break daily but not even everyday right and we’re going to use a technique of nerve block on the Greater and Lesser occipital nerves where they come out in the back of the skull right two and two the purpose is to block those nerves that serve sensation not only for the outside of school but even on the inside where you’re actually feeling the pain of the headache this will most often totally break a migraine so I was taught this technique at USC by dr. so much I srivastava and forgive me so much I got your name wrong but thank you so much for teaching and so many of many of my followers on YouTube they know when I was there because I made a little or try to make a little video on their their internet connection was down there but we’re going to bring that teaching from USC at their neurology conference to you right now okay we’re going to show how we do it I do a little differently from from soma and the way I’m doing it differently is that i’m using epinephrine with the lidocaine which I know that from my procedural background a little bit it helps to numb it longer the epinephrine will limit blood flow to and from the area so it doesn’t get filtered out and cleaned out it also makes for Leslie me which everybody likes now when we do these shots in people it’s right where your hair is so we’re not really doing a clean injection but we’re being very careful we go ahead and we we do a couple things to make it easier we rub the skin with an alcohol wipes there’s a little less bacteria on it we don’t shave hair off and we don’t need to because nobody really against infections from this and then she also sprays with a topical anaesthetics pray that I’ll put on it that makes it a little bit easier when you get the shot but we’re he’s not really planning needles yeah you remember that one so we’ll get started right away but so I’m going to push your hair forward you okay there we go come along come along oh so hair forward and people may notice you have a little coloration on your neck and that’s nothing abnormal that’s what I gave lots of yeah people people have coloration there that’s not part of what’s going on here so I’m going to be pushing and possibly a little uncomfortably pushing first I’m finding the prominence of the occiput Knoxville prominence is kind of in the mailbox yeah yeah yeahs there to walk and then amputation sort of amusing well I’m going to be going between that and the upper part of the tragus is right let me look here right here so if you draw a line between those I’m going to be going at the midpoint for the greater occipital nerve and then halfway between what’s left for the lesser occipital nerve so that means I’m going to be pushing right about here until I find the tender spot have I found the tender spot yeah yeah yeah okay good so yours yours is actually closer to this and some people will say instead the midpoint say do each of them they had a third of the distance Oh so if their or their walk a little ball all right let’s and again I just want to confirm that’s the tender spot huh all right so we’ll spray a little bit ethyl chloride to to make it cold and then we’ll give you a shot aiming upward to the spot not wanting to hit the skull drawing back to make sure we’re not in a blood vessel and then going ahead and administering I’m putting in two cc’s of lidocaine with epinephrine with 0.2 cc’s of sodium bicarbonate you don’t ok ok well let make sure you hadn’t passed down well I feel ya i’m going to fan it a little bit where I pull out and go back in draw a little bit more in that direction you still awake yeah ok is it hurting yeah a little bit i found that might be side effects like right on ok so this is the greater occipital nerve on the right and then i’m going to push it in and massage it in still okay with it off ok well i don’t want to find out that you passed out by having my foot get warm all of a sudden that’s not the way you want to fight that i haven’t but one of the instructors with dr. so he was talking about that’s how he found out that the patient passed out was his foot got warm yeah you don’t want to do that yeah ok and generally what they’ll do is give the patient a bit of a break between the injections because the the closer you do them together the more chance you’re going to cause stimulation that can lead to them passing out I’m going to very slowly go through this here and start to locate the lesser occipital nerve and start to clean the skin off with an alcohol wipe but we’re no rush here if you want me to slow down I can so we’re going to find the prominence again and you know two thirds of the way over let me feel where the tragus is there so I know we’re in the right spot so most likely it’s in this area yeah yeah you can push on it real tender spot I just find out yeah it’s right about there yes it is yes it is that’s what it feel like this right there is that where you were yeah a little bit yes rob was right thing yeah we compare that again I’m feeling the tragus feeling the prominence on the occiput and yeah about that would that would be it Wow let me give it a little straight always long oh yeah you’ll feel it’s all sorts of directions yeah so this is getting a little cold in that area to act as a local topical anesthetic so we can give you an injection in that same spot where you said you felt it and I’m going to start to inject the medicine that probably stings as it goes in and there’s a reason I’m directing from low to high on the patient’s body and that is to help to avoid accidental injection into the spinal canal which if you’re doing the opposite direction there’s a small risk although with these small needles it’s less likely and we make sure we’re up on the skull not down lower so I’m Fanning it out to get a larger area to spread out the anesthetic and then I’m going to rub that one in so that’s the lesser occipital nerve all good okay so not too bad can you tell any change in the headache pain I feel alone in the life sciences what no okay Wow so there’s tragus with that finger and I know that people in the video can’t even somebody in person here can’t see exactly what I’m touching because of the hair but that’s just the nature of it so that’s what that will put it right no no well we can get what’s called the dorsal occipital nerve most people don’t have one and it exists right here if you say yes writing your old guy well you may have a dorsal occipital nerve that we will go ahead we will give an injection there also oh okay so what I’m hitting is an area that’s actually just off to the side of mid line between the occipital prominence and the tragus of the ear on a line between them and yeah some people that is their tender spot so let me hit that on this one and maybe we’ll go back on the other one hit it too well of course you can get fit all over yeah quite worth it yeah okay I’m gonna hit it one more one more time as far as my finger on it right about there yes yeah some people that’ll be the spot to hit all right going to give you a shot there draw panic make sure there’s no blood start to inject you said ooh yeah close that’s where it hurts wha and we may have to do that also on the other side no no there’s variations from person to person yeah a little bleeding with that one so I’m going to push it in yeah we want to want to work that in how’s the headache last bowl better on one side or all over I would say just over all over fields when you say this kind of relief you mean like this is the best it’s felt in what two or three weeks that’s certainly gonna go all right okay good good good so we’re going to we’re going to journey over back to the right side because you seem to benefit from giving an injection where a dorsal occipital nerve would be located so let’s see if you have tenderness same size same nerve on the right side so we’ve hit two on the right side which actually for most people will be complete not so for you well as long as we know it and we can identify it and make you feel better by taking into account how you’re different then that’s great still feeling okay alright we’re going to yeah so I find the prominence again there it is and then I go just lateral to it that is it isn’t it yep and the reason I know where to go is just because of how far it is you know just just a centimeter be less than a centimeter over from you can see some plastic there that’s okay all right can I drop and inject you feel it like you did that last one off so you’re feeling it more than you did the the other two yeah and how about going down the back now is this causing a fastball sensation there just less pain Wow well we may not have to do anything more than this we may not have to do a greater and lesser on the left side if come on if this works if this totally eliminates the pain we don’t have to so let’s rub that in and probably have you sit up for a little bit after getting four of those injections still have headache well it’s pretty much long and can you localize where where you feel it if it is well just get so much back here that I thought well since you are plants that are getting it back sure so that means your neck that’s right your Twitter please figure out what to do go ahead and let raise your head up and sit up for a moment how’s that feel fine actually Wow can you can you sort of point to a region or area that still hurts well we thought you blocked a lot it’s all gone I have I have not felt this good in three weeks I am serious this is this is great and it isn’t bad I I didn’t know what to expect thank you so much for letting us do this thank you and thank you for joining us I do need to if you just allow me to thank some people who helped make this possible that they decided that would be like booboo Kitty and Lindsey antwine our new patron Petra from Sweden we thank you all for helping make this possible you also can become a part of that by looking at the auburn medical patreon will be a link to that and you can make sure you’re subscribed to this this channel if you like these type of medical videos and seeing patients who enjoyed helping you learn about medicine like like Rebecca here until next time Dr Marlin and Rebecca following all of you to stay in good health thanks

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