Dear insane headache thread-followers:
My husband had sinus surgery late August 2012 (moderate amount of work done) and exactly a month later his chronic headaches began. No history of headache or migraine other than sinusitis-related. 6 out of 10 pain scale -- 8 sends him to the ER. 6s and 7s for SIX MONTHS now every single day. Wakes up with it, no change without Maxalt or similar. Neurologists have him taking a rainbow of meds one after the other. Surgeon says not related - same as Splork - it's unbelievable. Period. Please keep the suggestions coming! Thanks!
I too suffer from these debilitating headaches! I had septoplasmy surgery in Jan 2011 to reduce sinus infections, and I did really well for 4 months after. I had no headaches and no infections all was well with the world; however, after that it has been horrible. I have migraines almost daily. Many times they come on while I am asleep and I am awakened by severe pain; I take an Imitrex together with an Aleve capsule and sometimes it will relieve the pain and others it will not. I have been to two neurologists and two ear,nose, and throat doctors (ENT) and I still do not know what the problem is. The neurologists say the headaches are sinus headaches and they cannot help me and the ENT's say they are migraines and they cannot help me. I am lost and suffering!!! I am currently taking 50mg of Amitryptolen every night before bed, and they have helped me sleep better, but they have not relieved the pain. I am also taking Nasonex Spray twice a day, two sprays in each nostril. Has anyone found an answer for this? I truly believe it was caused by the surgery. How do I get my doctors to understand what I am going through?
Last edited by lillygirlfletch; 05-21-2013 at 10:28 AM.
My husband (mentioned in post just before yours) also takes amytriptyline at night, but his dose is higher than yours now. He also takes valproic acid. His neurologist increased the doses for both a couple weeks ago, since there was an indication that they (or something) were helping (daily rating went from a 6 to a 4 during April). Increased dosage has not continued to improve the headache rating. Not sure if we'll stay with this treatment but not willing to back off yet in case it really is helping. Migraine diet for 5 months did nothing, so we're off that now.
You are right... these docs are in denial and someone needs to be doing the research to figure this problem out! There is a classification called NDPH--see article below. Wishing you better!
Young WB, Swanson JW. New daily-persistent headache: the
switched-on headache. Neurology. 2010;74:1338-1339
New daily persistent headache is
characterized by an out-of-the-blue onset of
a headache that becomes unremitting soon
after it develops. To receive a diagnosis of
NDPH, the patient must have a headache
that started suddenly and has continued for
3 months or more.
Most patients diagnosed with NDPH are
able to recall, to the day, when the headache
started. More than 50% report a precipitating
event, such as a viral illness, a stressful experience,
or surgery.15 ICHD-II defines NDPH
as having the characteristics of a tension
headache. Notably, however, migrainous
features are also common, and neurologists
often diagnose NDPH with either migrainous
or tension-type features.16
The sudden onset of NDPH is a red flag
and, like other red flags, always warrants
further work-up. Magnetic resonance imaging
with gadolinium is preferred to computed
tomography. Magnetic resonance
venography or lumbar puncture may also be
Thanks, Soule1. I am waiting for approval from my insurance provider to have a CT scan done. The last ENT that I've seen feels that the CT scan will rule out any sinus problems and I guess at that time I will be at the mercy of the neurologist again. I've had the MRI and it showed nothing, which is why the neurologist referred me to the ENT. It's a visious cycle! If your husband finds relief please let us know what the miracle cure is and if by chance I find relief I will post my results as well. Thanks for the info... I will share it with my ENT and neurologist.
OK guys and gals, I have read all entries. I found this search, tonight, which is my Post op day 8 following FESS (Functional endoscopic sinus surgery), and the third day of sudden, debilitating migrainous headaches like I have never had before,
Surgery was for chronic, recurrent sinusitis nearly three times yearly that recently have worsened to the point of requiring steroids and Augmentin each infection for ~10 days. So I had to do something. As above, I had septal re-orientation, bilateral maxillary and front ballooning of the septae, ethoimoid polyp removal and turbinectomies bilaterally. Also nearly 3 hours. First 5 days went as advertised...no problems. Had first endoscopic debridement Thursday, and was told then to start the nettie rinses BID. Previously doing q1-2 hour Ocean spray rinses as directed. No steroids up to this point, just vocodin as needed. Again, was going on-par.
After debridement I felt expected sinus pain, but generally breathed much better, had minimal drainage etc.
So the first nettie rinse. GENTLE, no pressure, lots of gunk out.. and then BAM, out of no where, both sinuses felt suddenly on fire and an immediate sharp pulsating pain in my left occipital-cervical junction about dropped me to the floor. I had previous migraines years ago..maybe had the most recent about a year ago, which are rather easily aborted with excedrin and motrin; Relpax has helped also. This was not disimilar...pulsating...unilateral...foc al, some nausea. No visual changes however. Since that event, they have recurred like clockwork about every 8-12 hours. More concerning, they wake me out of a deep sleep in the middle of the night (what is THAT?) Contacted my ENT,who has been GREAT, and we are now on a steroid taper. When the episodes occur, I take two Lortabs, 4 motrin, 20 prednisone and he suggested 500mg of Mag sulfate (supplement) to help. This abates it for about 6 hours. Then, slowly and predictably, I can feel it return. Same place, gradually super intense. They have NOT gotten better on the current regimen.
My ENT has been reluctant to start a triptan (imitrex,relpax etc) for the suspected re-activated migraines because of the unknown vaso-active effects...I am still technically within that 1% risk category for a re-bleed post op. BTW he did this without packing THANK GOD, as I was terrified of this, and he routinely avoids this technique in his patients. A great bonus!
I am concerned. I cannot function with these headaches. I'm a surgical PA in a high intensity, high volume practice. I am weighing the risks of re-bleed with starting migraine-specific abortive meds.
This thread was the first I stumbled upon regarding headaches AFTER FESS...lots on the net about surgery to TREAT sinus headaches, but not much on this.
My doc said he has seen the surgery re-activate migraines before, so I am not panicking...but I cannot live on steroids and narcotics that is for sure.
Any other input or suggestions is appreciated. Just glad, after reading this thread, I am not alone.
But to the OP, your Doc is whacked to say it isn't related to the surgery. OF COURSE it is, he just doesn't know about this nor have a solution....FAIL.
I hate to add yet another person to this list, but I also had sinus surgery, from one of the most respected surgeons in the US at MT Sinai Hospital in NYC. At my second follow-up appointment, I was diagnosed with another sinus infection - was already taking amoxclav875, cultured, and then given a saline suspension with antibiotic. (Gentamy)
I have had 3 major episodic headaches, that make you nauseated...and hypersentitive to light, sound, etc. Prior to the surgery, I had not experienced this kind of headache - perhaps one or twice in my life.
My surgeon used dissolving packing.
Went to GP, who referred me to a neurologist at Mount Sinai.
Immitrex plus alieve 500mg seem to break it, but it rebounds the next day -so I try to stay off the imitrex unless it's absolutely necessary.
I find it a disturbing pattern on this string of a "same story" and wonder if it might be work somehow finding a way to get our doctors together to see if there are any similar characteristics in our hx.
I will keep you guys posted after I see the neurologist.
After waiting weeks for my insurance company to approve a CT scan of my sinuses, I have just received a phone call from my ENT's office and they advised me that the scan results were good, nothing showed up. They advised me that I need to go back to see my neurologist for help with the headaches. While I am very happy to know that my polyps have not returned, I am still disappointed to know that I have not received an answer as to what is causing these horrible headaches. I am caught up again in the vicious cycle of back and forth between the ENT to the neurologist and I can't seem to find the off ramp.
The only good thing I can report is that my headaches are not as frequent as they have been. They have reduced to every three to four days and I have no idea why, but I am thankful!
If by some miracle my neurologist finds a solution I'll be sure to share it with you guys.
I have also read these posts as I have been suffering from terrible migraine headaches as well starting with my fifth day after FESS. Surgery was on July 3 and all went well. First migraine was on July 8 and have continued daily. First post-op appt was on July 9th to remove silicone rods (instead of packing) and scope out additional gunk. I thought migraine was due to weather conditions so I didn't make a big deal of it to ENT. I have been a headache/migraine sufferer my entire life and take Topomax daily to prevent tension headaches. I take Axert when I get migraines. However, I have never had the kind of migraines I've had since day 5 after FESS. In the past, when I get a migraine, one Axert will take care of it until the next migraine - which might not happen for a week or two or three. Since FESS, my migraine is continuous and the Axert will only work for a few hours and then headache/migraine returns. I will talk to ENT at next post-op appt. on July 16, but it is good to know that I am not alone.
I had FESS sinus surgery and septoplasty in March 2013 in the UK. I have CF & one of my issues was my sinuses.
I also am still experiencing dreadful debilitating headaches post surgery. I have seen my ENT surgeon who says it is a form of neurological facila pain syndrome stimulated by the surgery or the recurrent infections I had after.
I am due for an MRI facial scan today but meanwhile am taking medication called Gabbapentin which is meant to suppress the nerve endings sensitivity. It has partly worked but the problem is I then feel completely drowsy and can't work.
So the pay off is I have the headaches and can't work or take the meds that make me too drowsy to work. I'm self employed so thoroughly fed up with it after 5 months especially as this isn't my only health problem...
Has anyone tried a facial tens machine with any success?
I hope any headache sufferer after sinus surgery will see this: I had sinus surgery three years ago and had never really experienced any kind of headache. My headaches started within two weeks post surgery with mild to moderate level pain once per week. Within 6 months the headaches had become a regular part of my life (several per week). The symptoms had been headaches and general feeling like a had a bad sinus infection.
After going to many different types of specialists (ENT, Allergy, Immunologist, Infectious disease), I had enough and went to Mayo Clinic, where my initial appointment was with an ENT. The ENT inserted a fiber optic scope in my sinus's where I could observe on a HD screen, where he pointed out that my sinus's looked good. Something very interesting happened just prior to the insertion of the scope/camera, the ENT sprayed a numbing medication into my sinus's. At that time I had been feeling very lousy with headaches, once he sprayed the numbing medication, I immediately felt 100% better. The doc's comment was "that is interesting"!
He found nothing wrong with me, and sent me to the headache clinic. We were seen the next day, where the neurologist immediately knew what the problem was. The head is full of small fibrous nerves, and when the sinus surgery occurred, it cuts these nerves. Most of the time the nerves re-wire themselves correctly, but in my case that didn't happen. The situation is the nerves are sending false signals to my brain, where it is doing what it believes to be correct information in sounding an alarm of a problem in order to protect itself. I was put on Gabapentin to suppress the false nerve signals. Most of the time the drug works ok to good, not always though. I can maintain a relatively normal life, where I work, take care of a family (3 young kids, wife). It is certainly not always easy, but I try to maintain the best I can.
When I have gotten off track with managing this, I get pretty angry, trying to research an alternative treatment and cure. One thing that I do additionally rely on is peppermint oil (pure), I take about three drops on a Q-tip and rub it around my nostrils (remember I mentioned the numbing meds at Mayo). Peppermint oil has numbing properties and has a similar effect, just start slowly as it does sting a bit, but can provide temporary relief. Additionally I do have an RX for Midrin (I have this compounded at a Pharmacy in Michigan do to the unavailability of the original formula).
So if you suffer headaches after sinus surgery, there are some answers, you just have to go to the right caregiver. If they are not a Mayo Clinic type facility, don't waste your time, as most Neurologists don't see or have the answers for these situation's. My guess is there are very few docs in the world that can diagnose this, believe me, I spent many thousands of dollars trying to find out.
I searched far and wide before I found an answer. I hope someday that I am cured and off all meds, but in the meantime I have some solutions to get through the day. Headache pain is the worst I have ever had, so I know this is at best tough to deal with. I do hope this helps! Mike
My story is much the same as everyone elses. It has now been 2 years since my nasal passages were cleared and enlarged for chronic sinusitis and the headaches are terrible (also had deviated septum fixed at the same time).
My ENT keeps assuring me that the pain will get better, but HA! So far it hasn't.
Has anyone noticed the pain and headaches being worse when the weather changes?
Also, every time I work out enough to get my heart rate up, I pay for it for a week with intense pain in my sinus area.
Sure, I can breath all the time, no matter how bad my current sinus infection is, but the head pain is so bad that it drives me bonkers.
Glad to know that I'm not the only one. I'm going to see the ENT again (grrr) and mention the above comments about the nerve endings not rewiring properly. Every time the ENT tells me to just take some tylenol I want to find a way to make him switch noses with me.