March 15, 2022

Nurse becomes patient for migraine treatment

New procedure prevents use of opioids for severe headaches in some cases

Madison, Wis. ‒ A UW Health doctor and nurse partnered to perform dozens of migraine treatment surgeries, but one day in 2019, the physician was surprised to find the nurse waiting for her own appointment with him at the pain clinic.

Abby Turner, a registered nurse, who currently works at the allergy clinic at UW Health’s 20 S. Park Clinic, has battled headaches her entire life, but about seven years ago in nursing school, the intensity ramped up, she said.

This led her on a common journey for many migraine sufferers: The search for answers and relief.

She met with a primary care provider and received a prescription for Imitrex.

“It did not go well,” she said. “It made me faint.”

Her primary care physician then recommended she see a neurologist, which Turner did. She was prescribed propranolol, a drug for high blood pressure, but that didn’t really resolve the issue either, she said.

“It helped, but the migraines didn’t go away,” Turner said. “It got them down to once every few weeks instead of weekly.”

It so happened around that time, she began working at the UW Health pain surgery center alongside Dr. Alaa Abd-Elsayed, medical director, UW Health Pain Services and Pain Management Clinic, and associate professor of anesthesiology, UW School of Medicine and Public Health, assisting with radio frequency ablation for migraines, which is a procedure that uses heat delivered via electrical stimulation through wires and probes to nerves in the head.

Then came the day of Turner’s own appointment at the pain clinic.

“I walked in the room and there was Abby,” Abd-Elsayed said. “We had worked on so many cases together – dozens of cases – but now she was possibly the one I’d be treating.”

She wanted to know if radio frequency ablation treatment would work for her, and he was receptive, but Dr. Al (as he is known) had a new technique that could do even more for her.

This new technique combines the use of diagnostic nerve blocks, an injection that disrupts the nerve that signals pain, as a trial in preparation for radiofrequency ablation, which is used to extend the lifespan of the block, according to Abd-Elsayed.

“A colleague had heard about me using the technique, read my publications on the technique and thought I should name it, so I came up with ‘The ALblation Technique,’ ” he said.

The new treatment is for people who have tried other treatments, but have not been successful in preventing migraines, Abd-Elsayed said.

At first the results were puzzling because nothing happened for about two months, Turner said.

“But then, it was like a light switch,” she said. “I didn’t have another headache for 10 months.”

The technique’s results aren’t permanent, Abd-Elsayed said, but there are no known serious side effects, and its impact can last as long as 14 months to two years, he said.

“A year is far superior to drugs that must be taken daily and can have side effects, or worse, dependence on opioid medication and all that that entails,” Abd-Elsayed said.

Turner, who is expecting her first child, had her third ALblation procedure in July 2021 and it continues to prevent her migraines, she said.

“This has given me a life without this terrible pain,” Turner said.