Overcoming Migraine: A Patient’s Journey Through Post-Surgery Care

After undergoing major surgery for a complex tibial plateau break, a patient faced the daunting challenge of managing a persistent migraine that lasted for 19 days. This experience highlights the difficulties many individuals encounter when seeking effective treatment for migraines, particularly in a hospital setting. The situation underscores the need for better training and awareness among medical personnel regarding the complexities of migraine management.

From Surgery to Migraine: A Challenging Recovery

On December 17, 2024, following a fall that resulted in significant injuries, the patient underwent surgery to address an external tibia/fibula break and a complex tibial plateau fracture. The fall occurred while she was attempting to coax her puppy down a staircase. After surgery, she faced a recovery period that included 12 weeks of being non-weight bearing and six months of healing. Unfortunately, the healing process was complicated when the bones stopped mending after four months, necessitating a second surgery to replace the rod and hardware intended to stimulate healing.

Just four days after this second surgery, the patient began experiencing the onset of a migraine attack. Research has indicated a potential link between general anesthesia and the development of postoperative migraines. Initially, the rehabilitation facility did not provide her with her prescribed migraine medications due to unfamiliarity among staff. Despite her proactive approach in managing her treatment, she faced significant hurdles.

Navigating the Healthcare System

The patient found herself in a difficult position. As her migraine intensified, she was forced to advocate for her own care. After several days of ineffective medication management, she requested that the floor doctor consult her headache specialist. The specialist recommended a Medrol dose pack, but the floor doctor hesitated, citing concerns that steroids might impede her leg’s healing process. This dilemma forced the patient to weigh the risks of prolonged migraine symptoms against the potential for another setback in her recovery.

The rehabilitation staff, while competent and caring, were largely unprepared to address her migraine needs. Many perceived her condition as merely a “bad headache,” which compounded her struggles during rehabilitation. Simple tasks, such as transferring from bed to wheelchair, became excruciatingly difficult, exacerbated by the migraine symptoms.

After 16 days of persistent pain, she was able to contact her headache specialist, who arranged for her to receive IV infusions at her office. The relief she experienced upon returning to her specialist’s care was profound. The treatment included a variety of medications administered via IV, nerve blocks, and a short-term prescription that ultimately alleviated her migraine.

Two days following this treatment, the migraine lifted, allowing her to make significant progress in her physical and occupational therapy. Despite the lingering fear of a possible return of the migraine, it did not resurface. This experience not only provided her with an opportunity for self-advocacy but also allowed her to educate the rehabilitation staff about the nature of migraines and the importance of appropriate treatment.

As noted by the authors of a workforce gap analysis in headache medicine, “Few physicians receive adequate training to effectively diagnose and treat migraine.” This lack of training often results in misunderstanding and mismanagement of migraine conditions among healthcare providers.

While the patient’s journey through recovery was fraught with challenges, it also served as a crucial reminder of the gaps in knowledge surrounding migraine treatment in medical facilities. As healthcare systems continue to evolve, the emphasis on comprehensive training in headache management is essential for improving patient outcomes.