Fear and nerve pain POST surgery

Hiya, I am a 29 year old female, who was diagnosed with a 4cm AVM in the bottom right of my brain.

I was working two jobs as a policy consultant, one in science tech and innovation, and another in gender and conflict. I Handed in my notice to go freelance in June, 4 days before ending up in ICU. i suddenly had a huge headache and I could taste copper in my mouth. I never really paid attention to health, so I stuck an ice pack on my head and continued working. The next day my mum forced me into A and E, and I was swiftly stuck in ICU for 5 days, whilst they diagnosed me with an AVM.

I then made the choice to go for surgery rather than Gamma ray, because I wanted the thing out, and I really didn’t want to have to spend the next 4 years worrying about it. In probability terms, the surgery was much higher risk short term, (1/5 chance of stroke, death, loss of hearing, movement etc), but the gamma ray had the accumulated risk over 3 or four years of rupturing again.

long story short, I was meant to have surgery 3 weeks later, but it got cancelled (NHS underfunding) 6 times until I entered A and E again in September because I had an anxiety attack. I then had the surgery on the 5ht of September.

Recovery has, of course been brutal. Fatigue is a whole thing to deal with, so are the headaches.

It’s been 3 months now. What im currently struggling with is nerve pain where my scar is. shooting searing pain, and it sucks. Paracetamol, ibuprofen doesn’t work. I took pregabalin but I hate the side effects. what non medicinal things has anyone found helps? Massage? (Im absolutely terrified of touching the area incase my skull implodes), acupuncture? B12 vitamins? any advice?

I also have huge anxiety. I keep waking up to my body feeling like it’s dropping like an elevator, or watching a film and suddenly my body drops. Its terrifying. I used to never care about health, (my parents are French and I had a very French attitude about it, of don’t worry it will be fine don’t bother the doctor). ive travelled extensively, I have a masters I used to never worry about pushing myself or taking risks. And now im scared of even just walking in the street, going up and down stairs, getting drunk, it all terrifies me. ive had PTSD therapy. Im also finding it really hard to care about peoples menial problems, which is not a trait I want to keep because im normally a very empathetic person.

Has anyone else dealt with this? is it normal? what helps? Even knowing someone else has had these feelings might help me feel less scared.

Many thanks

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Hi @PopsAVM,

Welcome to the community. I like you went through craniotomy for an AVM in my Cerebellum, bottom middle right.

Like you mentioned, recovery is hard. I was told that waking up after surgery I would not have the AVM anymore, but recovery was going to be tough, and with extensive physical therapy (in my case) I should feel better 3-4 months down the road. I had surgery June 2022, and yes, recovery did get there.

Regarding the nerve endings on the scar, I had almost complete numbness on my back side of the scalp in my head. It was a mix between numbness and pinching. I was told by doctors that when they are performing cuts in surgery they can’t actually know what nerves they are cutting if any (microscopic). And I was also told that those nerve endings might take 6 months or longer to heal back, or not. That was @ Cleveland Clinic Ohio in the States. To this day the symptoms got better, no pinching or almost none, but I still have some numbness, which in my case is a trade off I am ok with.

I would say that many of your feelings post surgery are normal to all of us. Is not easy going through all of this. But in time you will feel better and learn to go through it all in baby steps.
Sometimes the fastest way to get to a destination is to go slow.

Take care

Francisco

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Hello @PopsAVM

A lot of your feelings are normal in my experience so unfortunately it’s typical of any Avm journey.
Age 19 i spent a year in hospital recovery from the bleed and surgery.
Fatigue is still a problem over 30 years later. Avm pain never stops.
I still don’t like touching my scar. The skin feels as thin as tissue paper but the first time i had a haircut post surgery i was convinced the skin would rip apart but of course it didn’t.
Id get some yoga or stretching a lessons with a sympathetic tutor, no headstands!, to see if it helps. There was some debate about me going to a gym but in the end i got go but had to start slowly.
You’ll have to adapt but eventually you can live post avm.

Good luck
Tim

@PopsAVM

Welcome to the forum! You’re definitely going through it and I’m very tempted to say that you’re still quite early in getting better, so don’t panic about not feeling ok yet. I had an embolisation and I’d say it took me at least 18m to 2 years to feel back to normal.

Fortunately for me, I’ve never felt PTSD, so I can’t tell you anything about that side of things. If you can access support for that, keep accessing it. I think it is a very debilitating thing that is dismissed by some but really important. Whatever support you can take up in that space, use, and don’t be shy about it.

I’ve not got a craniotomy scar either but I did have a carpal tunnel release surgery several years ago. With that, a cut is made in the heel of your hand to release [a tendon? Something like that] in your wrist. It’s a very simple thing in many ways but one of the elements to it is that since there are so many nerve endings in the hand, you can become hypersensitive in what sounds like a similar way to your scar.

I was advised as part of that carpal tunnel surgery to subject my hand to textures and basically re-teach it what normal sensation is like. That reeducation was to lightly touch with the pads of my fingers to start with and then move onto light running of my fingernails over the scar. Then to insert my hand into a bag of rice or lentils – things like that. Anyway, I can say that it was definitely important for my hand and effectively it desensitized it – took it back to rating things normally. So I think daring to touch your scar softly with the tips of your fingers could be a good thing: there’s no way your skull is going to implode: and you should expect it to be hypersensitive to start with. It is the repetition and familiarity that will help to reduce it.

From what I’ve read here, people do retain some sensitivity, perhaps where the bone is rougher than usual, but I’d hope that some gentle stimulation might have a similar effect as with my hand.

Always feel free to talk about stuff that’s bothering you here. That’s what this is all about.

Very best wishes,

Richard

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Hello @PopsAVM,

I hope I can maybe help a little bit. My background is also Science, Tech and Research and I have had two craniotomies initially for 4 dural fistulae and then for complications that arose that are still not okay. These complications had a number of inputs which included very poor judgement, terrifying post-operative (lack of) care and even worse communication from my surgeon to his colleagues as well as with me. I have now transferred my care to another hospital BUT there was at least one good thing that happened before I did this. I insisted on an appointment with specialist face, head and neck physiotherapists. They were able to support me with the pressure and nerve pain from my surgery and I understood from them that a self massage technique is possible to learn if the scar has healed (3 months should be long enough but get it checked). ‘Gentle’ is the key word here and you may want to ask for regular specialist physiotherapy appointments. I struggled for ages to gain the courage to touch my changed head because of how I still feel that I have let my body down. This does get better because the more you can massage your damaged areas, the more you can ‘reclaim’ your body from all the things that your medical team has done. Is ‘reclaim’ the right word? I’m not sure but I have found myself beginning to ‘make friends’ again with my changed head after I had to let my neurosurgeon take it over during surgery.
It is also horrendously traumatic to have suffered so many cancellations to your surgery before it finally took place. I have been fighting for absolutely ages to get a neuropsychological assessment (my first hospital just dismissed me) as I have noticed a change in my own emotions too. Never, never, never give in and feel forced to accept ‘no’. This neuropsychologist is aware that it is going to be hard to do an assessment as there are so many dreadful memories (I have given him the full story) but at least he is hearing my voice and somehow, we will achieve something. Can you perhaps ask for this too? Sorry if I am saying things that you have already tried. If you have anyone around you who has pets, I have found that animals can be very effective for PTSD injury. (Please ignore if you are not an animal person.)

Tons of encouragement,

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Thank you all so much for your kind words, this has helped enormously.

The big thing at the moment is nerve pain. I refuse to take pain meds because im sick of the side effects. Has anyone tried acupuncture? Does that work? Massage seems to help, but im still very scared of hurting my scar.

Many thanks!

I also have a really bad response to pain medication. Accupuncture is one of the best things for my tension, pain and distress but it’s important to feel that you can have a rapport with the acupuncturist. I have had really good and bad ones! I have also taught myself using any books I can access from the local library, some basic therapy with herbs and their properties for helping pain. On my very bad days, sometimes all I can do is to place my hands on my head scar and leave them there, letting my head rest in the palms of my hands.
I also now know that my fear is at its worst when I have neglected my food and drink. Homemade soup is a lifesaver!

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Welcome to the family @PopsAVM

Sorry to hear about your experience but rest assured there are many of us here who have gone through something similar or if not worse… the lack of worry about others minor issues was also something I experienced after surgery… kinda like I was rewired differently after surgery & thought life was too short to worry about petty things & add unnecessary stress!

As I get older I think this isn’t a bad trait to be a little selfish as we have been through a very traumatic experience & unless you have been through it, it is difficult for others to understand… not worrying about other ppls minor BS issues is quite normal & healthy!

Of course we are all human & this is life changing so please don’t beat yourself up over it… many of us live with anxiety & it is unfortunately a common thing in life that affects all walks of life!

I try to be grateful for what I have, how good life is, the second chance to live when it could have easily gone the other way… keep up the fight & look after number one… God bless!

I am so glad to see ALL of this. Really good info.

And, yes, I think “reclaim” is pretty good terminology.

Hi there, so sorry to hear that you are experiencing this. What you are describing is pretty common after someone has had a craniotomy and it varies for everyone. I too had something similar after my surgery but it was more of a sore feeling on the incision site where they did my surgery but it eventually subsided with time and with painkillers. As for your anxiety, I can relate, I had anxiety too after waking up from my coma but it went away after some time. I also had a bit of OCD before my AVM ruptured but that’s just one of the symptoms of my AVM being misdiagnosed as a mental illness. However, that too eventually stopped as time progressed. What I’m trying to say here is that the brain is a very complex organ and whenever it sustains damage, it will try to reorganize itself in a way that it works for you and cope with the damage it has so it will lead to problems like anxiety, forgetfulness, and depression. As bad as these things are it is nonetheless a good sign as your brain is trying its best recuperate. hope this helps. Take care.

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I had a spinal AVF (base of skull to C7) and as a result had an embolization surgery this summer - 14 palatium coils in my right vertebral artery to shut it down. Thankfully it worked. The pain in the back of my head was so unbearable after coming of dexamethasone steroids post surgery - I went back on them for a good 5 months. Although the side effects were challenging they really helped with the head pain and inflammation. Almost 6 months post surgery and I still feel as though I’m riding in an airplane. I assume my body is just adjusting to the change in blood flow/pressure etc. Still get random sensations like water dripping on my head and stinging but its not constant. What I find helpful is qi gong for brain and spine and gentle frequent walking. My balance is a bit off now but I find taking things slow helps me to stay on my feet. Soothing music helped me so much in recovering from the trauma of the whole experience. Also practicing Donna Eden energy exercises daily to try and rebalance my body. Before I was diagnosed I use to have regular massage and alternative treatments. I’ve been too afraid to try anything yet but I think I might start with foot reflexology and go from there. I don’t feel comfortable touching my own neck yet let alone letting anyone else touch it!

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Embolization seems, on the face of it, to be a minimally invasive procedure (and in many ways it is) but getting used to the new pressures everywhere can be a longer thing. I can say it took me a few months to feel “ok”, I then had a few days of quite significant dizziness – at about 6 months post op – and it took me 2 years before I basically felt “normal”. Not everyone gets back to fully “normal” so I feel completely lucky but 6 months post op is still very early. Hang in there!

Richard

Although two years feels like a long time - it is reassuring to know just how long the healing process can take. I am hopeful that eventually my “new normal” will be even better than I had before. Since coming off steroids my balance has been a bit off but it seems to be stabilizing again. I am so hopeful when things improve and it is so hard when they seem to go backwards. I have to remind myself frequently how far I’ve come and that there is still a ways to go. Truly grateful for how well things have worked out so far.

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