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Dr Elliot Shevel

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To be completely fair, I've been doing a LOT of research on Dr Shevel's patients.  

 

I'm finding about an equal count of people that it worked for, and it didn't work for.  Finding quotes like this:

" Last year she went to Dr Shevel in Johannesberg, had two operations, and was pain free for 4 months. Then they came back!!!!! We are beside ourselves as they are worse than ever."

 

"August 29, 2015  My niece went back to JoBerg and stayed there for three weeks. During that time she had 3 procedures done but unfortunately it didnt work. When she arrived home in Australia she was worse than ever and it has been devastating. "

 

Speaks loudly that this treatment is not a cure.  It does look to have helped some people for creating remission of varying time periods.  But CURE, it is not.  With air fare, lodging and of course the Dr's high charges.  Looks like the cost may be up around 25,000 to 40,000 US dollars.  That's not chump change for someone to get temporary relief for a few weeks to a few months from our CH.

 

I'll continue to post information I find, but so far the only reports of it working are short term help (accept for Deb's report).

 

J

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'Reading all the blogs that in no way represent the experience I, and so many others, have had at the clinic serves no purpose for me.'

 

Well, that says it all. You have posted on three of the Boards on this site. They all say the same thing. CURE. You want to speak at our conference even. You accuse this site of not honoring its' mission. In addition, you have provided no facts to support your stance.

 

We will keep an eye out for Neurologist's testing and replicating this methed for sure. If it is proven to be effective as a cure, I am certain that we will all celebrate and post the outcome here.

 

For now, perhaps you could provide facts? I am sure that my friend in South Africa, who has also undergone this treatment would be quite interested in reading them.

 

I have had CH for over 40 years. I have had a ten year remission during that time. I have seen treatments come and go too. If this treatment proves to be a 'cure' without creating casualties along the way I might be interested.

 

Facts please.

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I am 53 years old and can not remember not having these dan headaches. I had a 1 year remission completely migraine and cluster free about 20 years ago. I agree with spiny, if and when there is a cure it will be in the U.S. Why anyone would go and get these treatments that are not approved in the U.S is beyound me, complete desperation I guess?

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I have until now refrained from getting into an internet dispute but the damage caused by misinformed people online offering opinions without evidence has created untold harm to headache and particularly to cluster sufferers. Every patient that reads what Boston Headache Doc has written in relation to the treatment modalities The Headache Clinic offers (unique in the world) is deprived of the chance to live a normal, productive, and pain-free life. The efficacy of our treatments have been scientifically proven, have an extremely high success rate, and my medical research of more than 25 years into headache science has been extensively published in the medical literature, and I have lectured on the subject at congresses all over the world. Scientific evidence is the final arbiter, and not unsubstantiated opinions.

I will address each of the disparaging and patronising comments levelled at me and look forward to robust debate with Boston Headache doc and any other interested parties.

Boston Headache doc wrote:

 

“This man” likely knows very very little about headache medicine - he is a surgeon with NO training in headache medicine and does NOT manage headache patients”. 

 

My response:

 

“This man” has more than thirty publications in internationally recognized peer-reviewed journals – most of these publications deal with primary headaches. My publications can be accessed at http://www.theheadacheclinic.net/publications/ . “This man” is also a peer-reviewer for “Headache”, the official journal of the American Headache Society, “Cephalalgia”, the official journal of the International Headache Society, the Cochrane Collaboration, and many other medical journals. A peer reviewer is someone who is deemed by the journal’s editor to be an expert on the subject and to have the knowledge to judge whether articles submitted to the journal for publication are good enough to be published.  At my headache clinic in South Africa we see and treat approximately 70 new headache patients every month – having restricted my practice to the diagnosis and treatment of primary headaches for 25 years, this is in excess of 20,000 patients.

"This man" has also co-authored articles with Professors of Neurology at Harvard University Medical School, Cagliari University Medical School, and Bari Universiry Medical School, and many other prominent headache researchers.

Boston Headache doc wrote:

There are a number of surgeons offering a surgical 'cure of migraine and occasionally cluster headache as well. It appears “this man” ligates arteries, branches of the external carotid, and in addition can remove certain small facial muscles.

 

My response:

The surgery I do is completely different from the procedures that Boston Headache Doc is referring to. My surgical procedures are founded on indisputable, verified, and published scientific evidence, and this accounts for the excellent success rate that I am able to achieve. The rationale for ligating branches of the external carotid artery is all verifiable and is supported by medical literature. I do not and have never removed facial muscles – Boston Headache Doc clearly did not check his facts before criticizing me for doing so.

Boston Headache doc wrote:

Unfortunately this is all nonsense to me.”

 

My response:

To any person who has taken the time to study the medical literature on the subject, it is most certainly not nonsense. It is evident that Boston Headache Doc is not aware of the relevant literature.

Boston Headache doc wrote:

“These are brain disorders, and such procedures could never produce a 'cure' and it is very hard to find a biological rationale for improvement either.”

My response:

A common belief among “headache gurus” is that primary headaches such as cluster and migraine are brain disorders. I challenge Boston Headache Doc though to provide me with literature proving that these are brain disorders. This belief has never been substantiated scientifically, in spite of the millions of research dollars that have been spent in the search for this proof. But for me the most important thing is to eliminate the pain and allow sufferers to regain a normal and productive life. Whether it is a brain disorder or not, the pain does not originate in the brain - and it is the pain and the associated symptoms that cause the distress - the aim of my treatment is to eliminate the pain. If researchers one day find the root cause, whether it is in the brain or elsewhere, and find a way to eliminate it, my treatment will become obsolete - but until then it remains a valuable treatment modality.

Boston Headache doc wrote:

“I am open to odd treatments if there is some biological rationale but it is nonsense here.” and  “I have seen victims of migraine surgery but not cluster surgery like this...as yet.”

My response:

The fact that Boston Headache Doc has not seen the results of the vascular surgery is meaningless. I have published the results, and I have scores of testimonials, written and video, showing the excellent results. There is no other treatment modality with such a high success rate. As I mentioned above, the rationale for ligating branches of the external carotid artery is all verifiable and supported by the medical literature.

Boston Headache doc wrote:

“Noninvasive surgery'- isn't that an oxymoron?”

My response:

Yes it is indeed an oxymoron – but I have never claimed to perform non-invasive surgery nor have I ever used the term. What I do is “minimally invasive surgery” - this is essential to minimize side effects and post-operative trauma. There are entire medical journals devoted to minimally invasive surgery.

Boston Headache doc wrote:

“Happy to discuss further if needed.”

My response:

I am delighted that Boston Headache Doc is willing to enter into a dialog. Scientific evidence is the final arbiter, and not opinions. I believe that the pursuit of truth would be best served by Boston Headache Doc and I producing scientific evidence to back up our respective claims, and I invite Boston Headache Doc to take up the challenge.

Boston Headache doc wrote:

“Sorry if I am stern here, but I do not like vulnerable people being taken advantage off by, at best, misguided physicians.”

My response:

If anyone is misguided, according to the medical literature, then it is Boston Headache Doc. Most “headache gurus” have very little real knowledge of the origins of cluster pain. They offer opinions with emotive phrases to scare patients and when in fact they are dooming them to a life of misery when help is actually available and scientifically substantiated.

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Dr. E,  it took you a year and a half to come up with a response? 
Is business that bad?
All those peer reviewed articles not beating a path to your door?
Word of mouth from all those 'Cures' not working for you?
Sheeesh

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The thing is Mr. Shevel, the published studies that you are talking about include a total of one on cluster headaches and that study has a fail rate of 20%.  That's IF you actually got relief for these people by your surgery and it's not, to use your own words--  "In the treatment of CH, the possibility must always be borne in mind that the cluster stopped spontaneously, not because of the intervention, but because of the natural progression of the disease."   (or because you gave them the right drugs for anesthesia which knocked them out of cycle, just like many of the meds that we use for clusterbusting) The 80% success rate in this story gets a lot of press from you and your business, but very little attention gets paid to the failures.  What are their stories like?  Because on this site we have heard from more than one of them and the stories have been pretty horrific. In case Mr. Shevel has not taken the time to read through the rest of this post here are the reports-  

 

"August 29, 2015  My niece went back to JoBerg and stayed there for three weeks. During that time she had 3 procedures done but unfortunately it didnt work. When she arrived home in Australia she was worse than ever and it has been devastating. "  

 

"My sister went twice as she really believes Mr Shevel could cure her.  Both times her wounds got badly infected and the cuts in front of her ears looks horrible as the stitches were not done properly." 

 

"I have been through 2 operations, and sadly my headaches is not even 1% better. As a matter of fact, where he has cut hurts tremendously. AND I AM R70 000 South African Rand poorer. He promised me he would make it better.  >:( My husband took out a second mortgage on our home. I have also found out that he has lied to me. My jaw could not open after the first operation, and he said he never had this problem... Just to find out someone else on this forum had the same problem.

I went to the headache clinic specifically asking them to help me with medication overuse headaches, and they just wanted to operate. I was already taken morphine on a regular basis, I WAS DESPERATE.

I THINK THE HEADACHE CLINIC IS THE LAST PLACE TO VISIT IN SOUTH AFRICA IF YOU ARE SUFFERING FROM CH.

IN my opinion they are money hungry sharks, which thrive on the desperate and vulnerable."

After every operation, I got infection. They do not sterilize where they cut, that's why infection happens so frequently. I know they do not sterilize, because the tears on my cheeks where clearly visible through my make-up.

The day when they did the tests I have given them a list of all the meds and ASKED HIM ON SEVERAL OCCASIONS.... WHAT ABOUT THE DETOX. Seriously, if I asked him 5 times, I am not joking. Every time, he told me that so how, after the operations, there IS ZERO DETOX effects. I had the WORST DETOX in Desember after the first operation. Sad, since, my original reason I went there was for them to PLEASE get me off of all the meds!!!! For goodness sake, as a clinic specializing in headaches, the effect of rebound headaches should be so clear!!!  Again, they are money hungry sharks!!!"

 

Even if you get relief from your clusters, if your clinic is so messed up that you die of a sepsis infection because your wounds weren't treated right who cares?  Or how about some really great facial scarring with a side of bankruptcy and still have no relief from your clusters?

It's true that it is hard as hell to find a doctor that knows what they are talking about and when it comes to cluster headache there really is only one way to prove that you are actually basing your actions on facts, not opinions.  That's to pass the exam the United Council for Neurological Sub specialties has for headache medicine. https://www.ucns.org/  McGeeney has passed this, have you?    When you say

"If anyone is misguided, according to the medical literature, then it is Boston Headache Doc. Most “headache gurus” have very little real knowledge of the origins of cluster pain. They offer opinions with emotive phrases to scare patients and when in fact they are dooming them to a life of misery when help is actually available and scientifically substantiated."  

I would say you have this quite backwords.  McGeeney has proven time and time again to all of us here on this site that he has real answers that can and have helped us.  He's proven he knows what he is talking about and he has done all of this essentially for free, never once trying to make a buck off of anyone.  I am pretty sure he has not actually left anyone without the option of eating solid food anymore either, which I am pretty sure is something you can not say.  The only thing that you have proven is that you are willing to disparage people you know nothing about in order to save face from the mutilations and pain that you have caused in your effort to fill your bank account.

Final note--On this board it is generally frowned upon when people try to sell things to other members.  Especially when the price tag is around $50,000 and the only thing you are likely to get out of it is the knowledge that sometimes things actually can get worse than just having clusters.

By the way, thanks!  I'm giving a conference talk at the biggest psychedelics conference this world has ever seen in about a week and I was looking for some more material for my talk.  The rogue "Dr's" that are out there trying to make big bucks off of desperate people by the old slice and dice will make for a good attention getter.

-Ricardo

 

 

 

 

 

 

 

 

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I want to try to stay neutral when it comes to people posting on the board,  BUT...  

In situations that someone would post garbage bashing one of the BEST CH doctors there are, is a quack...  Plain and simple...  Boston Headache Doc listens to his patients, and works toward getting them to better manage their (our) condition..   Shevel for all practical purpose (IMHO) is a quack...  There's entirely too many first hand experiences that people are in the poor house (upwards of $50,000 for his procedures) with worse CH because of Shevel's procedures....   

J

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Mr Shevel,

 

I don't have the energy or time to empty my brain of all that I have to say to you.  I find it disgusting that you come here to try and find more ways to supplement your income.   You know well you don't offer a treatment worthwhile to even try and you should know full well your results have been poor while costly to the patients you have cut up.

 

Feel free to link your papers (not just a list of supposed papers).   Feel free to link your testimonials.   Mostly, would love for you to link a medical reason your cutting would work for CH.  

For full transparency, I plan on reading each with the sole purpose of preparing a stronger defense against your marketing efforts in CH patient sites like this.  For you, if you are legit, your work would stand the scrutiny (which we all know it won't).

Anyway, thank you for reminding us all you are still out there.  We need to make sure we are letting everyone know the truth about your profit making endeavor.

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Mr. Shevel never ever will stop shitting. His business model is just to much successful...
He just needs a few patients every year in order to make a nice income. Logic tells he is able to get them when trying hard enough. The onliest we could do is kick him out off this site/ignoring him, giving feedback on his writings thus warning all others...

If Mr. Shevel claims he being able giving cure to us, so it must be fact he knowing the root cause of our suffering, but he doesn't. 

20'000 und per patient for operating WHAT? There is no justification charging such a ridiculous amount. Last year I had 3 major surgeries (all emergency) in at top hospital and did not even spend half of that money...

This Mr. Shevel is well known also within other CH sites/portals having the same results/success as he is presenting here. Exactly the same bullshit results...

Probably we should apply this very special surgery on Mr. Shevel himself just in order to provide protection for possible future attacks :)

And now, better stop spending valuable time on this one...
******************************************************************************************************************************************************************************

...and bevor I even think about trying his method, I may try the latest technique a newbie mentioned just TODAY:

 

Masturbating during an attack newbie claims helping him abording CH. 
Having up to 9 attacks per day this youngster must be very potent ;)
Should I spend my money on Viagra instead on Sumatriptan nasal? Naturally I'm not able at any means creating more than 3 sessions per day :(

*******************************************************************************************************************************************************************************

Success rate from this site and techniques used is high. I don't have figures but guessing far more than 50% of us achieve being pain free. The rest does get huge relief. The minor part (I guess, I do not have correct numbers) say about 10% may live with status quo but I'm not sure probably even less.

Eventually a sticky message with a warning about Mr. Shevel does the job at least for this site. Talking even more about this guy is at the end of the day exactly what Mr. Shevel is locking for in order to get the one cluster head out of a thousand!

*******************************************************************************************************************************************************************************

Shouldn't we lock Mr. Shevel in a prison cell, giving him cluster and a multi pack of Viagra? Worthwhile a try isn't it?

 

(yes, I feel sad having to write like this but being nice on this one would be insane)

 

 

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OK so I am new to Dr Cluster Cutter.  Being a creature of the Apostle Thomas, I read the papers the good Dr posted to bolster his claims of surgical success in treating the cervical vascular tree of cluster sufferers while disparaging his Boston critic.  Of the papers listed one is a very small case report series with less than 6 months follow up.   Basically this is the type of "show and tell" paper most experts hate to see.  There is no reported evaluation, no description of prior treatments and no objective documentation of long term success.  A gratuitous failure is reported to seem genuine.  Most importantly there is no follow up paper reporting or describing the subsequent cohort of patients who benefited from this intervention.  The other papers listed are a repeated rehash of the same concepts. Putting sheepskin on theory presenting ideas and concepts as facts and forgone conclusions.  This type of appearance in peer review type publications is "padding the resume" and complete fluff.  This smacks of the worst medicine has to offer.

Physicians and surgeons who develop new techniques and have a modicum of ethics refine the techniques, continuously report the techniques outcomes with data and teach the techniques. Peers who review these techniques get fired up and want to learn them and independently validate the findings.  With all the folks who suffer these headaches (within the spectrum he alleges successful outcomes) throughout the world there is no way other surgeons would not become curious and investigate this as a possible effective treatment.  Believe it or not most physicians and surgeons want to make a difference and want people to get better.  Most medical communities have internal checks and balances to prevent individuals doing ineffective, unproven, exploitative procedures.  Doctors who do are often found only in independently owned free standing clinics and surgical centers where they can escape the scrutiny of medical staff review and ethic committees.   

Surgery is an irreversible act.  Once steel divides skin and vessels are divided its pretty hard to undo.  So be careful if you consent to having a novel procedure because it may make things worse or senselessly drain resources from you and your family.  This is also a good example of why controlled studies with long term follow up  are vital.  Here and on one of the cluster oriented FB pages there has been discussions of medications like ketamine and propofol being beneficial for treating clusters.  Both these medications are commonly used in anesthesia.   Suppose you have a novel surgery for your CH.  You get IV meds for anesthesia, a cut on your neck, irreversible vascular changes with a significant wallet biopsy and voila no headache.   You tell your surgeon he or she walks and water and fly home.  Three months later the demon returns, your bank account is dry and the surgeon reports your case as a win.  Is it possible the anesthetic agent actually provided some relief?  Does this sound like some of the medical treatments we take...works for a while and then you need another dose?  How do you know?  No way to know that is one reason studies are important and why CB has directed resources at doing important studies.   Please use care, inform yourself with independent information and don't be exploited.

'

  

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Daniel, stay in Cape Town and away from your father. He is a quack and you are a great marketer but you have both been revelead. Those videos are bulls!*** and you know that. None of them had clusters - they don't even know what a cluster is. I saw your father and got ripped off - buy a plate to relax my tongue and cure my clusters, it's the artery that causes clusters, etc. Load of crap  I should have bitten of his finger when he stuck it in my mouth.  

And I know people who know both of you so you can't pull the wool over my eyes. 

These are intelligent people here and those who are desperate have us to protect them against people like you and your quack father.

Stick to being a gym bunny and pretty boy and leave us sufferers alone.

Warning to others: MRI - migraine research institute is Daniel Shevel - it's no institute, it's another branding excercise 

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On 08/04/2017 at 1:16 PM, Dr Elliot Shevel said:

I have until now refrained from getting into an internet dispute but the damage caused by misinformed people online offering opinions without evidence has created untold harm to headache and particularly to cluster sufferers. Every patient that reads what Boston Headache Doc has written in relation to the treatment modalities The Headache Clinic offers (unique in the world) is deprived of the chance to live a normal, productive, and pain-free life. The efficacy of our treatments have been scientifically proven, have an extremely high success rate, and my medical research of more than 25 years into headache science has been extensively published in the medical literature, and I have lectured on the subject at congresses all over the world. Scientific evidence is the final arbiter, and not unsubstantiated opinions.

 

I will address each of the disparaging and patronising comments levelled at me and look forward to robust debate with Boston Headache doc and any other interested parties.

 

 

 

Boston Headache doc wrote:

 

 

 

“This man” likely knows very very little about headache medicine - he is a surgeon with NO training in headache medicine and does NOT manage headache patients”. 

 

 

 

My response:

 

 

 

“This man” has more than thirty publications in internationally recognized peer-reviewed journals – most of these publications deal with primary headaches. My publications can be accessed at http://www.theheadacheclinic.net/publications/ . “This man” is also a peer-reviewer for “Headache”, the official journal of the American Headache Society, “Cephalalgia”, the official journal of the International Headache Society, the Cochrane Collaboration, and many other medical journals. A peer reviewer is someone who is deemed by the journal’s editor to be an expert on the subject and to have the knowledge to judge whether articles submitted to the journal for publication are good enough to be published.  At my headache clinic in South Africa we see and treat approximately 70 new headache patients every month – having restricted my practice to the diagnosis and treatment of primary headaches for 25 years, this is in excess of 20,000 patients.

 

 

 

"This man" has also co-authored articles with Professors of Neurology at Harvard University Medical School, Cagliari University Medical School, and Bari Universiry Medical School, and many other prominent headache researchers.

 

Boston Headache doc wrote:

 

There are a number of surgeons offering a surgical 'cure of migraine and occasionally cluster headache as well. It appears “this man” ligates arteries, branches of the external carotid, and in addition can remove certain small facial muscles.

 

 

 

My response:

 

 

 

The surgery I do is completely different from the procedures that Boston Headache Doc is referring to. My surgical procedures are founded on indisputable, verified, and published scientific evidence, and this accounts for the excellent success rate that I am able to achieve. The rationale for ligating branches of the external carotid artery is all verifiable and is supported by medical literature. I do not and have never removed facial muscles – Boston Headache Doc clearly did not check his facts before criticizing me for doing so.

 

Boston Headache doc wrote:

 

Unfortunately this is all nonsense to me.”

 

 

 

My response:

 

 

 

To any person who has taken the time to study the medical literature on the subject, it is most certainly not nonsense. It is evident that Boston Headache Doc is not aware of the relevant literature.

 

Boston Headache doc wrote:

 

“These are brain disorders, and such procedures could never produce a 'cure' and it is very hard to find a biological rationale for improvement either.”

 

My response:

 

A common belief among “headache gurus” is that primary headaches such as cluster and migraine are brain disorders. I challenge Boston Headache Doc though to provide me with literature proving that these are brain disorders. This belief has never been substantiated scientifically, in spite of the millions of research dollars that have been spent in the search for this proof. But for me the most important thing is to eliminate the pain and allow sufferers to regain a normal and productive life. Whether it is a brain disorder or not, the pain does not originate in the brain - and it is the pain and the associated symptoms that cause the distress - the aim of my treatment is to eliminate the pain. If researchers one day find the root cause, whether it is in the brain or elsewhere, and find a way to eliminate it, my treatment will become obsolete - but until then it remains a valuable treatment modality.

 

 

 

Boston Headache doc wrote:

 

“I am open to odd treatments if there is some biological rationale but it is nonsense here.” and  “I have seen victims of migraine surgery but not cluster surgery like this...as yet.”

 

 

 

My response:

 

The fact that Boston Headache Doc has not seen the results of the vascular surgery is meaningless. I have published the results, and I have scores of testimonials, written and video, showing the excellent results. There is no other treatment modality with such a high success rate. As I mentioned above, the rationale for ligating branches of the external carotid artery is all verifiable and supported by the medical literature.

 

Boston Headache doc wrote:

 

“Noninvasive surgery'- isn't that an oxymoron?”

 

My response:

 

Yes it is indeed an oxymoron – but I have never claimed to perform non-invasive surgery nor have I ever used the term. What I do is “minimally invasive surgery” - this is essential to minimize side effects and post-operative trauma. There are entire medical journals devoted to minimally invasive surgery.

 

Boston Headache doc wrote:

 

“Happy to discuss further if needed.”

 

My response:

 

I am delighted that Boston Headache Doc is willing to enter into a dialog. Scientific evidence is the final arbiter, and not opinions. I believe that the pursuit of truth would be best served by Boston Headache Doc and I producing scientific evidence to back up our respective claims, and I invite Boston Headache Doc to take up the challenge.

 

Boston Headache doc wrote:

 

“Sorry if I am stern here, but I do not like vulnerable people being taken advantage off by, at best, misguided physicians.”

 

My response:

 

If anyone is misguided, according to the medical literature, then it is Boston Headache Doc. Most “headache gurus” have very little real knowledge of the origins of cluster pain. They offer opinions with emotive phrases to scare patients and when in fact they are dooming them to a life of misery when help is actually available and scientifically substantiated.

 

Absolute garbage Shevel. I know that your bulls**t so called cluster patients (who you could not even teach what a cluster is) on whose blatant lies you got some coverage in medical journals are total fakes coached by Daniel. Quacks are a disgrace to the medical profession and even more so when they take advantage of vulnerable and desperate people. 

You anger me.

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Reply to pc guy and other negative comments about me on Clusterbusters

In health and medicine, results can never be guaranteed. This is true for treating the common cold, to delivering babies, or performing organ-transplants. No matter how effective the treatment, or how capable doctor or expert, there are always some patients that don’t respond, have complications, or in the most unfortunate scenarios, have negative effects.

The sole inspirational factor that keeps me passionate and fascinated about discovering more about how headache pain is generated, is the number of patients that respond well to my treatment methods and regain their quality of life. This number many times over, outweighs the number of patients that I have not been able to help.

When a procedure is effective, the fact that there may be unsuccessful cases is not reason enough to discard it.

For those Clusterbuster members that keep insisting that I do brain surgery to treat headache, I do not. I do not operate in the brain, and no procedure I have ever performed involves the brain in any way.

Some people have criticised me for posting on Clusterbusters, claiming that I am advertising. I didn’t start the thread, and when misinformation is put out about me or my work in a public domain, it is my right and duty to respond.

Regarding psilocybin and the use of magic mushrooms, I perceive no conflict between my approach and the use of magic mushrooms. Patients who are experimenting with mushrooms often contact me for my opinion. I always encourage them to only contact me should they not gain relief. Cluster sufferers who have adequate relief from psilocybin/ magic mushrooms or in fact any other medication most certainly are not candidates for my treatment. It is only indicated in those where other methods have not given relief from the cluster monster. No-one in their right mind would travel thousands of miles to undergo a surgical procedure if they were getting adequate relief from their medications.

I am a triple qualified medical practitioner with degrees in Dentistry, Maxillo-Facial and Oral Surgery and Medicine. Head and facial pain has always been my speciality. The fact that I am not a neurologist is the very reason that I have been able to approach headache treatment from a different perspective.

It is because I specialise in the structures of the face, head and neck, that I discovered that these structures outside the skull actually cause the pain in primary headache. Not the structures inside the skull or in the brain.

The fact that I do not treat the brain is the reason that neurologists have no interest in my work. The anatomical structures that I treat do not form part of their knowledge base.

I see an average 100 new patients a month and I have been treating headaches since 1992. That’s 25 years and many thousands of patients, with the vast majority of these patients being treated successfully, more so even in recent years as my knowledge has expanded. Were my techniques largely unsuccessful, there would be considerably more negative information on me on the web by now, rather than the hundreds of positive stories online.

Some people have commented that if my methods work they would be in the USA, but while the USA is a great country with many great people in it, not everything originates on American soil, and it would take the awareness of something new, and the will of those in the USA to learn it, for it to spread.

There was an important request from FramCire asking for the medical reasons for my work, and even though FramCire’s motivation is to discredit me (and I expect the same from everyone else on Clusterbusters), I welcome the opportunity to explain the rationale for my treatment of cluster.

The medical rationale for my treatment of cluster headache is as follows:

Primary headaches, including cluster headache, are exceedingly complex conditions and difficult to treat due to the great number of anatomical structures in the head and neck, which are all interlinked in some way. These structures include the brain and nervous system, arteries, muscles, tendons, sinuses, joints, and teeth. Many of these structures are innervated by the trigeminal nerve, which is widely accepted as the main conduit for primary headache pain, including cluster. 

There is widespread agreement among headache specialists that many cluster symptoms occur due to the involvement of what is called the sphenopalatine ganglion (also known as the pterygopalatine Ganglion). One of the therapies being used at present to minimize the severity of cluster is sphenopalatine ganglion stimulation (Lainez, MA et al.Sphenopalatine ganglion stimulation for the treatment of cluster headache. Ther Adv Neurol Disord. 2014 May; 7(3): 162-168). The sphenopalatine ganglion is situated behind the upper jaw under the eye, and the maxillary artery is very close to it. When the maxillary artery dilates, it gives off pain producing neuropeptides – in patients where the dilated maxillary artery is very close to the sphenopalatine ganglion, the ganglion is without doubt affected.

Migraine can in no way be compared with cluster – but there is one vitally important similarity, and that is that they both respond to sumatriptan. Sumatriptan was developed as a vasoconstrictor to treat migraine, but as it transpired, it is far more efficacious in the treatment of cluster than it is in the treatment of migraine.

As the members of Clusterbusters are very aware, Imitrex (Imigran in some countries) injections are the most reliable and effective way of aborting cluster attacks for most cluster sufferers.

Remember, the only action of Imitrex is to constrict the painfully dilated extracranial terminal branches of the external carotid artery. It has no other action. This leads to the logic that if Imitrex works in cluster, then in cluster the painfully dilated EXTRACRANIAL TERMINAL BRANCHES OF THE EXTERNAL CAROTID ARTERY are INVOLVED IN THE PAIN.

The rationale and aim of my surgery is to achieve a permanent Imitrex effect. When the maxillary artery is permanently closed surgically, it no longer gives off pain-producing neuropeptides or impacts the collection of nerves of the sphenopalatine ganglion which generate the intense pain.

An illustration appeared on the cover of Cephalalgia in 2012, entitled “Location of maximum pain intensity in 209 patients with chronic and episodic cluster headache”. It is no coincidence that the precise area depicted is supplied by the maxillary artery. I am unable to post images here, but these can be referenced at http://www.theheadacheclinic.net/cluster-headache-treatment/

In my treatment of cluster, the most important element is permanent closure of the maxillary artery on the affected side. The major difference between the symptoms of cluster and migraine is because in cluster, not only are the scalp arteries involved, but the maxillary artery is also involved.

All the arteries that I close, including the maxillary, are done through small superficial incisions. These procedures are done in a day care facility and patients are discharged the same day.

It is important to note that these same arteries are closed by Neurosurgeons, Maxillo-Facial Surgeons, Plastic surgeons and ENT surgeons every day for a variety of other reasons. In spite of this there has never been a report of the blood supply being compromised as a result. A small number of patients have had temporary numbness of the skin or the cheek lining, most of whom recovered within a month or two. In the few cases where the numb patch persists, it is a relatively small price to pay for being pain free.

If it was only the maxillary artery that was responsible for cluster, the procedure would be done in a day and the patient would be able to fly home a few of days later. Frequently however, other anatomical structures are also involved in generating the pain. The most common are other terminal branches of the external carotid artery in the scalp, but the jaw and neck muscles and the three branches of the trigeminal nerve may also become painful.

Another factor is “central sensitivity” a term that has been given to an occurrence that I believe is correctly attributed to the brain itself becoming more sensitive to incoming impulses, and after time this heightened sensitivity also compounds the chronification of the headaches. Central sensitivity of the brain is one of the reasons why some patients don’t experience relief immediately after treatment, but report a gradual improvement over time as the central sensitivity subsides. An analogy for central sensitivity could be continuously scraping the skin on the same place so that any sensation on the inflamed spot is painful – yet as the skin heals, the sensations become less until no pain is felt at all – it is the same for the area of the brain that receives these pain signals.

If all these issues are not addressed, then the chances of success are much reduced. The varying roles of these interrelated structures determines the length of time and treatments needed for each patient – each patient has their own unique “pain map”.

I would like to state again, that the only patients I prescribe this surgery for are those who have not been helped sufficiently by the usual prescription medications used in cluster, or by oxygen, or by magic mushrooms, or by any other non-surgical treatment.

Here are the personal stories of some of my successful cluster patients http://www.theheadacheclinic.net/category/testimonials/video-testimonials/video-testimonials-cluster-headaches/  . None of them have to date had a recurrence of their clusters and none of them are taking any preventive medication: This most recent patient from Japan (subtitles are available on his video), nearly didn’t come for treatment after reading the comments on Clusterbusters.

If these people are all in remission, then it is an amazing coincidence that all their remissions started right after I operated on them, and that they are still cluster-free up to 4 years later.

For anyone interested in the complete story of what really happened with pc guy and other negative posts about me and my treatment methods on the web, they are available for full disclosure on The Headache Clinic website at http://www.theheadacheclinic.net/dr-shevel-addresses-negative-comments/

If I was unsuccessful with the majority of my patients, and was regularly faced with soul-destroying failures, I would never be able to continue treating cluster and other primary headache patients. On the contrary, it is the constant positive feedback from patients whose lives have been transformed that drives my passion and my commitment to the work I do.

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18 hours ago, Dr Elliot Shevel said:

The fact that I do not treat the brain is the reason that neurologists have no interest in my work. The anatomical structures that I treat do not form part of their knowledge base.

Neurologists have extensive knowledge of these structures. I find it hard to believe that you made such an ignorant statement.

 

19 hours ago, Dr Elliot Shevel said:

A small number of patients have had temporary numbness of the skin or the cheek lining, most of whom recovered within a month or two. In the few cases where the numb patch persists, it is a relatively small price to pay for being pain free.

I have a friend who came to your clinic several years ago for treatment. She did not have a little numbness. She had to take all food thru a straw for months following your procedure. You did not or could not correct it.

I am not at all sure that you respond to failed treatments or acknowledge the misery some of your patients have had following their visit to your clinic.

19 hours ago, Dr Elliot Shevel said:

I am a triple qualified medical practitioner with degrees in Dentistry, Maxillo-Facial and Oral Surgery and Medicine. Head and facial pain has always been my speciality. The fact that I am not a neurologist is the very reason that I have been able to approach headache treatment from a different perspective.

None of which qualify you to treat this condition. But all of which study the Trigeminal Nerve to some extent. Bandaids are not a 'cure' for disease. They just prevent pain by covering the area and protecting it for a short term. You are handing out expensive 'bandaids' and sometimes put them in the wrong location to boot.

I would like to see a paper with about 5 years of follow-up on your patients. That would eliminate some of your 'many' successes. And more sanitary working conditions that do not leave patients with infections are definitely needed at your clinic. That is unconscionable. For any Physician.

As a side note, I had an attack while awaiting surgery. The Physician had the pre-surgery injection given early and my attack completely vanished. I did not walk out and say that hernia surgery cured my CH. I said that the shot killed a hit.

If this method is so successful and your concern for our pain so high, why have you not trained other doctors in your procedure? Perhaps they are not beating a path to your door. For good reason?

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I don't like speaking ill of someone but I went to see Dr Shevel in 2013 and left the consultation in tears.

After suffering with clusters for many years, I stumbled across Dr Shevel on my local radio talking about his surgery and hope sprang up inside of me. I contacted his clinic and waited a few weeks till he came to my city. When I went to see him, he asked me what was wrong and I told him about my history of clusters. He seemed tired and uninterested and his answer was that I needed surgery and that it would cost round about R70 000 in total (That is our local currency) which medical aid does not even cover. No tests, no checking me out, nothing. I told him that I wasn't on medical aid and my family couldn't afford that type of money and he said a plan could be made. I will be emailed a quote.

As I was in a cycle at the time, I asked him for a script for the medication that my neurologist normally gives me and after I had told him, he said he needed to read up on Verapamil and will email the script to me. I saw him on the Friday and only received the scripts on the Monday. For someone that 'knows' the pain that we go through, there wasn't much urgency to get the script to me and I suffered with many beasts that weekend. (Still have the emails btw)

Anyways, I received the quote which I declined and promptly received a call from the clinic offering a smaller surgery at a cheaper cost (About half the price). Apparently they really wanted to help me. I declined this and went to see my old neurologist. When I told him about the surgery, he said that I'm not the only person that has been fooled.

Dr Shevel - Your procedure may or may not work but I will never forget the consultation that I had with you. Yes, you may help thousands of people but you didn't help me and your lack of empathy was soul crushing.

I am so grateful to people on sites like this that look out for one another and can identify with the pain that we all suffer with. Verapamil has helped me keep my clusters in control and this past week I went for my Vitamin D3 blood test for the first time and my doctor found that my level is very low. Today I started the D3 regimen and that's all thanks to sites like this.

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No, NO, a thousand times NOOOOOO on this bozo. One quote says it ALL...."said he'd have to read up on verapamil" THAT is standard treatment.... for YEARS!!!....any competent headaches specialist (and many neuros or even GP's) would be all over that script. Sheesh...this pisses me off..........follow the money

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Dear Jay,

We are so sorry that you left the clinic feeling uncared for. In an average month at The Headache Clinic we see approximately 80-100 NEW patients and around 400 patients in total. We endeavor to give each and every patient the highest level of care at all times. Occasionally it may happen that a patient feels let down or there is a misunderstanding but we do strive to accommodate each and every person. The hundreds of thank you letters we receive from patients complimenting us on how caring we are, especially our international patients who often express that they have never felt so cared for, is very rewarding for our team and motivates us to keep doing our best.

 Each year THOUSANDS of patients are treated successfully for headache, migraine and cluster and other head pain related conditions at The Headache Clinic. Our treatments are not covered by most South African medical aids because we offer are unique procedures which have no payment codes on the medical aid systems – that is the simple reason. It is most unfortunate that this prevents many people from receiving help. As in your case we offered a fee reduction and payment plan and so try our best to help people take treatment, but we are not able to offer treatment without payment.

There are no tests for cluster headaches – the International Headache Society guidelines state that the diagnosis is made ON THE HISTORY ALONE. It was perfectly clear from your history that you are a cluster sufferer, and it would be unscrupulous to send you for unnecessary tests. Additionally, you had already been receiving treatment for clusters by your neurologist.

Headache pain is by far one of the most complicated medical conditions to diagnose and treat successfully, and unfortunately for the small minority of patients who have a negative experience venting their frustrations anonymously online is a way of getting back at the doctor who has in fact gone out of his way to try and help them. As we offer a unique approach that challenges the conventional paradigm of treatments prescribed by neurologists, it makes us easier to label. The people who lose out most are people in pain who we most likely can help.

Thank you for your feedback about the script, a turnaround time from Friday afternoon to Monday morning seemed reasonable, but we understand that had an impact on you and in future we endeavor to do better.

Wishing you success with your new treatment regime,

Dr Shevel and The Headache Clinic Team.

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