How do you diagnose and then one is surgery necessary so the first thing we do is we’ve we’ve gone out to chat with our neural neurology colleagues and the primary care physician is to tell them what kind of patients to send us that to try to capture the kind of patient population that we are able to treat the first thing we do we take a history we do a physical and if we get a history that’s consistent with a nerve entrapment syndrome and what we discussed in the previous segment somebody who has anatomically consistent migraines that are very frequent that have failed medical management then we tell the patient to come see us when they’re having a migraine and don’t take any medications okay and and they call our office if I’m in the office I’ll see the patient even if it’s his patient and vice versa we one of us is always in our office and they call us and they come in with with with an active migraine or no medications and then we do nerve blocks of the of the suspected triggers we do a frontal blog or a temporal block or an occipital block and then we haven’t keep a pane log for the next 24 hours and then they tell us with it whether their migraine and without taking any medication right whether their migraine improved how did it improve what their pain level was when they walked into the office what it was an hour later what it was two hours later and then we see them again couple days later and we and we look at that if their symptoms are significantly alleviated by those blocks then we consider them entrapment patients and we we we offer them surgical decompression of their triggers you