It's a process, but initially you start off with an ultrasound to determine if you have a blockage of blood flowing from your aorta. Mine is over 70 % blocked at this time. Then I had a temporary procedure called plexus nerve block, it prevents celiac plexus nerves from sending pain messages to the brain. If it works then you are a good candidate for the surgery to remove the celiac nerves. Mine did work so I am on to the final visit with the surgeon. While I wait I just manage my pain, medication does not help me.