By Wanda –
In 2010, Botox (onabotulinum-A by Allergan) was approved by the FDA as a treatment to prevent chronic migraines. Chronic migraine is defined by the FDA as affecting at least 2% of the population — those people having at least 15 migraine days a month. This was a historic step forward for those of us suffering from chronic migraines!
While people joked about my “free Botox,” they obviously weren’t willing to take on the pain of migraines or to undergo the 27 injections every 3 months that go with it. I was more than happy to do both for any sort of relief. See, back in 2010, I was experiencing 25 or more migraine days a month.
There really hasn’t been a time in my life when migraines weren’t a constant companion. Unlike many migraineurs, mine are not hereditary. I’ve suffered a number of moderate and severe traumatic brain injuries (TBI), the first one at 3 years old. TBI migraines often do not respond to conventional preventatives, which held true in my case. This means Botox was an amazing resource. Yes, it meant a number of injections of a “poison” every year. Yes, there were possible side effects. Yes, at the time it was not known whether Botox would work on TBI migraines. Yes, I really was THAT desperate!
While Botox didn’t prevent the almost daily migraines, it did give me a few days of relief a month. It was worth the fights with the insurance to get approved, worth being pretty much a test subject (both because of the TBIs and because I was my clinic’s first Botox patient), and completely worth the needles and injections. Botox gave me relief when nothing else had. It was a game changer for me.
At one point, in the early days of my Botox treatments, I had my daughter take a video of the procedure to post on Facebook. Many people never got past the medical tray with the loaded needles, alcohol swabs, and gauze pads. When you see all that for the first time, it’s pretty daunting. These days, I receive more injections than back then and have become used to the now five needles on the tray. My neurologist, Dr. Shen, is amazing and always offers to take breaks if needed during the injections. I prefer to push on and be done with them.
So, what have I learned?
1. We are not alone. The neurology clinic I use now has a scheduler just for Botox treatments. The oddity of getting the injections no longer exists. There are support groups just for Botox migraine patients.
2. There are a number of different injection patterns. Personally, I’m on my 7th. Botox can be used on the forehead, near the eyebrows, over the ears, at the hairline, near the base of the skull, and along the shoulders. One of the most helpful for me are the shots in the shoulder muscles. Everyone’s preferred pattern varies; different doctors use different patterns.
3. Botox isn’t a cure for chronic migraine. There is no cure for chronic migraine, only management and treatments. There are a number of hopeful recent developments, both in preventatives and abortive medications though.
4. Botox does NOT cause forehead pain. It seems odd, but all those years of injections really don’t cause any extra pain to the forehead. That’s not to say the injections don’t hurt, they just don’t damage the forehead like one might think. This is new information for me. I’ve been experiencing sensitivity to touch in the forehead lately and discussed it in depth with Dr. Shen this month. In my case, this is caused by cervical spine issues, so if you are having the same trouble be sure to talk to your doctor.
Over 9 years, I’ve learned a few tricks for Botox days as well:
Hydration is important, both for your body and for your skin. Injection sites are cleaned with alcohol which will dry your skin out.
Having a sense of humor is important, as you might be walking around with little red dots for a few days, because you are getting injections.
Taking an analgesic or anti-inflammatory can help before the appointments with the mild pain of multiple injections.
Above all, be willing to give Botox 3 to 4 rounds to work. Be patient with yourself, your doctor, and with the treatments.