Well, I had the BOTOX Injection Therapy a week ago, so I thought I'd report back on how things went and the progress(?) so far. Just to reiterate the basics, I'm 47 and have had common migraines(no aura) since I was about 8 years old. I've probably tried EVERY medication associated with prevention/aborting migraines that has been available in the past 38+ years. I'm now on disability, partially due to the frequency of my migraines. I average 2-3 migraines a week, roughly about 50% of my life I have some degree of migraine, which is the qualification to get the BOTOX Injection Therapy. My main trigger is weather...changes in barometric pressure and/or temperature absolutely nail me every time. I live in Central Virginia, and the weather changes here very FREQUENTLY!
I currently take 400mg of Zonegran and 25mg of Atenelol as a preventative(not very successfully) on a daily basis. I take 300mg. of Seroquel and 50mg. of Hydroxizine as an abortive when I feel a migraine beginning to take hold. If I can't sleep off the migraine, about once a week I end up having to get an injection of 15mg. of Nubain and 50mg. of Phenergan. The shot usually does the trick, although sometimes a DR will only give me 10mg of Nubain, which means I may end up having to get a shot two days in a row.
ANYWAY, I'm really tired of spending so much time in migraine land, so last week I went to see my migraine specialist, Dr. Timothy Collins, a Neurologist at Duke University Hospital, in Durham, N.C. for the BOTOX Injection Therapy. In order to qualify for the treatment, I had to chart my headaches on a daily basis for 4-5 months, and had to average being affected by migraines approximately 50% of the time.
It's a good thing I didn't know what the procedure involved, because I might have talked myself out of it, as it sounds pretty bad. The treatment is a series of 31 injections of BOTOX, spread out between the temples on either side of the head, across the forehead, between the eyebrows, around back of the head, and down into the neck. The injections were pretty quick and thankfully the needle was fairly small. It kind of felt like a sequence of reasonably quick bee stings. The whole procedure only took a couple of minutes, and must be repeated again in three months. Apparently, to get the full effect of the procedure, it takes more than one round of shots.
So, how has it turned out so far? Well, a couple days after the procedure my first migraine started kicking in when a really bad weather front rolled in, and I ended up with some of the very rare side effects. I got a really stiff neck and my TMJ started acting up. It probably didn't help that I ran out of my muscle relaxer prescription the same morning and had to wait a day to get a refill called in by my PCP's office. I had started to get some numbness in my forehead area, which is a good thing, but I ended up with a combination of muscle spasms and nerve twitching. I had a combination of two things going on...first was the trauma to the muscles at all the injection sites, and second was the effect of the toxin proliferating in the nerve tissue. So, in addition to my normal ice pick migraine pain behind my right eye, which I'm used to, it felt like I had rubberbands stretching and snapping all around my head, while my surface of my whole face twitched. I have to say, it was the worst migraine I've had in as long as I can remember.
Unfortunately, I couldn't get in to see my PCP to get my normal Nubain shot, so I ended up going to the Emergency Room because I was so miserable. That was not exactly a pleasant experience in itself, as the ER's "Migraine Cocktail" included a steroid that gave me "restless legs"...like I needed that...LOL!!! They gave me a double dose of Benedryl to "counter-act" the steroid, and put me on IV fluids for a while. I was given a second steroid and some IV Toredol, and eventually sent home to sleep. I didn't actually get any real relief until I got my muscle relaxer prescription refilled.
Things definitely improved over the next couple of days, even though I kept getting migraines due to repeated weather fronts. It's now been a week since the procedure, and I can report that even though I did fall into the minute 2-3% of people that have some adverse side effects(stiff neck, muscle spasms, nerve twitching), things seem to have settled down and the typical paralyzation process is well underway. It's kind of a funny feeling to have the outside layer of your head somewhat numb and immobile, but it definitely taken the major edge off of the migraine experience. I haven't had a fullblown migraine in three days and counting, so I am defintely cautiously optimistic. I'm not looking forward to getting another round of shots, but if that's what I have to do every three months to keep the migraines down, then it's definitely worth it. From the literature I've read, the side effects I've encountered usually only occur during the first and/or second round of injections. I'm hoping that's the case anyway.
So, that's the scoop. Feel free to comment or ask questions if you have any.