Today, I am driving down to Dartmouth-Hitchcock Hospital’s Headache Clinic for my first set of Botox injections for my migraines. The Botox will be injected around the “pain fibers” that are involved in causing my headaches. According to the Botox website, Botox enters the nerve endings around where it is injected and blocks the release of chemicals involved in pain transmission to prevents the activation of pain networks in the brain. Botox is supposed to prevent migraine headaches before they start, but I’ve read that it takes time to work. It can take two to three treatments (6-9 months) before the treatment reaches its maximum effects. A treatment lasts for 10-12 weeks, and patients report that in as little as two Botox treatments headache days are reduced by approximately 50%.
In general, the FDA-recommended dosage of 155 units costs between $300 to $600 for each treatment. As I understand it, Botox is packaged in 200 unites, so many doctors inject the remaining 45 units into the worst affected areas so as not to waste the medicine. Luckily, my insurance company seems to have approved the treatment. I have not heard anything to the contrary. It has taken over a month to get the treatments approved. My insurance company has fought my doctor and me on each of these new migraine treatments, but my neurologist is very good at getting appeals approved. I have tried the CGRP migraine preventive medications (Emgality and Aimovig), but the first was not deemed successful enough by my neurologist, and the second caused no improvement at all. In fact, with the second, I went back to having daily migraines. Throughout my life, I have also tried a variety of antidepressants and blood pressure medications that are typically used to prevent migraines. I am unable to take any of the anti-seizure medications because I have a sulfur allergy and thus would likely be allergic to those medications. The Botox injections are getting close to the end of the line of possible treatments. I’m not sure what the next step would be, but there are some alternative medicine techniques that have been helpful in some migraine sufferers.
My appointment is expected to only take about 20 minutes, a short appointment for an hour's drive down to the clinic. The doctor will use a very small needle that I was told would feel like a pinprick. At my last visit, she told me that it would be painful and/or uncomfortable but with my history of migraines, it should be a breeze. Each treatment typically involves 31 injections in seven key areas of the head and neck. Sadly, it can take up to six months to see the maximum benefit from Botox. I just hope and pray I see some improvement fairly soon. I am at my wits end with these migraines. I’ve read that I could see results in as little as two to three weeks after my first treatment.
UPDATE (2:30 pm): I just got back home from getting the Botox treatment. It was a little painful and uncomfortable but nothing too bad. The whole procedure took less than 10 minutes, actually closer to 5 minutes. I have little red dots all over my head form where I bled at the injection spots. I am not sore from the injections which is good. Time will tell how well it works. I currently don't have much of a headache, but I slept wrong last night and my neck and shoulder are in a lot of pain, so that is overshadowing any headache I have. I just wanted to give a quick update and say that all went well.