It’s been over two years since I “came out” about having a chronic illness on my blog. So I’m no stranger to announcing my annoying, bizarre and sometimes sad symptoms to the world. And after dutifully blogging about skull-cramping migraines and methodically failing every migraine treatment a series of neurologists put me on, I finally decided to try a last ditch effort before decapitation: Botox.
The decision wasn’t something that happened overnight. In fact, the first neurologist I went to scared the absolute shit out of me about getting the treatment: “Well, there is a chance one of the injections could migrate from your jaw to your throat, and your throat would be numb,” she said, casually. “You wouldn’t be able to swallow.”
What the fuck? I mean, the migraines were bad, but worth taking the risk of poison migrating to my trachea? Eh.
A few weeks later, I told my general doctor about the consult.
“Your throat won’t be paralyzed!” he said. “I mean, it might be paralyzed if you have her do it. She doesn’t sound like she’s ever done it. You just need to go with someone experienced.”
His incredulousness made me feel a little bit better about the idea, but I still wasn’t sold. I’d been trying to treat the symptoms on and off for years. I tried preventative medications like Immitrex, rescue medications like Excedrin and Tramadol. But when those failed and I started getting daily episodes, I realized I was quickly running out of options.
I started researching local neurologists who offered Botox and finally made an appointment. Even though I couldn’t get in to see him for several weeks, I felt a lot of relief knowing that there was at least one more option a little on down the line.
When the migraines got so severe and became so persistent, I started taking narcotic pain killers. Unfortunately, these medications lead to rebound headaches meaning that even if you treat it today, chances are it will be back tomorrow, sometimes worse than before. I spent my days in a vortex of nausea, excruciating pain and stopped being able to drive at night. I would fall asleep with my sunglasses on, afraid of waking up to the blinding light I had become so sensitive to.
By the time my appointment came with the new neurologist, I was a frazzled, over-sensitive zombie ready to let him inject Botox into my eyeballs if he thought that would help my situation.
Here was the good news: Having failed all other treatments, I was an excellent candidate for Botox. And my insurance company would cover the full cost of the injections. Here was the bad news: I would have to wait another three weeks to get my first treatment. But then here was some more good news: I was already so strung out on painkillers, the time passed quicker than I could contemplate how rapidly my liver was rotting.
When the morning of my appointment came I looked at myself in the mirror. I hardly felt connected to my body anymore. My face was swollen and my eyes sunken. Maybe Botox wasn’t such a bad idea after all.
Softer than an ant bite, sharper than tweezing a wayward chin hair, the first series of injections that went over my eyebrows were done in rapid succession. All I felt was the needle swiftly popping out of my skin and back in. Then I was moved to a chair where the doctor injected a second series of shots into the side of my face, the back of my head, neck and finally into my jaw.
The shots didn’t actually hurt. The sense of overwhelming terror that my face might never unfreeze was there, but really there wasn’t much pain.
The worst part was the shot in my jaw -- again, not because it hurt, but because I could hear the fluid being injected through my muscle. Super-creepy.
When it was all over I walked out of the office pressing an ice pack to my face. By the time I got to the parking lot I dropped it in a trashcan. I didn’t feel numb. I didn’t feel pain. I didn’t feel a thing.
Nothing happened for the first week and a half. I still had migraines every day. I still found myself knocking back painkillers. And then, one day, I woke up and felt fine. The light didn’t bother me. I wasn’t seeing auras. And for the next month, I blissfully went through my days migraine-free! It seemed like whenever I’d feel a migraine coming on, it wouldn’t radiate through my face like it normally would.
The skull-cramping headaches were really gone.
It was during that time that I realized I also couldn’t lift my eyebrows anymore. A small price to pay.
I was a Botox fan, an advocate, a worshipper!
And then, of course, about two months after my treatment, it all came crumbling down and I found myself on the bathroom floor, head wrapped in a towel, fumbling around in my medicine cabinet for the right bottle of pills.
What had happened? Everything was going so well!
I called my neurologist and came back in for a check up. I told him that the pain was coming back and asked if I could get the second treatment sooner. He said no, that the insurance company wouldn’t approve it, but that he would order more units for the next treatment.
Instead of getting back on the Oxycodone train, I got myself to a pain management doctor during the interim. He put me on a few general daily pain medications that didn’t end up making a difference. He also prescribed me shots of Torridol and gave me a rescue medication called Cambia, which worked wonders during my next episode. You can only use these medications once a week, though, so I was constantly trying to figure out whether or not today’s migraine was worse than yesterday’s migraine and if tomorrow’s migraine would be the real challenge.
My next treatment is finally coming up in a few days, and I’m excited to experience a few more weeks without pain, even if it doesn’t last the entire three-month period. Overall, I wouldn’t say that Botox is the end-all be-all of migraine treatments. Like most medications it doesn’t work for everyone and doesn’t last as long for some as it does for others. But then, if you’ve ever experienced chronic migraines, you’ll be grateful for any relief you can get your insurance company to cover.
For those considering the treatment, I’d say don’t let the fear of potentially painful injections stop you. And don’t just find a good doctor -- find the best one. Get multiple recommendations from other patients. Talk to your insurance company, and try every preventative medication you can before taking this last, serious step.
I’m glad I made the decision to get the treatment. I don’t regret taking the risks that come along with getting actual botulism injected into my body. I don’t think we’ve really perfected the ultimate migraine treatment, but for today, it’s nice to know the options there.