As promised, this is the next installation in my series about my journey as a jeweler migraineur. The topic du jour is Botox treatments. You have probably heard of Botox being used for cosmetic reasons, but it’s also a FDA-approved treatment for chronic migraines (15 or more migraines a month). A Botox treatment involves injecting tiny amounts of botulinum bacteria into targeted muscles, which effectively paralyzes those muscles.

The Start of My Botox Story

I had heard about Botox being used for chronic migraines for years, but I had resisted trying it because to me it sounded kinda risky and, from reading the statistics, not very effective. After trying every treatment my neurologist recommended, my friends urged me to find a new doctor. So I searched for a neurologist in my area who was experienced treating headache patients.I found one in Oakland who looked promising, and I made an appointment to see him in March.

My First Appointment

At my first appointment with my new neurologist, he asked about my migraine frequency, triggers, all the usual things, and we went through the (very long) list of all of the treatments I had already tried. He told me that for a patient in my situation, the next thing he would recommend would be a Botox treatment. This time I didn’t resist the suggestion, and he fetched the vial and needle to start my first treatment.

While preparing the toxin to inject into my face, he explained to me that I would need to come back about every 12 weeks for another treatment. The treatment would consist of 31 injections in my face and neck, and that the treatments usually are effective after you’ve had one or two done. I was relieved to see that the needle was really tiny, and I laid back on the table a little nervous about having a needle stuck in my face repeatedly, but more than that, I was hopeful that it would help my migraines. The doctor was kind enough to distract me from what he was doing by asking about my job. I have to admit that I kind of love to talk about what I do. He did a series of injections in my forehead along the hairline, and up into my hairline. The procedure wasn’t very painful; he finished with a few injections in the back of my neck, and then I looked in the mirror. I had a series of what looked like bee stings across my forehead, but it wasn’t really noticeable.

This Isn’t Television

On TV shows when someone gets a Botox treatment, it’s like their face is numb and paralyzed. Reality is nothing like that. There’s no numbing at all, and the muscles don’t relax all at once. It happens over the course of the next few days, and it’s such a slow process that you don’t really notice it. I really didn’t feel different at all.

After my appointment, I wandered around some shops on Piedmont (I don’t get into Oakland often) and even stopped at a cafe for a bagel and a cup of tea. I felt a little dazed after having an unexpected course of injections, and a bit self-conscious about my “bee stings,” but I’m sure nobody noticed.

For the first month after the treatment, I actually got fewer migraines. I was excited and so hopeful that I’d finally found something that worked. But the migraines came back. My usual, incapacitating, exhausting regularity of migraines.

The Second Appointment

Admittedly, the second appointment was much like the first. I took the BART (train) up to Oakland for my appointment – this time with a nurse who specializes in administering Botox treatments to migraine patients. She was so friendly and funny. I relaxed immediately, and I showed her the migraine diary I’d been keeping since my first appointment. She took one look at it, and said, “Oh my! What’s happening in the evening to give you all these migraines?” We discussed strategies for avoiding migraines while she prepped my vial of Botox.

Like the doctor I’d seen the last time, she talked through my entire treatment, which was a welcome distraction. She asked which spots I usually get migraines and gave me a few extra injections in those areas for good measure. It was a surprisingly pleasant experience. Unfortunately, this treatment hurt more than the first one and left bruises across my forehead, which I wasn’t expecting. I walked out of the office hopeful that this treatment round would be more effective than the first.

This has not turned out to be the case. Somehow the injections made my neck really sore – my theory is that because the injected muscles were paralyzed, other muscles in my neck needed to compensate to support the weight of my head. I have no idea if that’s true, but it’s the best I can think of. It was seriously killer to bend over anything. Turning my neck hurt too, so I’d turn my whole body if I needed to see behind me. Bending over my work was agony, and the neck pain triggered more migraines. The neck pain persisted for several weeks – it still hurts some – and I’ve seen no reduction in migraine frequency. 

A High Note

One positive thing I can say is that I haven’t had any gut-wrenching migraines since my Botox treatments. These are what I call the “8+” migraines, where I rate the pain on a scale of 1 to 10. I’ve had a lot of 6’s, and the occasional 7, but no 8s or higher.

What’s Next?

As crazy as this sounds, I plan to follow through with my third Botox treatment in October. I feel like I need to give this a serious try before moving on. Future treatment options only get scarier and riskier, so I have to be thorough. I’ll post again next month to let you know how it goes. Keep your fingers crossed for me.