Botox for Chronic Migraine - My Experience
I'd been having a great run with my Migraine preventives working well, then problems hit. Due to losing weight, my dosage of verapamil had to be cut in half, and I had to stop taking fosinopril. Both of these medications had been integral parts of my Migraine prevention, and my Migraines soon increased in both frequency and severity. My doctor prescribed another medication, but it didn't help.
Dr. David Watson, my Migraine specialist, asked me how many days a month I was having Migraines and headaches. I had to admit that I had stopped keeping my Migraine diary when I was doing well, and wasn't really sure. Then, he asked the question that counted, "How many days a month do you feel well, Migraine-free and headache-free?" That was when we both realized that my Migraines had progressed from episodic Migraine to chronic Migraine - again.
His suggestion? Botox injections. I agreed, and he did the first set of Botox injections in December. The protocol for Botox injections for chronic Migraine is an injection pattern that includes 31 injections. You can see the injection sites in these images: Botox-Injection-Sites-Migraine.
The injections took less than 15 minutes, and I hardly felt most of them. The forehead injections did hurt a bit, but only for a few seconds. Dr. Watson had warned me that the injections can sometimes trigger a Migraine, so I was prepared with my abortive medications, but the injections didn't trigger a Migraine that day.
It's been nearly three months since that treatment, and I'm quite pleased with the results. My Migraine and headache days have decreased from 25 in November to 12 in February, and the severity of the Migraines has decreased. A surprising effect is that I'm not as sensitive to light between Migraines as I was before the Botox treatment. I've also discontinued the last oral medication that we were trying for Migraine prevention.
My insurance company did cover the Botox since it's now FDA approved for chronic Migraine. My copayment was a bit over $300, which is offset by the discontinuation of one preventive medication and less need for abortive and rescue medications.
Before I left my specialist's office after the Botox treatment, his nurse gave me an information sheet about Allergan's Partnership for Access program. This program is to help patients with treatment costs, and its available to those of us with insurance if our insurance is not Medicare, Medicaid, or any other federal or state government health care program. The sheet instructed me to go to the Partnership for Access program web site and apply. I did that, and received a registration packet in the mail. I completed it and returned it with a copy of the insurance explanation of benefits form that showed my payment. They'll be sending me a MasterCard debit card for $100, meant to be used at hospitals, physician offices, and pharmacies for future medical expenses. Allergan also has a patient assistance program for people who can't afford Botox treatment.
Overall, I'm very pleased with Botox treatment so far. It was quick and nearly painless, and I'm definitely seeing an improvement in my Migraines. I've had absolutely no negative side effects from the treatment. The only visible effect is that my forehead is smoother - definitely NOT a problem. Dr. Watson has told me that there tends to be a cumulative effects, so I could see even better results after my next treatment, which is scheduled for March 22.
If you have chronic Migraine and are having problems finding effective preventive treatment, you may find it helpful to discuss the possibility of Botox treatment with your doctor. One precautionary note - It's important that the doctor administering Botox for chronic Migraine be trained and experienced in administering Botox for Migraine. The injection sites are far different for Migraine than for other conditions or for cosmetic purposes. I've talked with some people whose doctors didn't follow the chronic Migraine protocol and had no results from Botox treatment, but did have positive results when they received treatment from a doctor experienced in administering Botox for chronic Migraine. Also, the chronic Migraine injection sites have changed from the period of time when Botox was in clinical trials. The final protocol for injections is that which I linked to above.
How much has your migraine disease changed or evolved over time?