My First Experience with Botox for Migraines

Recently, I shared that I'd transitioned from a migraine specialist to a headache clinic and have ultimately been so pleased with the improved and personalized treatment plan and attention I've received.

Why did I leave my headache specialist?

This summer, after struggling for quite some time with migraines related to changes in my hormones and significantly exacerbated by struggling with fertility treatments and miscarriages, I left the specialist I'd been seeing. He had provided me with some abortive treatment options, but that was it. Over and over again, he told me that until I was done trying to conceive, being pregnant, and breastfeeding, he wouldn't recommend any of the available migraine prevention treatments.

The headache clinic advised me otherwise...

How was my first headache clinic appointment?

During my first appointment at the headache clinic, I had a 3+ hour extensive intake filled with questions and examinations and a recount of my migraine history, including what had and hadn't worked to break up these attacks, how often they came, and how often they knocked me out. At the end of that appointment, my doctor offered me a multifaceted migraine treatment plan. It included some medications and treatments to use preventatively to stave off potential migraines, some medications to use abortively when a migraine appears, and what order I should use those rescue meds based on the severity and symptoms of my migraines.

What preventive treatments were recommended?

The preventative treatments my doctor was offering included taking Nurtec ODT every other day, adding a beta-blocker called nebivolol (often used as blood pressure medication) and a supplement called EBH4 daily, and receiving Botox injections in my face, around my head, and at the base of my skull every three months. Nebivolol, EBH4, and Botox had been deemed safe for pregnancy, and we'd stop the Nurtec just before proceeding with an embryo transfer as it hadn't yet received a pregnancy seal of approval.

One of these recommendations surprised me...

Which recommendation surprised me?

Botox. Something I knew was used for migraine prevention (heck, I even knew migraine patients who swore by this treatment) - but I somehow never expected to be prescribed.

After consulting with my reproductive endocrinologist and high-risk OBGYN, I agreed to try Botox. I learned that it requires prior insurance authorization, which took a few weeks, and then the clinic was able to get me scheduled.

The appointment is fairly quick, about 15 minutes, and involves 31 injections - above the eyebrows, along the hairline, behind the ears, and at the base of the skull. It's done in the office by my doctor's PA and really has no significant risks/side effects.

What did I think of Botox?

Here's the truth. I hated it. I'm not a stranger to needles or injections - I receive IV medication every five weeks for my Crohn's disease, and I've done 500+ injections for fertility treatments in the last few years. But none of those needles have gone into my face, head, or neck. There's not really much fat or buffer anywhere, and almost every injection involved a bit of blood dripping down my face. It wasn't so much painful as it was strongly uncomfortable, and I desperately wanted the appointment to be over. The PA told me they recommended doing it three times (every three months, for nine months total) before deciding if it was beneficial for migraine prevention or if I'd rather discontinue it.

Will I continue to get injections?

It's been about six weeks since that appointment, and I'll tell you two things. One - my eyebrows arch a tiny bit more than they did previously, and I notice it every time I look in the mirror, and two - I haven't had to use abortive migraine medication since getting the injections. Does this mean Botox is working for my migraines? It's too early to tell - but it feels like the possibility very much exists. My next appointment will be in February, and then in May, and in August, I'll decide if it's a process I'm going to continue.

Have you gotten Botox for your migraines? What did you think? Was the discomfort worth the results? I'd love to hear your experiences below.