Botox update

botox-for-chronic-migraine31shotsof-funess

So it has been a week-ish since my botox.

My forehead did not go numb. This surprised me because it had back in the day such that I thought this was Normal. But just a side effect, potentially depending on where they stick you.

My forehead feels frozen, heavy and restricted to movement. My eyebrows? Lift a little. No Spock eyebrow lift anymore. Damn it. But I have a mild surprise look possible in me, but not much.

It is said directly after things will be painful. They are right. Not only do I have wicked allodynia but I also had very painful spots where they injected in the base of my skull.

Annnd. Migraine pain has been sky high and horrible. Including areas where I had the shots. So no effect as of yet. But remember this is my 1st round and it can take up to 3 for any effect.

The Botox

BOTOX for migraine feels a lot like rubbing a porcupine all over your head for funsies..png

So a couple days after my BOTOX and my forehead feels stiff and my eyebrows are stiff as well. This is better than the first time which I got complete numbness over the forehead for the whole duration and could not move my eyebrows a bit. So an improvement I’d say since I still have sensation.

“When the researchers looked at the placebo-controlled trials, they found that Botox was associated with about two fewer headaches a month for people with chronic migraines and those with chronic daily headache. However, the report states that “Botox is no help for people with episodic migraines (fewer than 15 a month) or chronic tension-type headaches.”” Migraine Again

Basically they say a ‘modest’ improvement. And really 2 migraines less a month doesn’t sound astonishingly impressive. But when you consider what we are Dealing with anything is a good thing. So yeah maybe 2 less migraines. But also maybe less intensity, so there is that.

But I generally will not know yet. This is my first round which generally doesn’t show a damn thing. Usually benefits are not seen until the second or third go around.

So it isn’t fun to get, or experience after, for a modest benefit. That is what migraineurs are willing to do for their pain… any damn thing that helps in the least bit.

Got botox? In the brain?

Facial Injection For Women

Well they don’t shoot it into the brain. But it IS supposed to stop the brain pain. Well the brain doesn’t feel pain. But the signals coming out from the brain.

What I am saying here is Botox is one of the two things used to treat chronic migraines, the other being Topamax, which I am also on.

I got botox 7 or 8 years ago. Don’t even remember how long ago it was. But I was not a responder. As in it didn’t work at all. But I also only had it across the forehead, not the full protocol they have now. The protocol now is 31 shots in the locations below:

BOTOX USPI OAB ONLY (Track-changes)_AGN comments

The recommended dilution is 200 Units/4 mL or 100 Units/2 mL, with a final concentration of 5 Units per 0.1 mL (see Table 1). The recommended dose for treating chronic migraine is 155 Units administered intramuscularly using a sterile 30-gauge, 0.5 inch needle as 0.1 mL (5 Units) injections per each site. Injections should be divided across 7 specific head/neck muscle areas as specified in the diagrams and Table 2 below. A one inch needle may be needed in the neck region for patients with thick neck muscles. With the exception of the procerus muscle, which should be injected at one site (midline), all muscles should be injected bilaterally with half the number of injection sites administered to the left, and half to the right side of the head and neck. The recommended re-treatment schedule is every 12 weeks.Drugs.com

 

And it looks painful to have 31 needles jabbed into your head injecting a fluid. But it sounds more painful than it is. The forehead does hurt a little, because of the nerves and thin skin. But once they go around to above the ears and back of the head and to the shoulders… not bad at all. Meh, I’d say. Didn’t mind it t’all. Keep in mind I have no fear of needles in the least bit.

Your forehead though does ache after for some time. Stinging ache from that abuse thrust upon it. And as one might expect it does trigger a migraine, or I was getting on anyway, hard to say.

We shall see how to feels tomorrow after it settles.

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Botox happening soon

 

Facial Injection For Women
Clearly getting BOTOX cosmetically but you get the point. Needles in the face.

I am getting to Botox soon. I will Be done. I don’t effing care if it takes three rounds to have any potential effects. I want to start now to see if I get those effects.

Just have to get the damn insurance company sorted out with its pre-authorization to authorize me to use it for medical purposes. Which if it is late then my appoint will have to be back up further. One way or another it is Happening.

Here are some of the side effects you might want to watch out for :

The injections are slightly prickly or stingy and take about 5 minutes to complete.

It is possible, though rare, to have an acute allergic response so you should stay in the clinic for several minutes after the first set of injections.

Less than one in ten patients experience each of the following side effects:-

ā  Worsening migraine. This can begin within a day or two of the injections, usually lasts a small number of days. It can be treated with triptans and/or regular naproxen 250 mg or 375 mg three times daily after meals.

ā  Rash, itching

ā  As with all injections; pain, bruising, bleeding or infection where the injection was given are a possibility

1.       Drooping of eyebrows or eye lids. This begins after a couple or a few weeks and can last for a small number of weeks.

2.       Muscle weakness, pain, cramp, stiffness or tightness

3.       Weakness and pain in the neck. This begins after a couple or a few weeks and can last for a small number of weeks. It can be treated with regular naproxen as in (1) above.

Less than 1 in 100 may experience:

ā  Difficulty in swallowing

ā  Skin pain

ā  Jaw pain

ā  Swollen eyelid

 

If you have any difficulty in breathing, swallowing or speaking after receiving Botox contact your GP immediately.

If you experience hives, swelling including the face or throat, wheezing, feeling faint and shortness of breath please also contact your GP immediately.National migraine center

I never experienced any of that when I went. However it did make me feel like crap. Immediately more pain and a wicked migraine. And that seems to be common. That stick needles into a head and oddly enough it causes so aggravation and pain. The migraines don’t agree with it a go a little nuts. The day of botox, isn’t a pleasant one.

Just how effective are we looking at here? Everyone benefits? Only 25% or is it 75?

The goal is not to become completely free of headache or migraine; but to improve quality of life, and to convert migraine from chronic to episodic.

About one in four patients do not respond; one in four respond well to the first or second set of injections, and half need more than two sets of injections to get a good response.  Studies show show that 47% of patients had a 50% or greater reduction in the number of days with headache.

The biological effect of botulinum toxin on nerves takes several days or a few weeks to work. You should not expect chronic migraine to improve properly in less than 4 weeks. Some patients do not start to improve until after their second set of injections which is given 12 weeks after the first set of injections.National migraine center

1 in 4 patients do Not respond. Which would be me last time. And why every neuro since believes I won’t again. Other take time… and that is the category I might be in since I only ever did one round of noresponse. Anyway 47% get a 50% reduction in the number of migraine days. That impresses me. Hell at this point I would take a significant reduction in intensity.