If you've ever had a migraine, or know someone who has, you know how painful and debilitating it can be. Imagine having a migraine for half a month, or more. That was a reality for Terry DuBose, a patient at the VA Western New York Healthcare System. Terry had suffered migraines for more than 20 years. His migraines were so severe they lasted for weeks, sometimes months.
"These are headaches that put you down, and down for a long time," he said. "You're living hell half the month and the other half the month, you're only about half."
Migraine headaches are typically described as "throbbing headaches". They are classically located on one side of the head, but most people will describe pain on both sides --generally in the front or back. Symptoms may begin with an "aura", which can include visual symptoms like sparkling lights, or sensory symptoms like acute sense of smell. And once the headaches occur, patients may experience nausea, vomiting and may be sensitive to lights and sound.
Terry tried every preventative medication on the market, but nothing stopped his migraines from coming back. That was, until his neurologist, Dr. Nicholas Silvestri, suggested he try a treatment many of us associate with fine lines against wrinkles: Botox.
"Botox can be used both cosmetically and medically," said Dr. Silvestri. "And how it was stumbled upon for migraine headaches was through its use to treat wrinkles. The people were treated for wrinkles and their headaches went away."
Botox is only used to treat patients who have chronic migraines. These are migraines that occur half the days in a month, and last 4 hours or longer each day. Patients who are treated with Botox receive 31 injections to the forehead, side of the head, neck and upper back region. Doctors believe Botox works by blocking pain signals from reaching nerve endings inside the brain.
The effects of Botox typically last about 8 to 12 weeks, so patients must continue to receive injections about every 3 months. Side effects include neck pain, bleeding and risk for infection. Some patients may also experience drooping of the eyelid. But there is one side effect many don't mind: fewer wrinkles.
Dr. Silvestri administers Botox injections to about thirty patients at the VA, and so far has a 100% success rate.
"Most of the patients I've treated with Botox have responded very well. I'm very happy with the results I've gotten and so are my patients," said Dr. Silvestri.
Doctors have been using Botox to treat chronic migraines for years, but it wasn't approved by the FDA as a preventative treatment until 2010.
That allowed physicians, like Dr. Silvestri, to offer it to their patients and has paved the way for insurance companies to pick up the tab.
But for those who suffer from chronic migraines, the treatment is priceless.
"Waking up in the morning with that feeling that you're going to get through the day without a headache ... it's just amazing," said Terry. "It just seems like a different chapter, a chapter with no headaches."
For more information on treating chronic migraines with Botox, visit this website.