46 days after botox

Today is about halfway until my next set of injections. It's hard to believe it's been nearly 7 weeks. I've had 2 headaches since my last post, one of which was a migraine. According to my headache diary app, iheadache, I've only had 6 headaches following the 8 day headache from hell triggered by the injections themselves. That's a lot of numbers, but it boils down to an average of one headache a week lasting no more than 24 hours. Sound like a lot?

Well, consider this, in order to be approved for botox therapy you have to meet the criteria of having chronic migraines. Chronic migraines, as defined by Humana and most insurance companies I've researched, are at least 15 migraine/tension headaches a month, or more than half the time. I met that criteria - and then some. Migraines are know to last anywhere from 12 to 72 hours. Oh yeah, at least. You also have to meet some scarey criteria.

For about two years I worked as a mental health social worker, or a CSI Worker - "Consumer Support Individual" - as they are called in Georgia. It was by far the hardest job of my life, and I worked in a federal prison for 4 years. I participated in the lives of so many hurting people, many of whom were on mental health medications. I saw the side effects it had on them and on their families. For most of them, these side effects lessened in comparison to the way their lives were without the medication.

One of the requirements for insurance companies to approve botox for migraines is to be on some of these medications because they prevent migraines for some folks. Not the case for me. I've tried so many medications I can't even remember them all. The most frightening was nortiptyline, a tricyclic antidepressant. Talk about a black cloud, and flushing, and a black cloud, and a dry mouth, and a black cloud, and constipation, and well, you get the point. Oh, and the headaches didn't change. There are other meds that are recommended, medications like Depakote, which I refused to try.  Triptans are the golden egg for migraine relief, but they only work after the headache starts. My insurance covers 6 of these a month. The retail price for one of these pills is $27.50. Multiply that times 15 headaches a month, and well, you get the picture. I guess I just learned to push through it.

It's been interesting watching the responses of my friends and acquaintances as they start to realize what all that means. I get statements like, "I had no idea. I'm so sorry you were in so much pain. I never knew it was that bad." Part of me wants to jump up and down and shout "hurray for me! I seemed normal!" But part of me wants to sit in the floor and cry because I didn't trust my friends to help me carry this burden. I am continually learning about myself.

My next follow up isn't until November. I plan to share a good report - a hopeful report. I plan to schedule the next set of injections, and I plan to find out what to do to prevent the inevitable migraine that will follow. I remain hopeful.