Botox…Not Just for Beverly Hills Housewives

Let me just preface this by saying that my eye pain has come back and that it is really hard for me to look at any screen or book…otherwise I’d be in college, finished, and have a job instead of writing about all my chronic illnesses.  Time for steroids…Prednisone, that is.  I’m not a WWE wrestler.

I’ve been getting Botox injections for headaches and chronic “trigger points” for 2 years.  I first heard about it approximately 8 years ago from a Russian neurologist…like Putin-Russian…that I was seeing for headaches as my original neurologist had left.  I had terrible headache pain when I was 14 years old.  I remember Freshman year 2004, sitting in Honors Biology–I’m a Type A, overachiever–, and having to bite my lower lip hard so I could concentrate on the whiteboard and what was being taught.  The pain above and right between my eyebrows was so intense.  My mom took me to a recommended neurologist, my first of many, and he prescribed me Firoicet which has caffeine, Tylenol, and something else in it.  It worked wonders.  Actually, for a period of 2-3 years, I rarely had a headache.

Then came my Fibromyalgia in 2007 and I had “trigger points.”  I was also diagnosed with TMJ in 2006, plus I have a hereditary clenching problem, especially at night or when I’m concentrating on something intensely like exercise, so the muscles (masseters and pterygoids) would get tight and sore.  Botox-TMD1Then because everything is interrelated, my headaches started coming back due to the TMJ trigger points and clenching.  To finish out this cyclical pain, I was getting trigger points all down my neck or sternocleidomastoid (SCMs), trapezius muscles, and my suboccpitals at the base of my skull.  The pain never shut off and kept feeding in to each other.

I tried massage therapy, do physical therapy…which I could write another blog about all the dud PTs I’ve had…where the physical therapist can release the trigger points doing myofascial release, but the relief was short lived, did acupuncture with electrostimulaton and cupping for 10 years…but gradually it became less and less effective over the years and now results are the same as the PT.  {I will write anther blog post on acupuncture.}  I was in a lot of pain, especially in my neck and shoulders.

Finally, after a lot of research on my dad’s part, we found a neurologist who did Botox injections.  I was nervous as hell the first time.  I can’t tell you how many Xanax I took.  I felt like I was going to pass out, have a heart attack, and an anxiety attack all at once.  Once I got in the room, it was surprisingly painless…or maybe because I’ve had acupuncture done for so long and am used to being stuck with needles, it didn’t bother me.  The theory is that injecting Botox relaxes muscles.  That’s why people get it for cosmetic reasons; it relaxes the frown lines, the brow furrows, etc.  BLOG-triggerpointThe same principle applies for actual symptomatic reasons.  You inject into the muscle, try to deactivate or minimize the trigger points and give the muscle spasms time to relax over three months until the Botox wears off and you need another treatment.  Currently, I get routine injections every three months, which my family’s insurance covers.

There is a book called “The Trigger Point Therapy Workbook (3rd Edition)” by Dr. Clair Davies which illustrates all the parts of the body where trigger points can be located and where in the body that they correspondingly cause pain.  It is a huge help to have a physical therapist who is well-versed in this type of work and theory.

tmd-trigger-point-3a
Figure 1.

 

Here is an example of my frequent trigger point areas and where the pain is then referred.  [Figure 1.]

When I go to the neurologist for the Botox injections, he usually injects the sites. [Figure 2.]  This Monday was the last time I got my injections.  I can tell instantly when they are starting to wear off as I get pounding headaches, really debilitating vertigo, and knots all over my traps and in my masseters and pterygoids.  My initial neurologist who performed the first Botox injections as well as my current neurologist who I’ve been seeing ever since, both said that each session of Botox injections should help my muscles relax and that over time, they won’t be as tight any more.  Additonally, they said that the more you use Botox, the longer it will last between each injection session.  Well, because it’s me, the opposite is happening.  The muscles never relax and the Botox is only lasting for half of the time.

Screen-Shot-2015-06-29-at-8_50_35-AM
Figure 2.

As you can see, Botox has many different purposes, including treating hyperhidrosis.  Ironically, my doctor mentioned that the USDF is doing testing to approve Botox for combating depression.  If that’s true, it certainly hasn’t helped my depression in the last two years.