BOTOX for Pain Relief - Delusional or Miraculous?

After decades of intractable migraines and an array of pharmaceuticals ranging from beta blockers (Inderal) to anti-seizure medications (Topamax, Neurontin) to antidepressant (Prozac, Elavil) and various combinations therein, my interest in trying new things has been on the wane.

I have ruled out the possibility of a tumor (CT scan, MRI) or cancer and have even gone under the knife when I was told I had a nasal obstruction – it didn’t work.

Also Lasik, to remove eye tension that is a potential source of headaches, had the extremely beneficial side effect of giving me 20/20 vision. Having exhausted western medicine, I resolved to try another tack and pursue alternative medicine for pain relief.

This led me to try acupuncture, cranial sacral treatments, diet management, chiropractic, St. John’s wort, butterbur and magnesium and even talk therapy (for stress). The result? Zilch. I gave up for awhile and resolved myself to a life of pain management (yoga, hiking, tiger balm, Excedrin, Maxalt, neti pot).

The headaches themselves, while still frequent and on the whole manageable, sometimes veered into more dangerous territory. One time, I passed out on the San Francisco Muni and found myself face down, nestled against passengers’ shins. The most excruciating incarnation brought incessant nausea, vomiting and the unfortunate sensation that an ice pick had been lodged in my temple or an anvil placed atop my head.

Knowing the above, it may be easier for you to understand why I would even consider injecting Botulinum toxin type A into my very own epidermis. While BOTOX is considered safe and was even endorsed by the U.S. Food and Drug Administration (FDA) in 2010, I had seen Taylor Armstrong receive injections on "The Real Housewives of Beverly Hills," her forehead instantly breaking out into unsightly masses, and felt only horror.

But…the strain of near-daily tension between my brows and the fear of damaging my liver with daily doses of acetaminophen drove me to take another look.

According to Medical News Today, BOTOX is a "neurotoxic protein…that in large doses causes botulism…often linked to food poisoning." That’s not exactly encouraging. It just so happens headaches are one of the injections’ side effects. However, it also turns out that the absence of headaches for those getting BOTOX for wrinkles was how the efficacy was discovered in the first place. Pure accident.

A similar "accident" occurred while Bahman Guyuron, M.D. was performing face lifts. According to his study published in 2009, an aspect of the procedure - the release of the supraorbital nerve (the frown line) - provided headache relief as a side effect. This led to BOTOX use to test the theory that paralyzing the nerve removes the pain. Compared to more surgery, BOTOX felt like a cakewalk.

An added bonus emerged in an article recently published in the Journal of Psychiatric Research; it found that BOTOX relieves depression. The study’s author, psychiatrist M. Axel Wollmer, thinks BOTOX "interrupts feedback from the facial musculature to the brain, which may be involved in the development and maintenance of negative emotions." Talk about your beneficial side effects.

It seemed to add up to something worth pursuing. I searched around for a reputable plastic surgeon (is that an oxymoron?) and considered a neurologist (too expensive, no health insurance BTW) and settled on Grant Stevens, M.D., F.A.C.S. in Marina Del Rey. He has all the right certificates: professor of surgery at the USC Division of Plastic Surgery, on the board of directors of the American Society of Aesthetic Plastic Surgery, etc. Plus, his office is close by.

The office sported a sort of aquatic theme with a fish tank and a mermaid painting. Binders filled with "before and after" photos littered the coffee tables, and the pamphlet with the list of procedures administered made my head spin.

Laura K. Pietrzak, MSHS, PA-C quickly reassured me with her own tales of headaches and BOTOX, and I felt hopeful. Maybe they were on to something.

Without too much preamble, Laura whipped out the syringe and injected me with 50 units of the stuff – 16 shots. The whole thing took less than five minutes. I can’t say it didn’t hurt, but it definitely went down easier then a leg waxing.

Slightly discombobulated, I drove home wiggling my forehead. The next day, I noticed a drooping at the center of my (very full) eyebrows and decided I had morphed from concerned to Dracula, looking down my nose at the world as if I might take a bite. I also developed a purple bruise beside my right eye that went away after four days.

I have to admit, I'm enjoying the sensation of a relaxed brow. It sort of feels like the relief you might have post-massage when your muscles have finally let go of their accumulated tension.

I haven’t had a major headache in two weeks and am sleeping much better. So far, the upsides are far outweighing the risk. So much so, I’m considering Latisse to thicken and lengthen my eyelashes, a desirable side effect discovered by accident in patients treated for glaucoma.

From Campus Circle

By Angela Matano