Wednesday, 28 November 2012

Botox for Migraines Part 2

IT has been a while since my last post, sadly because there hasn't been a lot to update you on...  Until now.  Back in January I reported that I had been accepted for the Botox treatment and that they were waiting on approval.  You can read all about it here...

Botox was finally approved by NICE on 27th June this year.  The clock started to tick and local health authorities (more commonly known as Primary Care Trusts (PCT)) had three months to arrange for funding to make the treatment available to the general public.  So that would be the end of September then?  Well yes it would!  So why am I only blogging about this in November?  No, it's not because I am lazy and didn't get around to it.  It's because... well let me tell you why.

September came and went as did a number of calls to the hospital.  Still no funding.  They were waiting as well.  Then came an email from Migraine Trust asking for people who have not yet received an appointment. If not, then they run an advocacy service who you should contact to ask for help.  So I gave them a ring.  And they pointed out that the PCT has a legal obligation to provide this service by the end of September.  The advocacy service contacted my local PCT under the freedom of information act to ask why funding had not yet been provided.

Call me a cynic, but two weeks later approval was given.  Two weeks after that, the appointment letter dropped on my doorstep.  Shock horror and surprise!  Appointments with the NHS are normally for months in advance.  This one was for next Tuesday.  A week away.  Seven days!  Wow.  The day before, curiosity got the better of me and I looked on-line to see how the process works.
"Prepare myself for it," I thought.  I forgot that I have a phobia of needles.  My legs almost went from beneath me when the on-line doctor said,
"This one will crunch a bit".  Eeek!!!

So Tuesday came... and stayed... and dragged on... then I got a migraine which wouldn't go... and then it was 7pm and I was in the waiting room completing a brief questionnaire.  Five minutes later I was called in to see the doctor.  I was the first one on the list for the official treatment.  The doctor has been trialling it for a year on 60 other patients, so I wasn't the first person he had treated, which stopped me bolting for the door there and then.  It took the doctor longer to draw the Botox into the needles than it did to inject it into my head.

I know, I know.  This is the bit that you have been waiting for the whole time.  The info on how I got there is all well and good, but how did it go?  What did it feel like?  And more importantly, has it worked yet?

If you are feeling squeamish, then probably best miss out the next paragraph.  You have been warned!

Ok, here we go.  It hurt.  Sorry to burst any bubbles, but it hurt.  The needles are really thin, so think diabetic needles rather than blood giving needles.  They are only put in for a split second each, after all I got thirty injection in about four minutes.  But they stung.  Some more than others, but they all stung.  Some of them bled as well.  The doctor mopped most of the blood up (ok, I exaggerate slightly for dramatic effect), but he did miss one on the side of my head and the dried circle of blood made it look a little macabre by the time I got home.  That wasn't the worst of it.  Do you remember the on-line doctors comments of a few paragraphs ago (come on, do try to keep up) and that I had a migraine at the time?  When injecting on my migraine side (...double squeamish alert...) the needle crunched through the gristle each time it was pushed in.  It didn't do it on the left of my head, just the right.  That meant that I could hear as well as feel the needle as it went in crunch and out... in crunch and out... in crunch and out.  I think you get the picture now.

I have to admit that when he finished, with a flourish of four injections in my upper back and shoulders, I was feeling a little queasy and more than a little faint.  The migraine didn't help, but the doctor noticed that the colour had somewhat drained from my face and escorted me to a nearby bed where I lay to recover.  But fear not dear reader as a few minutes and a cup of water later, I was back on my feet.  And that was it.  
"Thank's very much, I'll make an appointment for you in three months time." and I was out of the door and wandering, poor punctured soul and all, back to my car.

For the techy amongst you I received 150mg of Botox, 5mg at each injection site.  If that doesn't work then at my next appointment they will up it to 200mg.  If that doesn't work then it is not suited to me, but we're not focussing on that possibility right now.  If it does work then we can look at being more specific in where we inject to try and target the more common areas that my migraines strike and not inject so much elsewhere.  100mg works for some people so we would also explore reducing the dosage slightly.

I know, I know.  This is the bit that you have been waiting for the whole time.  Um, didn't you say that further up...?  I know, but this is the really important bit.  Have my wrinkles gone?

Sorry to disappoint you but I didn't really have that many to begin with so no.  Also, I only had the treatment yesterday and it can take up to two weeks for it to work (that's for diminished wrinkles and migraines).  What I can tell you is that by the time I got home, I could still feel the stinging in some of the injection sites, but not as bad and some of them felt a bit bruised.  But I was warned that this might be the case beforehand and had to sign that I agreed to it.

Today the stinging has completely gone and has been replaced by an itchy feeling on three of the sites.  Again, this was on the list of after effects.  It feels ever so slightly tight and numb on the sides of my head.  Oh and I have a migraine that is trying to come out.  But as yes hasn't managed it.  So who knows, maybe it has worked already.  Or is that asking for too much...?

Stand by for Botox Part 3 coming to all good screens near you soon where I will tell you whether it has actually worked or not.