Hi. Ive never posted to a forum before, so pardon me if I say anything wrong. I have read a lot of your entries over the past 6 months. I wanted to post to give some of you a possible answer. I have to say I had at least every other day migraines that were affecting my work, relationships and health. I was in abject misery. The first migraine I ever had was several years ago right after my hysterectomy. I have every classic sign, aura, light sensitivity, pain on the right side of my head and eye, feels so bad I am nauseated. I have visited 3 neurologists, begged to go to a pain specialist, seen two TMJ specialtists, my dentist swears nothing is wrong with my teeth, had multiple MRIs, CTs, EMGs, and nothing shows with any of them. Just ongoing misery. I have taken it all, from excedrin migraine to every triptans, DHE, toradol/phenergain toradol injections, and even some strong narcotics being careful to not have "rebound" headaches. Been trialed on every "maintenance" drug you can imagine. Had numerous trips to the ED, and urgent care knows me on first name basis. My family doctor calls me weekly to offer new advice without success. Changed my diet, my work hours, my job, even moved across country to a new climate. So what was the "magic bullet" you say...well, heres the skinny of it.
I have private insurance through a TIGHT HMO. But I called them and insisted I talk to a case manager for chronic illness. So I met Rosemary, my casemanager. She was able to pull up my healthcare usage and see I had been using ED and urgent care up to 6 times a month and all the tests the HMO had approved, she was shocked. I then insisted she take my attendance records from work, showing I had missed 27 days using FMLA. When she saw the picture, she was really surprised, since the HMO usually flags people like me. I had fallen through the cracks, so to say. So, Rosemary went to two other case workers in other areas of case management, according to her. They had the solution. BOTOX. A 2000 treatment, 32 injections, and if I found a neurologist to do it, they would approve. I was totally skeptical. How could Botox work. But I called my neurologist. She has a partner who does it, but due to my insurance, she had not even offered to have this as an option. Now, figuring all the costs of treatment, missing work, you can imagine I could, in no way, afford $2000 for a treatment that MIGHT work. But I decided to try it. When the preauthorization was submitted to my HMO, it was approved in 7 hours. Yes, hours. Rosemary was so on top of it. She called me to tell me!
It took 4 weeks to see him. I had to wait what seemed forever for this voodoo medicine I couldn't believe would work. I got through another round of ED and urgent care visits, stressed, puking, in pain. Then the day came. My copay was $250. I really hurt paying that money, but decided Id do it. ONE TIME ONLY. So I sat patiently through 32 injections that hurt like hades, burned and bruising my face and scalp. I went home with a roaring migraine and went to bed, cushioned by percocet and relpax. Then I woke up later, and my scalp was numb. It felt weird. But I had no headache. Hmm. The day went along, and no aura. But there was that stuffy head feeling after migraine relief. Then I slept the next night. When I woke, no headache. Hmm. Now I was perplexed. I looked in the mirror and my forehead wrinkles were gone. What a strange side effect, I thought. The botox had kicked in (It takes up to 48 hours, Ive read). I went on with Day two, not headache. Day three dawned, no headache. Eight more days, no headache and I was delirious, could go out during the day and had shop, work, talk, watch TV, read. OMG. What a rush. Then day 12, I had an aura.....on came a mild migraine. But one relpax and it was gone in an hour. On I went with my day.
So, here it is 2 months later. Ive had exactly 6 migraines. In two MONTHS. I have had a few tension headaches at the base of my head, but excedrin has relieved those. So would I do it again? Am I going to do it again? In 4 weeks, when the next round is supposed to be performed, I intend to be on that doctor's table patient, letting him stick me with more needles than an acupuncturist.
I hope this story will help at least one of you. If you are in abject misery and have private insurance, call for a case manager to review your case. Be persistent. TRY it. IT WORKS!!!! Well, at least for me! 
Denise