Hello Fellow Bloggers!
One of the fun things about working on The Doctors is the information exchange. I know you might think it's about us giving the information and you receiving it, but we doctors are learning every week, too!
Plastic surgeon Dr. Bahman Guyuron was on the show today and shared that he noticed that people who had forehead lifts, who coincidentally suffered from migraines, experienced improvement of their migraine symptoms post-surgery. He began a study with 400 patients to see the effects of a forehead lift on migraine pain. The results are statistically significant and warrant further study.
In my view, there is strong evidence that a forehead lift may be recommended in the future for people who fail medical therapy, but I'd stop short of recommending this surgery for all migraine sufferers. We do not regularly recommend surgery when medication or non-surgical measures may suffice; it is part of the "less is more" and "do no harm" philosophy that we doctors adhere to. But in the future, you never know: we may be operating on migraines!
Currently, we regularly use Botox for migraines, as the advantage is that the paralytic agent acts quickly and carries with it very little risk. Injecting Botox for migraines is an acquired art. Often the patient knows where his or her trigger points are and will tells us, “Inject it here!"
When I examine the patient, I have them bite down to get a sense of which muscles are overdeveloped and spastic. The reason for this is because Botox is used in muscles, not nerves. Then I inject slightly diluted Botox directly into the muscles, massaging the injection site, so as to diffuse the agent and evenly distribute it for maximum effect. The treatment takes about 20 minutes, takes effect in a few days and lasts approximately four months. It works!
More from this episode.
~Dr. Drew Ordon
DrOrdon's Blog
Botox for Migraines
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Hi Dr. O
Fellow THE DOCTORS member catluv has so many migraines every since I've met her online a few years ago on Dr. Phil Website. Breaks my heart because I know disrupts her life. Not sure why yet botox concerns me more than Plastic surgeon Dr. Bahman Guyuron's forehead lifts.
Dr. Jim said on twitter that you have to approve Ultimate Makeovers and I'm still hoping and praying for a medical, dental, visual (the works) Ultimate Makeover, please. To feel in tip top shape. Whatever y'all decide would be the best route since I trust y'all. Totally would like to kick my gallbladder to the curb. Pros & cons of meniscal tear repair in knees if best to fix or leave be. See, I miss my powerful, prayerful walks as feels like a car without shocks since slipping on hay and landing mostly on right knee so hard felt like shattered knee cap... and twisting left leg so much scraped leather off shoe. Especially would love a dental overhaul. Would like to know if vision can be tweaked etc. And, as you know, everyone wants Dr. O's magic touch. Thank you. Sincerely, Ultimatemakeoverless in Dallas, Ms. Stephenson
Are there any new lumbar procedures that would tend to improve dessication in 2 disks? And is this procedure minimally invasive? I have numbness in both feet almost constantly and my surgeon told me yesterday that even with surgery that the numbness (coming from the spinal cord nerve impingment would probably not improve by much), but he is prescribing cortisone injections temporarily. Since this worker's comp, I have to wait and have been waiting over 10 years for the surgery. It has deteriorated considerably in that time, but I had other more serious injuries to overcome (brainstem and brain injury, then cerval intervention in July of this year). I have improved more than any of my doctors anticipated and now am in a dire situation regarding movement and comfort. But I still go dancing and move my booty as much as I can as I know if you don't use it you lose it.
Also I have been doing substantial core movement and stretching on a daily basis to increase the circulation and ability to move the area (L3-5) with some improvement in the numbness (unless I sit or lay on it for any length of time) and been doing yoga, which I have practiced most of my life. I keep thinking if I increase the muscular tone it might tend to improve my chances, but I know that the 2 level dessication with the 5 mm bulge and nerve root impingement on the MRI means that they may be beyond retrieval.
Couldn't stem cell therapy work? I would love to volunteer-I don't think I have much to lose and maybe can bring excellent results with my strong physical condition and yoga, weight lifting and life-long dance training.
What do you think, Dr. Ordin? And does anyone have any good references or ideas beyond what I have mentioned. I am open to anything.
Thanks
Jaleen Clark
I've suffered from weekly migraines for 5 years. My GP prescribed birth control pills and several meds, including Topamax. I tried over-the counter products. No success.
I then went to a Cosmetic and Plastic Surgery Center for Botox. The woman who treated me is a PA. She is very knowledgeable about Botox for migraine relief and had also found that Neurologists tended to poo-poo Botox as a solution. After 10 minutes, 20 units and $300, I found my cure! It took about 2 weeks to kick in but I have been migraine free for a full month!
I encourage anyone with migraines to give it a try. If you're worried about injecting a toxin into your body, research death from Botox verses too much Tylenol. I bet Botox is safer!
I am told that migraine relief from Botox will last for 3-4 months, but regular users can often go 6 months between procedures. This PA also said that she finds that those patients, whose migraines start in the forehead area (as opposed to the base of the neck), have the most success with Botox. Seek out someone with experience because if they don't know where to inject the Botox, you won't obtain relief.
Whats the best method to find a good plastic surgeon. I live in the NYC area. Thanks
I'm 40 now and had a nerve tumor when I was 15 and didnt get it removed untill 23 years old. So basically I have always suffered from migranes even once my tumor was removed - that is untill I found botox!! I have tried every kind of pill out there over the counter and prescribed and they didn't always work. I would get so sick to my stomache that I couldnt keep it down, I evven tried the shots and they still didn't always work. I might get 3 migranes a year now at the very most and it's usually if I'm behind on my botox. I used to get 3-4 a week where I would be in bed sick to my stomach all day over them I spent my whole 20's and mid 30's like this it was terrible. So I am a firm believer that botox will cure migranes.
I'm 40 now and had a nerve tumor when I was 15 and didnt get it removed untill 23 years old. So basically I have always suffered from migranes even once my tumor was removed - that is untill I found botox!! I have tried every kind of pill out there over the counter and prescribed and they didn't always work. I would get so sick to my stomache that I couldnt keep it down, I evven tried the shots and they still didn't always work. I might get 3 migranes a year now at the very most and it's usually if I'm behind on my botox. I used to get 3-4 a week where I would be in bed sick to my stomach all day over them I spent my whole 20's and mid 30's like this it was terrible. So I am a firm believer that botox will cure migranes.
I'm 40 now and had a nerve tumor when I was 15 and didnt get it removed untill 23 years old. So basically I have always suffered from migranes even once my tumor was removed - that is untill I found botox!! I have tried every kind of pill out there over the counter and prescribed and they didn't always work. I would get so sick to my stomache that I couldnt keep it down, I evven tried the shots and they still didn't always work. I might get 3 migranes a year now at the very most and it's usually if I'm behind on my botox. I used to get 3-4 a week where I would be in bed sick to my stomach all day over them I spent my whole 20's and mid 30's like this it was terrible. So I am a firm believer that botox will cure migranes.
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