Discussions that mention botox

Pain Management board

Hey everyone!

My name's Jeff and I'm an 18 year old college student. I've been browsing this message board for some time now, but I've never posted anything. Since I've read some of the stories of people who suffer from chronic pain here, I feel happy that I'm able to relate to a big group of friendly people.

I guess I'll start of with my story. In August of 2006, I was diagnosed with an osteoblastoma of the frontal right sinus cavity. Since its such a rare condition, I'll explain. An osteoblastoma is basically a mass of bone that usually forms in legs or arms. I was lucky enough to get one in my forehead, which is even more of a rarity. Anyways, I was sent to a head and neck surgeon at Stanford University, which is where I got the tumor removed in September of 2006. During the excision, I basically had an incision from ear to ear over the top of my head and had my face peeled down while the drilled through the skull to remove the tumor. As it was, the tumor had a massive infection surrounding it and the infection had eroded most of the bone separating the sinus cavity from where the brain rests. When they grafted the bone to cover this erosion, somewhere along the lines a bundle of nerves were damaged, and as later MRI's show, the plate was set incorrectly, causing bone to brush up against each other.

Now, in 2008, I just saw a pain management doctor for the first time after 12 Norco 10/325's didn't cut it for controlling my pain. The doctor started me on a 25 mcg/h Fentanyl patch and cut my Norco in half. I also have anxiety issues which I take a half milligram of alprazolam (Xanax) three times a day and 30 milligrams of temazepam (Restoril) at night to sleep because of some of the worst insomnia you could imagine.

So if I'm lucky, the fentanyl/hydrocodone/acetaminophen combo will take my pain down to a five or a six, which just won't cut it as I'm a full-time student. I'd heard about using Botox to alleviate pain, so I suggested that to my doctor and we're going through the insurance approval state. If it isn't approved, I can't afford to go through with it. In the meantime, what can I suggest trying that will get my pain down lower than a five or a six. I've tried so many pills other than narcotics. I've tried acupuncture, massage therapy, self-hypnosis, nothing works.

I'm sorry for making the post so long, but this pain is just going to be the end of me. I don't know how much more of this I can stand. I really want to thank everyone in this community for being so nice and supportive to everyone else. It really amazes me that there are people who would be so willing to share their own stories and help others through their struggles.

Thank you all so much in advance,

Wow, Jeff, for only being 18 you have been through a lot! You are an amazing person to continue to go to school full time, deal with the horrendous pain and keep up with everything. I have 2 small boys, stay at home, and do the best I can to take care of the house, the boys, me, and not to mention my husband.
I have been dealing with chronic pain for 6 months. I now take 40 mg oxcontin every 12 hours, vicoprofen 7.5 X4 as needed for breakthrough pain, and flexerill and valium for muscle relaxants. I also take lexapro for anxiety and depression.

I hope your new combo of pain medications will help, and I hope that the botox will be covered by your insurance. I am battling my insurance company for surgery on my tmj, an I have been battling them for 6 months. Did you just start the new round of medications, and if so how are they working, are they getting it down to a 5? I hope so, and don't be afraid to call and tell them it is not working. Everybody is different, and what works for one does not the other. I wish I could help you more, but it would be great if you could write us back and tell us how your medication is working. Keep your head up, and it seems you have a good doctor who is helping you with the pain. Please keep in touch. Kassandra
Thanks for your reply, Kassandra.

I've been on the fentanyl and 6 Norco's for about two weeks now and I'm really lucky if it takes me down to a 5 or a 6. I have my appointment with the pain management doctor this afternoon, so if the botox is covered I'll be able to get the shot today. If its not covered, it would be somewhere around 2 grand every few months, which is just too much. I'm lucky enough not to have any side effects from the narcotics or the benzo's, (being able to drive, ect.) but if I have to go on a higher dose or switch to something like morphine, I don't know how I'll handle it in situations such as class if it effects me. Just hope the botox works.

Hope everyone has a pain free day!
Hi Jeff, welcome to the boards, I was just curious as to why do you think that the Botox will work? I know Botox is used for cosmetic reasons and to relieve muscles spasms. So I was wondering do you have some kind of muscle spasms in your face or is Botox being used for another reason? I also notice that you suffer from nerve damage so I was wondering have you tried any kind of nerve medications? There are excellent medications that help with nerve pain such as Neurontin, Lyrica and Topamax. Maybe one of these would help you with the nerve pain as well as with the other medications you are currently taking. Most narcotic medications don't work on nerve pain as well as some nerve medications do. I do hope you find some type of relief for the pain so you can continue your education. I know it's hard for you to suffer like this and try to concentrate on your school work.
Hi Jeff,
Welcome! I am pretty new here myself. I've been living with chronic pain now for 8 years give or take. I have a myriad of medical issues and was lucky enough to have been referred to a great PM doc pretty early on. I just heard that my doc is doing Botox too, one day a week at another location. I haven't had a chance to talk to him about it yet, but plan to at next appt. The nurse explained that it has been shown to be beneficial for nerve and muscle pain (of which I have both) but I haven't talked to anyone who has had it. I would be thrilled to hear how it works if that's the route you & your doc go. Thanks for sharing your story. Hope to see posts from you often.

Thanks so much for all of the replies, everyone.

The surgical aspect of treatment is complete. Speaking of the surgery itself, the osteoblastoma was surrounded by infection, which caused the bone between the back of the sinus cavity and the brain to erode. There was mesh placed in the back of my sinus to replace the eroded bone, but somewhere along the lines some sort of nerve damage took place and I now suffer from petite mal seizures. Before the seizures started, I had tried topamax and gabapentin for pain, which were unsuccessful. After the onset of the seizures, I started on Lyrica because of its action on nerve pain as well as the anti-convulsant effects. I don't notice any relief when the Lyrica dose is taken.

A few of my doctors (specialists from UCSF and Stanford) suggested botox might be effective in treating the pain, although I have yet to do much research on my own. I have asked about facial nerve blocks and the like also. I would gladly have permanent numbness than permanent pain.

I really can't thank you all enough for taking time out of your days to reply with suggestions and encouragement. I don't know anyone outside of the online world who suffers from chronic pain, so nobody knows what its like not to be able to get out of bed or not being able to do anything without my pills. I apologize for my long winded posts, but I find it therapeutic to post on these forums in such a friendly community.

I know there must be a ton of people on here with problems much worse than me, so I really want to do my best to contribute and try to encourage others who are having bad days.

Thank you so much to everyone that's a member here for providing a place for me to come and relate to people with similar problems as my own.

Disrielgears-I don't know much about the Botox injections, as I have not had them, but I did want to welcome you to the board and to encourage you to continue to post questions and thoughts that you have. There are many people here who have a lot of valuable information. I am sorry that you are in so much pain and esspecially while in school. I want to encourage you by letting you know that my daughter has had auto-immune disorders, since she was 16 (which is when they 1st noticed that she has DDD in the lumbar of her spine) and since then, she has had several surgeries and has suffered through TMJ and her jaw completly locking up...then having to go to the ER to have then crack the jaw andput it back in the correct position. All of the things she has gone through, she has been away at college. Freshman year was very difficult for her and she came home to see her Drs. that she knew, when she needed surgery. But then as classes got harder and the drive got to be more of a hassle, she has found Drs. near her school and she is now a Senior and she has made it through all of the pain. So, keep you chin up and the focus on the studies (as much as you can) and I know you will be a Senior very soon;).

Good luck with the Botox and/or any other injections that they decide to try on you and I will keep you in my prayers.
[QUOTE]A few of my doctors (specialists and UCSF and Stanford) suggested botox might be effective in treating the pain, although I have yet to do much research on my own.

Just wanted to comment to rayefaye and DisraeliGears that botox is being used in the treatment of migraine headaches. My Migraine Specialist, and one at Emery University offered the treatment to me about five years ago after participating in a study because my ENTIRE family has migraines. For me, I could never get past injecting BOTULISM into my brain stem, which at that time is where they wanted to put it. :eek: I don't know what the treatment consists of now, but now, I'm curious again, and am off to go look up the treatment.

DG, it sounds that your docs are willing to try treatments that are new, and on the cutting edge of medical research. You are lucky to have (what sounds like) a good team of docs working for you in your care plan.

I'm just so sorry it's for the reason it is. :( Oh, and BTW, welcome to the boards. Stay strong in your fight against CP, you are a bright young man! I'm praying that your docs can find a regime that can help you fight your pain!!

Did a bit more of research and here's what I find:

[*]Botox has been used for treatment of migraines since 1992.
[*]Work with botulinum toxin type A as a therapeutic agent to treat human disease began in the late 1960s.
[*]This is when botulinum toxin type A was first considered not as an agent of human sickness and disease but as a powerful therapeutic agent to treat symptoms of neurological disorders.

[QUOTE]...results indicate that botulinum toxin A injected into the muscles of the brow, eyes, forehead, side of the head and back of the head near the neck (a point that earlier investigators have neglected) induce sometimes immediate Migraine relief and provide benefit for up to six months, he said. Botox® dosage in his case studies averaged 80 units per patient.

[QUOTE]Reports have described the purported effectiveness of using a biologic neuromuscular blocking agent, botulinum toxin, in the treatment of painful conditions associated with skeletal muscle. While incompletely understood and at times controversial, use of botulinum toxin in the treatment of conditions associated with involuntary muscle contraction, such as focal dystonia and spasticity, is supported by prospective, randomized clinical research; however, while the volume of comparable studies in pain syndromes is growing, the number of clinical randomized trials is limited. Moreover, not all such reports have demonstrated clear efficacy of the use of botulinum toxin under all circumstances. Therefore, in view of our current understanding of the nature of muscle-induced pain and the paucity of prospective research regarding neuromuscular blockade and/or inhibition of nociception in such conditions, critical and careful analysis of the data and opinions presented in this section is appropriate.

Interesting.... good luck DG!!
Thanks bgsigns for the info, I knew that Botox was used for muscle spasms. I have had them before for my Cervical Dystonia but they were as no help for me as far as the spasms were concerned.

Jeff, I do hope you can them approved and I do hope they you will get some relief from them. If they don't approve them don't give up trying to find ways to help you relieve the pain. I wish you the best of luck.
Jumping on the welcome wagon late but....Welcome Jeff!!

This is a great place full of wonderful people who will let you vent when you need to, give you advice when you need it and kick you in the butt when you need that too!!

I'm sorry to hear that you have joined those of us with chronic pain. You are so right about people not understanding unless they deal with it every day. You have mentioned some of the medications you have tried that I was going to suggest but I haven't heard you mention Oxycontin or oxycodone. Have you tried these? Since medications work differently for everyone I think it is important to give others a try if you are not happy with where you're at pain-wise. (sorry, I'm tired today, did that make sense?) Oxycontin has given me my life back(most days) and when I grew tolerant my pm tried me on many other meds before he went back to Oxy and raised the dose.

Have you heard back about the botox? I hope you get approved and it is a 'wonder drug' for you. I've heard of people taking it successfully for migraines.

Kudos to you for staying in school with all you have going on. I have one more quarter left in my program. I dropped out last year because of the medication roller coaster that I was on at the time and because I was the primary caregiver for my mom who subsequently died and I still haven't got the energy back to reapply for financial aid. Maybe today....

Anyway, keep us posted and don't worry about long posts....I like them too!!!lol~Mush