37 Y.o. Neck Pain, Migraines, Occiptal Neuralgia - Colorado, CO

I decided to switch doctors and get a second opinion after Dr. Birlea failed to ever call me back (extra calls to office over a 3 month period!). I have switched to Dr. McNutt and what a huge difference! We decided to go back on the Botox (I started having more severe and prolonged headaches unable to fix with abortives almost every day). However, he uses MUCH less, and is better about tailoring the injections so it's not overkill! He also kept me but switched me to another ADHD med (Adderall) and we slowly try new preventatives such as switching from Topomax to other seizure meds in the same class. And better yet, he calls back and is a fraction of the cost of Birlea - $4000 to $1500 so my insurance now pays 100%!!!!! I now get injections just inbetween the forhead and a little on top of my eyebrows and not all over my forehead like before (also didn't get them inbetween eyebrows either so goodbye 11's!). This has seemed to help the most as it seems some of my headaches start as tension and move into migraines, or maybe it hits a nerve or whatever causing my specific ones? The next time, he also added in my mastours as I said I have pain here sometimes and gave me a touch so I stop clenching and grinding at night and get in that pain cycle! So no my injection sites are - bilateral occipitals, neck, traps, mastours, and eyebrows (inbetween and one line above). So, far I get maybe a migraine every 2 weeks! I have noticed that I am less fatigued and feel like I have the flu! I do notice a correlation between fatigue and headaches, so am thinking I was still having silent migraines even with all that botox. It appears I have fatigue before and after a migraine, although I attribute some of that flu like feeling to the overdosing as that has gone away once we spot targeted my "trigger" spots. The right doctor that actually listens to his patients is such a blessing and I am so thankful I switched. I have also just recently did a cleanse (after switching docs but just in the last 3 months) and moved to a more plant based clean diet. This has also make a remarkable difference as I have found additional triggers -artificial sweeteners of all kinds, gluten, dairy, eggs, and MSG are all at the top of the list! If I start to not eat clean - I start getting more headaches. I feel so much more in control with having the right diet and preventative med plan. When you are in so much pain everyday, it is hard to take care of yourself right! I also am able to go to the gym 3-5 times a week and discovered a love of Zumba! Hope this helps others to find that "right" fit doctor! Don't stick with the same person if you are not getting results and feeling better! There are others so don't ever give up! It makes it so much easier to work on the stuff you can help - elimination diet and exercise once you can get a little handle on the pain and related side effects!

I have been getting botox for the last year from Dr. Birlea for migraines and neck/shoulder pain. I was having almost daily headaches, had to quit my job, was taking a slew of narcotics and preventative medications to try and treat neck/shoulder pain/spasms and headaches. I was diagnosed with several conditions from occipital neuralgia, cluster headaches, medication overuse, migraines and more. He also checked me for increased intercranial eye pressure because I was in a car accident. His diagnoses seemed all over the place but I decided to try anything because I desperate for relief and wanted to get off all of my medications. Injection was painful, not horribly, but it took some getting used to. I started to cry a little, unvoluntarily, and Dr. Birlea snapped at me for wiping my tears away. After the injections (over 30+ in face, head, temples, neck, and shoulders) I was sore for 2-3 days and this seems to be the pattern after every round of botox. A couple of times I have felt like I have had the flu with body aches and chills, nausea, and severe fatigue. I have had varied results with pain control. My headaches/pain has gone down to about 15/month. However, I have severe fatigue/anxiety that now I have to take medications for. I do not know if this is Botox related or not. I feel very foggy all of the time and have trouble concentrating. I have had to go on ADHD medications. My eyebrows are not the same - one is higher arched than the other and only one part goes up which makes my kids giggle and makes me feel embarrased. I have brought these concerns up to Birlea who has dismissed my fatigue from the Botox and has not changed placement to give me a better look and makes me feel vain. I don't think I will be back for another round and see if I start to improve. It's difficult because I don't want the headaches/pain to return either but hate to feel like I'm walking in a cloud all day!