Dr. Rhine (4:35)

Hey, Nora. So cool to be back with you again.

Nora McInerney (4:38)

So we have some very nuanced and dare I say, personal conversations to have today. We have explored many different parts of the experience of living with chronic migraine, but we have never explored how it can affect intimacy. How often does this part of life and a patient's experience come up in your office?

Dr. Rhine (5:02)

Yeah, this issue is brought up by nearly every adult patient in conversation around their migraine attacks and their migraine triggers, the concerns often brought up while discussing the impact of the symptoms and the way that that could impact their intimacy. And so I'm really glad that we get a chance to explore that with this episode.

Nora McInerney (5:16)

Me too. Okay, let's meet today's guest, Tom Pno. Hi, Tom.

Ruby (5:28)

Hey, Nora. It's great to be here.

Nora McInerney (5:30)

I'm so glad you're able to join us and we can get to hear more of your story. But before we get into that, I want to ask you about music, because I saw that you sometimes use music to help you cope with a migraine attack, which is actually really interesting to me because most of the people that we've spoken to have said that they actually prefer silence when they have a migraine attack. So I have to know what kind of music helps you during a migraine attack and is that different from the music you might enjoy at other times.

Ruby (6:04)

I use the music that I normally listen to just every day. So sometimes I could use anything from classical music to more hard rocking type music.

Nora McInerney (6:17)

Hard rock. Oh my God.

Ruby (6:19)

Yeah, I have a few favorite tunes that or on my migraine playlist.

Nora McInerney (6:23)

So yeah, yeah, that makes sense to me. So, Tom, I want you to set the scene for us a little bit. Can you give our listeners an example of what a migraine attack feels like for you?

Ruby (6:36)

For me, I have chronic migraine. So usually when I'm getting a migraine attack, one of the key indicators for me is, is my aura. I usually start to see my field of vision like in a crescent and it starts to blur and that blur moves across my field of vision. So that's when I know that I'm truly having a migraine attack. So I know that if I'm feeling discomfort at the same time as the aura, then I know that I'm in for a rough ride. And if I'm driving in a car, I immediately know I need to pull over and I just have to wait it out and see what happens. That's how it all starts for me for the most part.

Nora McInerney (7:16)

Do you have a particular moment or a particular time when you felt that coming? Like you can feel the migraine attack coming and you have to make an adjustment to what your life is going to look like that day?

Ruby (7:31)

Definitely. While I was still working, I had to educate my team on what migraine was like for me so that they can understand when they notice that I'm not. I'm not feeling like I'm not mentally engaged in what we're talking about. So I have to bring them all up to speed. But if I'm on my way to the workplace or something like that, one of my first things after pulling off the road if I'm driving is I need to notify someone where I'm going to let them know I was on my way. This is what's happening. If it gets worse, I will not be there. If it improves to the point that I can function, I will be there. So there's a lot of education just to make my life easier.

Nora McInerney (8:16)

And also I think that kind of communication makes everybody's life better, even the people who are around you and not experiencing a migraine attack. I do think most people want to be as good as possible for the people around us. Right. Your colleagues want to know how you're feeling so they can jump into action. Pick up slack if you can't, because you would do the same for them, right? Absolutely am really appreciative of the work that you have done. Being so open in your writing about your experience living with chronic migraine and especially how that affects your relationship with your wife, who also experiences migraine attacks, because that is not easy to talk about. We don't really talk about intimacy very much. You route that you have started to reframe what intimacy means, knowing that it is something that has to be flexible to your reality. Will you tell us about that? What does it mean to be intimate?

Ruby (9:23)

For me, the little things. Now, if we get a chance to sit together on the couch and watch a movie, we'll hold hands just so that we have some kind of physical connection when we sleep at night. Quite often we'll just hold hands when we're lying in bed. It's just like the things that a lot of people take for granted, those are the things that get reframed as our intimate times. We don't do the whole dating thing like other couples do. A lot of times it's, oh, we need to go to the store and get paper towels and toilet paper. Okay, that's a date. We're gonna go, and maybe we'll get a. An ice cream or something. Either going or coming back. And that's it right there.

Nora McInerney (10:08)

Yeah, I really love that. I fully agree. There's also, of course, like, the traditional definition of physical intimacy, which is for a lot of people, saying that is like a very physical need or a desire. Is there anything that you have found that has worked in your marriage for how you both approach that part of your relationship? Knowing that chronic migraine can affect that at any moment?

Ruby (10:38)

Yep. Don't want to sound, like, cold about things, but we kind of plan things out. Yeah, we know we're going to go away for this weekend and we're going to just do something that we both enjoy. Go look at antiques or something like that. But we know that we're going to be by ourselves. So that opportunity to have that physical intimacy is definitely going to be there. Whether, you know, my head, my body, and her head and her body will all sync up at that time. Maybe it happens and maybe it doesn't. And it's like we're past the point where I don't really get upset about it anymore. Yeah, she doesn't get upset about it anymore. It just is what it is. We just. We really focus on trying to appreciate the time that we have together. And, like, something that's soothing for both of us is shower time. Yeah, that's always been, like, a Time for us to be together and to relax and we can decompress.

Nora McInerney (11:36)

I also think that there's something to, like the scheduling aspect of it. I think you were getting to this point. Like, even that can build up in anticipation more than just the maybe it'll happen, maybe it won't. So I love that. I love that, and I love your relationship, which is why I am so glad that we get to bring your wife into this conversation. Before we meet Tom's wife, Cheryl, I'm going to check in with Dr. Ryne. Okay. I want to bring you back into the conversation here, Dr. Rhine. Tom has brought up some really good ideas around how we can reframe our definition of intimacy and be more intentional with scheduling time for intimacy with our partner, with the goal of creating a partnership that can accommodate migraine attacks. But the current underneath all of this is around the stigmas that are faced by people living with chronic migraine and how they have to mask their experience to fit in. So let's refresh people's memories a bit. What are some of the most common stigmas you hear about from your patients?

Dr. Rhine (12:51)

Nora? The stigma that breaks my heart the most is that people don't trust the migraine patient. They think that they're faking it. They think that they're faking the intensity of the illness or the impact that the disability has on their everyday life. Worse than that, patients are often made to feel like they're scapegoated, that their illness is there for personal gain or personal preference. As ridiculous as that sounds. Their coworkers make them feel like they're using chronic migraine diagnosis to avoid work or to work less. Their partners sometimes make them feel like they're using their diagnosis to avoid intimate encounters. Family members make them feel like they're using their diagnosis to avoid family responsibilities or even family interactions, which is the exact opposite of what these patients really feel and want. What we end up then with is an impact that isolates people living with chronic migraine even further. It keeps them from developing open and honest communication around what they're experiencing. Yeah.

Nora McInerney (13:45)

I would imagine that seeing and feeling these stigmas every day would make you hesitant to be vulnerable and to share your story with other people and even with your doctor. Is this a factor in why you've seen people hesitate to seek care? And what other reasons have you seen that makes people hesitate a bit?

Dr. Rhine (14:06)

Nora, this blows my mind. A couple of years ago, a study came out that found that nearly half of people with migraine hesitate to seek care. It's a huge number and sadly not surprising in the study. They also try to get a better picture of why those people hesitated. What they found was that over a third of those people said that they hesitated because they were afraid their symptoms weren't going to be taken seriously. And it's sad to see for me in my practice, I mean, they're internalizing all of the questioning that they've received their whole life about whether or not their disease is legitimate. Are they really having symptoms? Are the symptoms that bad? And they're afraid that they're not going to have their needs met again when they finally do get the chance to see the physician. They're scared of the cynicism and disbelief. They're scared of the stigma that they've experienced already. And it's why I try so hard to save space for them when they do share their story. At the very beginning of the relationship that we're building clinically, it's really important for that treatment journey, but it's also really important for them to have that level of trust.

Nora McInerney (15:07)

Alright, thanks Dr. Rhine. After the break, we'll get back to the conversation and meet Tom's wife, Cheryl.

Botox Safety Information (15:21)

Chronic migraine is 15 or more headache days a month, each lasting four hours or more. Botox onapotulinum toxin A prevents headaches in adults with chronic migraine. It's not for adults with migraine with 414 or fewer headache days a month. It prevents on average eight to nine headache days a month versus six to seven for placebo.

Botox Safety Information (15:39)

Prescription Botox is injected by your doctor. Effects of Botox may spread hours to weeks after injection causing serious symptoms. Alert your doctor right away as difficulty swallowing, speaking, breathing, eye problems or muscle weakness can be signs of a life threatening condition. Patients with these conditions before injection are at highest risk. Side effects may include allergic reactions, neck and injection site pain, fatigue and headache. Allergic reactions can include rash, welts, asthma symptoms and dizziness. Don't receive Botox if there's a skin infection. Tell your doctor your medical history, muscle or nerve conditions including als, Lou Gehrig's disease, Myasthenia gravis or Lambert Eaton syndrome and medications including botulinum toxins as these may increase the risk of serious side effects.

Botox Safety Information (16:16)

Ask your doctor and visit botoxchronicmigraine.com or call 1-800-44-BOTOX to learn more.

Nora McInerney (16:40)

It's time to bring Cheryl into the chat.

Cheryl (16:42)

Hi Nora, it's great to be here. Thanks for having me.

Nora McInerney (16:45)

Cheryl. It's so good to meet you and I am grateful that our audience gets to hear about this partnership that you two have and that you have built and that you have maintained and that you have been able to navigate this experience and stay close to each other through all of this. A lot of a relationship comes down to communication. How do you two communicate? Check in with each other and stay connected.

Cheryl (17:14)

So, yes, the answer to your question, we just have to feel it out. Because he'll pretend he doesn't have a headache, or he'll take medicine and say, oh, I'm fine. And I'll be like, are you sure? Because you're acting like I really don't want to be with you right now. And of course, I understand that being uncomfortable makes those times difficult. And then I was chuckling to myself because we went away for our anniversary last year and we thought we'd be together. And first day we're there, I'm like, honey, I'm getting an aura. And I had a migraine attack for two days. And we're just like those times we were just laying in bed together, and I was listening to a movie, and he was watching the movie. And so it was flip sides. We just weren't through it. So intimacy is more than a feeling. It's part of a being who you are and that you're together.

Nora McInerney (18:08)

Yeah, that's really beautiful. And I love that you just. You talked about the example of you're going away for your anniversary. Everyone thinks the anniversary trip is going to be the time that's the most relatable thing. We're going away together. We're celebrating. You're getting a migraine attack. You're listening to a movie now. Like, I don't think that there's anything more relatable than that. Whether or not you experience chronic migraine, like, the expectations versus reality require, it just requires a lot of flexibility. It requires, like, that deeper intimacy that you're talking about, which is compassion for each other and compassion for yourselves. I want to talk about how you've navigated those not tonight moments, because I think that's a hard thing. It's a hard thing for somebody to say at times. It's a hard thing for somebody to hear as well.

Cheryl (19:02)

It's really funny because my chronic migraine, I had four or five migraine attacks a week. Fortunately, Tom didn't have migraine then. For me, it'd be like, I really. I've taken care of all the kids today. I vomited like, four times today. I feel ugly, like, I don't want to do anything. And he believe it or not, has it that isn't him all the time, because he always wants me to be happy as well.

Nora McInerney (19:29)

Yeah.

Cheryl (19:30)

So now it's the flip side. And women are a little different than men. Men strive to be more intimate, and women are like, oh, okay, I can sleep tonight. So for us, like Tom said, we could sit on the couch and hold hands and just snuggle and. And they'll be okay, and he'll apologize to me. And I'm like, there's no need to apologize. I loved just sitting there and watching the movie with you or having you lay there and snore. Either way, I know that he's here. So I'm just grateful that I have him snoring next to me or with an ice pack or whatever.

Nora McInerney (20:05)

So in a world where media often presents one version of intimacy above all others, this is a softer form of it. It's one that respects that bodies don't always do what we want them to do, and that love and connection can take many forms. Tom, I want to ask you. There's a lot. Culturally, there's a lot of pressure as a man to not, oh, don't experience any vulnerability and weakness in quotation marks. Certainly don't talk about it if you. If you are experiencing it. And it's very toxic. It's very toxic to men. It's toxic to the people they love. And there's so much strength to be found, like inner strength, but also connection with other people in sharing those experiences openly. Can you talk to us about that?

Ruby (20:54)

Yeah, I just. You just happen to get to the point where I was able to do that because you're working with a group of people, you're talking with your supervisor or something like that, and they're used to you being very on top of things, very sharp. And one of my bosses used to tell me, he didn't hire you for anything but the space between your ears. He says, I want that three inches between your ears. That's great. But during a migraine attack, I'm not at my best at that point in time. I just had to come to the realization that I could, try and, quote, man up and try and cover it up and put on the little happy face or whatever and say, oh, no, I'm fine. I've got this. I've got that. I'm also the kind of person where if I'm going to do something, I like to try and do it at the best level that I can. And I just knew that wasn't happening. I could just feel it in myself. It's, yeah, I see that this project is done, but I could have done better, but I just don't know how I could have done better. So it was like, I have to start telling the people that work with me, telling the people that are above me. I've been seeing a doctor about this, and this is how it has to be for me, and I'd like you guys to be on board with it. So it's like, it was very difficult. I lived on FMLA intermittent leave for three years at the end of my career. It was a tough conversation to have because I had to admit to myself that you're not who you were. That person is no longer viable in your life. So I had to kind of recreate myself and repurpose myself into something else. And that's when I found migraine.com and I submitted some writing, and they liked it, and they brought me on to do some content for them.

Nora McInerney (22:51)

Yeah.

Ruby (22:51)

And that really allow me to kind of repurpose myself. Now I can help another set of people.

Nora McInerney (22:59)

Yeah.

Ruby (23:00)

By sharing my experience and just trying to be open, honest, and, I guess, vulnerable, because it's one of those things that's, if I'm suffering, then other people are suffering. But what I've learned with chronic migraine is that you can talk to 10 different people, and they're gonna have 10 different angles on how it impacts their life.

Nora McInerney (23:31)

Okay. Dr. Ryan, how much do you love these two? They are like the shining stars of the migraine classroom. Now, I always love hearing your thoughts on how people living with chronic migraine could approach doctors and their workplaces with this conversation, but we have never really talked about how they could approach their partners, their spouses, their boyfriends, their girlfriends. Do you have any numbers that help illustrate how hesitant people are to share their migraine experience? And how do you try to help them navigate these conversations with their partners?

Dr. Rhine (24:05)

Nora, this is, I think, the piece that helps these patients realize that they are not alone. So there are. And unfortunately, the first one is really concerning. There was a large observational study that was done with almost 12,000 episodic and chronic migraine respondents. So a huge study that basically showed that the closer you are in a relationship to someone who experienced migraine attacks, the more stigmatizing your attitude is toward them. So the closer that you are, the worse that you're treating that individual that suffers with migraine. Of the 12,000 people with both episodic and chronic migraine that were surveyed, 70% endorsed a stigma toward individuals living with Migraine. So these people were asked, who had a relationship with someone who had either episodic or chronic migraine, do you do stigmatizing things to that person? And 70% of them said yes. And this was more common in those respondents who had even closer relationships through a partnership or family relationship, a friendship, to those that were living with migraine clinically. The way that we address this in my office, Nora, is that we put it all out in the open, that they made an awesome choice in coming to seek care, and we validate their experience. Finally, and really importantly, after we have that sort of bridge to trust and understanding, we look toward exploring treatment options with really specific goals in mind.

Nora McInerney (25:23)

All right, let's get back to Tom. Tom, you said something earlier that I want to revisit, which is you had to disassemble who you thought you were and what your life was going to be like and rebuild that. I imagine that had to be pretty hard emotionally. How did that feel for you? And then, Cheryl, I want to hear how that felt for you, watching Tom go through that.

Ruby (25:56)

For me, it was a very emotional thing for me because I had always been the provider. And I got to the point where it's. I just. I couldn't do that anymore, at least not to the level that I thought that I could do. And it was a hard transition to make, but my wife was there to support me, and we knew where things were going to be going, and we planned the best way that we could to make a way for the future. I made concessions to pull back out of my career and go on disability, and she made plans to step back up into the out of the home workforce. I have to be real about it. I have to be honest and to set myself aside. And I try not to project the emotion that I'm feeling on the people around me and people in my family and things like that. But sometimes it's just how it is.

Cheryl (26:59)

So as I'm sitting and listening to all of this and I'm thinking and thinking of my answer, I can recall when he first started getting his migraine attacks. He missed out on a daddy daughter dance with his daughter. And we have pictures of someone who stepped in for him, and he felt really bad about it, but he just couldn't bring himself to do it. And that was the first time where I'm like, this has to be a debilitating feeling, like he can't make himself go to a Daddy Donner dinner. That's only two hours long, you know, so that's when you're like, maybe there is something a little more to this headache than it being just a headache. It wasn't until about six years ago that I really started to realize that he really was struggling, trying to keep his head on top of the cheese, per se. And Christmas was coming, and we're pretty good financially with our money and spending it wisely and everything. But I went up to a local department store and I went in. I'll never forget it. I went in for my interview and I just broke down tears. And the lady was like. And I'm like, look, I'm not asking you to hire me because I'm crying, but I'm like, my husband has chronic migraine, and I don't want you to hire me because my husband has chronic migraine. I may call out a couple of times because of that, but I'm like, I'm just trying to get back into the workforce. And they did hire me, which was amazing because I was bawling like a baby. But it wasn't until then that it real that I realized that this is now who I am redefined as. Like, I'm the person that's going to have to provide or whatever. So we're walking into a different era. So that's one of the realizations that we have as well. And he understands that. And so that's a lot on my shoulders.

Nora McInerney (28:56)

Yeah, I think it's really beautiful for people to hear that any relationship can change and evolve. Yeah, it's like you change, that changes the marriage, the marriage changes you. You change each other. Like, it's all just constant evolution. And I think that's really valuable for people to hear. Tom, I want to end by talking about the writing that you've done. What does it feel like to hear from people who have read your story and connected with.

Ruby (29:25)

Feels good. And I'm very grateful that they acknowledge that I've written something that resonates with them. It just. It gives me a good feeling. It reinforces the new purpose that I have, that I can touch other people that are not even in my area and stuff like that. I think I've developed maybe the most meaningful connections with some of the people that are across the world. I've connected with someone from Germany, and what I wrote impacted him, and the comments that he wrote in response to what I had written resonated with me. So we traded information and yeah, yeah.

Nora McInerney (30:11)

Yeah, you made him feel seen. He made you feel seen. And that's so powerful and it's so valuable and so generous of you to do, Tom. And it was so generous of both of you to share so much of yourselves and your relationship with us and with our listeners. It is truly a gift, and I'm so grateful to you both for being here. So thank you.

Ruby (30:34)

Thank you for having us.

Cheryl (30:35)

Thank you.

Nora McInerney (30:38)

Okay, Dr. Ryan, Tom brought up something that's really important. The idea that men feel this pressure to not open up about their experience, that sharing all their symptoms or being vulnerable could be seen as being weak, and that it makes them hesitate. We've touched a bit on this before, but what do the numbers show us?

Dr. Rhine (31:02)

Yeah, I think, Nora, it's super important for us to keep this out in front because this really is the. One of the first hurdles that patients are going to experience is that hesitancy. So the prevalence of people with migraine is significantly higher in females than in males. Studies have shown that the ratio of female to male people with Migraine is roughly 3 to 1, meaning that for every male migraine patient out there, there are three female migraine patients. The Global Burden of Disease Study is a comprehensive research effort that has consistently highlighted migraine as a leading cause of disability worldwide. And that's where this data is coming from. Migraine attacks affect more than 1 billion people worldwide, according to the study. Women even more so. So men with migraine generally have less severe migraine attacks. And unfortunately, what that translates into is that they're less likely to seek treatment. And if they do seek treatment, they're less likely to receive a diagnosis versus women.

Nora McInerney (31:53)

So with all that in mind, are there unique challenges to men with chronic migraine finding care?

Dr. Rhine (32:02)

Yeah, I look at the patients that I've treated in the past. There are several challenges. Let's take the perception and awareness, for example. Men might not recognize their symptoms as migraine attacks. They might underestimate the severity of their symptoms and then ultimately dismiss what they're experiencing as, you know, quote, unquote, just a headache to avoid that stigma and ultimately avoid the conversation altogether. Nor the bottom line is that men are less likely to talk to a doctor about their migraine attacks and about the symptoms that they're experiencing.

Nora McInerney (32:30)

Thank you, Dr. Rhine. That was truly one of the most beautiful conversations that I've had. I am so grateful for Tom for sharing everything, for Cheryl for joining in, and for them laying out so much of their relationship, their marriage, their personal, personal and shared experiences for all of us. No two marriages are alike. Just like Tom noted that no two migraine experiences are exactly alike. And I think it's so valuable to hear that reinventing yourself when you don't necessarily want to, when reconfiguring your marriage, your relationship with each other, your relationship with yourself. This is necessary often and it can be beautiful. It can be beautiful even if we didn't choose it. So I hope you loved today's conversation. I know I did. Thanks for listening to the Head Start Embracing the Journey we hope you found something worthwhile here with us today. A new coping strategy, a relatable story, the comfort of knowing you're not alone. I'm so happy to be a part of creating this community for all of us and especially for people living with chronic migraine. If you haven't found a treatment plan that is working for you, please do reach out to your headache specialist to explore your options. I truly hope this has helped you find a bit of comfort and maybe a smile. Maybe. See you next episode. And stay tuned for more important safety information. The Head Start Embracing the Journey is hosted by myself, Nora McInerney, executive produced by Yvonne Sheehan. Our Head of Post Production is James Foster, our researcher is Sierra Kaiser and our writer is John Irwin. The show is mixed by Michael Hardman, original music by Soundcat Productions and Artlist Foreign.

Botox Safety Information (34:42)

Safety information continued. There has not been a confirmed serious case of spread of toxin effect away from the injection site when Botox has been used at the recommended dose to treat chronic migraine. Botox may cause loss of strength or general muscle weakness, vision problems or dizziness within hours to weeks of receiving Botox. If this happens, do not drive a car, operate machinery or do other dangerous activities. Do not receive Botox if you are allergic to any of the ingredients in Botox. See Medication Guide for ingredients. Had an allergic reaction to any other botulinum toxin product such as Myobloc Rima Botulinum toxin B Dysportulinum toxin A Zeomin Incubotulinum toxin A Jeuveau Prebotulinum toxin A XVFS Daxify Daxibotulinum toxin a LANM or La Tibo Ledibotulinum Toxin awlbg. This may not be a complete list of all botulinum toxin products have a skin infection at the planned injection site. The dose of Botox is not the same as or comparable to another botulinum toxin product. Serious and or immediate allergic reactions have been reported including itching, rash, red itchy welts, wheezing, asthma symptoms, dizziness or feeling faint. Get medical help right away if you experience symptoms further injection of Botox should be discontinued. Tell your doctor about all your muscle or nerve conditions such as ALS or Lou Gehrig's disease, Myasthenia gravis or Lambert Eaton Syndrome as you may be at increased risk of serious side effects including difficulty swallowing and difficulty breathing from typical doses of Botox. Tell your doctor about all your medical conditions, including if you have or have had bleeding problems, have plans to have surgery, had surgery on your face, have weakness of forehead muscles, trouble raising your eyebrows, drooping eyelids and any other abnormal facial change. Are pregnant or plan to become pregnant. It is not known if Botox can harm your unborn baby Are breastfeeding, eating or plan to it is not known if Botox passes into breast milk Tell your doctor about all the medicines you take, including prescription and over the counter medicines, vitamins and herbal supplements. Using Botox with certain other medicines may cause serious side effects. Do not start any new medicines until you have told your doctor that you have received Botox in the past. Tell your doctor if you received any other botulinum toxin product in the last four months. Have received injections of botulinum toxin such as Myobloc, Dysport, Xeomin, Jeuveau, Daxify or Letibo in the past. This may not be a complete list of all botulinum toxin products. Tell your doctor exactly which product you received have recently received an antibiotic by injection take muscle relaxants, take an allergy or cold medicine, take a sleep medicine, take aspirin like products or blood thinner. Other other side effects of Botox include dry mouth, discomfort or pain at the injection site, tiredness, headache, neck pain, eye problems such as double vision, blurred vision, decreased eyesight, drooping eyelids, swelling of your eyelids and dry eyes, drooping eyebrows and upper respiratory tract infection. For more information, refer to the Medication Guide or talk with your doctor. You are encouraged to report negative side effects of prescription drugs to the FDA, visit www.fda.gov MedWatch or call 1-800-FDA-1088. Please see Botox full product information including boxed warning and medication guide by clicking the link provided in the podcast description or by visiting www.rxabvie.com PDF botoxpi.PDF if you are having difficulty paying for your medicine, AbbVie may be able to help. Visit abbvie.com Patient Access Support to learn more. Chronic migraine is 15 or more headache days a month, each lasting 4 hours or more. Botox Onapatulinum Toxin A prevents headaches in adults with chronic migraine. It's not for adults with migraine with 14 or fewer headache days a month. It Prevents on average 8 weeks 8 to 9 headache days a month versus 6 to 7 for placebo.

Botox Safety Information (38:55)

Prescription Botox is injected by your doctor. Effects of Botox may spread hours to weeks after injection causing serious symptoms. Alert your doctor right away as difficulty swallowing, speaking, breathing, eye problems or muscle weakness can be signs of a life threatening condition. Patients with these conditions before injection are at highest risk. Side effects may include allergic reactions, neck and injection site pain, fatigue and headache. Allergic reactions can include rash, welts, asthma symptoms and dizziness. Don't receive Botox if there's a skin infection. Tell your doctor your medical history, muscle or nerve conditions including als, Lou Gehrig's disease, Myasthenia gravis or Lambert Eaton syndrome and medications including botulinum toxins as these may increase the risk of serious side effects.

Botox Safety Information (39:32)

Ask your doctor and visit botoxchronicmigraine.com or call 1-800-44-BOTOX to learn more. This is an I Heart podcast.