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Nora McInerney
Life sometimes has a way of blindsiding you with a feeling of being overwhelmed at the worst possible time. That's why you have your self care, your coping strategies. That's why you have us. I'm Nora McInerney and this is the Head Start Embracing the Journey, a podcast where we'll be taking all those things you usually save for your friend group out into the open so we can all find a bit of optimism for those battling chronic migraine. These conversations are going to be even more helpful and relatable, so definitely stick around. This show is brought to you in partnership with AbbVie. So first let's hear some important safety information and stay tuned to the end of the podcast for more.
Botox Safety Information
Indication Botox Anabotulinum Toxin A is a prescription medicine that is injected into muscles and used to prevent headaches in adults with chronic migraine who have 15 or more days each month with headache lasting four or more hours each day in people 18 years and older. It is not known whether Botox is safe and effective to prevent headaches in patients with migraine who have 14 or fewer headache days each month or episodic migraine. Important Safety Botox may cause serious side effects that can be life threatening. Get medical help right away if you have any of these problems Anytime hours to weeks after injection of Botox, problems swallowing, speaking or breathing due to weakening of associated muscles can be severe and result in loss of life. You are at the highest risk if these problems are pre existing before injection. Swallowing problems may last for several months. Spread of Toxin Effects the effect of Botulinum toxin may affect areas away from the injection site and cause serious symptoms including loss of strength and all over muscle weakness, double vision, blurred vision, drooping eyelids, hoarseness or change or loss of voice, trouble saying words clearly, loss of bladder control, trouble breathing and trouble swallowing. Please stay tuned for additional important safety information within this podcast.
Nora McInerney
Hello and welcome back to the Head Start Embracing the journey. I'm Nora McInerney and this is season two of our show. I am a writer and a performer. I have given a TED Talk. I have performed in theaters for hundreds of people at a time. I have bombed so hard. Not at a live show where people bought actual tickets to see me, but in a classroom filled with kids who are the toughest audience on earth. I went in feeling excited. I left feeling like the biggest loser who has ever lost. As soon as I started talking my mouth went completely dry. I don't know what I said. I was talking in circles. I struggled not to notice that every kid in the audience had a facial expression that said, get this lady out of here. So all this is to say that teachers are amazing. Amazing. It is amazing to hold the attention of a group of kids, to pour the necessary knowledge into their spongy little brains, to not have a near panic attack when all you had to do was talk for 20 minutes about your career, and then to go home after putting so much love and energy into other people's children and still make time for your own family. It is truly astonishing work. And I am very grateful that there are people out there who can do this. Today's guest, Danielle, or Mrs. Mendoza to her students, spends her days in the preschool classroom helping the littlest of little kids learn their letters and colors, sparking and fostering a love of learning, while also living with chronic migraine. And then she goes home and pulls the second shift. That is familiar to anyone who has kids. During the pandemic, we all agreed that teachers are heroes, superheroes. But the thing about being labeled a superhero is that people often forget that behind it all, you have struggles of your own. So in today's conversation, we are letting Danielle take off her superhero cape and just be a person or living with chronic migraine. So, as always, I am joined by my buddy, my, in this instance, colleague, Dr. Christopher Ryne.
Dr. Christopher Ryne
Hey, Nora, what's going on? We are definitely buddies and definitely colleagues. I'm stoked to sit and talk with you today and really dig into Danielle's story. She is so focused on finding the right treatment plan for her chronic migraine. She has been open to trying different options that could work for her. And it's been awesome to listen in as she shares her journey with you and the larger chronic migraine community.
Nora McInerney
So let's get into my conversation with Danielle. Danielle, thank you for being here. I know it's no small thing to try to arrange your schedule, especially when you have kids. Right before this conversation, I was thinking about teachers. I was at school at my kids school this morning and just feeling so grateful for the teachers that they have in their lives. Teaching is such an incredible gift that you give to the world. Did you always know that you wanted to teach? Did you always know that you wanted to teach little kids?
Danielle Mendoza
I. Yes and no. Like, ever since I was little, I. I have younger siblings, so I would always, like, play school with them over the summer and, like, give them worksheets. And I always was like, oh, I'm gonna be a teacher, you know? And then high school hit and I was like, I don't know So I actually kind of considered looking into, like, forensic science. I took some criminal justice courses and forensic science courses, and I really enjoyed it. But then I just ended up following my gut and trying to go to school for elementary education. Life happened, and I had a daughter a little earlier, so I didn't get to finish my degree, and I was like, you know what? Why don't I try a daycare? I love it. I can't see myself doing anything else. And I am actually planning on going back to school to be able to go back to elementary education. I really love it. I've tried not to, but it's just. I truly think it's. It's my calling.
Nora McInerney
I love that. And also, I don't think that there's anything more big sister energy than making worksheets for your little siblings. That's hilarious.
Danielle Mendoza
Yes. They're like, oh, again, that's incredible.
Nora McInerney
You're like, we're gonna play school. Okay. And you guys are gonna learn today.
Danielle Mendoza
And I know it's summer break, but I don't care. This is my enjoyment.
Nora McInerney
Oh, that's so cute. So, Danielle, you were joining us on this show because you live with chronic mig. Can you share your long journey from where you started experiencing symptoms to your chronic migraine diagnosis?
Danielle Mendoza
Yeah, absolutely. So I started experiencing migraine attacks when I was younger, and people are like, oh, you need glasses? Like, go to the eye doctor and see. So we tried that. I did get reading glasses, but I continued to have migraine attacks. And I think pretty recently, maybe within the last seven years, I got diagnosed with chronic migraines. I met with a neurologist, and they asked me different questions, and I explained to them kind of what I was going through and how I tried different things, and I would take different, like, over the counter medicine, and nothing is working, and it's debilitating. That's how I really felt. And they were like, yep, based on everything you're explaining to us and your symptoms, you have chronic migraine. So we are going to work with you on it.
Nora McInerney
So, Dr. Ryan, I'm interested in getting your take on what Danielle just talked about, this long journey to a diagnosis. What are some of the things to keep in mind to help people describe their experience to their doctor so that their doctor better understands their headaches and migraine attacks?
Dr. Christopher Ryne
I love this question so much, Nora. So it's so important that once we have put the time together in our busy lives to finally go sit down with a provider or prepared for that discussion, that this isn't something that we should do sort of off the cuff. So with those chronic migraine symptoms that those patients are experiencing, they show up in front of that provider. And the number one most important statement that I can make is that you should talk to your doctor and don't leave details out. You want to be really explicit about everything that you're experiencing. There can be a lot of stigma and insecurity around discussing. I'm nauseous. My. You know, the lights bother me. There are foods that I can't eat. There are things that I can't do or that it's impacting my relationships. And around that, we just want to be really, really clear. We don't minimize any of that experience when we're talking to a provider. I think that we should be really specific about the number of days, particularly in a month, that you're experiencing symptoms of any kind. And even better, if you could keep a really specific headache diary to share with that provider when you show up, that'd be even better. We want to let our doctor know if we've experienced light or sound sensitivity with those headaches and those migraine attacks. We want to pay attention to things like nausea, like we've talked about already, even if there's not vomiting. One of my favorite things about patients is I'll ask. I go, you know, are you ever nauseous? And the first thing out of their mouth will be, well, I never throw up. And so what I would argue there is, it's okay in this place with the door closed, to be a little bit more vulnerable is probably, you know, the key takeaway is to simply be very clear. You know, that provider, hopefully sitting across from you, recognizes everything that migraine attacks are doing to your life. They just need to hear it from you first so that they can provide a diagnosis, and then we can move forward with discussing treatment options. I think it's really critical. Again, as we sort of move down this list of things to prepare for that provider, that we talk about how long we've been dealing with these headaches or migraine attacks, when you first started experiencing them, when they changed, if they changed, how they changed. And then lastly, we want to make sure that we mention medications that we're currently taking that we've taken in the past. Things like that are really critical for your provider to hear about.
Nora McInerney
All right, back to my conversation with Danielle. What are your migraine attacks like? And do you know what your triggers are?
Danielle Mendoza
So I'm still kind of working to learn my triggers. I know for some people, it's like, certain foods and things like that. I have not really narrowed it down. I know things that can contribute to it for sure or make it worse. Like, if I already have something, I know for me, lights are really big, especially fluorescent lights. They really impact me. Noise and then heat is a really big one for me as well. If I start getting hot, I can have a migraine attack.
Nora McInerney
Is there anyone out there who's like, you know what? I love fluorescent lights. Like, is the fluorescent light industry. What did they do to get just a lock on lighting?
Danielle Mendoza
Yeah. Who came up with that idea? Because I want to have a conversation.
Nora McInerney
Yeah. So I can only imagine what it feels like when these migraine attacks hit. Could you put us in a moment, kind of paint us a picture of what they look and feel like?
Danielle Mendoza
For me, personally, they start in my neck, and they kind of just work up my neck and through my entire head to the point where, you know, my. My vision starts to kind of get real blurry on the sides. A lot of times, I'll end up throwing up any noises, lights, sound. I don't want any of it. I want to be in a black room. I want to be alone. I don't want anyone talking to me. It just feels this pressure, and I cannot get rid of it.
Botox Safety Information
Oh, God.
Nora McInerney
And also, you're experiencing this while you are in charge of a room full of small children. Will you kind of walk us through this example where you experienced a migraine attack while you were at work?
Danielle Mendoza
Yeah. So the night before, I was totally fine. I went to bed. I woke up right away with it. So I was like, okay, I'm gonna take something over the counter. I'll be fine. So I get ready, get my kids ready, and we leave to go to work and school. We get up really, really early. So there's, like, no lights on. It's very dark. It's quiet. We're all still half asleep. I'm like, all right. I really don't feel great, but I'm going to. I'm going to make it through work. It's okay. I get to work, and as soon as I walk in the door with the fluorescent lights, it hits. And I'm like, I'm not okay. This is definitely a migraine attack. And as soon as I walked in, I told my director, I am not going to be able to make it through the day. I'm just letting you know, I'll stick it out as long as I can. But as soon as I walked in here and those lights hit my eyes so she was like, well, you know, now the sun's kind of coming up. You can turn off your fluorescent lights and just use the natural sunlight. I was like, all right, you know, sure, I'll give that a shot. So I went to my room, turned off the fluorescent lights. We slowly started having kids. And I'm trying to deep breathe to just calm myself down, because if I stress out, that's not helping my migraine attack. It's just. It's not going away. I called my director, and within about 30 minutes, she got someone in there. So she got me out of the room, and she was like, you know, why don't you go do some work trainings on the computer? As soon as I opened the laptop, I was like, nope, it was all the way on brightness. She had me go back in the room while she was trying to find coverage, and they got it within probably about two hours. I did end up leaving for the day, but those two hours were really brutal. And I love my job. I loved being there. But personally, I feel like if someone had something else going on, like they were. Had the flu or something, they would get them out immediately. But when it came to my migraine attack, it kind of felt like, I'm sure it'll be fine. She'll make it through. So I had teachers and parents stop me and ask, hey, are you okay? Like, what's going on with you? And I was like, I know. I'm really struggling today. I actually, you know, I'm going through some stuff, and it's just been a rough day.
Nora McInerney
Yeah, hours feel differently when your body feels differently. You mentioned that throughout this journey, there were moments when you felt misunderstood or you felt alone. I've learned over the years that even when people have the best intentions, even when they are really trying to show up in the right way, they don't always realize what you are actually going through. And they do say and do the wrong things. How do you think that affected how long it took you to seek out a doctor and seek treatment?
Danielle Mendoza
So migraine attacks are actually my. My grandma had them, my mom had them, my sister has them. So it's been in our family. So even as long as it took me to get the help I needed, I think it was still cut a lot shorter than some people. Because I do have family who have had chronic migraines. I do think that it was definitely downplayed, like, oh, it's just a headache. And then once my neurologist was like, hey, no, she has chronic migraines. Then they finally did take it serious and they are more sensitive to it. And when I talk to anyone in my family or, you know, people like that, a lot of times they are more receptive to, oh, okay. It's actually chronic migraine and it's not just a headache.
Nora McInerney
Do you think that kind of minimization, whether or not it was intentional? And I've heard that, by the way, from every single person that I've interviewed for this show. Like, okay, well, it's just a headache. Oh, you're. Well, you look fine. Do you think that delayed your seeking out a treatment that would work for you?
Danielle Mendoza
Um, probably, like you said, it's. I look fine for the most part. But I, I do think just because typically, like there's no real like a broken arm, you can tell it's broken. When I tell you I have a migraine attack, you're kind of just gotta take my word for it, you know, and realize, like, I know how I'm feeling. So I do think that played a little bit of a part in getting the delay of actually getting into a neurologist and getting diagnosed with chronic migraine.
Nora McInerney
After the break, we'll be right back with more from Dr. Rhinestone. And so stick around.
Botox Safety Information
What is chronic migraine? It's 15 or more headache days a month, each lasting four hours or more. Botox Onobotulinum toxinae prevents headaches in adults with chronic migraine. It's not approved for adults with migraine who have 14 or 14 fewer headache days a month. Ask your doctor about Botox.
Botox Safety Information Continued
Botox is a prescription medicine 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 Lambord Eaton syndrome and medications including botulinum toxins as these may increase the risk of serious side effects.
Botox Safety Information
Talk to your doctor and visit botoxchronicmigraine.com or call 1-844botox to learn more.
Nora McInerney
Welcome back to the Head. Start embracing the journey. So, Dr. Rhine, we just heard Danielle recount the details of her chronic migraine journey and receiving A diagnosis. So when it comes to considering treatment, can you tell us about Botox for chronic migraine as a preventive treatment option?
Dr. Christopher Ryne
Awesome question, Nora. I really think understanding first what her experience is helps us really sort of understand her journey to diagnosis of chronic migraine. So let's talk about Botox for chronic migraine. Botox prevents headaches in adults with chronic migraine, which is 15 or more headache days per month, each lasting for four or more hours. It's not approved for adults with migraine who have 14 or fewer headache days per month. 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 weaknesses can be a sign of a life threatening condition. Patients with these conditions before the injection are at higher risk of those side effects. And 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 for chronic migraine if there's a skin infection. And tell your doctor your medical history, muscle or nerve condition history, along with things like als, which is Lou Gehrig's disease, Myasthenia gravis, Lambert Eaton syndrome, any medications, including other botulinum toxins that you might be utilizing as they may increase the risk of these serious side effects.
Nora McInerney
So what can someone expect when they're receiving Botox for chronic migraine treatment? Walk us through that procedure, what it's like.
Dr. Christopher Ryne
So this is one of my very favorite things to do with patients because there's so much sort of preconceived notion around what Botox is and what the process kind of goes through. So the first thing we need to understand when it comes to Botox for chronic migraine is that there is a set injection protocol. So we talk to patients about that experience. We let them know that they're going to be seated in a clinical setting. Maybe it's a procedural suite like I use here at the hospital that I work out of, or maybe it's just your physician's office. Botox is injected in 31 shallow sites into seven muscle groups that the FDA approved. Those areas are going to be in the head and the neck. You start with two treatments, so those are gonna be 12 weeks apart. And then we continue that every 12 weeks thereafter. So we do this every three months, four times a year. Oftentimes, patients are worried about the needles in the procedure and they might feel discomfort. Many patients, however, tell me that after the injections, they feel like tiny pinches.
Nora McInerney
So once the procedure is done, how soon can people usually feel the effects from the treatment?
Dr. Christopher Ryne
Awesome question, and it's one that I get all the time. So patients may feel results as soon as four weeks with full effects after two treatments. So those Botox experiences are going to be different based on the patient. In the data that was presented to the FDA, Botox prevented, on average, eight to nine headache days a month at 24 weeks, versus six to seven with placebo.
Nora McInerney
Let's jump back into my conversation with today's guest, Danielle Mendoza. So it's interesting that your journey also, of course, includes a whole separate path of finding a treatment that works for you. When did you first try Botox for chronic migraine?
Danielle Mendoza
Four and a half years ago, maybe five years ago. I went to my neurologist. They were like, okay, you know what? I think you would be a candidate to try Botox for chronic migraine. What do you think? And I'm like, hey, if you can tell me, like, there's a chance it could work. And I'm. I'm all for it.
Nora McInerney
There are some listeners who might have a fear of needles. Can you walk us through what your Botox for chronic migraine injection experience is like?
Danielle Mendoza
Yeah. So I have an amazing neurologist. I go in there, and I like, I'm not scared of needles, but the thought of having quite a few injections into the muscles in my head and neck doesn't really sit well with me either. So, of course, I'm a little nervous when I walk in there. But my neurologist is so amazing. And I do personally think, like, having an awesome neurologist helps a lot with that process. But I come in, he's like, how you feeling today? What do you want to talk about? What's going on? And we just small talk for a little bit about, like, how I've been feeling, how I felt after my last treatment of Botox, what I'm feeling now. So he really makes me feel at ease before we even sit down. But once I sit down and do it, he's like, all right, you ready for this? And I'm like, all right, ready as I'm ever gonna be. And the treatment is done within probably 10 minutes. He. I've learned so much, honestly, about my chronic migraine through my neurologist. He listens to what I'm telling him about my migraine attacks. He discusses it. It's just really awesome to see somebody who genuinely cares about your story and your experience. And I really have found that in him. So I'm very thankful for him.
Nora McInerney
Oh, that was great. So let's jump back to Botox for chronic migraine. It sounds like it's been effective for you personally.
Danielle Mendoza
For me personally, it has reduced the number of headache days. And I think in my experience it's been helpful.
Nora McInerney
There will be people listening on their own chronic migraine journey. Do you have any words of wisdom, words of encouragement for them?
Danielle Mendoza
I would first say that you are not alone. I know a lot of times when you're experiencing migraine attacks, you feel like nobody knows how you feel. And everyone's migraine attack, of course, is probably different from person to person. So I would say don't give up until you find a treatment plan that works for you. Whether it's it is a treatment plan or whether it's just an incredible neurologist, don't give up.
Nora McInerney
That was really beautiful. An absolute pleasure to meet you and thank you for all that you do for kids.
Danielle Mendoza
Thank you so much. Bye bye.
Nora McInerney
All right, so, Dr. Ryan, now it is time for us to talk about access. Are there any hurdles that patients face in trying to get access to Botox for chronic migraine?
Dr. Christopher Ryne
Absolutely. And some of those really can be handled by your provider, you know, providing the appropriate documentation to discuss why we made the diagnosis and sort of justifying the diagnosis of chronic migraine, which then puts us in a good place to pursue Botox for chronic migraine for that patient, if it's appropriate. But, you know, patients are gonna ask, what are the side effects, what's the experience? How effective is it? And we' talked a little bit about that and we've heard through Danielle's story, her experience with that. But cost tends to be a hurdle for many patients. Oftentimes they're surprised to hear that most insurance providers, as well as Medicaid and Medicare programs, do cover Botox for chronic migraine. I'd advise patients interested in Botox to contact their insurance providers. I think it's really important to know that your provider is not allowed to contact your insurance provider on your behalf to find out if a particular therapy, Botox or otherwise, is covered, that you would be responsible for doing that and have a discussion with that particular insurance plan. Additionally, there are patient support programs like Botox Savings Program, which helps eligible commercially insured patients save on certain out of pocket costs related to both Botox medicine and the injection procedure.
Nora McInerney
Are there any other side effects that listeners should know about for Botox for chronic migraine?
Dr. Christopher Ryne
Absolutely. It's super important to go in with eyes wide open. And the most common side effect that we see are neck pain and headache. There is other side effects effects as well that can occur with Botox for chronic migraine which we saw in clinical trials. So that doesn't cover all of the possible serious side effects with Botox. So it's important that a patient speak to their physician about the important safety information concerning Botox for chronic migraine and see the full prescribing information. It's important for you to talk to your doctor or headache specialist to see if Botox is right for you and our listeners can find out more important safety information throughout this episode and at the URL to the full product information including box warning on our show description and at the end of each episode.
Nora McInerney
Dr. Ryan, thank you. Thank you so much for being here. I am so glad that you are out there doing the work that you are doing. I am so glad that there are providers like you out in the world who care so deeply about their patients. And thank you for doing this work with me.
Dr. Christopher Ryne
Thank you for doing it with me, Nora. I really appreciate the way that you bring this to light and bring it to life for people who are really struggling. We couldn't do it without you.
Nora McInerney
Whether or not we're facing a room of preschoolers every day, I think everyone can relate to Danielle's story. It is hard even on the best of days to put forward our best effort and it is even harder when you're doing it with chronic migraine. I am so appreciative of Danielle for reminding us of the power of asking for help. Nobody is a superhero, not really. And even superheroes are really just people with fancy costumes. So if you are feeling like you have to keep it together for everyone around you, I hope Danielle's story reminds you to raise your hand and let people in. Let people know when you need help. Help even when you're not really sure what that help looks like. As a reminder, Botox is a prescription medicine given by your doctor. So it's important to talk to your doctor about the important safety information for Botox that we talked about earlier and the additional important safety information at the end of the episode. The Head Start Embracing the Journey is hosted by myself, Nora McInerney and executive executive produced by Yvonne Sheehan. Our EP of post production is James Foster, our supervising producer is Sierra Kaiser, our writer is John Irwin and the show is mixed by Nick Cipriano for Bang Audio Post Original Music by Sound Cat Productions and Art List.
Botox Safety Information
Important Safety Information continued There has not been a confirmed serious case of spread of toxin effects 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 Myobloc, Rimabotulinum toxin B. Dysport Abobobotulinum toxin A Xeomin Incubotulitum toxin A Jeuveau Probotulinum toxin A xvfs Daxify Daxibotulinum toxin A LANM or Latibo Ladibotulinum toxin AWLBG this may not be a complete list of all botulinum toxin products. 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, 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 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 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 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. 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 four hours or more. Botox Onobotulinum 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 eight to nine headache days a month versus six to seven for placebo.
Botox Safety Information Continued
Prescription Botox is injected by your doctor. Effects of Botox may spread hours to weeks after injection, causing serious symptoms. 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
Ask your doctor and visit botoxchronicmigraine.com or call 1-800-44-BOTOX to learn more. This is an iHeart podcast.
Episode Title: Teaching Through the Struggle: A Conversation with Danielle Mendoza
Host: Nora McInerney
Guest: Danielle Mendoza
Co-Host: Dr. Christopher Ryne
Release Date: June 25, 2024
Nora McInerney opens the episode by highlighting the unexpected challenges life can present, emphasizing the importance of self-care and community support for those battling chronic migraine. She introduces the show's mission to foster open and honest conversations about the struggles and triumphs associated with chronic migraine, setting the stage for an enlightening discussion with Danielle Mendoza.
[02:26] Nora McInerney:
Nora introduces Danielle Mendoza, a dedicated preschool teacher who balances her demanding job with living with chronic migraine. She commends Danielle's unwavering commitment to her students despite her personal health challenges, setting a heartfelt tone for the conversation.
[04:52] Dr. Christopher Ryne:
Dr. Ryne expresses enthusiasm about Danielle's journey, emphasizing her proactive approach in seeking effective treatments for chronic migraine and her role in the broader migraine community.
[05:14] Nora McInerney:
Nora asks Danielle about her journey into teaching, revealing her initial indecision and eventual passion for educating young children.
[06:06] Danielle Mendoza:
Danielle shares, “I always was like, oh, I'm gonna be a teacher, you know?” detailing her early experiences teaching her younger siblings and her eventual decision to pursue a career in elementary education despite initial interests in forensic science. She reflects on her love for teaching and her plans to return to school to further her education.
[07:04] Nora McInerney:
Nora adds a personal touch by relating to Danielle's experiences with her siblings, highlighting the nurturing aspect of teaching.
[07:26] Nora McInerney:
Nora transitions the conversation to Danielle's chronic migraine, setting the stage for an in-depth discussion about her experiences.
[07:42] Danielle Mendoza:
Danielle recounts her long journey with migraines, starting from childhood. "I met with a neurologist, and they asked me different questions, and I explained to them kind of what I was going through... that's how I really felt. And they were like, yep, based on everything you're explaining to us and your symptoms, you have chronic migraine."
[09:02] Dr. Christopher Ryne:
Dr. Ryne emphasizes the importance of effective communication with healthcare providers. He advises patients to be thorough and honest about their symptoms, suggesting, “...be very specific about the number of days... keep a really specific headache diary to share with that provider.”
[11:15] Nora McInerney:
Nora delves deeper into Danielle's migraine experiences, asking about triggers and the nature of her attacks.
[11:31] Danielle Mendoza:
Danielle admits she’s still identifying her triggers but identifies key factors like fluorescent lights, noise, and heat as significant contributors. “If I start getting hot, I can have a migraine attack.”
[12:34] Danielle Mendoza:
She vividly describes her migraine episodes: “They start in my neck... pressure, and I cannot get rid of it,” detailing the debilitating symptoms that compel her to seek isolation and relief from sensory stimuli.
[13:23] Danielle Mendoza:
Danielle recounts a specific incident at work where a migraine attack was exacerbated by fluorescent lighting. “As soon as I walked in the door with the fluorescent lights, it hits. And I'm like, I'm not okay.”
[15:34] Nora McInerney:
Nora addresses the emotional toll of feeling misunderstood, asking Danielle how this affected her pursuit of treatment.
[16:15] Danielle Mendoza:
Danielle discusses the familial aspect of her migraines and how having relatives with similar conditions provided some understanding but also acknowledges the societal minimization of her pain. “I think that played a little bit of a part in getting the delay of actually getting into a neurologist and getting diagnosed with chronic migraine.”
[19:24] Nora McInerney:
Post-break, Nora brings the focus back to treatment options, specifically Botox, by inviting Dr. Ryne to elaborate.
[19:48] Dr. Christopher Ryne:
Dr. Ryne provides a comprehensive overview of Botox as a preventive treatment for chronic migraine, explaining the procedure, its efficacy, and potential side effects. “Botox prevents headaches in adults with chronic migraine, which is 15 or more headache days per month... Effects of Botox may spread hours to weeks after injection, causing serious symptoms.”
[21:09] Nora McInerney:
Nora inquires about the Botox procedure to demystify it for listeners.
[21:19] Dr. Christopher Ryne:
He details the injection process, emphasizing the protocol and patient experience: “Botox is injected in 31 shallow sites into seven muscle groups... The treatment is done within probably 10 minutes.”
[22:25] Dr. Christopher Ryne:
Dr. Ryne explains the timeline for Botox's effectiveness: “Patients may feel results as soon as four weeks with full effects after two treatments.”
[23:13] Danielle Mendoza:
Danielle shares her personal experience with Botox, initiated five years ago. She describes the support from her neurologist and the positive impact on her migraine frequency: “For me personally, it has reduced the number of headache days. And I think in my experience it's been helpful.”
[25:27] Danielle Mendoza:
Offering encouragement, Danielle advises others: “You are not alone... don't give up until you find a treatment plan that works for you.”
[26:06] Nora McInerney:
Nora shifts the discussion to accessibility, prompting Dr. Ryne to address potential barriers.
[26:20] Dr. Christopher Ryne:
Dr. Ryne acknowledges hurdles like insurance coverage and cost, advising patients to proactively engage with their insurance providers. He mentions support programs like the Botox Savings Program to alleviate financial burdens.
[27:40] Dr. Christopher Ryne:
He reiterates the importance of understanding side effects and encourages listeners to consult their physicians: “It's important that a patient speak to their physician about the important safety information concerning Botox for chronic migraine.”
[28:24] Nora McInerney:
Nora wraps up the conversation by acknowledging Danielle's dual role as an educator and a migraine struggler, emphasizing the universality of her story. She encourages listeners to seek support and not to bear their burdens alone.
[28:42] Dr. Christopher Ryne:
Dr. Ryne commends Nora for bringing these important issues to light and supporting those struggling with chronic migraine.
[28:55] Nora McInerney:
Nora concludes by reinforcing the episode's key messages: the importance of asking for help and being open about one's struggles. She reiterates the necessity of consulting healthcare professionals when considering treatments like Botox and directs listeners to additional resources for safety information.
Danielle Mendoza's Dual Role:
Effective Communication with Healthcare Providers:
Botox as a Preventive Treatment:
Accessibility and Support:
Holistic Understanding of Chronic Migraine:
Danielle Mendoza [07:42]:
“So we are going to work with you on it.”
Dr. Christopher Ryne [09:02]:
“You want to be really, really clear. You know, that provider, hopefully sitting across from you, recognizes everything that migraine attacks are doing to your life.”
Danielle Mendoza [16:15]:
“I think that it was still cut a lot shorter than some people... once my neurologist was like, hey, no, she has chronic migraines. Then they finally did take it serious.”
Nora McInerney [25:27]:
“Don't give up until you find a treatment plan that works for you.”
Danielle Mendoza [25:27]:
“You are not alone... don’t give up.”
Botox Safety Information: Throughout the episode, vital safety information about Botox as a treatment for chronic migraine is provided, emphasizing the importance of consulting healthcare professionals and adhering to prescribed guidelines.
Botox Support Programs: Danielle and Dr. Ryne mention programs like the Botox Savings Program, which assists eligible patients with out-of-pocket costs related to Botox treatment.
Further Information:
Listeners are encouraged to visit botoxchronicmigraine.com or call 1-800-44-BOTOX for more details on Botox treatment for chronic migraine.
Nora McInerney concludes the episode by reiterating the importance of community, support, and seeking help when dealing with chronic conditions like migraine. She thanks Danielle Mendoza for her courage and dedication, while also acknowledging the critical role of healthcare providers like Dr. Christopher Ryne in managing chronic migraine.
This episode of The Head Start: Embracing the Journey offers a poignant and comprehensive look into the lives of those managing chronic migraine, blending personal narratives with expert insights to provide listeners with both empathy and practical information.