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Until a year ago, Lee Foster’s life was consumed with pain. The 55-year-old Thornhill woman suffers from fibromyalgia, which includes severe neck pain, chronic fatigue syndrome and migraine headaches. Pain had been a routine part of her day since she was in her mid-30s.
“Some days, I would be in my room with ice packs, taking what seemed like hundreds of pills, and just praying that I would die,” she says.
Over the years, she consulted a long line of professionals and specialists, most of whom had been disappointing at best. The worst were those who dismissed her pain as being all in her head.
“One of them even asked me if I was happy in my marriage, and another told me I likely had a brain tumour.
“Nothing really worked,” she says of the different treatments she tried. “Changing my diet helped a little, exercise helped a little, I tried allergy shots, massage, but as the years went by, the pain seemed to be getting worse.”
Then she went to see Dr. Mark Baily, who was featured in a newspaper article about the therapeutic use of Botox, a muscle relaxant produced by American-based drug company Allergan Inc.
Baily explained he could treat her symptoms with Botox, a protein toxin produced by the same bacteria that causes botulism, a lethal form of food poisoning. The toxin produces prolonged muscle relaxation and, in minute dosages, has been used for several years to treat eye diseases and to control spasms in people with cerebral palsy.
It’s also been used cosmetically for about 10 years, to ease the furrows and frown lines on the forehead and around the eyes. (Botox demonstrations attracted some of the biggest crowds at last weekend’s New You cosmetic surgery and anti-aging show at the Metro Toronto Convention Centre.)
The cosmetic use of Botox led to the discovery that the toxin can also reduce migraines.
“People who were being treated in a cosmetic way with Botox, and who also suffered from migraine headaches, started to report they weren’t getting headaches, or if they did they weren’t as severe,” says Baily, who specializes in headache and pain management treatment at his clinics in Brampton and Toronto. He also trains other physicians on using Botox to treat pain.
Patricia Niesczeri, a Botox medical consultant with Allergan, explains Botox is cleared from the body within 48 hours, but its muscle relaxation qualities can last for three months or longer. It has no reported side effects.
The diluted substance is injected locally into the head, facial muscles, neck or shoulders, depending on the source of the pain.
Most medical insurance companies will cover the cost of therapeutic Botox treatments, which can cost up to $700 every three months. Cosmetic use is not covered.
Foster began noticing a difference in her pain a couple of weeks after her injections into her head and neck.
“Fibromyalgia is sort of like arthritis pain,” she explains, “except that it can be all over your body.
“Every joint and muscle seems to be affected. It is a gnawing pain that eats away at you.” Her neck is particularly affected by debilitating pain, she says.
“After Botox, the pain was down so much I could think again. Before, I was living in a blur. Now … it is so much better.”
Foster has also been able to cut back on her medication, which has helped her relax a little more about her overall health. “Botox really has changed my life and that is not an exaggeration,” she says.
Deanna Pietramala of Newmarket also knows the agony of chronic pain. She had suffered from severe migraines for more than 20 years, starting in her mid-teens. Hundreds of medical appointments and specialized tests never did determine why her headaches were so constant. Medications rarely helped.
“Every single day for 20 years, I had a headache,” says the 33- year-old mother of one. “You are in terrible pain, but you still have to work, and look after your kids. I started Botox last year and had the best year of my life. Within three weeks of the first treatment, I didn’t have a headache.”
Pietramala is an education specialist who designs programs for children with special needs, including autism. No matter how bad her headaches were, she had to keep working.
“You can’t say, ‘Sorry, I have a really bad headache, so I can’t meet with you today,’ when parents and children are counting on you to help. I’ve been in a darkened room, wearing sunglasses and working on my laptop, on medications that were narcotic, so I was kind of out of it. It wasn’t fun.”
Now, she only gets a sinus-type headache when she’s due for another treatment. She had to pay for her last treatment when her insurance company refused to cover it, but she has launched an appeal.
“This is a real quality of life issue for me and, in the long run, it saves a lot of money because I am not taking the other medicines, which they will cover.”
Baily says most insurers are starting to understand the long- term benefits of Botox and are covering treatment. Pain resulting from soft-tissue injuries such as whiplash has been particularly difficult to treat in the past, he adds.
“Now, we have a treatment that works, and works well, so they (insurers) are starting to see the benefits of getting people well and productive again.”
Dr. Amber Brown is a Brantford-based general practitioner who discovered Botox when she was establishing a cosmetic arm of her family practice. The more she learned about the therapeutic uses of Botox, the more she could see the benefits for many of her patients.
“The more I heard about the pain management effects, the more intrigued I became.”
Her own mother had suffered from debilitating low back pain for years, so Brown had a personal reason to discover whether Botox would work.
“If you can keep people away from the pill bottles and from things that don’t affect the whole body- that could affect your liver and kidneys- I think you have to try,” she says. “It is so rewarding to see how well these patients do.”
Brown has seen many women who have been living with pain for years. Statistically, women seem to suffer headaches, particularly migraines, more often than men, possibly because of hormonal changes during the menstrual cycle. In her experience, the ratio is about 8 to 1.
Chronic pain, she points out, “impairs so many areas of life.
“Imagine being unable to dress yourself, or make your bed, do your own grocery shopping, or cook a meal.”
Deanna Pietramala sees her Botox treatment results as nothing short of miraculous and is thankful for every pain-free day.
“This stuff is a godsend. It has changed everything. To have a day without a headache?
“A year ago, I just couldn’t have imagined it.”