A unique method for relieving chronic headaches or migraines

Headaches from time to time are normal. But, when it’s frequent and severe, it can be debilitating.

Constantly having to take medications, trying home remedies and sleeping because of your chronic headaches or migraines can alter your lifestyle and become exhausting. For most who have experienced this, they would try about anything to find sustained relief.

At 14 years old, Bailey had migraines and daily pressure headaches. She would miss school and had to quit competitive soccer because she would endure days of pain.

After trying many preventative and as-needed medications for headaches that didn’t work for her, Bailey met Thomas (Tom) Drahos, PA-C, AQH, at MercyCare North Liberty, who specializes in the FDA-approved Botox® treatment for migraines. After reviewing her medical history and talking with Bailey about her symptoms, Tom concluded she would be a good candidate for Botox® therapy.

Botox®? That’s right; it’s not just a cosmetic solution. It also serves to block the nerve endings that cause headaches.

“For a patient’s first appointment, I would use the standard method of Botox® which is where I inject the recommended areas that typically cover the majority of the nerves that cause headaches for people, such as the forehead, both temples, and down the back of the head into the neck and upper shoulders,” Tom said. “Once I become familiar with the areas that are causing the pain, I can follow the pain by making slight changes to the standard method based on how people feel after their first round of injections.”

For example, if someone is noticing improvements in their headaches after the first round of Botox® but is still noticing some pain on the back, right side of their head, Tom would inject more Botox® in that area. This helps personalize the treatment since there is often not a “one size fit all” based on different headache patterns and anatomy differences between patients.

The Botox® blocks the nerves so pain is no longer felt. The nerves then stay blocked by the Botox® for up to 12 weeks (three months).

Bailey, who is now of college student age, visits Tom every three months for her Botox® injections. Over the course of four years, she has seen a lot of improvement in reducing severe headaches since seeing Tom for treatments.

“After the first couple of appointments, I would get an instant headache and it sometimes lasted for a few days,” Bailey said. “Now that I have been doing Botox regularly, I do not get the instant headache anymore since my muscles are less tense than they used to be. I begin to feel relief from the Botox after about a week. Additionally, if I do get a headache, which is now very rare for me, my as-needed medications work 99% of the time.”

Many patients describe a similar experience as Bailey where they felt some relief after receiving the Botox® injection but have reported feeling much better after a few appointments.

“While most people start feeling relief within the first week after the Botox procedure, sometimes it takes a couple rounds of treatment to reach maximal relief,” Tom said. “The procedure is done every 12 weeks and is used solely for migraine prevention. Many patients report that if they continue to get the Botox every 12 weeks, it keeps their migraines under great control.”

At MercyCare North Liberty, Tom has streamlined the Botox® process so patients can experience an efficient appointment.

“Typically, patients are in and out in less than 15 minutes,” Tom said. “Only about two minutes of that time is the actual procedure. The remainder is spent discussing how the migraines have been between appointments and any other issues. Patients can leave immediately after the procedure, and most will go back to work or do their normal daily activities. Most patients describe the procedure as ‘quick bee stings’ but ‘totally worth it.’ There is rarely any lasting pain after the injection is over.”

As a family practice provider at MercyCare North Liberty, Tom’s interest grew in Botox® treatment because it’s an unfilled need in eastern Iowa. Since 2013, Tom has specialized in injecting Botox® and has performed the procedure thousands of times on hundreds of patients. Plus, like Bailey, he has personal experience with migraines.

“I suffer from migraines myself and have used Botox to help keep them under control,” Tom said. “It’s extremely effective at migraine prevention.”

In order for a patient to be a candidate for Botox® to treat their chronic headaches or migraines through their insurance, they need to meet a few requirements. Patients must have a diagnosis of chronic migraines which requires the presence of a headache for 15 or more days per month for more than three months with features of migraine headaches present on at least eight days per month. So, the patient doesn’t need to experience a headache every day and not every headache needs to be a migraine. Also, patients are required to fail two to three preventative medications that are taken every day to stop migraines from occurring (not “as needed” medications), which needs to be medically documented.

Once patients have met the criteria, Tom can submit their information to their insurance for approval coverage of Botox® for their chronic headaches or migraines.

If you’re experiencing chronic headaches or migraines, talk to your primary care provider about your options. You may be a good candidate to receive Botox® injections from Tom Drahos at MercyCare North Liberty, so you can finally feel the relief you need.