Friday, September 20, 2013

Botox Treatment for Facial Pain

So along the many paths you can take on the road to recovery, I've recently wandered down another one- Botox injections. No, I'm not getting a little nip/tuck. I'd heard that Botox can be used for facial pain.

THE BACKSTORY:  My orofacial pain doc recommended Botox early in 2013, but it took me over 6 months to actually go through with it.

Part of my hesitation was that he said Botox could make your cheeks look more hollow - if you have a round face or a few extra pounds, this might be a very desirable side effect! I, however, have very well defined cheekbones and lost a great deal of weight due to stress plus, now that I'm getting older, my face has thinned dramatically. You're going to hate me for this, but, I literally tried to put on a few pounds in preparation for the injections. (My apologies to those who struggle to lose weight; it's in the genes.)

Anyway, I wasn't so sure I wanted to risk changing my appearance, nor to have toxin willingly injected into my face.

So I did my usual research, consulting "Dr. Google," and some of my Facebook friends. Sandy M, in particular mentioned that she'd done very well with the Botox (Thanks, Sandy!). So just a speedy 2 months and 3 cancelled appointments later, I finally mustered the bravery to have the injections yesterday.

Just for context, I was expecting Botox to help with my facial pain - if it could eliminate the tongue tingling too, that'd be a bonus! The pain developed from me tensing/clenching my face unconsciously, as a reaction to the protracted pain of the throbbing teeth and burning tongue. This created a perfect storm of tension in my face that has made the masseter muscle hard as a rock instead of pliable. The primary purpose of the masseter is for chewing. Here's a fun image.

The "medial pterygoid" is where I have chronic pain - it feels like pressure- like someone is pressing down their knuckle very, very hard on that spot, 24x7. Pain radiates to my ear, so that I can't sleep on my left side, rest my head in my hands, or hold a telephone to that side.

When I decide to live on the edge and eat something crunchy or chewy (for that matter, any food not suitable for babies and grandmas,) I am left with even more achiness for days afterward.

Because this is all in close proximity to the lingual and thus trigeminal nerve, it's hard say which came first, the chicken or the inflamed nerve egg but, voila, I now have chronic facial pain. Did I mention how much fun this is?

THE PROCEDURE: There is no prep, no numbing creme or anything, they just go for it: stick, stick, stick, you're done. It was painful for maybe 60 seconds as the Botox went in, and for 30 minutes after I was  sore, but no pain.  (They did not inject in my forehead, unfortunately, so I look just as old as before LOL!)

The neurologist stuck me at the trigger points on cheek in front of the ear. No bleeding, no marks, very small needle.

I think the whole procedure took about a minute, if you don't count all the chit-chat that preceeded it (my doc has a fabulously charming assistant, and I have the overwhelming desire to strike up conversation with anyone to help distract me from matters at hand!)

THE COST - I had to first visit the neurologist ($50 co-pay) for evaluation. His office submitted the request to my insurance company, and after a few weeks they approved coverage. So I'm just paying a $50 co-pay for every Botox visit going forward.

THE RESULT: I'd love to say that, with the Botox, I suddenly am pain-free and look like a Supermodel...but no such luck!

But seriously, the good news is, I look exactly the same...though I realize this could change over time as it takes a few weeks to really settle in. We shall see. I will post again after the toxin has had a chance to really do its stuff.

The pain reduction was noticeable for the first 24 hours. However, I made steak stir-fry for dinner, complete with crunchy veggies. (sigh) Silly, silly girl. Now I'm hurting again.

I don't jump/wince as much when touching the left side of my face and head as I once did, though. I'd say about a 30% improvement on Day 2. From what I hear, pain may lessen more over the course of weeks and months, til the botox finally wears off, and you need the shots again. As for the tongue, real change at this time.

Will post again in a few weeks with an update.