"Following a total thyroidectomy in 1994, I developed chronic, crippling migraines. It was normal for me to have two, three-day, attacks each week with severe headaches on any migraine-free days. In March 2012, following a holiday totally ruined by constant migraine, I asked my GP to refer me to Dr Nick Silver, consultant neurologist at the Spire Cheshire Hospital. By that time, I was no longer able to exercise, work, or to perform as a musician. My whole life was dominated by migraines.
"Thanks to Dr Silver's unsurpassed understanding, intelligence and skill in treating this chronic condition, my quality of life has improved out of all recognition"
"Dr Silver carried out a detailed assessment and advised me to go through an abrupt detoxification. This meant stopping all painkillers, anti-migraine drugs and caffeine. I had to drink three litres of water each day, never miss a meal, and go to bed and get up at the same time each day.
"Within less than 48 hours, withdrawal symptoms began. I was confined to bed by a very severe headache, intense nausea and uncontrollable shaking. The worst stage of the detox lasted about two weeks, but it was a year before I was completely free of withdrawal symptoms.
"Three months later I saw Dr Silver again, and he was pleased with my progress. We then began the hard work of whittling away the number of headache and migraine days each month with a carefully-selected programme of medication, whilst continuing to review my treatment regularly.
"In 2013 we started to discuss my long term options, including the possibility of using Botulinum toxin type A injections, (commonly known as ‘Botox’), which is a purified neurotoxin (nerve toxin) derived from the bacterium Clostridium Botulinum. It works by paralysing the nerve supply to muscles, thereby restricting their movement."
The National Institute for Health and Clinical Excellence (NICE) recommends Botox as an option for people who have headaches at least 15 days every month, where at least eight days of which are migraine. Botox is only considered when the condition has not responded to at least three prior preventative drug treatments.*
"Dr Silver and I decided Botox would be the best way forward, and I had the first treatment in September 2013. The injections, into my head, neck and shoulders are repeated every three months, and have a cumulative effect. Since starting them, I have gradually improved, with the last three months having been the best for over 20 years.
"Although not totally headache and migraine free, I now have far more good days than in the past. I can go shopping, or for a walk, without causing a migraine, and have recently bought a battery-assisted bike, which I use almost every day. Last week my husband and I went for a cycle ride and picnic with some friends, and I can honestly say it was the happiest day I can remember since before my thyroid illness started.
"Two years after my initial referral, life has certainly changed for the better. Although the migraines and headaches are not cured, they are largely controlled by the lifestyle changes, medication and injections prescribed by Dr Silver. Thanks to his unsurpassed understanding, intelligence and skill in treating this chronic condition, my quality of life has improved out of all recognition.
Dr Nick Silver is a consultant neurologist at Spire Cheshire Hospital. He says: “Some people with migraine will have single occasional attacks that they can cope with using simple painkillers and rest.
"However, for many people, migraine will dominate their lives and potentially the lives of those around them, including their families, children, friends and work colleagues. The impact may be life-changing for all so that they all become prisoners to this condition.
"With a careful and methodical approach to diagnosis and management, most patients with frequent, severe, incapacitating and/or regular headaches and/or other symptoms suggestive of a headache disorder can learn to significantly improve or fully turn off their symptoms and control their condition, as opposed to their condition completely controlling their life and that of their close family and friends.
"In my experience, it is possible for most patients to get their lives back with a methodical treatment approach."
The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional
• * http://www.nice.org.uk/guidance/TA260