Chronic Migraine Q&A with Kristin Chenoweth

[Please see full Product Information, including Boxed Warning and Medication Guide, in the provided links or at BOTOXChronicMigrainePI.com]

[INDICATION]
[BOTOX® prevents headaches in adults with Chronic Migraine, 15 or more headache days a month, each lasting 4 or more hours. BOTOX is not approved for 14 or fewer headache days a month.]

[IMPORTANT SAFETY INFORMATION]
[BOTOX may cause serious side effects that can be life threatening. Get medical help right away if you have any of these problems any time (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 preexisting 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 through the end of the video for full Indication, Limitations of Use, and additional Important Safety Information.]

[Prescription only. Talk to your doctor or call 1-866-310-4649. Kristin Chenoweth is a paid spokesperson by AbbVie. Other participants received compensation from AbbVie.]

[Before we start, please listen to this Important Safety Information.]

VO:
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.

Don’t receive BOTOX® if there’s a skin infection. [Allergic reactions can include rash, welts, asthma symptoms, and dizziness.]

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.

[Please stay through the end of the video for additional Important Safety Information or see full Product Information, including Boxed Warning and Medication Guide, in the provided links or at BOTOXChronicMigrainePI.com]

KRISTIN:
Whoo – hoo! Hey there y’all! Hello, hello, hello!

So, listen, I am so excited - thank you all so, so much for taking the time to be here with me. I know how busy you all are, so I really appreciate it!

Just to let you know what’s comin’ up, I’m partnering with AbbVie to host this very special Q&A event – or Q&K as I’m calling it – cute like me huh? – so we could spend some time together talking about something that’s extremely important to me.

And no, it’s not about my next Broadway show, or chatting about my new children’s book. It’s about something intensely personal, and that something is Chronic Migraine. As some of you guys might already know, I’ve been living with Chronic Migraine for most of my adult life.

And it’s because I’ve experienced first-hand just how horribly debilitating Chronic Migraine can be that makes me so, so passionate about wanting to help other people learn more about it and find ways to manage it with their doctors.

So, for the next half hour or so, I’ll be sharing a few of my own stories with you. I’ll be talking about my treatment journey and maybe, and hopefully, help answer what it’s like to live with Chronic Migraine. A little later on we’re going to be joined by a couple more real Chronic Migraine patients to hear about their experiences too.

But first! To help make sure we get all the right answers, because I’m no medical expert! Let’s say hello to the fabulous Dr. Larry Charleston IV a neurologist and headache specialist based in Michigan.

Nice to see you Dr. Charleston! I’m so happy to see you! How are you?

DR. CHARLESTON:
Oh, I am great - my pleasure Kristin, it’s so wonderful to see you as well!

Well first off, I’m a HUGE music fan, so you’re gonna have to promise me a selfie at the end of our session.

KRISTIN:
Wait! I wanna ask you a question. How tall are you?

DR. CHARLESTON:
I am just about 6 6.

KRISTIN:
I’m 4 11, so, if you get on your knees we’ll do our selfie!

DR. CHARLESTON:
Oh, fair enough, fair enough! You know, I actually write songs and music in my free time! [holds up saxophone] so if you ever need help with the orchestra…?

KRISTIN:
Well, I heard you play the sax and you know I love a horn, so, you know I’m going to take you up on that.

DR. CHARLESTON:
Perfect! So, Kristin, I just want to say thank you so much for inviting me today. It’s really, really important that people get to know the facts about Chronic Migraine and learn about the treatment options that can help them out.

KRISTIN:
Yes

DR. CHARLESTON:
So, like you said, I’m a doctor and board-certified neurologist and work out of Michigan. I specialize in treating headaches and migraine, and a lot of the patients I see are diagnosed with Chronic Migraine. And right there is an important first point.

For the vast majority of people out there, it can take years to be properly diagnosed as having Chronic Migraine. And these can be some pretty challenging times, believe me. That’s why it’s so important to talk with your doctor sooner rather than later because you can’t find the proper treatment until you’ve found the proper diagnosis.

In fact, that is a major reason why I became a headache specialist. I learned that although there are well over 100 different headache diagnoses, when we give the patients the right diagnosis, we have the best opportunity to optimize their care.

KRISTIN:
Okay, so let’s start right there and I’m just going to dive in with a pretty obvious first question if that’s alright- what exactly is Chronic Migraine?

DR. CHARLESTON:
Ah wow, well let’s start with what it’s not.

KRISTIN:
Okay.

DR. CHARLESTON:
So, Chronic Migraine is not just a headache. It’s much, much more than that. In fact, it’s defined as 15 or more headache days a month each lasting 4 hours or more with about half of those being associated with migraine, so around a half of every month is impacted. So we’re not just talking about headaches here.

KRISTIN:
No.

DR. CHARLESTON:
A migraine attack can include something we call “auras” which are reversible neurological symptoms. The most common auras are visual auras, so one can have a disturbing visual effect that can mean floating, swirling colors swimming in front of your eyes.

KRISTIN:
Oh yes! I know it well! That’s what I call my kaleidoscope eyes! You know, being under stage lights or being on the computer can trigger that for me!

DR. CHARLESTON:
Another symptom one can have with a migraine attack is nausea.

KRISTIN:
Been there, done that, thrown up on stage!

DR. CHARLESTON:
Oh, I’m so sorry to hear that.

KRISTIN:
I know – true story!

DR. CHARLESTON:
Yes, Chronic Migraine can be physically debilitating. And it can leave you feeling isolated.

So, Kristin, I’d like to know, can you tell me when Chronic Migraine symptoms first started for you?

KRISTIN:
Yeah, I’m glad you asked. It’s been such a journey. So, my first migraine attack happened right in the middle of a performance with the Virginia Symphony when I was 25 years old.

DR. CHARLESTON:
Oh wow!

KRISTIN:
So last year, right? I had a full show, in other words, Act 1 and Act 2. So, I’m on stage in the middle of Act 1 and I thought something was wrong with the spotlight. It was a full house, so I saw this, you know, like a bunch of lights and people sitting in their seats and I’m on stage with the orchestra, so picture that. But I’m looking at the spotlight, as many performers do and I thought, don’t look at the spotlight because it’s causing like, what I told you before, my kaleidoscope eyes.

And so, I looked away and shut my eyes and tried to gather myself, but all I feel, is this, what began to feel, was this excruciating pain like a train running through my head, but I kept singing. You know in show business, we just keep going. I finished the song. I looked at the conductor. But I started feeling like “Oh no, I think I’m gonna be sick.”

By the time I muscled through it, we got to intermission, and I mean, the curtain went down. I went to my knees and, unfortunately, you guessed it, I threw up right there on the stage. My maestra at the time, my conductor, he knew me so well. He said, “you are so sick.”

I said, “I can’t see. I cannot see.” I have a loud, pounding headache. Like a brain freeze. The only way I know to explain it. A brain freeze. Like when you drink a slushie too quickly and it doesn’t stop, eventually it passes, only this doesn’t stop! And I’m thinking how am I going to do Act 2? How am I gonna get through this? It’s not letting up. It’s not letting up. I’m so sick. I had no idea what it was. I was very scared and I had no idea how serious it was.

They got me to my dressing room, and somebody gave me two over-the-counter pain relievers from the first aid kit, and I’m still facing another half hour to 45 minutes on stage of performance.

DR. CHARLESTON:
Wow!

KRISTIN:
So, I know. So, anyway, somehow, I got back out there for Act 2. I sang the show not ever looking at the spotlight again. And you’re in music, you know what that means - it’s like, you don’t look at the spot, people can’t see your eyes. Everything was so loud. I only just got through it and by the time I was done, I just got off the stage, and there was a doctor in the house, thank goodness, and he came backstage. And he said, “it seems to me you’re having a migraine attack.” Honestly, at that moment I really thought I was gonna have to retire.

DR. CHARLESTON:
Wow! Yes, so all those horrible feelings of helplessness and confusion you started experiencing back then, I hear a lot of those similar descriptions from so many of my patients when we talk about migraine attacks. The shock and severity of those first attacks can be really terrifying - it can leave them feeling devastated both emotionally and physically.

KRISTIN:
Oh, you’re so right, it’s true. I mean, back then I had no idea what was happening - no idea of what it was and if it was just happening to me. Of course, now I realize that a ton of people experience some of the very same symptoms and they’re living with Chronic Migraine. So, as hard as it is, it was a relief to me to know that it wasn’t just me. Do we know, this is just something I’ve always wanted to know, do we know about how many people we’re talking about here Doctor? I mean, how many people are affected by this?

DR. CHARLESTON:
Yes. For the US, it’s around 3.3 million people who are living with Chronic Migraine, and it affects so many aspects of their lives. Sometimes being unable to spend time with their family, with their friend or at work.

KRISTIN:
Yah! So even though more than 3 million people are affected - including little ol’ me! - it’s still incredibly misunderstood. That is why it is so important that we start to break down some of the most common myths surrounding Chronic Migraine.

So, to help us do that, now is the perfect time to open this up and bring in our two other real Chronic Migraine patients, Kendall and Kim, so we can hear from them.

Hey guys! Thanks for joining us today.

DR. CHARLESTON:
Nice to see you!

KRISTIN:
Why don’t you go ahead and tell us your stories.

KENDALL:
Hey Kristin! Thanks for letting me share my story with you.

My name’s Kendall, born and raised in Oklahoma, but my Chronic Migraine story really started when we moved to Texas. After making the move, I started experiencing more frequent and more disabling episodes which led me to seeing my first neurologist. At the time, I felt my main triggers were always anxiety or feeling stressed.

My first doctor also told me to try and cut down on the time spent at my computer screen. For me, it was always about finding a dark place that’s quiet, and being an educator, that was not always the easiest thing to do. I was so noise sensitive, so light sensitive. Nausea always came with it of course - and I never ate during my migraine attacks, my appetite was gone.

KIM:
So, I’m Kim. I live on Long Island. I have two sons who are working on their Masters’, and I work as a dental hygienist. I guess I’m pretty unlucky because my first migraine attacks happened pretty early on in life. I needed to be in a completely silent, dark room. I couldn’t do anything. I’d have a pounding headache so bad I’d ask my mom to rush me to an emergency room. You know – those type of migraine attacks!

KRISTIN:
Wow! I know those attacks. Y’all thank you so much. I feel your pain, believe me!

So, that brings us to myth #1: Chronic Migraine is just a headache – don’t y’all love it when people say, “Oh you have a bad headache”. I wish it were just a headache…

DR. CHARLESTON:
That is false! The fact is, Chronic Migraine is a neurologic disease that has associated symptoms, many of which have already been mentioned (such as sensitivity to light and sound and nausea) and can significantly affect peoples’ day-to-day activities.

KIM:
I found out years after my diagnosis that my Chronic Migraine may have been hereditary and also hormonally triggered. I visited a ton of neurologists before I found my current doctor about 3 or 4 years ago who helped find a treatment plan that had worked for me. I’m a dental hygienist so obviously I can’t clean teeth from home. I have to go into the office to work; people have planned their day around coming to see me, and I need to be there. But it’s tough when the people around you don’t understand what you’re going through. I had an old boss who would keep the office at 82 degrees year-round which used to really trigger my migraines. Once when I told him that I felt all this pain and pressure behind my right eye, he just said, “Well, you have a left eye, don’t ya?”

So I’m now in a much better office where people can understand I might need some help or a few minutes to myself.

KRISTIN:
I so get it, people just, and they can’t help it, sometimes they just… if you don’t experience it, how can you know? You’re in an island by yourself.

Okay, myth #2: there are no treatments out there that can prevent my headaches and migraines before they start.

DR. CHARLESTON:
No, no no! Wrong! We’ll go on to talk about treatment options there a little bit more in detail a little later but, the truth is, headaches and migraine attacks can be prevented.

KENDALL:
So, my story picks up 8 years after my migraines became more severe. At that time we lived in Austin, and a friend recommended another neurologist that I went to see. That’s when they did an MRI, a CAT scan, and they couldn’t find anything physically wrong with me, which was a relief and also a concern.

I had been appointed to my first principal position, so I continued to tell myself that it was the increased stress with the promotion. Around this same time, my wife and I started talking about having our first child – another stressful topic! We got pregnant and we decided to move back to Oklahoma to be closer to our family. So, there was a lot happening! With everything that was going on, I was having a migraine attack pretty much every day.

With all the stress a new baby brings- all the lack of sleep. Then, 2 weeks after our son was born, my wife got diagnosed with cancer. That right there was the moment for me when I said, okay, I got an infant child to look after. I got my wife dealing with this diagnosis. If I don’t get right, then I can’t help either of them. So that’s when I finally went to my 7th neurologist back in Oklahoma and was officially diagnosed as having Chronic Migraine and finally found a treatment that worked for me.

KRISTIN:
Oh, thank goodness - thank goodness!

Okay, on to myth #3, huh, one of my personal favorites. Only women suffer from Chronic Migraine.

DR. CHARLESTON:
Oh absolutely false. Although women are more likely to experience Chronic Migraine than men, I think Kendall’s a living proof that men suffer from Chronic Migraine as well.

KENDALL:
For me, it was about continuing to power on and take care of my family. Besides doctors I would go to, I never spoke to anybody. My wife of course knew. She’d see it put me down for days and I’d still try to power through my work. So, with that last neurologist in Oklahoma – she’s my current doctor today.

That was the moment for me when I finally opened up and told her I was open to trying anything that might help me. She talked me through the process to get to the treatment plan I’m on now that has worked for me. She really helped me to get through it and helped me to understand it. And that changed my mindset.  We got good news about my wife’s cancer; we have a bouncing baby boy, and it was like I remember saying – okay, we’re gonna beat this thing and I can take care of Chronic Migraine.

KRISTIN:
Just on a side note, I’m so happy about your wife too as well.

Myth #4: I just have to tough it out on my own.

DR. CHARLESTON:
Again, not true! Remember you are on a journey in partnership with your primary care provider, neurologist, or headache specialist to find the right treatment plan for you. Kim and Kendall both talked earlier about having to ‘tough it out’ or just ‘powering through things’. But talking to your doctor can help change all that – believe me!

A headache specialist’s main focus is on headache disorders. That’s their thing, that’s what they do. They specialize in treating people with migraine and headaches. They’re highly educated and knowledgeable when it comes to treatments for Chronic Migraine. And that makes them a top choice to help you find the right treatment plan that’s right for you.

KRISTIN:
Ah, you see, that’s so important!

It starts by talking with your doctor, and not to be embarrassed, that’s why we go to doctors - to help us. It’s really important you get to know and recognize your triggers.

A huge thanks to Kendall my Oklahoma guy and Kim, hello, Long Island, my girl! for sharing your stories with us today – huge thanks, thanks y’all so much - bye!

DR. CHARLESTON:
Thank you. Bye guys. Thank you.

[Kendall and Kim wave goodbye]

KRISTIN:
Like I was telling everybody at the beginning, as an actor, it was the days under hot, bright studio lights that first triggered my attacks.

So, Dr. Charleston, I’m curious to find out. What else can trigger migraine attacks? What can cause Chronic Migraine?

DR. CHARLESTON:
Well, there are many possible causes, some of the most common are: Genetics. Studies suggest that half of the risk for migraine comes from your family history. If a relative has migraine, you’re more likely to have it.

KRISTIN:
My mother had migraines in the 60s! So it is definitely in my DNA. This is actually in my body. It’s part of who I am.

DR. CHARLESTON:
Some common triggers are certain foods, drink, and caffeine. Skipping meals, excess caffeine, and alcohol can all trigger migraine attacks.

KRISTIN:
Okay, so salt and alcohol are some of my triggers. So I avoid alcohol. I very, very rarely drink. I really do try to live by that rule. I also live by a low-salt diet. It stinks, but I do it.

DR. CHARLESTON:
Changes in humidity, temperature, barometric pressure are some of the most common triggers and, of course, some of the hardest to control, really.

KRISTIN:
He-llo! This girl is on a flight two, three times a week. Help! Help! I can’t wait till we can learn how to teleport. But, until we do, I have to fly all the time. The barometric pressure, all of these things can affect me.

DR. CHARLESTON:
Yeah, the change in your sleep schedule, whether sleeping too much or too little, can really set off a migraine.

KRISTIN:
It’s really hard when all of us have such busy schedules, with work, with kids, with friends.

You know Doctor, I really try to listen to my body. It tells me, most of the time, what’s happening. So I try to plan ahead as much as I can.

DR. CHARLESTON:
That’s awesome. That’s awesome. Now, anxiety and stress – so a stressful time can be a trigger, but migraine can show up even once you’re relaxed after the stressful time is over.

You know, early around the beginning of the pandemic, there was research that showed that there was a big spike in people getting migraine attacks partly because of the stress of it all.

KRISTIN:
It’s so interesting that you mention that Dr. Charleston. During those early days in quarantine when we were all in lockdown, remember that very first, like, 7, 8, 10 weeks, I got really anxious about all of the extra screen time I had to start using just to be able to talk to people. I was really worried it might trigger more attacks.

DR. CHARLESTON:
And remember, external triggers like that also come with internal ones. It’s worth pointing out that a lot of women often notice a relationship between headaches, migraine, and changes in their hormonal balance.

KRISTIN:
[sings] Aaaaaaah!! I know about hormones and how women are, so we have a lot going on in our bodies. I mean we have a lot going on in our system hormonally which is why it’s so important to listen to your body and do the research.

DR. CHARLESTON:
Yeah, and going back to what you were telling us about not being able to look at the spotlights on stage, and the intensity and brightness that triggered your first attack. How do you cope with that now?  I mean, you can’t avoid those bright lights. They’re all part of what you do most every day. So, do you have to do something different? Or if you’re on set or anything like that?

KRISTIN:
Oh, you bet. You bet.

It looks a little weird, but a lot of times I’ll pop on my sunglasses. Right? So, I’ll walk into theater, or I’ll walk outside most of the time with my sunglasses on - even at night. So I already look like I wanna be a rock star and I am so not! As you can see! I am so not!

I think it’s important to explain to coworkers that I have a disease called Chronic Migraine. I think a lot of people are afraid to share something like that because their coworkers will say, “Oh don’t come in here with all that baloney.” I think the opposite.

I think when you’re gonna be on a long-running Broadway show or a TV show or a film with people that you’re going to be close with, I think you share. Look, I have this thing. If it starts to happen, we know what to do. Don’t worry about it. I think, just say it, just tell them and get it out. To let people know - it’s freeing!

DR. CHARLESTON:
That’s such great advice. Unfortunately, like a lot of things that we don’t fully understand, there’s a lot of stigma attached to Chronic Migraine. It’s like you’re supposed to get on and deal with it. Like somehow, you’re weak and not strong you just gotta go with it. It’s just a headache, right?

KRISTIN:
Right!

DR. CHARLESTON:
Everybody gets headaches, right?

KRISTIN:
Right!

DR. CHARLESTON:
Why don’t we all just run to our beds and lay down?

KRISTIN:
Exactly! That word, oh that word ‘stigma’ that you brought up, it really, really bothers me so much. I think the real stigma you’re talking about there when it comes to Chronic Migraine is that a lot of people have no clue about the severity of symptoms that people with this disease have to live with.

That they can even be bad enough to shut down parts of your life, again and again and again. I really wish more people understood that so that we’re not facing this every day on our own, that there was a better understanding out there of what our reality is.

It’s frustrating you know because people think it’s just a headache. And it’s like I’m on an island by myself and no one understands. Like I said before, it’s just something that you’re just supposed to push through - right?

There have been times when I’ve been on the floor unable to move. Also vomiting, and not being able to go out on stage, and that’s been very difficult. And then there’s the guilt! Feeling guilty because, of course, you always want to be there for all the people in your life.

Once the facts about Chronic Migraine are out there, and the fact that this is what you’re having to live with, you’d be amazed at how many of your coworkers or your family or your friends share that they, or someone that they know, is living with Chronic Migraine too.

Sharing your Chronic Migraine story could help you find allies and help educate those folks who just don’t believe Chronic Migraine is a very real and very debilitating disease. How it impacts your daily life and your career.

After my first attack, my symptoms eventually subsided after a day or two, but then the attacks became more frequent. There have been times when I wasn’t able to perform because of a migraine attack. And when I won an Emmy Award, I couldn’t even attend an after-party because taking pictures and chatting with everyone during a migraine attack was just too much. The last thing I wanted to do is not be dependable and let down my colleagues.

DR. CHARLESTON:
It’s interesting you know, and not for a second to downplay other headache conditions, but Chronic Migraine specifically has been shown to be truly debilitating and can be a great burden on daily life.

KRISTIN:
I totally get it! I can totally relate to the negative impact it has for everyone in any walk of life. It makes no difference who you are, or what you do. Chronic Migraine doesn’t pay any attention to that. And that’s what we all have to deal with.

For me, I always think of that little girl in the audience who’s never seen a Broadway show and you want to go out there and you want to give it your all. And I can’t help it. I still want to do that. Especially when I see them with their parents or young people in the audience. The good news is, Chronic Migraine can be treated.

Go on Dr. Charleston, can you talk about what some of our treatment options are? We want to know from you.

DR. CHARLESTON:
Sure thing, when it comes to Chronic Migraine, people should be aware of the three different treatment options available: acute, preventive, and non-pharmacological or non-medicinal modalities such as “headache healthiness,” some of the things we talked about earlier, and behavioral modalities.

Usually, preventive medications are taken on a regular basis. One of the goals, as the name suggests, is to prevent headaches and migraine attacks before they start.

On the other hand, acute medications are usually taken after a migraine attack has already begun. Preventive medication is available only by prescription through your doctor or neurologist. Acute medications are available over the counter as well as by prescription.

Another interesting fact worth mentioning is that taking certain acute medications too often to treat migraine and headaches can lead to a condition called “Medication Overuse Headache,” simply put, means more headaches! Surprising, but true.

KRISTIN:
Didn’t know it!

DR. CHARLESTON:
Yes, and that’s why it’s so important to talk to your doctor about all your medications when discussing Chronic Migraine treatment. And Kristin, I know you want to talk a little bit about which treatment option ended up working for you.

KRISTIN:
Yep!

DR. CHARLESTON:
Oh yes, I hear from a ton of my patients that their journey with Chronic Migraine can be so long before getting an accurate diagnosis. Right?

KRISTIN:
Yes!

DR. CHARLESTON:
I mean, it can go on for years, progressing and changing over time. And then finally, they may consider a treatment like BOTOX® for Chronic Migraine, right?

KRISTIN:
Right.

DR. CHARLESTON:
So, when did you first start that conversation with your doctor, Kristin?

KRISTIN:
So, like I was saying at the beginning. After my first migraine attack on stage, my attacks were becoming more and more frequent until I finally found a doctor like you who specialized in headaches and was able to diagnose me with having Chronic Migraine. So, yay on that! I didn’t even know what that was or that there were different types of migraine that might need different types of treatment.

When BOTOX® first came up, I learned it prevents headaches in adults with Chronic Migraine, which means 15 or more headache days a month, lasting 4 hours or more.

[BOTOX® is not approved for adults with migraine who have 14 or fewer headache days a month. BOTOX® prevents, on average, 8 to 9 headache days and migraine/probable migraine days a month (vs 6 to 7 for placebo).]

KRISTIN:
It prevents headaches before they even start!

[BOTOX® is not approved for adults with migraine who have 14 or fewer headache days a month. BOTOX® prevents, on average, 8 to 9 headache days and migraine/probable migraine days a month (vs 6 to 7 for placebo).]

KRISTIN:
I found out that BOTOX® injections were given by my doctor and it definitely took a couple of conversations for me to relax about the procedure, you know? I felt like a little kid who’s worried about going to see the doctor. I worried about needles and everything.

Back then, I thought, I can’t believe I’m agreeing to do this. So, my doctor, she said, “You can try this, but remember it may take a few treatments to see if it’s working for you.”

I really didn’t know what to expect at the beginning. But now, I’m so grateful for BOTOX® for Chronic Migraine, I can’t tell you!

DR. CHARLESTON:
Yes, that sentiment, that kind of story, and those kinds of experiences you’ve shared, I’ve heard from countless other patients over the years and still do very often in my practice!

So, now, just before we go into a little bit more of detail and talk about this a little bit more, there’s some important safety information we need to share with everyone first.

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.]

DR. CHARLESTON:
Side effects may include allergic reactions, neck and injection site pain, fatigue, and headache.

Don’t receive BOTOX® if there’s a skin infection.

[Allergic reactions can include rash, welts, asthma symptoms, and dizziness.]

DR. CHARLESTON:
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.

DR. CHARLESTON:
And please keep an eye out for more Important Safety Information about BOTOX® for Chronic Migraine later on in our discussion.

KRISTIN:
So now, back to me, speaking personally, I have my BOTOX® for Chronic Migraine treatment every 12 weeks and it has cut down the number of headache days per month. You have no idea how grateful I am for that and for people like you. And to be honest, I was amazed at the whole process.

The treatment takes about 10 minutes, and you do it once every 3 months.

[BOTOX® injections are given by your doctor.]

DR. CHARLESTON:
Yeah, just a minute ago, you mentioned about everyone’s fears of needles - right? That is super common, and a lot of my patients bring that up as a worry right off the bat.

KRISTIN:
I mean, I wanna say the procedure was 31 shots around my head and neck. And, you know, my doctor, she was so good at making me feel at ease. She really did. Like, I had been afraid at the beginning, but she was so supportive and so good. Honestly, they felt like tiny little pinches and, hey, compared to having a migraine - there’s really no contest! For me, the fear was far worse than the reality for sure!

DR. CHARLESTON:
Yes, that’s pretty much what I hear back in my practice. The procedure is 31 injections in seven different areas of the neck and head like you said. And, I think to your point the relationship with your doctor is so, so important – it’s vital to build that connection and trust. It’s really all about being able to make sure patients feel comfortable and putting them at ease before and during the treatment. I play music during the procedures, naturally, right?

KRISTIN:
Of course!

DR. CHARLESTON:
I talk and partner with patients through the process. While individuals vary, it’s been extremely rewarding to hear the feedback from my patients. 

KRISTIN:
To be honest, I’m so lucky. My treatment journey has been beautiful, and I thank my lucky stars that at least I have my doctor who understands me and my condition. And, well, I certainly plan to keep on using BOTOX® for my Chronic Migraine that’s for sure! I can do without a lot of things, but not those BOTOX® appointments with my specialist. I am always right on time for those!

KRISTIN:
So, Doctor Charleston, while we’re talking about BOTOX® for Chronic Migraine, could you tell us about any possible side effects?

DR. CHARLESTON:
Of course. The most common side effects found in BOTOX® clinical trials for Chronic Migraine were neck pain and headache. This doesn’t cover all the possible serious side effects of BOTOX®. You should always talk to your doctor and review the Important Safety Information as well as the Product Information about BOTOX®.

KRISTIN:
Got it. Thanks!

DR. CHARLESTON:
So, Kristin, we’ve talked about your treatment, we’ve talked about your Chronic Migraine journey. Are there any important lessons you think you’ve learned along the way?

KRISTIN:
Well, after all my years of living with Chronic Migraine, I suppose there’s a couple of approaches that have risen to the top. I’m always very open about my triggers. For me, as I’ve said, it can be the bright lights that set off a migraine attack.

It took me a long time to feel comfortable enough to tell people around me what I was feeling. Now, I feel empowered to let my colleagues and friends know when I need a break or just a second to myself. And mostly, I try not to be too hard on myself. I’m a perfectionist. This has been a very tough lesson for me.

I always want to do my best at work, just like you, but there are days where I just don’t feel like myself. And I have accepted that I need to take the time that I need to take to rest.

What’s also helped me is when I realized that I needed to become my own advocate – to not be afraid to speak up with my doctor. Truth is, it’s only ME who really knows what I’m experiencing and feeling inside. So, if a treatment plan wasn’t working for me, I needed to know that there were other options out there. I’m truly grateful that I found BOTOX® for Chronic Migraine with the help of my doctor.

DR. CHARLESTON:
That’s really great Kristin – and really, thank you for that.

So, as we wrap up, here are a few other practical considerations I can give you as you work with your doctor to treat your Chronic Migraine.

KRISTIN:
Okay!

DR. CHARLESTON:
Notice your triggers okay?

Keep track of what’s going on before a headache or a migraine comes on. When you recognize the triggers or patterns, you can work to try to avoid them. Downloading a headache and migraine tracker can be a great place to start and be an incredibly useful tool.

I know you can find one on the BOTOX® for Chronic Migraine website.

[BOTOXChronicMigraine.com]

DR. CHARLESTON:
Keep it moving. Exercise helps you feel good and relieves stress. Try going for a short walk every day if you can. I know you try for 10,000 steps a day Kristin!

Keep calm. Yoga, meditation, deep breathing exercises, progressive relaxation and talking with someone are ways to keep stress levels down and migraine attacks at bay.

Stay loose. Talk to your headache specialist about stretches and massage therapy to alleviate that tension and stress.

Hydrate and hydrate some more. And did I mention hydrating? And hydrating!

KRISTIN:
I think you said dehydrate. I think you said hydrating not dehydrating right?

DR. CHARLESTON:
Okay yes, see remember dehydration can trigger migraine attacks. So don’t forget to stay hydrated! And try not to miss meals.

DR. CHARLESTON:
Rely on good habits. A consistent sleep schedule, exercising, or keeping a migraine diary are all the things that can help keep your headaches and migraine attacks in check.

And finally, always seek treatment for mood disorders, such as depression and anxiety, or sleep disorders.

…and that’s it!

KRISTIN:
Amazing!

Thank you so, so much Dr. Charleston! It’s been such fun talking with you and tapping into your expert advice, I could keep going all day. Take care!

DR. CHARLESTON:
Bye everybody!

KRISTIN:
Thank you, thank you, thank you, to each and every one of you who joined us here today. I really hope you found it fun and helpful.

Just remember, if nothing else, the one thing, the single most important thing to take away from our conversation today, is that finding the right Chronic Migraine treatment for you starts by finding the right doctor and talking to a headache specialist.

We’ve just made it super easy for ya - just visit BotoxChronicMigraine.com and punch in your ZIP code to find the BOTOX® specialists closest to you.

[BOTOXChronicMigraine.com]

KRISTIN:
Last but certainly not least, I really want to thank AbbVie for partnering with me today to help me host this event. It’s not every day that you can take a challenging experience and turn it into a positive one. I hope that by sharing my experiences with Chronic Migraine I can inspire others to talk to a doctor about how to manage this disease.

I just want us to reach out to each other, to this ‘club’ that we’re in, and let you all know we’re in this together. Group hug! I’m no different or special than anyone else in trying to get through life with living with Chronic Migraine...

None of us asked to be in this club, or even wanted to be in this club, but here we are. So, let’s share. Let’s share our experiences with each other.

It’s not a fun club to be in, but we’re in it nonetheless, and it’s nice to be able to reach across and give each other a helping hand.

I hope you all enjoyed it. I hope you found it helpful. And I hope to see you all again real soon.

I love y’all! I really mean it. Take care of yourselves.

Be sure to stay online through the end to hear additional important information about BOTOX® for Chronic Migraine and click on the provided link to see full Product Information, including Boxed Warning and Medication Guide.

[Stay tuned for Important Safety Information and see full Product Information, including Boxed Warning and Medication Guide, in the provided links or at BOTOXChronicMigrainePI.com]

KRISTIN:
And, I think I shall say goodbye to you like this.

[Puts on sunglasses]

[sings] Au Revoir!!!

Bye!

[Stay tuned for Important Safety Information and see full Product Information, including Boxed Warning and Medication Guide, in the provided links or at BOTOXChronicMigrainePI.com]

[BOTOX Important Information]

VO:
IMPORTANT SAFETY INFORMATION

BOTOX may cause serious side effects that can be life threatening. Get medical help right away if you have any of these problems any time (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 preexisting 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.

There has not been a confirmed serious case of spread of toxin 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 as Myobloc® (rimabotulinumtoxinB), Dysport® (abobotulinumtoxinA), or Xeomin® (incobotulinumtoxinA); 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, 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 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 4 months; have received injections of botulinum toxin such as Myobloc®, Dysport®, or Xeomin® in the past (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 thinners.

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.

Please see BOTOX full Product Information, including Boxed Warning and Medication Guide at www.rxabbvie.com/pdf/botox_pi.pdf.

If you are having difficulty paying for your medicine, AbbVie may be able to help. Visit AbbVie.com/myAbbVieAssist to learn more.

 


VO and SUPER:
INDICATION  
BOTOX® (onabotulinumtoxinA) 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 4 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 (episodic migraine).

IMPORTANT SAFETY INFORMATION  
BOTOX may cause serious side effects that can be life threatening. Get medical help right away if you have any of these problems any time (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 preexisting 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. 

There has not been a confirmed serious case of spread of toxin 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 as Myobloc® (rimabotulinumtoxinB), Dysport® (abobotulinumtoxinA), or Xeomin® (incobotulinumtoxinA); 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, 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 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 4 months; have received injections of botulinum toxin such as Myobloc®, Dysport®, or Xeomin® in the past (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 thinners. 

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.  

Please see BOTOX® full Product Information, including Boxed Warning and Medication Guide, at www.rxabbvie.com/pdf/botox_pi.pdf.

If you are having difficulty paying for your medicine, AbbVie may be able to help.  
Visit AbbVie.com/myAbbVieAssist to learn more.