Pressure Under the Bright Lights: A Conversation with Kristin Chenoweth

Nora McInerny:

Life sometimes has a way of blindsiding you with a feeling of being overwhelmed at the worst possible time. It could come while you're out with friends, running an important meeting or just with your family at home, a spiraling thought that leaves you feeling helpless. That's why you have your self-care, your coping strategies. That's why you have us.

I'm Nora McInerny and this is The Head Start: Embracing the Journey, a podcast where we'll be taking all those things you usually save for your friend group out into the open, so we can all find a bit of optimism.

We all have social pressure, pressure from our job, pressure from our family, pressure that's real and pressure that just feels real. When it all starts to pile up, it can be really triggering. And then add on a migraine attack that can pop up out of nowhere, and it makes even the simplest task feel nearly impossible. That's why we're here, because when life gets hard, you do need to be around people who get it, people who aren't afraid to tell you what happened and what helped.

I am someone whose life's mission is to make space to talk about the hard things in life because I have been a person who needed that space herself. I'll definitely be sharing my experiences and vulnerabilities and trying to pick up some things along the way to work into my own routine. But this show isn't about me, it's about life. And wow, that just made it sound very deep, and I guess it will be deep, but it won't be heavy. Lighthearted life talk is what we're aiming for here.

For those battling Chronic Migraine, these conversations are going to be even more helpful and relatable, so definitely stick around.

This show is brought to you in partnership with AbbVie. So first, let's hear some important safety information and stay tuned to the end of the podcast for more.

Speaker 1:

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 or 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.

Please see Important Safety Information, including Boxed Warning, within this podcast or on the website below.

Nora McInerny:

Long before this episode, this show, and most of my career, I had a very intense fear of public speaking. I could think of a brilliant idea at work and then find myself completely unable to present it in a meeting of my peers.

I had practiced, I had written it out, and when the time came for me to say those words to my clients or my colleagues, I was sweating, I was blushing, I was stuttering, and this was strange because I have always loved to talk. But once I had to stand up in front of other people, I was in my head, imagining what they were thinking of me, and I never imagined good things. I imagined judgment.

This was the opposite of my first husband, Aaron. He loved the spotlight and the spotlight loved him. But after Aaron died, I cared a lot less about a lot of things. And when I was invited to speak to small audiences about cancer and grief and widowhood, I said yes. That's how I found my people. The more I talked about loss and grief, the more people I met who knew what it was like to walk through the world missing a huge part of themselves. One of the gifts of modern life is that it has never been easier for us to find and connect with other people, to have glimpses into lives and stories we would otherwise never see.

Which is why I am so thrilled to share today's interview with you, because today's guest knows what that feels like on a much bigger, if not the biggest scale. Kristin Chenoweth is a literal living legend. Glinda the Good Witch in Wicked, Olive Snook on Pushing Daisies, Annabeth Schott on the West Wing. She's an Emmy and Tony winner. The list goes on and on and on.

I can't imagine the pressure to perform and tap into your truth and share a piece of yourself on the scale that she does. And on top of all of that, she battles Chronic Migraine as well.

I cannot wait to talk to her, but first, I get to introduce the voice of reason to my voice of... What would I be the voice of? Relatability, humor, all the above?

Nora McInerny:

Hello, Dr. Rhyne. Welcome. It is so great to have you on the show.

Dr. Christopher Rhyne:

Nora, thanks for having me, and I'm so excited to be able to sit down and talk with you a little bit and talk with folks, learning more about their experience with Chronic Migraine so I can't wait.

Nora McInerny:

For listeners, you have to know that I am not just talking to a guy that I now call my friend, Chris. I'm talking to Dr. Christopher Rhyne, who is a board-certified headache specialist and the Director of Clinical Research at the Diamond Headache Clinic in Illinois, which are impeccable credentials for this show.

And also, before we pressed record on this, we discovered a fun fact about one another, which is that we are both adult learners of piano.

Dr. Christopher Rhyne:

That's right. I just stare at this beautiful keyboard sitting in my office and need to spend more time doing it. So, this is the classic story, you watch a motivational video about getting motivated to go do the thing that you're not doing. And it was like, "You know, if you just do 10 minutes a day, if you do that for a year, you'll be more proficient than 95% of the population of the world." And I spent 10 minutes watching that video instead of playing the piano. So, I'm one of the best motivational video watchers you'll ever meet, Nora.

Nora McInerny:

And I aspire to be motivated to watch the motivational videos. Piano is so fun for me. I do sweat in class and I sweat when I'm playing because my brain is working in a way that it has never had to. I can feel it. I can feel neural pathways forming and they are working hard to get through this brain.

So let's talk more about brains, shall we?

Dr. Christopher Rhyne:

Let's do it.

Nora McInerny:

I want to start with the basics, mostly for my sake and also for listeners who might be early in their migraine journey.

Dr. Christopher Rhyne:

Sure.

Nora McInerny:

So first, can you give us the definition of Chronic Migraine?

Dr. Christopher Rhyne:

Fundamentally, migraine is a central nervous system disorder that involves a level of light and sound sensitivity, being exposed to light and sound would make things more difficult, a level of nausea, even vomiting associated with the symptoms that people experience.

The timeline for these headaches is at least four hours in experiencing pain without being treated. 15 headache days, only eight of them need to meet the criteria of migraine.

And so, I think this is another thing that patients go, "Well, I don't know. I wasn't puking, so I guess this one doesn't count," it absolutely does when we look at it through the lens of Chronic Migraine in that 30, 31 day month. We only have 15 headache days per month where eight of them meet that criteria for migraine, and that meets the definition of Chronic Migraine. Versus less than that is episodic migraine.

As we go on this journey together and we hear stories of people in their experience, the thing as a headache doctor that breaks my heart is it screams to me that they're experiencing migraine and people will go decades without ever making the diagnosis because people didn't know that it was this straightforward to make the call and to make that definitional diagnosis of migraine and then move on to therapy for those folks.

Nora McInerny:

What might a typical journey look like before someone is diagnosed with Chronic Migraine?

Dr. Christopher Rhyne:

Typically, we get into early adulthood and we're taking on challenges. And so, there's a little bit more attention paid to it, because if I miss class, if I miss work, the disability that's associated with migraine starts to stand out.

It really oftentimes becomes a situation where they know there's something going on, but they're trying to avoid the stigma, the disability, they're putting their head down. There may even be in some situations because of family relationship, sort of a cultural approach by the family to just sorta put your head down and get through it and suck it up. And I'm sure that we're going to talk to guests throughout this process that have that exact story that they had something they needed to do and they weren't going to let their headaches get in the way of that. And so they just gutted it out. And so that's really what it comes to. And generally when people start getting to my door is when they're desperate because they can't fake it anymore, and they really have to seek out help.

Nora McInerny:

So when people come to you, they've been dealing often with this for a long, long time. And I imagine that there are a lot of emotions that you see in your office, but one of them that surprised me is fear.

Dr. Christopher Rhyne:

Yeah, nobody likes bad news. And so the honest to God truth is they already know something's going on. On one end, they might be thinking, is this a tumor? Is this an aneurysm? Is this something really scary, life-threatening scary? So oftentimes we have to walk through that together and talk to them about why I do or don't think that's going on. Some people don't want to know the answer to that question because then they have to deal with those emotions that might be tied up in a million other experiences that they had, you know? Does this keep me from being able to pursue medical school, law school.

And so for all of those reasons, personal and professional, patients sometimes really just cover it over or hide from it.

Nora McInerny:

Yeah. We also have this particularly western attitude I've learned over the years, which is Americans especially, we power through.

Dr. Christopher Rhyne:

Yep.

Nora McInerny:

Right?

Dr. Christopher Rhyne:

Yep.

Nora McInerny:

And we like a winner. And every setback is really just a setup for your best work and the best day ever. And you smile through it and you brush yourself off, and you pull yourself up by the bootstraps and you play through the pain. And it really, I think, has created a culture where we've become so dismissive of our bodies, like our physical feelings.

Dr. Christopher Rhyne:

It's true. The human being's ability to rationalize its experience is phenomenal. No, no, no, no, this is just because I didn't eat any breakfast or this is just because I'm a little stressed. And the cute thing that ends up happening as we walk through the stories, we take an hour just to talk about what their experience is when we first meet. And what they're doing is they're quietly telling me all of their triggers. So sometimes if you can weave that story into an understanding about the disease, patients can relate to their disease more, which seems like a silly thing to say because they're experiencing it so much, but because they're rationalizing their experience away, sometimes you have to bring them back to their experience. Let me be the thing that helps you pull yourself up. You don't have to fake it, that there are therapies and approaches that you can take without just trying to ignore what's going on with your body.

Nora McInerny:

Thank you for the work you do. It's really wonderful to be with a person who knows what to do and does it, so thank you.

Dr. Christopher Rhyne:

You're welcome. It's a blast. I get to wear pajamas to work every day. I wear scrubs to work.

Nora McInerny:

You know what? I'm glad you said it.

Dr. Christopher Rhyne:

Yeah. Come on. Let's keep it real.

Nora McInerny:

I'll be right back after the break with Kristin Chenoweth, who is a paid spokesperson for AbbVie, so stick around.

GUIDE VO:
BOTOX Chronic Migraine branded mid-roll spot to be inserted here. US-BCM-230048 What is CM?

Nora McInerny:

Welcome back to The Head Start: Embracing the Journey. Hi, Kristin, welcome. Welcome to the show.

Kristin Chenoweth:

Thank You. It's good to be here and nice to meet you.

Nora McInerny:

Oh, nice to meet you. Good to see your beautiful face as close to in person as you can get.

Kristin Chenoweth:

Thank you.

Nora McInerny:

I love to start the show by asking people a question. I want to know what are you listening to lately, music, podcasts, books? What's in your headphones?

Kristin Chenoweth:

I have just started the audiobook, how's this for random, the audiobook for Heather Gay's book and I'm obsessed. I know her from afar, and she sent me the book and I'm a big audio listener.

Nora McInerny:

Yeah, same.

Kristin Chenoweth:

Yeah. And so I'm listening to that. I'm listening to Lainey Wilson right now. I got a heart like a truck. I'm obsessed with the song and obviously I listen to music all the time. But those are the two things that are going on in my earbuds.

Nora McInerny:

If you're listening to music, are you singing along also?

Kristin Chenoweth:

Not always. Not always because I'm also trying to get their words, but Lainey's song, I was practicing it in the car yesterday and I was like, "I got a heart like a truck. It's been drug through the mud, runs on dreams and gasoline, that ole highway holds the key." So I'm just learning the words as I go. I get obsessed about a song and I listen to it and it drives other people crazy.

Nora McInerny:

I do the same thing. I'm like, well, if I liked it once, I'll like it a thousand times.

Kristin Chenoweth:

That's right.

Nora McInerny:

Completely. And if I could sing, Kristin, I would never talk if I were you. I would literally be singing every word.

Kristin Chenoweth:

I sing to my dog. My dog's got her own song. I love, I love, I love my Thunder Pup, her name's Thunder Pup. That tells you a lot about me and what I do in my spare time.

Nora McInerny:

Which I love. I love knowing that. I love knowing that. Those are facts that people did not know before, and now we know. And you heard it here first. Kristin, in addition to writing original songs for Thunder Pup, you've also been living with Chronic Migraine for many years now, and I am fascinated by the story of how you discovered it. Can you put us in that moment?

Kristin Chenoweth:

Sure. I'm 25 years old. I've been invited my first big solo concert with the Virginia Symphony, and I'm doing two acts, and about halfway through act one, I'm standing on stage and the lights started bothering me. I thought I had something in my eye. And then about five minutes later I'm singing and I see swirls and bright flashing lights, and all of a sudden my head started feeling like a sledgehammer was on top of it. And I started getting nauseous, and I finally finished the act. It was three songs to the end. The curtain came down and I threw up.

And I think by sheer adrenaline and just prayer, and please God, please, I got through the rest of the show, but by the end, I call it a brain freeze. It feels to me when I get a migraine attack, so I didn't know how to put it to people. They're like, "Oh, you got a really bad headache." I'm like, "No, no, it's not that because I've had a bad headache before." It's like when you drink a Slurpee or you have something really cold and your brain freezes, it just stays with you. And for me, it makes me very nauseous.

Nora McInerny:

So you throw up, the janitorial staff is getting the wood shavings. They're jumping into action. You also finish the show.

Kristin Chenoweth:

Yeah. Yeah. I call that…A lot of live performers have had it on Broadway, and we call it doctor footlights. You can be broken and walk out on stage and those lights and the audience, I don't know if I could do it with film or TV. In fact, it's harder because I thrive off of that personal relationship with the audience. When a migraine attack hits and you're on stage, and I've had it happen a couple of times, you can't believe it's happening. There's many experiences over my career that it's happened and it's unfortunately taken some special nights away from me.

Nora McInerny:

After that show, you finish, you've gone through this incredibly physically taxing experience. What happens after that show?

Kristin Chenoweth:

Well, I actually stayed an extra day, thank goodness I didn't have to be anywhere that next day, to just assess the situation. I did have a doctor come and he said, "You probably did have a migraine attack." And I can tell you this, Nora, it was very scary.

Because I love being on stage, and to not have that be safe was a bummer.

Nora McInerny:

And when that doctor said to you, "Well, that was probably migraine," what did you know about that word?

Kristin Chenoweth:

Not much. The journey to finding out what it really was and what it really entailed was a longer conversation. Yeah. I didn't know. I was just scared and nervous and wondering when it was going to happen again. It's like allergy season. People that have that go, "Oh, it's October. I'm going to be sick." You don't get to say, "Okay, I have a day off Saturday, so migraine if you're coming, come on." You don't get to do that. It's a constant surprise.

Nora McInerny:

It takes, I think for you, years between that first show and that first attack to actually get an official diagnosis. You called it a fear of having your safe, happy place invaded by this dark force. What are some of those special nights, or what did it feel like to have that looming around not just your livelihood, but truly your joy?

Kristin Chenoweth:

It was embarrassing, if I'm being honest, because if it happened surrounded by work, people are like, "She's having some kind of episode," or, "Hey, try this. You squeeze yourself between your thumb and your finger." I was squeezing my hand off. My years were spent hoping and praying it wouldn't hit at a very big time, which it did. I won an Emmy for a TV show called Pushing Daisies, and I did a full red carpet with tons of flashing lights. I felt no pre-warning or anything like that. I'm sitting there waiting for my category thinking, I think I might be getting one, but I just kept willing it away.

AndI did win and after you win, you go and you take more pictures. Talk about being a best actress, I was really trying not to let this steal my moment. That's just an example of how Chronic Migraine has affected me in my career.

Nora McInerny:

Oh, and that's such an evocative example too, because I'm sure if we went online right now and searched Kristin Chenoweth, Emmys, Pushing Daisies, we would only see…

Kristin Chenoweth:

Smile.

Nora McInerny:

... beautiful photos, smiling, gorgeous. Oh, that's so powerful.

Kristin Chenoweth:

That's another problem is that you just got to be so in tune. I'd like to think being an actress and a dancer and things, I'm really in tune to my body. The frustration was, I couldn't tell when it was going to hit. I did everything. I'd drink tons of water. I didn't eat chocolate. I didn't drink wine and it still would happen.

Nora McInerny:

Yeah. You mentioned too, the embarrassing aspect of it, which as much as I want to be like, no, no, no, don't be embarrassed, we also know that we live in a world where we do expect a lot from everybody, expect a lot from women, expect a lot from women.

Kristin Chenoweth:

Absolutely.

Nora McInerny:

Especially in the industry that you are in, it's like you cannot be labeled difficult.

Kristin Chenoweth:

Nope.

Nora McInerny:

Difficult can mean anything, truly.

Kristin Chenoweth:

Oh, right. "Oh, she's a high-

Nora McInerny:

[inaudible 00:23:50].

Kristin Chenoweth:

... maintenance because she has…

Nora McInerny:

High maintenance.

Kristin Chenoweth:

... to have lower light," or whatever. I know. Well said. Well said, Nora. To further explain my fear, it wasn't just for myself, it was for others, and not just their judgment. I didn't want to be looked at as weak. I'm not going to let that go down. Also, when this all started, nowadays, Nora, I feel like the younger generation is teaching me a little bit more of have some grace with yourself. But I grew up in a time where you weren't late. You didn't talk about your problems. I do a cheer from the South. I'm from the South, and I made it up. It's called push it down, push it down, way down. Push it down, push it down, way down. And no matter how hard I tried, it still would come up, and I would not give myself any grace.

Nora McInerny:

Oh, God no. No, no, no. Ourselves? No.

Kristin Chenoweth:

No.

Nora McInerny:

Other people, sure. There's this additional aspect to that I know you've talked about before, which is when people show up to see you, they're showing up to see you. They're traveling. Also, behind the stage or behind the camera, there's literally hundreds, if not thousands, of other people whose jobs are also connected to and rely on your performance, which is just an extraordinary amount of pressure.

Kristin Chenoweth:

I always used to think, there's a kid out there that's flown here, and the first time they're going to see a Broadway show, and you do it and I did push through it a lot of times.There was a Broadway show I did called Promises, Promises. My leading man was Sean Hayes from Will & Grace. And I was just starting getting a little bit more bold and actually telling my leading men, "Hey, I have this thing, but if you'll just be patient with me." Sean was the guy that it hit really bad in act two. I was on the bed and he leans down, I go, "Migraine." He goes, "Got it." We continued the scene. He held me up, which makes sense for the role even. But he held me up through the whole rest of the act and even implementing like, "Would you like some water, Fran?" Fran was my character. He gave me some water. He was so caring. He just wanted me to get to the end. I'll tell you what, it was very freeing to be able to finally tell somebody and have them just go, "I got your back."

Nora McInerny:

Oh, everyone needs that. Everyone needs that person who can do that dance with them and improv that in that way. Oh my God, that's so beautiful.

Kristin Chenoweth:

Oh, I love him so much. When I tell you he was there for me, he was there for me.

Nora McInerny:

How does it feel to have that official Chronic Migraine diagnosis?

Kristin Chenoweth:

I was still a little confused of how I was going to handle it, and should I cut my work schedule back? I was wearing sunglasses in the nighttime, just anything that I thought could trigger it. But then after I got over my panic and started releasing some of those fears and shameful thoughts, which is ridiculous, I started working with a team of doctors to try to help. And she said, "Okay, do you want to let me give you BOTOX for Chronic Migraine and see if it helps?"

Nora McInerny:

I love that that doctor saw you and saw not just you as a star, but really saw all of those vulnerabilities because no matter what scale of life that you are performing on, and everyone is doing some kind of performance every day, everyone really does have so much to lose.

Kristin Chenoweth:

Yes. I'm really glad to be partnered with AbbVie on something that actually means a lot to me. This is my life, and I'm really, really glad to be able to come on this show and talk about it because I bet a lot of women and men, people who struggle with Chronic Migraine are out there and they're like ... People are like, "Try to reduce stress”. Because stress is also, remember, happy. The night I won the Emmy, that was happy stress. It's happy, sad. So what am I supposed to be, a robot?

Nora McInerny:

That's such a good point, Kristin. Reducing stress is always the first thing people tell you for anything. I can't stop laughing.

Kristin Chenoweth:

I know.

But part of this whole journey for you too is learning. As a performer, you mentioned you're so in tune with your body, and your body is like an instrument, and your body is yourself and a vehicle and a machine, all these things. What are the other migraine attack triggers for you besides bright lights, which is, what a ...

Kristin Chenoweth:

A bummer since I'm in show business.

Nora McInerny:

Right? Kind of. Yeah. So aside from that, what are the other ones?

Kristin Chenoweth:

My schedule, I never know what time zone I'm on. I really live in a plane, so flying a lot and also lack of sleep has been, for sure, something that I feel that could bring it on.

Nora McInerny:

Yeah.

Kristin Chenoweth:

Since I've come out with it, the ugly, awful truth, a lot of people at my meet and greets or book signings, they'll say, "I have terrible migraine attacks, and I didn't know you had that." And I just felt, wow, just by sharing one thing with one person, if it could help one person, then I'm happy.

Nora McInerny:

Yeah. Kristin Chenoweth, you are even better than I imagined and my expectations were through the roof. Okay.

Kristin Chenoweth:

Thank you.

Nora McInerny:

We like to end the show by asking guests to share a message for people living with Chronic Migraine, and this episode is filled with just shining diamonds, hopeful diamonds for people, so it almost feels greedy of me to ask you for another.

Kristin Chenoweth:

It's okay.

Nora McInerny:

But is there a message that you would like to leave the audience with?

Kristin Chenoweth:

Yes. I really just want to encourage people who struggle with Chronic Migraine, I think it's absolutely A-okay to tell your coworkers or your neighbors or close friends and you'll find how encouraging people will be to you. When you share with people, you might find out that they suffer with it too, or it opens up a conversation. It creates a more inspired workplace and even with family that you're still pushing it down and being tough, just to share what's going on and they might share something with you, and you know, you can talk about it. So those are things that I just want to really encourage people to remember.

Nora McInerny:

That was beautiful. If you say the horrible, awful thing out loud, you never know who else is listening. Who will be like, "Me too."

Kristin Chenoweth:

Oh, you're not alone. When you have Chronic Migraine, it's the invisible disease, right? So you think you're on a planet alone, but you're not. There are other people that have it as well.

Nora McInerny:

And the crowd went wild. Oh, I think you're so wonderful. Kristin Chenoweth, thank you so much for being exactly who you are. What a gift.

Kristin Chenoweth:

Same, girl. Same. Thank you.

Nora McInerny:

What a gift.

Thanks for listening to The Head Start: Embracing the Journey. We hope you found something worthwhile here with us today. A new coping strategy, a relatable story. The comfort of knowing you're not alone. I am so happy to be a part of creating this community for all of us, and especially for people living with Chronic Migraine. If you haven't found a treatment plan that is working for you, please do reach out to your headache specialist to explore your options. I truly hope this has helped you find a bit of comfort and maybe a smile. Maybe? See you next episode.

The Head Start: Embracing the Journey is hosted by myself, Nora McInerny, executive produced by Yvonne Sheehan, our head of post-production is James Foster, our researcher is Ciara Kaiser, and our writer is Jon Erwin. Original music by Soundcat Productions and Artlist and stay tuned for Important Safety Information

Speaker 1:

IMPORTANT SAFETY INFORMATION continued

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), Xeomin^® (incobotulinumtoxinA), Jeuveau^® (prabotulinumtoxinA-xvfs), Daxxify^® (daxibotulinumtoxinA-lanm), or Letybo^® (letibotulinumtoxinA-wlbg) (this may not be a complete list of all botulinum toxin products); 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^®, Xeomin^®, Jeuveau^®, Daxxify^®, or Letybo^® in the past (this may not be a complete list of all botulinum toxin products; 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 thinner.

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.

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