Written by Nicole Safran, Presented to you by Chronic Migraine Awareness, Inc.

I am sure almost all of us have had some disruption of care during COVID-19, whether it’s in-person doctor’s appointments or routine procedures  such as Botox, never blocks, and injections.

Like many of you, I’ve also had several disruptions in care. I was due for my Botox on April 7th at my pain management doctor in NYC, one of the epicenters of the virus. I received a call that my Botox, IV infusions, and lumbar epidural were canceled. She has a private practice and was closed. To date the office remains closed for the foreseeable future. On one hand I fully understand, flattening the curve is vital and protecting the health of herself and her family. However, part of me was angry. Especially since she has a private practice and was not under the control of an academic institution, regulating whether or not she could practice. The same day I heard from my headache specialist’s office where I receive monthly occipital nerve blocks and SPG blocks. The academic hospital was mandating non-essential visits and procedures canceled. The above is not for me to compete with anyone or “prove” anything, but rather show the disruptions in my care have impacted my health and wellbeing. 

I was in pain, suffering and my health declining, I felt there was nothing anyone could or cared to do. I was given a prescription for one of the new migraine abortive medications, which worked okay, but it was only 8 pills a month. I now had migraine every day with the intensity increasing along with other symptoms.

I reached out to my headache specialist and pain management doctor to ask if they knew of any providers currently providing Botox. Surprisingly, I was put in touch with another pain management doctor within a day. To note, he also had a private practice. We had a telemedicine appointment within the week to discuss my medical and migraine history.

I’m sure many of you are wondering how I got my Botox released. I am part of the Botox savings program. My pain management doctor, who has a private practice, released the Botox too me the day prior to my Botox appointment. The new doctor processed it through the Botox savings program. I am sure things would be more challenging if it was approved directly through my insurance. However, I am on both a CGRP and Botox, and my insurance makes me choose only one for approval.

The day of my Botox appointment came, and I was so nervous. I was going to another provider after getting Botox from the same provider for the past 3 years. New providers always give me anxiety.

Fortunately, I got my Botox on the exact date I was due, April 7th, 84 days since my last injection. This was one of the first times I went outside, since NY was quarantined, so I was a bit anxious walking from where I parked to the office. I went in with my face mask and was taken right back to the exam room. The doctor instantly put me at ease. He even has this freeze spray that makes the injections less painful, something I never had before. It was a little different than I was used to, but I was very satisfied.

About a week later I had a horrific migraine. It was one of those can’t open your eyes, intense nausea, and every movement makes you feel as if your head is going to burst. Luckily, he was able to see me the next day where I got occipital nerve blocks and an IV push of medications to break the attack.

I’ve even connected two people with his practice where they can hopefully receive their Botox and injections for the time being.

I want to acknowledge two things. Going to a private pain management specialist is not an accessible option for everyone due to the costs. Additionally, not all physicians will release Botox to be used by another provider.

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