I had the experience of never being told by 2 PCP and 2 neuros about MOH, though luckily they all treated me appropriately for chronic daily headaches and migraines right from the start. I did start out with the odd migraine every couple months while pregnant and as my kids went thru preschool, my headaches became more frequent until I was taking advil regularly during the day and saving my fioricet (the "migraine" medicine) for the headaches that stopped me in my tracks. This first PCP did start me on topomax but never really diagnosed migraines b/c I wasn't throwing up like my mother did (when I gave a history). That didn't come until the 2nd PCP and he really worked with me and got me started on the path to a more educated life.

Fast forward 12 years later to a headache specialist and Botox which seems to help but the 2nd round may have given me unnerving side effects-swallowing difficulties, numb nose sensation, another round of neck pain (though I was also having some horrid allergy/asthma symptoms and started new meds for those). Fortunately 2 months into the 2nd round after the initial boost has worn off, I can say I'm a bit happier. But back to the MOH - while they hand you a packet of educational material at the first visit, really, the whole topic of MOH is not a hot topic. Sadly, I've learned more on my own on the internet that from any doctor.

Chronic pain is very difficult to deal with and I'm as tough as they get but it has just about worn me down at this point. Emotionally and physically - I literally have to sleep all day some days just to rest from working a full week. At my last visit to the neuro he asked what I wanted. He truly seemed confused. UH? NO MORE PAIN?! My old life back from 15 yrs ago? But I'd be happy with no side effects even if I had to take a handful of meds and have no neck pain, no nausea, and only a mild headache every month or two! I know this is the life I have now and I'm not going to stop living b/c of it, but at the same time, we also have to function in our day to day - work, take care of our families, grocery shop, socialize, etc. It's very hard NOT to grab 2 advil, a maxalt, some excedrin, or even a bottle of blarney juice from the some crazy ad in the back of People magazine even if you doubt they'll work, if there is just a glimmer of hope that they will get you thru a child's play, soccer game, a run to the store for the basic groceries for dinner. whatever.