Smooth Out Migraines




A local surgery center uses BOTOX® to take the wrinkle out of migraine pain.

Laura Olberding is a busy lady. When we finally caught up with her last month, she was experiencing a host of technical difficulties at work, such as a week-long computer meltdown. It would be enough to give any client-service champion a headache—something that Olberding knows about all too well.

“If I was going to get a headache, I would have gotten one in the past year or year and a half,” says Olberding of her bustling career and lifestyle.

But thanks to J.B. Moore, MD, FACS, at Heartland Surgical Specialty Hospital in Overland Park, Olberding says that she can now march through life without the painful migraines that would have floored her for hours in the past.

“Dr. Moore completely changed my life,” says Olberding about the plastic surgeon. “I don’t have to worry about redoing my day because of a migraine.”

Olberding suffered from intense migraines ever since she was three or four years old. Her most horrible headaches would last up to eight hours and would happen three to five times per month. Olberding would lie on the bathroom floor waiting for relief that never came. She would miss meetings and appointments at work on a regular basis.

“I would be violently ill and throwing up,” says Olberding. “When I had a migraine, I wouldn’t drive. I wouldn’t eat. I wouldn’t turn on a light.”

Often, Olberding would end up at the hospital because the pain was so excruciating that she wanted to be “knocked out.”

“Migraines are a totally different classification of pain,” says Olberding. “Once I even put my head in between a mattress and a box spring and told my brother to sit on it (the mattress) to help.”

After years of trial and error with multiple migraine drugs and alternative therapies, Olberding’s family saw a news story about a study that was using BOTOX® to fight migraines. They immediately urged Olberding to enroll in the study. She didn’t hesitate.

“I went to Dr. Moore and got a BOTOX shot in the frown muscle in my forehead,” she said. “And I didn’t have a migraine for two months.”

Olberding saw the decrease in frequency of her migraines as success. She went back to Dr. Moore for another BOTOX injection that resulted in an even more dramatic decrease. After reviewing Olberding’s response to the shots, Dr. Moore permanently removed the frown muscle in her forehead.

“The BOTOX is like a test,” says Dr. Moore who uses the injections to identify migraine trigger points in patients like Olberding prior to surgery. “Eighty percent of patients respond to BOTOX, and 90 percent of operated patients get a decrease in their migraines with 50 percent getting complete relief.”

The major physical trigger points for migraine sufferers are in the back of the neck, near the temples, inside the nose and right above the eyebrows where sensory nerves with several pain fibers connect directly to the brain without going through the spinal cord as a buffer.

Dr. Moore believes that trigger point muscles pinch the sensory nerves to create pain, causing a migraine. He says that BOTOX injections lessen or relieve this pain by temporarily paralyzing the muscles around the sensory nerves. The surgery to remove the muscles may permanently reduce the pain and the migraines.

“Every time you frown, a nerve is being pinched,” says Dr. Moore who explained Olberding’s trigger point. “Bright lights, stress and loud sounds all cause you to grimace.”

Olberding is no longer grimacing. However, she says her lack of a furrowed brow was worth it.

“I was back to work the next day,” says Olberding about her recovery after the outpatient surgery. “Dr. Moore is meticulous. He’s an artist.”

Dr. Moore says that Olberding’s case was the catalyst for opening the doors at the Migraine Center at Heartland Surgical Specialty Hospital. The Migraine Center opened in March 2011 and is unique to the Kansas City area.

“We often see desperate patients who want to be on the surgery schedule tomorrow,” says Dr. Moore. “These patients are so eager to get relief for migraines.”

Surgery candidates must meet certain criteria. Patients must have a significant history of chronic migraines and must be under the care of a neurologist to rule out any other possible causes. Patients must have tried other medical treatments without success and must respond positively to BOTOX injections before surgery.

Dr. Moore tracks patient results closely, and all patients are required to keep a diary of their experiences. These results are compared with other surgeons in the United States who are studying the results of the relatively new procedure.

“There is no 100 percent cure for migraines,” says Dr. Moore. “A positive result is a 50 percent reduction in frequency, duration and/or severity in migraines.”

The typical cost for the migraine surgery is approximately $4,500 per trigger zone, which includes surgeon and hospital fees. The BOTOX treatments cost almost $300 per trigger zone for duration of three to four months.

The Migraine Center is located in Heartland Surgical Specialty Hospital in Overland Park. Patients who are interested in more information should visit www.midwestmigrainesurgerycenter.com or call (913) 951-2031.