To Whom It May Concern,

I am a migraine headache patient and have suffered with this condition accompanied by spinal pain and contracted muscles for approximately fourteen years. I was involved in two serious car accidents in which my head cracked the windshield and various other sporting accidents resulting in permanent spinal injury. During this time period, I have experienced small windows of pain relief that can be measured in terms of days or sometimes only hours in which I haven't had some component of pain associated with migraine and spinal dysfunction. Basically, I had to learn how to "live" with this condition by changing lifestyle, trying new medications, light stretch exercises, cold pacs, hot moist heat pacs, new medical technology or ancient remedies like acupuncture. Everything that I tried was marginally helpful and most certainly temporary.

In the early eighties, I began practicing dental hygiene which requires a lot of upper body strength and control. I had to hold my elbows up and away from my body as I worked on patients which caused extreme fatigue and aggravated muscle contractions up the back of my neck and down my left shoulder and into my arm. After four years of dental hygine, I was experiencing constant migraines and severe muscular pain that weakened both arms and hands, especially on the left side. Medication took the edge off, but the pain never went away completely. My daily medications consisted of Midrin for headache, Robaxin for muscle contraction, maybe compazine for nausea, blood pressure medications to keep the vessels within an acceptable range in order to prevent a migraine and aspirin for pain and inflamation. In the early days of migraine study, there were few medications available and the ones that were available had only minimal effects. I had reached the point where I had to consider a career change.

I decided to go back to college and study pharmacy and in 1994, after completing school, I received a license to practice in the state of Georgia. It was during this time that Imitrex became available to treat migraines. Imitrex proved to be very effective in treating my headaches temporarily, however it had no effect what so ever on the deep muscular pain in my arm, shoulder and base of my neck. The mechanism of Imitrex is only designed to treat migraines in progress, not the contracted muscles that cause migraine. Therefore, these muscles remain constantly inflamed and trigger migraine pain every day of my life.

Then, in 1998, I became aware of an injection medication derived from botulin toxin marketed under the brand name "Botox®" which can prevent the activation of muscle contraction. I researched use and safety of Botox® and discovered that it has several indications for use, but mainly for a condition known as spasmodic torticollis which is when the muscles of the neck become extremely contracted. An injection direcly into the contracted muscle results in deactivation of the contraction with little muscle weakness and a high safety profile. I contacted the National Spasmodic Torticollis Association and was referred to Dr. Gwynn in Atlanta. The first appointment with Dr. Gwynn consisted of discussing my health history and fourteen year battle with spinal pain and migraines and if Botox® treatment could help. Dr. Gwynn displayed a positive attitude at our first meeting as he discussed the possibilities for pain and migraine relief. We decided to begin the first treatment that very day and before the appointment was over, I experienced pain relief in the back of my neck and the low grade migraine subsided. Dr. Gwynn recommended that I come in about every three months for reinjection which is the average amount of time that Botox® is effective or when its effects begin to wear off. Each visit proves to be successful in decreasing the number of headaches experienced and in decreasing the severity of breakthrough migraines and neck/shoulder pain responsible for causing them in the first place.

This treatment has changed my life and I am grateful beyond words. Dr. Gwynn has restored my hope for having a brighter future. Early on, I knew that I was with the right doctor because he had the skills from medical school and the experience that comes from treating patients, but medical school and experience cannot teach compassion, that is a unique quality that comes from the heart. Dr. Gwynn has that compassion and I'm lucky to be one of his patients. Many thanks to you Dr. Gwynn.

Cherry Haughton

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