Hi @jbarb.. I'm so sorry to hear of your migraine struggles. They are miserable and debilitating to deal with. I've gotten relief from botox every 3 months ( but it took 2 rounds to produce). Aimovig and Emgality both did their job but after 8+ months they each became less effective. To that, my neurologist says, then we keep rotating once you build tolerance. I'm now using Ajovy which are 3 needles once every 90 days. I'm back on track...til the next time. Also, my Neuro suggested Cambia, a powdered abortive medicine, mixed with water, taken upon onset of severe migraine. It is a game changer!

My only other advice is about clear diagnosis. I was also diagnosed with occipital neuralgia which led me to greater and lesser occipital nerve blocks in my head which then turned into several radio frequency ablations to kill the nerves.

I also have Small Fiber poly neuropathy. It is whole body but is predominant in my head, neck and shoulders so, that all presents mitigating factors for me.

Some days I don't know if I'm coming or going! Trying to navigate the root of pain and cause can be a challenge. No more injections/RFA's for me as I don't believe they helped my cause and perhaps contributed to permanent nerve damage.

Hoping to have helped you in some small way. May you find answers and relief soon. Be well -
Rachel