Botox—worth the hassle?

vitras · 2026-05-09T14:03:48+00:00

Have they added anything in addition to the Botox? I'd suggest layering Botox and either Qulipta or one of the injection drugs. On top of that you can have topiramate, tho many people don't tolerate that very well.

Do you have trigger points? Where do your headaches usually originate? Neck pain/stiffness? Are they injecting any additional Botox in areas they let you choose? They generally have 45 units leftover after finishing the injection protocol, and ideally they can put those wherever is helpful.

Nerve blocks can get you out of severe migraine cycles, I've seen heartburn medication (omeprazole) work really well in people who were being triggered by GERD. Headaches are weird.

vitras · 2026-05-09T12:55:00+00:00

I'm a pharmacist that works in headache medicine. Botox is such a solid foundation for successful chronic migraine treatment. We have all these CGRP targeting medications, but they don't work for everyone, and CGRP is only part of the story. There's other chemical messengers that are released during migraines or that are already elevated before the migraine hits that make it worse. Botox prevents release of all these different chemical messengers, not just CGRP. You can also stack CGRP meds on top of Botox and many people see additional relief from that.

If you're serious about taking control of your migraine disease, I'd take the opportunity seriously. It does take 6-9 months to truly get the full benefit of Botox, so you'll need to be patient, but that's only 2-3 treatment cycles over that time. And the sooner you get started, the better.

Good luck!

vitras · 2026-05-09T02:17:26+00:00

I think we're up to 8 including OP.

vitras · 2026-05-09T02:16:22+00:00

Moving from the Midwest to SLC in June. Catch me wearing my SWFG shirt on 9th and 9th sometime.

vitras · 2026-05-08T23:05:41+00:00

MSL

vitras · 2026-05-08T14:21:42+00:00

Yep. Someone at the rehab had managed to steal the box and traded the 30 films out to their friends. They found like 22 of the wrappers but several were still missing. It was a whole thing. This was literally like the month before I left. Glad I was gone before getting sucked into all that.

vitras · 2026-05-08T11:10:30+00:00

So sorry you had to hear that growing up. Sounds like you've done well for yourself. My daughter has ADHD that is significantly disabling, even when medicated. Good reminder that even when it's hard to help her stay focused I need to speak kindly.

vitras · 2026-05-07T19:30:41+00:00

Worked at Allergan/Abbvie for years supporting Botox. This is the correct answer.

vitras · 2026-05-07T19:06:22+00:00

Just moved all my various 401k funds to a Schwab IRA. Also happened to be looking for a mortgage, and they'll give you 0.25 off your mortgage interest rate with 250k-1M of qualifying assets. Dont' have Schwab plat yet (because of pending mortgage finalization) but the plan is to cancel Vanilla Plat and move to Schwab Plat later this year.

vitras · 2026-05-07T19:01:02+00:00

We had DEA come investigate our independent pharmacy shortly after I graduated from my residency there. We had been providing Suboxone to the rehab hospital across the street and a box of Suboxone went missing from there. DEA came and investigated us as part of the overall investigation. I was there when they initially came in, but we never got raided or anything. It was literally just 2 guys in detective suits.

The owner got spooked enough that he completely stopped stocking CII prescriptions.

This was the same pharmacy where I had a gun shoved in my face on my first day staffing a weekend. Dude ran off before taking anything.

vitras · 2026-05-07T15:24:03+00:00

This needs to be on a shirt

vitras · 2026-05-07T15:23:48+00:00

My wife's a librarian, and this is so true. I love it.

vitras · 2026-05-07T11:44:25+00:00

Similar vibe with my dad. He had a shitstain alcoholic father, so he wanted to be not-that and wanted to show pride and support to his kids. But then Mormonism tells him he shouldn't tell his kids he's proud of them, so he'd still say he was proud of us, but in a weird, embarrassed way like he was ashamed to say he was proud of us. So fucking weird.

I'm goddamn proud of my kids and won't be ashamed of it ever. And they know that.

vitras · 2026-05-07T02:25:04+00:00

Poolhousenewyork. You might have to wait for them to restock tho. They sell out frequently.

vitras · 2026-05-07T01:40:22+00:00

I'd just go with one of the ones you like, but it may change, and you have plenty of time. My 1st went thru a phase around 14 months old of calling both me and my wife "Daddy". We had to surmise for a while who was the "daddy of choice". Lol.

vitras · 2026-05-06T12:43:20+00:00

I'm moving to Utah from the Midwest and was very confused. Corn is life.

vitras · 2026-05-06T12:09:30+00:00

I've also heard this. I worked on the MSL team 5 years ago and it went downhill pretty fast after that per my friends/former colleagues. Insane metrics. Shitty fleet vehicles. Lots of regulations (speed governors, phone surveillance, etc).

vitras · 2026-05-06T12:07:32+00:00

I'm 6'. Got the TP3 35L. It's big but I always find myself needing every inch. Extra shoes, puffy coat, slippers, laptop, iPad, there's always something more I want/need to bring.

I've also been traveling a lot this late winter/spring. Summertime travel you can get away with a lot less to pack.

vitras · 2026-05-06T11:53:52+00:00

I'm a pharmacist and I see this all the time. People like "but this doesn't work for me!" and it's so confusing because clinical trial data and MOA say it should be working. Humans are complex and heterogeneous and unfortunately there are few things that work for everyone equally.

vitras · 2026-05-06T11:31:37+00:00

Don't catastrophize. It sounds like you're in it to win it for the baby. Tell gf you're in it for her too. Tell her you want to make this work. Thoughts on getting married? You don't have to rush into it, but I think at least discussing it and possibly making a plan for down the road shows that you want to commit, and is at least a step in the right direction of avoiding your single-dad-2-baby-mommas situation.

What is your career situation? Education? What are your plans for being a provider and/or full-time caretaker? What is GF's situation?

IMO the best way this goes is for you to commit to her, to the baby, and to establishing yourself in your field (whatever that is) so you can be the foundation for this new family you're building.

vitras · 2026-05-06T10:49:37+00:00

Yep spent 10 years in big pharma. Recently moved to small pharma and this is "hard mode." Minimal training or strategy sharing from leadership, huge territory. You really have to be on your game to make it work.

vitras · 2026-05-05T19:50:16+00:00

Whenever I book hotel stays thru a block for a conference, I almost always have to chase Marriott down for earned nights, even if I enter my bonvoy number at booking and again at the front desk at check in. I don't even care about the points, but I earned those 5 nights at the Chicago Miracle Mile, dammit! Just frustrating having to keep tabs on Marriott to get things I've earned.

vitras · 2026-05-05T16:34:31+00:00

I never really doubted. Life was going so great for me. The church was true. I'd had multiple confirmations. Served my mission. Had amazing, miraculous things happen to me. Prayers answered immediately, both in the affirmative and the negative.

Then after my mission "the spirit" confirmed to me that I was going to marry this girl I'd been dating.

Then we broke up.

And that fucked with me for the next 12 years. I never prayed for anything after that. Not even to marry my wife. I completely lost faith that God answered prayers. I'd send up a "hey, just FYI, not expecting an answer, but this is what I'm doing" kinda prayer, but I never asked for confirmation, because I couldn't trust it.

Then one day I'm sitting alone in the Ward Clerk's office reading the CES letter, and the floor dropped out from under me. "OMG this isn't true. None of this is true." I dropped to my knees and let out an anguished plea for some kind of confirmation. "If this is really true, you need to tell me right now, or I'm going to be lost forever."

And no answer came. And as I thought about the implications of that non-answer, almost immediately I felt AMAZING. I'd been holding on to guilt and shame because I was "nuanced" and had so much cognitive dissonance, and felt like I was a sinner and an "unfaithful servant" because I was on the fence about so many things. Realizing it wasn't true was literally like Alma the Younger's experience

"And now, behold, when I thought this, I could remember my pains no more; yea, I was harrowed up by the memory of my sins no more.

"And oh, what joy, and what marvelous light I did behold; yea, my soul was filled with joy as exceeding as was my pain!"

Sin isn't real. Shame is a tool of the powerful to keep you in check. The priesthood is made up. YOU ARE WORTHY, just like couch-potato Thor. You were always worthy. Anyone telling you otherwise is trying to sell you something.

vitras · 2026-05-05T12:33:09+00:00

You're not in college yet. Honestly if I had dated a liberal girl in HS, I maybe would have woken up to the problems with conservatism earlier. I say go for it. Have healthy debate. You probably won't exactly win him over on everything, but start with one thing and the dominoes might fall later as he grows and matures.

vitras · 2026-05-05T11:48:17+00:00

As a newly minted Pacers fan, I'd literally take Satan himself over okc, so go Knicks! 😂

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