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Can Botox for Migraines Help Me?

I began offering BOTOX® injections for chronic migraines at our Pasadena practice in December 2015. Since then I have treated a number of patients who have noticed significant improvement. One patient was having migraines almost on a daily basis, and 1 month after beginning treatment, has had only 2 mild headaches. Another patient I’ve been treating went from having 20 severe migraine headaches per month to 14 (8 mild and 6 moderate), and has not had to take prescription pain medications since her first Botox treatment.

BOTOX® is the only FDA-approved, preventative treatment that is injected by a doctor every 12 weeks for adults with Chronic Migraine (15 or more headache days a month, each lasting 4 hours or more). BOTOX® prevents up to 9 headache days a month (vs. up to 7 for placebo). BOTOX® therapy is not approved for adults with migraine who have 14 or fewer headache days a month.

Most insurances will cover BOTOX® as long as you meet the criteria for chronic migraine (see above) and have tried at least 2 chronic medications, such as beta blockers or other blood pressure medications, Topiramate, anti-depressants, etc. Even if you have experienced some improvement with these medications, you may still qualify for BOTOX®.

The most common side effect of BOTOX® is neck pain. Other side effects which may occur include dry mouth, discomfort or pain at the injection site, tiredness, headache, neck pain, and eye problems, such as double vision, blurred vision, decreased eyesight, drooping eyelids, swelling of your eyelids, and dry eyes. Serious and/or immediate allergic reactions may include itching, rash, red itchy welts, wheezing, asthma symptoms, or dizziness or feeling faint.

If you suffer from chronic migraines and want to see if this course of treatment might be right for you, you should discuss this option with your primary care provider. For more information please call our office at 410.255.2700, or visit the Pasadena office page.


Trang Pham, M.D.Dr. Pham is a Maryland Primary Care Physicians, LLC partner, is certified by the American Board of Family Medicine, and has been performing cosmetic BOTOX® injections since 2008.

Be Kind to Yourself

New research on the mind-body connection

Are you your own worst critic? Do you treat friends and family better than you treat yourself? If you answered “yes” to these questions, you’re not alone. In fact, many of us find it easy to be supportive of others, but we are hard on ourselves for not measuring up in some way.

However, new scientific research is broadening the concept of how important the mind-body connection is to our health. Researchers at Wake Forest University and other institutions are looking at the psychological area of “self-compassion.” The research suggests that actually giving ourselves a break and accepting our imperfections may be the first step to better health. People who score high on tests of self-compassion have less stress and anxiety, and tend to be more optimistic. Data suggests that self-compassion can even influence how much we eat and may help some people lose weight, or stick to an exercise plan over time.

But “cutting ourselves slack” is often thought of as being undisciplined or self-indulgent, right? Researchers counter this much-held thought by saying that a cycle of self-criticism or negativity actually leaves us feeling less motivated to change.

“We don’t understand exactly how optimistic thinking translates to better health, but we see examples of it every day,” says Trang Pham, M.D. of MPCP Pasadena. “We know that thoughts and mood affect brain chemistry and immune function, so this is part of the answer. We also know that people who have a sense of control or optimism recover faster or deal better with disease or injury.”

Doctors aren’t saying to give up the daily practices that go with a healthy lifestyle- eating right, exercise, taking medications if needed – but to try to include positive thinking or self-compassion as much as possible. “Changing habits is hard, and this goes for our thought patterns as well,” says Dr. Pham. “But, as primary care doctors we know that making small changes can have a huge impact on health.”

Try some of the following tips to help influence positive thinking:

  • Monitor negative self-talk. If the thoughts that run through your head during the day are mostly negative, try to switch that around. For example, instead of thinking “I’ve never done this before,” try, “Here’s a chance to learn something new.”
  • Identify small changes. To become more optimistic, identify parts of your life that you typically think negatively about- work, your daily commute, relationships, parenting- and pick one area to approach in a more positive way. Either come up with a better idea to control/improve the situation, or realize that you may just need to change your attitude about it.
  • Surround yourself with positive people. Research shows that our relationships play a key role in our outlook and health, so keep ties with those who are supportive and add some fun to your life.
  • Act positive. Many experts ascribe to the “fake it til you make it” concept of becoming more optimistic. If you actually act happy, or force yourself to smile more often or try to find the humor in a situation, it becomes more natural over time.

With actual practice you can change your self-compassion. You may even improve the lives of those around you in the process!

Trang Pham, M.D.
Dr. Trang Pham, an MPCP partner who practices in our Pasadena office, is certified by the American Board of Family Medicine. She received her medical degree from Jefferson Medical College and completed a residency program in Family Practice at University of Maryland Medical Center.