Hi and welcome to the Migraines & Headaches Community.
One thing you need to know is treating migraines...especially long term migraines like you have....it is a marathon, not a sprint. Everyone is different. What triggers yours may not trigger mine and what treats mine may not treat yours. And for most ppl it takes a combo of meds to treat them, not just one. So, then you get into trying to figure out what combination of meds will work with you and there is just not much you can do about that. No one wants to hear this cause everyone is looking for something to fix it right now! And that just isn't always possible. And keep in mind it takes a good 4-12 weeks for you to know if the medication is helping or not.
In the meantime, here are a few tips that may help you. You can try any of them or all of them and hopefully something on the list will help.
1. There are several symptoms of migraines and what causes the pain of a migraine is the blood vessels in your brain become dilated. So, sometimes it helps it you put a bit of pressure on your head. I am sure you have already been doing this unconsciously with your hands from time to time. So, get a bandanna or a cloth headband and wrap it snugly around your head.
2. If you rub Mentholatum across your forehead and on your temples that helps relax those tense muscles. You can do this with or without the wrap, depending on if you like the heat or not.
3. Try either a cold or hot pack, whichever is more comfy to you.
4. The best OTC meds that I have found that works is Excedrin. It is a combo of Aspirin, Tylenol and Caffeine and that happens to be an excellent combo for migraines.
5. I mentioned caffeine before...well, drink coffee, Mt Dew, take Vivirin...sometimes a mega dose of caffeine will stop it in its tracks.
6. If you get nauseous or dizzy get some Meclizine from the pharmacy (the stuff behind the counter) you can take 25mg three times a day as needed. Yes it works on both.
Obviously you need to get a diagnosis and the correct one. I hope the doctors take you seriously and do the tests necessary. It is quite unusual with migraines getting worse after 40 or 50 so you need to check this up.
Botox is not always very effective, there are better medicines. Usually beta blockers or amitriptyline is considered first choice drugs.