Unlike some resurfacing or surgical procedures, after which there is possible pigmentation or scarring, when Botox is done correctly, it can be done on all skin tones. “This is a procedure [and] product that crosses all divides,” says Dr. Matarasso. “Men, women, Caucasian, African-American, Asian, Indian. I don’t think there is a demographic that has not enjoyed the benefit of this product.”
In patients who are not catheterizing, post-void residual (PVR) urine volume should be assessed within 2 weeks post-treatment and periodically as medically appropriate up to 12 weeks, particularly in patients with multiple sclerosis or diabetes mellitus. Depending on patient symptoms, institute catheterization if PVR urine volume exceeds 200 mL and continue until PVR falls below 200 mL. Instruct patients to contact their physician if they experience difficulty in voiding as catheterization may be required.
It’s been a little over three weeks. The neurologist said that after two weeks, my migraines and headaches should be substantially reduced. I haven’t spoken about it much even to people close to me because I didn’t want to jinx it, but right around the two-week mark, my headaches faded. I did have a migraine the day after the injections, followed by a lingering headache for about a week, but my neurologist didn’t think it was caused by the Botox. I know my body and have a feeling it was, especially because the introduction or removal of medication can exacerbate lupus symptoms and flares, so I was put on a prednisone taper just to be safe.
Postmarketing safety data from BOTOX and other approved botulinum toxins suggest that botulinum toxin effects may, in some cases, be observed beyond the site of local injection. The symptoms are consistent with the mechanism of action of botulinum toxin and may include asthenia, generalized muscle weakness, diplopia, ptosis, dysphagia, dysphonia, dysarthria, urinary incontinence, and breathing difficulties. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulti es can be life threatening and there have been reports of death related to spread of toxin effects. The risk of symptoms is probably greatest in children treated for spasticity but symptoms can also occur in adults treated for spasticity and other conditions, and partic ularly in those patients who have an underlying condition that would predispose them to these symptoms. In unapproved uses, including spasticity in children, and in approved indications, symptoms consistent with spread of toxin effect have been reported at do ses comparable to or lower than doses used to treat cervical dystonia and spasticity. Patients or caregivers should be advised to seek immediate medical care if swallowing, speech or respiratory disorders occur.
This product contains albumin, a derivative of human blood. Based on effective donor screening and product manufacturi ng processes, it carries an extremely remote risk for transmission of viral diseases. A theoretical risk for transmission of Creutzfeldt -Jakob disease (CJD) is also considered extremely remote. No cases of transmission of viral diseases or CJD have ever be en reported for albumin.
BOTOX® can be used on the forehead lines, frown lines, crow’s feet, bunny lines (lines in the nose), chin (for dimpling), skin bands on the neck, and around the mouth (for smoker’s lines and down-turned corners of the mouth). Wrinkles caused by sun damage and gravity often will not respond to BOTOX®. It is important to re-emphasize that BOTOX® is NOT a facial filler (that is, it does not fill existing wrinkles) – it merely relaxes the muscles that are creating those wrinkles.
After the injection moves from the dermis and into the desired muscle, the nerves there are blocked—rather, their synapses, are blocked—by the Botox. So even though your brain my fire and signal for your body to move a particular muscle, Botox effectively blocks that firing and keeps the muscle from moving. The injected muscle can no longer contract, which causes the wrinkles to relax and soften, and also helps prevent new ones from forming.
No definitive serious adverse event reports of distant spread of toxin effect associated with dermatologic use of BOTOX® Cosmetic at the labeled dose of 20 Units (for glabellar lines), 24 Units (for lateral canthal lines), 40 Units (for forehead lines with glabellar lines), 44 Units (for simultaneous treatment of lateral canthal lines and glabellar lines), and 64 Units (for simultaneous treatment of lateral canthal lines, glabellar lines, and forehead lines) have been reported.
Above all, I try to be gentle with myself and my children. It’s easier said than done. Mom guilt and migraine guilt weigh heavy on my heart, and I continue to remind myself that I’m doing my best. I give myself a break as I do with my children when they’re having a bad day. I’m patient with them and try to give myself the same respect. As a mom, it seems like my job is never done and that I can always do better. The reality is, no one is perfect, and we all have our flaws. We don’t expect our children to be perfect, and we should not expect ourselves to be. We do what we can when we can and take each day as it comes. I find joy in the smallest things and find that being grateful and mindful remind me off all the blessings I have, despite my unpredictable and chronic migraine attacks.
Some doctors, however, say their experience with their own patients indicates Botox — which was approved by the FDA in 2010 to treat migraines — is quite effective for this purpose. Lawrence Newman, MD, a neurologist and director of the headache division at NYU Langone Medical Center in New York City, says many of his patients have experienced a significant decline in the number of headaches per month after receiving Botox. In many cases, he says, it has cut down that number by 50% and frequently more than that.
Andrew M. Blumenfeld is director of The Headache Center of Southern California. Most of his research has focused on the use of OnabotulinumtoxinA in the treatment of chronic migraine. He helped develop the injection paradigm approved by the United States Food and Drug Administration and has taught providers around the world on practical aspects of this treatment option.
With small children, I find that being prepared allows us to function better. My family food preps for the week with fruits, veggies and snack-size portions. I keep the snacks on a shelf that my children can easily reach, so they can choose a healthy option if they’re hungry and I’m unable to get up. Meals are well-thought-out and prepared ahead of time, in case of a migraine attack. I always have a back-up plan for my children. I have alternative arrangements for them after school if I am unable to care for them or myself. I also have activities planned. I keep crafts around that occupy my children’s time but also keep sound and stress to a minimum. We color, build Legos and play with Play-Doh all while sitting in rooms with strategically placed lights and brightness. I save screen time for when I need a few moments of quiet. We keep a routine and schedule, but also stay flexible. A schedule allows my family to know what to expect for our days and evenings. My children are able to continue their day if I have a migraine attack because they know what needs to be done and in what order. We have strict bedtimes that allow my children’s brains to grow and mine to recover. Along with this, I have taught them that moms don’t always feel well, and we may need to adjust the schedule from time to time to accommodate my migraine. I keep medication that can fight a migraine attack with me for use on the go and safely at home. I see a neurologist on a regular basis who helps me manage my migraine symptoms and medication.
There are several medically related BOTOX ® treatments that are usually covered by insurance, including treatment for blepharospasm (uncontrollable eye twitching), excessive sweating, constant pain, and others. Insurance coverage for cosmetic uses of BOTOX® injections is much less common, but you should consult your insurance provider to find out if you have coverage for BOTOX® treatment. Also, Allergan, the maker of BOTOX ®, provides a Reimbursement Hotline at 1-800-530-6680. An Allergan representative can help you determine whether your procedure is covered by insurance.
The co-primary endpoints were the average of the change from baseline in modified Ashworth Scale (MAS) ankle score at Week 4 and Week 6, and the average of the Physician Global Assessment of Response (CGI) at Week 4 and Week 6. The CGI evaluated the response to treatment in terms of how the patient was doing in his/her life using a 9-point scale from -4=very marked worsening to +4=very marked improvement).
Jump up ^ van Ermengem E (1979). "Classics in infectious diseases. A new anaerobic bacillus and its relation to botulism. E. van Ermengem. Originally published as "Ueber einen neuen anaëroben Bacillus und seine Beziehungen zum Botulismus" in Zeitschrift für Hygiene und Infektionskrankheiten 26: 1–56, 1897". Reviews of Infectious Diseases (in German). 1 (4): 701–19. PMID 399378. Original doi:10.1007/BF02220526
These injection sites have been carefully chosen to treat specific nerve endings that are sending pain signals. BOTOX for migraines has proven to be a highly-effective treatment for people who are living with the painful, debilitating symptoms of chronic migraines. BOTOX will be carefully and correctly injected into muscles just beneath the skin. The procedure is not particularly painful, with a sensation of pinpricks.
Autonomic dysreflexia in patients treated for overactive bladder due to neurologic disease. Autonomic dysreflexia associated with intradetrusor injections of BOTOX® could occur in patients treated for detrusor overactivity associated with a neurologic condition and may require prompt medical therapy. In clinical trials, the incidence of autonomic dysreflexia was greater in patients treated with BOTOX® 200 Units compared with placebo (1.5% versus 0.4%, respectively).