UPPER LIMB BOTOX TREATMENT
Indications
BOTOX® (onabotulinumtoxinA) is a prescription medicine that is injected into muscles and used:
to treat leakage of urine (incontinence) in adults with overactive bladder due to neurologic disease who still have leakage or experience too many side effects after trying an anticholinergic medication in people 18 years and older
to prevent headaches in adults with chronic migraine who have 15 or more days each month with headache lasting 4 or more hours each day in people 18 years or older
to treat increased muscle stiffness in elbow, wrist, and finger muscles in people 18 years and older with upper limb spasticity to treat the abnormal head position and neck pain that happens with cervical dystonia (CD) in people 16 years and older to treat certain types of eye muscle problems (strabismus) or abnormal spasm of the eyelids (blepharospasm) in people 12 years and older
BOTOX® is also injected into the skin to treat the symptoms of severe underarm sweating (severe primary axillary hyperhidrosis) when medicines used on the skin (topical) do not work well enough in people 18 years and older.
BOTOX® Cosmetic is a prescription medicine that is injected into muscles and used to improve the look of moderate to severe frown lines between the eyebrows (glabellar lines) in people 18 to 65 years of age for a short period of time (temporary).
It is not known whether BOTOX® and BOTOX® Cosmetic is safe or effective to prevent headaches in patients with migraine who have 14 or fewer headache days each month (episodic migraine).
It is not known whether BOTOX® and BOTOX® Cosmetic is safe or effective to treat increased stiffness in upper-limb muscles other than those in the elbow, wrist, and fingers, or to treat increased stiffness in lower-limb muscles. BOTOX® has not been shown to help people perform task-specific functions with their upper limbs or increase movement in joints that are permanently fixed in position by stiff muscles. Treatment with BOTOX® is not meant to replace your existing physical therapy or other rehabilitation that your doctor may have prescribed.
It is not known whether BOTOX® and BOTOX® Cosmetic are safe or effective for severe sweating anywhere other than your armpits.
IMPORTANT SAFETY INFORMATION
BOTOX® and BOTOX® Cosmetic may cause serious side effects that can be life threatening. Call your doctor or get medical help right away if you have any of these problems any time (hours to weeks) after injection of BOTOX® and BOTOX® Cosmetic:
Problems swallowing, speaking, or breathing, due to weakening of associated muscles, can be severe and result in loss of life. You are at the highest risk if these problems are pre-existing before injection. Swallowing problems may last for several months
Spread of toxin effects. The effect of botulinum toxin may affect areas away from the injection site and cause serious symptoms including: loss of strength and all-over muscle weakness, double vision, blurred vision and drooping eyelids, hoarseness or change or loss of voice (dysphonia), trouble saying words clearly (dysarthria), loss of bladder control, trouble breathing, trouble swallowing. If this happens, do not drive a car, operate machinery, or do other dangerous activities
There has not been a confirmed serious case of spread of toxin effect away from the injection site when BOTOX® has been used at the recommended dose to treat chronic migraine, severe underarm sweating, blepharospasm, strabismus, or when BOTOX® Cosmetic has been used at the recommended dose to treat frown lines.
Do not take BOTOX® or BOTOX® Cosmetic if you: are allergic to any of the ingredients in BOTOX® (see Medication Guide for ingredients); had an allergic reaction to any other botulinum toxin product such as Myobloc® (rimabotulinumtoxinB), Dysport® (abobotulinumtoxinA), or Xeomin® (incobotulinumtoxinA); have a skin infection at the planned injection site.
Do not take BOTOX® for the treatment of urinary incontinence if you: have a urinary tract infection (UTI) or cannot empty your bladder on your own and are not routinely catheterizing.
The dose of BOTOX® and BOTOX® Cosmetic is not the same as, or comparable to, another botulinum toxin product.
Serious and/or immediate allergic reactions have been reported. These reactions include itching, rash, red itchy welts, wheezing, asthma symptoms, or dizziness or feeling faint. Tell your doctor or get medical help right away if you experience any such symptoms; further injection of BOTOX® or BOTOX® Cosmetic should be discontinued.
Tell your doctor about all your muscle or nerve conditions such as amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease), myasthenia gravis, or Lambert-Eaton syndrome, as you may be at increased risk of serious side effects including severe dysphagia (difficulty swallowing) and respiratory compromise (difficulty breathing) from typical doses of BOTOX® or BOTOX® Cosmetic.
Tell your doctor if you have any breathing-related problems. Your doctor will want to monitor you for any breathing problems during your treatment with BOTOX® for upper limb spasticity or for detrusor overactivity associated with a neurologic condition.
Cornea problems have been reported. Cornea (surface of the eye) problems have been reported in some people receiving BOTOX® for their blepharospasm, especially in people with certain nerve disorders. BOTOX® may cause the eyelids to blink less, which could lead to the surface of the eye being exposed to air more than is usual. Tell your doctor if you experience any problems with your eyes while receiving BOTOX®. Your doctor may treat your eyes with drops, ointments, contact lenses, or with an eye patch.
Bleeding behind the eye has been reported. Bleeding behind the eyeball has been reported in some people receiving BOTOX® for their strabismus. Tell your doctor if you notice any new visual problems while receiving BOTOX®.
Bronchitis and upper respiratory tract infections (common colds) have been reported. Bronchitis was reported more frequently in people receiving BOTOX® for their upper limb spasticity. Upper respiratory infections (common colds) were also reported more frequently in people with prior breathing-related problems.
Human albumin and spread of viral diseases. BOTOX® and BOTOX® Cosmetic contains albumin, a protein component of human blood. The potential risk of spreading viral diseases (eg, Creutzfeldt-Jakob disease [CJD]) via human serum albumin is extremely rare. No cases of viral diseases or CJD have ever been reported in association with human serum albumin.
Tell your doctor about all your medical conditions, including if you have: plans to have surgery; had surgery on your face; weakness of forehead muscles, such as trouble raising your eyebrows; drooping eyelids; any other abnormal facial change; have symptoms of a urinary tract infection (UTI) and are being treated for urinary incontinence. Symptoms of a urinary tract infection may include pain or burning with urination, frequent urination, or fever; have problems emptying your bladder on your own and are being treated for urinary incontinence; are pregnant or plan to become pregnant (it is not known if BOTOX® or BOTOX® Cosmetic can harm your unborn baby); are breastfeeding or plan to breastfeed (it is not known if BOTOX® or BOTOX® Cosmetic passes into breast milk).
Tell your doctor about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal products. Using BOTOX® or BOTOX® Cosmetic with certain other medicines may cause serious side effects. Do not start any new medicines until you have told your doctor that you have received BOTOX® or BOTOX® Cosmetic in the past.
Especially tell your doctor if you: have received any other botulinum toxin product in the last 4 months; have received injections of botulinum toxin such as Myobloc®, Dysport®, or Xeomin® in the past (be sure your doctor knows exactly which product you received); have recently received an antibiotic by injection; take muscle relaxants; take an allergy or cold medicine; take a sleep medicine; take anti-platelets (aspirin-like products) or anti-coagulants (blood thinners).
Other side effects of BOTOX® and BOTOX® Cosmetic include: dry mouth, discomfort or pain at the injection site, tiredness, headache, neck pain, and eye problems: double vision, blurred vision, decreased eyesight, drooping eyelids, swelling of your eyelids, and dry eyes; urinary tract infection and/or inability to empty your bladder on your own (in people being treated for urinary incontinence).
For more information refer to the Medication Guide or talk with your doctor.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088 begin_of_the_skype_highlighting 1-800-FDA-1088 end_of_the_skype_highlighting .
AILESBURY UPDATES: 'Opinion Split On Botox And Migraines' by Dr. Patrick Treacy
The Director of the migraine clinic at Cork University Hospital, Dr Eddie O’Sullivan, has said there is not yet enough evidence to suggest botox should be offered to patients as a reliable first-line treatment for migraine, which affects thousands of people daily in Ireland.
“It is an area of controversy, there are some small international studies done in relation to the treatment of migraine with botox injections, but the outcome didn’t show huge support for the treatment.
“However, there is some evidence to demonstrate that it has been useful in the treatment of tension (or muscle contraction) headaches, but we wouldn’t traditionally recommend it to manage migraines,” said Dr O’Sullivan.
“I think there is evidence to show it could help people with a particular type of tension headache but I think it has a very limited role in managing migraine.” Two studies were presented at a meeting of the American Association for the Study of Headache initially suggested botox can treat certain types of headache.
According to Dr Patrick Treacy, Medical Director of the Ailesbury Clinic in Dublin, 55 per cent of 58 patients in a recent Mayo Clinic study who received Botox reported a moderate improvement in their headaches.
“In a retrospective study at the Ailesbury Clinic 13 patients out of 23 who suffered from moderately severe migraine said their headaches almost completely disappeared and they knew when their Botox was wearing off when the headaches started to return after about four to six months,” he said. However, I agree with Dr. O' Sullivan that "there is not yet enough evidence to suggest botox should be offered to patients as a reliable first-line treatment for migraine"
Dr O’Sullivan and Dr Treacy are both speaking at a migraine education lecture in Clare on September 15, organised by the Migraine Association of Ireland.
Ailesbury Clinics Ltd is the leading provider of advanced medical aesthetic skin care in Ireland. It was awarded Best Medical Practice in Ireland 2005.
Further details WEBSITE http://www.ailesburyclinic.ie
PHONE +3531 2692255/ 2133 Fax 2692250
Once frowned-upon, now the most popular
Introduced in the 1980’s for treating disorders of the optic muscles and vocal cord spasms, Botox also found a role in cosmetic facial enhancement. In 2002, the FDA approved Botox for use as an injectible in cosmetic procedures. Today, it is approved in more than 75 countries, and is one of the most researched toxins and the most studied medicine in the world.
Since its widespread acceptance, Botox injections have helped millions of men and women prevent or eliminate unwanted wrinkles and facial lines. In fact, according to the American Society of Plastic Surgeons (ASPS), Botox injections accounted for over 4.8 million procedures—more than any other cosmetic procedure.
Where is Botox used?
Known as Botulinum Toxin Type A, Botox is an injectible protein used by board certified plastic surgeons in the treatment of various types of facial lines and wrinkles. It is primarily administered in the crow’s feet, forehead, and glabellar (between the eyebrows) areas.
Frown lines between the brows result from the contracture of two muscles that occur from squinting in the sunlight or from frowning over a period of years. When these muscles contract, the brows are pulled closer together. Over time, as the skin loses its elasticity, and the lines become more and more prominent. After years of muscle contraction, those lines of expressions linger longer and become deeper and more visible.
Ironically, happy people are the most endowed with unwanted signs of aging, called “crow’s feet.” Such laugh lines are etched in the skin by overactive facial muscles in the process of smiling.
Fretting, anger, fear and other different emotional reactions also manifest themselves as different facial expressions.
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Botox training has become very popular
Botox training has become very popular within the cosmetic industry, as botox is used by many famous and ‘normal’ women and men who are unhappy with lines and wrinkles on their face. The face is the first thing one looks at on a person, thus it is important to many to keep themselves looking aesthetically pleasing – being wrinkle free is in this criteria for many.
Training to provide botox to those who are unhappy with their appearance involves a lot of skill, as you will have a high degree of responsibility. Botox training courses are intensive and hands-on, with courses mainly aimed at professionals who are used to similar procedures – such as doctors, dentists and nurses. Botox training is both an art and a science, which can only be learnt from someone who has a long experience of botox training.
Some courses offer a training masterclass, run with a small number of trainees, including one-to-one tuition and mentoring. The best courses are those which are certified, with the tutor being a highly experienced professional. Training will provide all equipment and injectables for your hands on botox training. Training courses are intensive and competence oriented, so once you have completed botox training you should attend future botox training courses to refresh your skills.
Botox training courses are held in a totally professional environment, courses are run on a not for profit basis and therefore are totally objective. Companies say they represent the true state of the art of aesthetics, claiming that after the one day botox training, trainees feel confident to start injecting professionally.
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