Botox Basics - How to find your best options
I have answered a lot of questions about Botox on several forums and I would like to compile a database of people's experiences to see if we can suggest some guidelines for someone looking at Botox treatments.
First of all, everyone should realize that Botox injections are more of an art form than a science. It requires precision in dosage, location, and muscle selection. A Botox specialist is essentially a sculptor of muscles not just a botox delivery system.
I have a theory as to what makes a successful treatment and what causes immunity. First of all, I understand that the rule of thumb is Botox should be applied every 13 weeks. More frequent injections will result in the body fighting the toxin with antibodies. Excessive amounts of Botox can also cause antibodies to form. Once you have been injected, you can't come back a week later because you missed a location or there wasn't enough Botox.
I believe the most successful treatments are given by neuros who have a lot of training and experience or a good sense of what needs to be relieved. Allergan is the manufacturer of Botox A and often holds conferences to teach neuros to inject Botox using a modified EMG machine. There is your basic difference in treatments. 4 years of training and extensive experience vs a weekend at a resort and training from an Allergan hired neuro. Not all of the neuros who get a crash course are bad, many of them are excellent neuros who have excellent medical skills and insight. I have had both types and the best neuros do not need the help of an EMG machine, they can observe and/or feel your spasms and make good quick decisions on dosage, muscle selection, depth, and pattern. Again, not all neuros who use EMG machines are bad. They may lack the confidence or are using the EMG to check their decision. My experience was horrible, it would take up to an hour of torture and bad results. Now, my neuro and I discuss the effectiveness of the last treatment then he observes my movements carefully for a few minutes then he maps out what he wants to do and the injections are done in less than 5 minutes. I get 275 units now and my previous neuro was 400 to 500 units.
Where am I headed with this? I want to empower other Dystonia sufferers to have a voice in their Botox treatments. Don't be afraid to ask where the neuro got his Botox training. Don't be afraid to ask how many he does in a year. The better the training and the more the experience, the chances of success is higher.
I'd like those who get or got Botox treatments to share their experiences and to ask their neuros the questions I mentioned above. We all deserve a better quality of life and it is up to us to find the best way to get it. Botox experience varies and it does not translate to expertise. Take charge of your treatment. If you don't get a warm fuzzy after asking the questions, go to the next neuro. Ask for recommendations on the many local support groups that are forming. I just started one on Facebook for those in the Metro NY and Metro Philadelphia area. I happen to live right smack in between the 2 cities.
First of all, everyone should realize that Botox injections are more of an art form than a science. It requires precision in dosage, location, and muscle selection. A Botox specialist is essentially a sculptor of muscles not just a botox delivery system.
I have a theory as to what makes a successful treatment and what causes immunity. First of all, I understand that the rule of thumb is Botox should be applied every 13 weeks. More frequent injections will result in the body fighting the toxin with antibodies. Excessive amounts of Botox can also cause antibodies to form. Once you have been injected, you can't come back a week later because you missed a location or there wasn't enough Botox.
I believe the most successful treatments are given by neuros who have a lot of training and experience or a good sense of what needs to be relieved. Allergan is the manufacturer of Botox A and often holds conferences to teach neuros to inject Botox using a modified EMG machine. There is your basic difference in treatments. 4 years of training and extensive experience vs a weekend at a resort and training from an Allergan hired neuro. Not all of the neuros who get a crash course are bad, many of them are excellent neuros who have excellent medical skills and insight. I have had both types and the best neuros do not need the help of an EMG machine, they can observe and/or feel your spasms and make good quick decisions on dosage, muscle selection, depth, and pattern. Again, not all neuros who use EMG machines are bad. They may lack the confidence or are using the EMG to check their decision. My experience was horrible, it would take up to an hour of torture and bad results. Now, my neuro and I discuss the effectiveness of the last treatment then he observes my movements carefully for a few minutes then he maps out what he wants to do and the injections are done in less than 5 minutes. I get 275 units now and my previous neuro was 400 to 500 units.
Where am I headed with this? I want to empower other Dystonia sufferers to have a voice in their Botox treatments. Don't be afraid to ask where the neuro got his Botox training. Don't be afraid to ask how many he does in a year. The better the training and the more the experience, the chances of success is higher.
I'd like those who get or got Botox treatments to share their experiences and to ask their neuros the questions I mentioned above. We all deserve a better quality of life and it is up to us to find the best way to get it. Botox experience varies and it does not translate to expertise. Take charge of your treatment. If you don't get a warm fuzzy after asking the questions, go to the next neuro. Ask for recommendations on the many local support groups that are forming. I just started one on Facebook for those in the Metro NY and Metro Philadelphia area. I happen to live right smack in between the 2 cities.
Tags: botox
Replies to This Discussion
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Permalink Reply by Jodes on -
Thanks for putting this into the forum. I, too, have had my share of horror stories--most of them involve being over-medicated with botox. I kept telling the first neuro I went to that I was having a hard time holding my head up and was in a great deal of pain. His answer was that cervical dystonia is about pain...I went to him for 3 long years, because I just thought that was the hand I had been dealt. Duh!
It is very important to understand the credentials, trainig and experience of your neuro! It is very important that you see someone who listens to you and spends time watching your movements. Treating CD with botox is like trying to hit a bullseye on a moving target...and it needs to be a team effort.
I would like to add that I do not think that the utilization of an EMG machine is a good indicator of skill. My current neuro is the only doc that I have been to that uses one, and he is the best I have seen. The other neuros did not use the EMG machine, and my results were not as good. I think it really goes back to true experience with movement disorders and an ability to listen and observe.
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Permalink Reply by BotoxTraining on -
These "horror" stories are quite common with physicians that don't receive the proper training or are pretty new to the practice. Practice makes perfect. We are proud to say that we have trained over 30,000 physicians to perform the procedure. We'd be lying if we said they are all perfect, but through the course of action we experience that doctors who are comfortable with needles and have previous experience with them tend to be more successful in the practice. We recommend you learn of doctors background and if the field is "needle friendly" you have a better chance of being happy with your procedure.
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Permalink Reply by noelv on -
Maybe you should keep track of these 30,000 physicians you have proudly trained and poll their patients and compile a database of results. I know there is a series of Dystonia Practicums, as they are called, coming up this fall. The chairpeople and advisory board are respected neurologists that I would be glad to have treat me. But I noticed the agenda dedicated 45 minutes to Dystonia Overview followed by 10 minutes of Q&A, 45 minutes on Chermodenervation (Botox Injections) Basics followed by a 10 minute Q&A Session, then the coup de grace, a TWO HOUR Injection training workshop with live volunteers. Great for the volunteers who get free BOTOX, but if you call TWO HOURS as training, I hope you never have to get treatment from these "practitioners". Even 17 year olds are required more practical hours behind the wheel before getting a drivers license and we know how "expert" drivers they become. Nothing substitutes for training with a real clinical practitioner/teacher. I'm not buying what you're selling. I have spoken with several Fellows and friends who are on Medical School Faculty who say that to even be a decent practioner, you need injection several cycles with the same patient to see what works and how to get feedback and make adjustments. That is at least a year of practical training under the guidance of a mentor. Take your sales pitch elsewhere, I'm not buying and still recommending everyone is better off with a fully trained Botox practitioner. It takes much more time than a day just to be proficient with an EMG machine.
"we experience that doctors who are comfortable with needles and have previous experience with them tend to be more successful in the practice" Your words. Those doctors are the ones who are fully trained at a teaching hospital not at a 7 hour "Practicum" that includes a 30 minute breakfast and a 45 minute lunch.
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Permalink Reply by noelv on
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I suspect you work for Empire Medical Training which specializes in one day Botox training for cosmetic purposes. You likely have no idea what Dystonia is like nor do your 30,000 "trained" practitioners. I don't see anything even related to CD or ST on the company's website. I think your "trained" practitioners are useless to us. At least the "Practicums" are led by expert Botox practitioners who are well versed and capable and directed at neurologists who have a foundation to perform these treatments. Your cosmetic training is open to any specialty who is attracted to the high profit margins such procedures provide. I now get 22 injections, down from as high as 50. My dosage would serve 30 cosmetic injections at $500-1000 each plus a 400% markup on the toxin, he would make up to $37,000. I assure you his bill is not that big, They make no profit on the Botox and insurance reimburses him less than 5% of $37,000/ I'm happy he chooses to help Dystonia patients than chase the money. Please take your sales pitch elsewhere, your training is irrelevant to the needs of this community. and very likely hurtful. Fellow Dystonia patients, here is proof as to why you need to know where your physician, especially if he is not a neuro, got his/her training.
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