What all is Botox used for? I thought it was just for wrinkles. But a friend told me she got it for migraines. What else is there and why is it such a cure-all?
Interestingly, Botox is actually a toxin produced by the bacteria that causes botulism, but it seems to have multiple medical applications because of how the toxin works. Botox causes localized muscle relaxation by blocking the nerve conduction to a group of muscles. By decreasing nerve conduction and causing muscle relaxation, Botox can decrease the appearance of wrinkles and cause some headache relief in those with chronic headaches. In all, the FDA has approved the use of Botox for certain muscle spasm disorders, temporary improvement in the appearance of wrinkles, excessive sweating under the arms known as hyperhidrosis, prevention treatment for chronic migraine headaches and treatment of urinary incontinence in some with overactive bladder.
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At what age should a parent be concerned if their child still wets the bed? My daughter is in elementary school. What should I do?
Nighttime bed wetting in children 5 years of age or older, which is termed enuresis, is relatively common and decreases with increasing age. In children without other urinary symptoms and no previous history of a known bladder dysfunction, enuresis occurs in about 16 percent of 5 year olds, 13 percent of 6 year olds, 10 percent of 7 year olds, 7 percent of 8 year olds, 5 percent of 9 year olds, and 2-3 percent of 12-14 year olds. Your child should see the doctor if there are other lower urinary tract symptoms such as daytime wetting, dribbling, straining to urinate, a weak stream, feelings of incomplete emptying or pain. At the appointment, the doctor will go through a complete history with you and ask further questions that will help explain what might be causing the problem. Here are a few pointers to know since enuresis in children is relatively common.
(1) Do not punish the child because it is neither the child’s nor the parents’ fault.
(2) Keep a record of when the child urinates both during the day and overnight. The child should attempt to urinate regularly during the day and just before bed (a total of 4 to 7 times). If the child wakes at night, the caregiver should take the child to the bathroom to attempt to urinate.
(3) Sugary and caffeinated drinks should be avoided, especially before bedtime. Daily fluid intake should be concentrated in the morning and early afternoon hours and should be minimized during the evening hours.
(4) The routine use of diapers and pull-ups can interfere with motivation for getting up at night and is generally discouraged.
(5) Upon visiting with your doctor, he/she may suggest other strategies including motivational therapy, enuresis alarms, and/or medication.
Angelina Jolie got a lot of attention for pro-actively dealing with cancer. But is that an option for the rest of us? How would I go about finding out? And would insurance even cover something like that?
Angelia Jolie received a lot of attention for her double mastectomy (removal of both breasts) and oophorectomy (removal of the ovaries) due to her fame, but she had a legitimate reason for being this proactive about her cancer risk. Jolie has a mutation known as BRCA-1, which increases her risk of developing breast and ovarian cancers. Jolie also has a strong family history of breast and ovarian cancers. Her mother, grandmother, great-grandmother, aunt and cousin all had BRCA-1 associated cancers. In the general population, a woman’s risk of developing breast cancer in a lifetime is about 12 percent, and this can increase to almost 60 percent in those with a BRCA-1 mutation. When doing the math and calculating the risk for Jolie based on her family history, she had an 87 percent chance of developing breast cancer and a 50 percent chance of developing ovarian cancer during her lifetime. Based on Jolie’s high risk, her interventions to prevent breast and ovarian cancers seem reasonable, but these decisions should be based entirely on individual preferences after understanding both sides of the coin, including the risks of developing cancer weighed against the immediate and long-term risks of certain medical procedures. Jolie did not undergo mastectomies and oophorectomies simply because of her fame and fortune. These interventions are options for others as well, and whether insurance would cover these interventions would most likely depend on individual circumstances including genetic predisposition based on genetic testing and risk stratification based on family history. However, insurance plans are very different from one to the next, so one would need to check with a provider first about coverage. If interested, genetic testing can be performed by certain laboratories. Please see your doctor for more information on genetic testing and individualizing risk and strategies for health management.
What can I do about my son’s nervous tics? He’s always bouncing his legs or tapping his feet. Is that normal?
For a child with these signs, I would have to know more information in order to say if this was considered “normal” or “abnormal.” The reason I say this is because there are many different movement disorders that affect children. A true tic disorder is formally defined as repeated, individually recognizable, intermittent movements or movement fragments that are almost always briefly suppressible and are usually associated with awareness of an urge to perform the movement. Unlike other movement disorders, tics cease during sleep. Temporary tic disorders are particularly common during childhood, where they occur in up to 25 percent of normal children. Most children with simple motor tics do not require treatment as they are in many cases temporary. Tourette’s syndrome is always considered if there is also a component of a vocal tic. Temporary tics usually resolve over the period of months. However, again, there are different causes for tics, so when in doubt, always schedule an appointment with your doctor to go over a complete medical history.
