Botox
Say the word Botox and an image of a tightened, expressionless face appears. The household name in plastic surgery is on the frontlines of our societys’ obsession with anti-ageing, but it may also have inadvertently found itself on the frontlines of a legitimate medical use.
The Mackay Rehabilitation Center in partnership with the McGill University Health Center is host to the Saliva Management Clinic; the first of it’s kind in Quebec, the second in Canada. Dr. Sam Daniel is director of the clinic, and the man responsible for saving the life of an infant child who was drowning in his own saliva. The family has asked to not have their name published, Dr. Daniel simply referred to the infant as Mikhail.
Mikhail was born with CHARGE Syndrome, an acronym referring to children born with specific birth defects. Saliva secretions had been pooling in his lungs since he was born, causing numerous bouts of pneumonia and literally drowning the boy from the inside out.
For six weeks after his birth he was in an intubator, with a tube inserted down his throat into his lungs. A number of attempts to remove the tube were unsuccessful, and witnessing their infant sons suffering and ultimate decline tortured his parents.
“His parents almost put an end to treatment,” says Dr. Daniel, “watching Mikhail suffer became to much for them”.
After the considering and ruling out all other medical procedures, Dr. Daniel presented Mikhail’s parents with an experimental option; botulinum toxin injections, commonly known as Botox.
The use of Botox in resolving saliva management issues had never before been used on a child younger four years old. Dr. Daniel was not sure it would work.
“Everyone told me you’re crazy, don’t do it” said Dr. Daniel, “I didn’t even know what side effects there’d be.”
At eight weeks old, young Mikhail became a clinical trial and success. Dr. Daniel injected the Botox into a number of his saliva glands, thus paralyzing them.
Within two weeks of Mikhail’s Botox injection, the infant was removed from the ventilator and released from the hospital. Mikhail is now eight months old, and has just received his second injection. According to Dr. Daniel “it is still too early to tell if he’ll require Botox every six months or not”.
There are hundreds of saliva glands in the human mouth; Dr. Daniel injects only the four major ones with Botox. The use of this drug for saliva management issues is still fairly new and there are no set dosages. Dr. Daniel prefers to use multiple small doses over a period of time, as opposed to a larger dose that may cause excessive dryness in the mouth.
The Botox is injected using a guided method where electrodes placed on the cheek guide the needle to saliva glands and not muscle tissue. A local anesthetic cream is rubbed into the cheek, and the procedure takes less than a minute. The results become apparent after two weeks, and each injection can last anywhere from six to nine months, depending on the child.
Because this procedure is so new, the Canadian government does not provide coverage for it. “Botox isn’t covered for saliva problems,” explains Dr. Daniel “it costs approximately $360 a vial, or $250 to $300 a dose”.
Saliva management issues such as drooling are common but stigmatized in our society, which is why Dr. Daniel is a strong advocate for the Clinic, and making the public aware of this problem.
Children who suffer from saliva management issues are turned away from daycares, have trouble making friends, and are often plagued with medical conditions resulting from the saliva management issue.
Samuel Chayer-Lapointe, 15, was a chronic drooler. His teachers told his parents he would be unable to find employment at 16 due to his drooling. He had no friends growing up because few children wished to play with his saliva-drenched toys. Dr. Daniel met with the Chayer-Lapointe family a year ago, and began to treat Samuel with Botox injections. Now, one year later, his drooling has almost stopped, and with it the social ramifications “family life, the life of Samuel is much easier now, thanks to the injections” says his mother.
Botox has had a colourful history, and it’s wide array of uses are still being discovered. From its’ beginnings as a research tool for neurological disorders, to the 1989 FDA approval for eye muscle disorders, and finally to it’s well known uses in plastic surgery. Only the future will tell what else this drug will be used for.
The Mackay Rehabilitation Center in partnership with the McGill University Health Center is host to the Saliva Management Clinic; the first of it’s kind in Quebec, the second in Canada. Dr. Sam Daniel is director of the clinic, and the man responsible for saving the life of an infant child who was drowning in his own saliva. The family has asked to not have their name published, Dr. Daniel simply referred to the infant as Mikhail.
Mikhail was born with CHARGE Syndrome, an acronym referring to children born with specific birth defects. Saliva secretions had been pooling in his lungs since he was born, causing numerous bouts of pneumonia and literally drowning the boy from the inside out.
For six weeks after his birth he was in an intubator, with a tube inserted down his throat into his lungs. A number of attempts to remove the tube were unsuccessful, and witnessing their infant sons suffering and ultimate decline tortured his parents.
“His parents almost put an end to treatment,” says Dr. Daniel, “watching Mikhail suffer became to much for them”.
After the considering and ruling out all other medical procedures, Dr. Daniel presented Mikhail’s parents with an experimental option; botulinum toxin injections, commonly known as Botox.
The use of Botox in resolving saliva management issues had never before been used on a child younger four years old. Dr. Daniel was not sure it would work.
“Everyone told me you’re crazy, don’t do it” said Dr. Daniel, “I didn’t even know what side effects there’d be.”
At eight weeks old, young Mikhail became a clinical trial and success. Dr. Daniel injected the Botox into a number of his saliva glands, thus paralyzing them.
Within two weeks of Mikhail’s Botox injection, the infant was removed from the ventilator and released from the hospital. Mikhail is now eight months old, and has just received his second injection. According to Dr. Daniel “it is still too early to tell if he’ll require Botox every six months or not”.
There are hundreds of saliva glands in the human mouth; Dr. Daniel injects only the four major ones with Botox. The use of this drug for saliva management issues is still fairly new and there are no set dosages. Dr. Daniel prefers to use multiple small doses over a period of time, as opposed to a larger dose that may cause excessive dryness in the mouth.
The Botox is injected using a guided method where electrodes placed on the cheek guide the needle to saliva glands and not muscle tissue. A local anesthetic cream is rubbed into the cheek, and the procedure takes less than a minute. The results become apparent after two weeks, and each injection can last anywhere from six to nine months, depending on the child.
Because this procedure is so new, the Canadian government does not provide coverage for it. “Botox isn’t covered for saliva problems,” explains Dr. Daniel “it costs approximately $360 a vial, or $250 to $300 a dose”.
Saliva management issues such as drooling are common but stigmatized in our society, which is why Dr. Daniel is a strong advocate for the Clinic, and making the public aware of this problem.
Children who suffer from saliva management issues are turned away from daycares, have trouble making friends, and are often plagued with medical conditions resulting from the saliva management issue.
Samuel Chayer-Lapointe, 15, was a chronic drooler. His teachers told his parents he would be unable to find employment at 16 due to his drooling. He had no friends growing up because few children wished to play with his saliva-drenched toys. Dr. Daniel met with the Chayer-Lapointe family a year ago, and began to treat Samuel with Botox injections. Now, one year later, his drooling has almost stopped, and with it the social ramifications “family life, the life of Samuel is much easier now, thanks to the injections” says his mother.
Botox has had a colourful history, and it’s wide array of uses are still being discovered. From its’ beginnings as a research tool for neurological disorders, to the 1989 FDA approval for eye muscle disorders, and finally to it’s well known uses in plastic surgery. Only the future will tell what else this drug will be used for.
posted by Steph Darwish at 1:14 AM
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