botox

[Guest guest]

Yes, I've heard about it. I'm not a candidate since to many muscles are stiff, but mt PT says it helps some alot. Marcie perfectlysunnyday <mmmorris@...> wrote: I'm having laser hair removal done at a GP's office. The technician was telling me that they have done Botox shots in the legs of their MS patients to help them walk...with great results. Has anyone heard of this before?

[Guest guest]

Yes. I went thrugh the botox inections or 5 yrs then

it stopped working. I also tried botox type B aka

myobloc and with the type B I had a severe reaction to

it as it mfg tod me I was 1 step below toxic shock. I

had the max they could inject you with and I had

little relief for 6 weeks. My injections were in my

hamstrings, heel cord, abductors and hip flexor

muscles. Maureen

--- perfectlysunnyday <mmmorris@...> wrote:

> I'm having laser hair removal done at a GP's office.

> The technician was

> telling me that they have done Botox shots in the

> legs of their MS

> patients to help them walk...with great results. Has

> anyone heard of

> this before?

>

>

>

>

__________________________________________________

[Guest guest]

I've heard that the botox will help at first, but then wear off and things will end up much worse.

Re: [low dose naltrexone] Botox

Yes. I went thrugh the botox inections or 5 yrs thenit stopped working. I also tried botox type B akamyobloc and with the type B I had a severe reaction toit as it mfg tod me I was 1 step below toxic shock. Ihad the max they could inject you with and I hadlittle relief for 6 weeks. My injections were in myhamstrings, heel cord, abductors and hip flexormuscles. Maureen--- perfectlysunnyday <mmmorrisknology (DOT) net> wrote:> I'm having laser hair removal done at a GP's office.> The technician was > telling me that they have done Botox shots in the> legs of their MS > patients to help them walk...with great results. Has> anyone heard of > this before? > > > > __________________________________________________

[Guest guest]

Maureen, tell me more please!

-- Re: [low dose naltrexone] Botox

Yes. I went thrugh the botox inections or 5 yrs thenit stopped working. I also tried botox type B akamyobloc and with the type B I had a severe reaction toit as it mfg tod me I was 1 step below toxic shock. Ihad the max they could inject you with and I hadlittle relief for 6 weeks. My injections were in myhamstrings, heel cord, abductors and hip flexormuscles. Maureen> > > > __________________________________________________

[Guest guest]

what else do uwant to know? please email me

privtewly at

skippertulip2@...

--- and Iselborn <camjak@...>

wrote:

> Maureen, tell me more please!

>

>

> -- Re: [low dose naltrexone] Botox

>

> Yes. I went thrugh the botox inections or 5 yrs then

> it stopped working. I also tried botox type B aka

> myobloc and with the type B I had a severe reaction

> to

> it as it mfg tod me I was 1 step below toxic shock.

> I

> had the max they could inject you with and I had

> little relief for 6 weeks. My injections were in my

> hamstrings, heel cord, abductors and hip flexor

> muscles. Maureen

>

> >

> >

> >

> >

>

> __________________________________________________

>

[Guest guest]

Where are you located? Who is your doctor? How old are you, and when

were you diagnosed with Achalasia? Most of the advice you will find

on this board is to avoid botox. Has your doctor mentioned Heller

Myotomy? Welcome to the board! We look forward to hearing more from

you. This board is informative and very supportive.

Jo in Southwest Michigan

-- In achalasia , " listenhappy05 " <listenhappy05@...>

wrote:

>

> I just joined and don't really understand how this works, but I

> desperately could use some advise. I have had 5 dilitations and my

Dr.

> says my risk of a tear is to high to repeat so she wants to do

botox.

> But I am worried that if I do this I will more problems. Can

anyone

> shed some light.

>

[Guest guest]

AOL now offers free email to everyone. Find out more about what's free from AOL at AOL.com.

[Guest guest]

Welcome to the group. I would advise against the Botox. I

had two in the beginning and I wish I hadn't had them. I

have not had the surgery, but I have read many articles that

say it causes a lot of scar tissue that makes the surgery

more difficult.

Please tell the group where you live and I am sure someone

can refer you to the closest best surgeon for myotomy's in

your area.

Maggie

Alabama

AOL now offers free email to everyone. Find out more about what's free from AOL at AOL.com.

[Guest guest]

I bet the headache is from the anesthesia, that will get you!

I have had 3 botox injections, 2 done wrong and the last one right and

it has helped me tremendously with the pain, they are just a temporary

bandaids, s Hopkins studies show on those who have had no prior

surgeries they have lasted 6 months to 3 years. In my case no one

knows because I had one botched lapro myotomy then my first botox and

then another botched lapro myotomy and another botox.

My only successful botox injection was from Dr. Ravich in Baltimore

last month, he should be able to do it right because he was the first

to use it on Achalasia patients.

The only thing I felt from the botox is NO PAIN eating, if you hurt I

bet it is from the endoscope, sometimes it would cause me pain for

several days sometimes it was like I never had one (have had a LOT of

them).

All my scar tissue I had was from the myotomies & fundoplication, the

second time they went in my liver was attached to my stomach from scar

tissue. Some people are naturally scarrers some are normal, I am

not !

>

> Last Thursday I had the Botox injections. I was wondering if anyone

who has had these could tell me how they felt following the

injections. While they seem to have worked nicely, I also seem to be

having a great deal of discomfort that I didn't have before. I had

spasms and pain of food/liquid sticking, but this is more of an

achy/pressure feeling. I have also had headaches since the injections??

> Also, for anyone looking for a good Doctor in the Chicago area, Dr.

Gene Chiao moved his practice there from the Indiana University Medical

Center. He is nationally known for his work with Achalasia, so I have

heard the " best of the best " . I was told by my nurse at IU that he

moved to private practice on the North (? she thought north anyway)

side of Chicago. I saw him when he was at IU. Only twice before he

moved, but he made some great choices in my care on the first visit.

As a matter of fact, my doctors are still following his notes.

> Carol

> Laughter is the shortest distance between two people.

>

[Guest guest]

Hi ,

Here's what I was talking about:

>>>>>>>>>>>>>>>>>>>

After a decade of use, BoT-A injections for achalasia

can generally be considered safe. The low dose of

toxin used for treatment of achalasia has virtually no

risk of causing generalized neuromuscular blockade or

paralysis. Immediate postprocedural transient and

minor chest pain is reported in up to 25%, and

heartburn may occur in up to 5% of patients.71

Esophageal wall injury and paraesophageal tissue

inflammation have only rarely been reported

clinically,99 and no significant mucosal or submucosal

changes have been seen during endoscopic ultrasound

following treatment.100 However, both PD and BoT-A

injections caused similar degrees of inflammation and

fibrosis in the swine esophagus.101 The histologic

changes included acute and chronic inflammation with

areas of increased fibrosis in the muscle. This is of

potential concern because of possible interference

with subsequent surgery, if required. Some surgeons

have reported greater difficulty in performing myotomy

after prior BoT-A injections, although this has been

refuted by others.102, 103, 104 In another study that

included 15 patients who had received preoperative

BoT-A injections,105 difficulties in dissection of the

submucosal plane were encountered significantly more

often in the BoT-A group (53% versus 7%). However,

there was no difference in postoperative symptom

improvement between the two groups, and the operation

was considered equally successful in both groups.

Although neutralizing antibodies have been detected in

10% to 20% of patients treated chronically with BoT-A

for skeletal muscle conditions106, 107 their clinical

significance remains unclear. It is not known whether

this phenomenon occurs in patients with achalasia

treated with multiple injections, and if it does,

whether it could limit the efficacy of this approach.

>>>>>>>>>>>>>>>>>>>>>>>>>

http://www.nature.com/gimo/contents/pt1/full/gimo52.html

It is also worth noting that this article claims that

balloon dilation has better results if it is done by

more experienced people. That has shown up in a few

other places. If dilation is not done correctly, you

can have problems. I ruled dilation out because of

that.

If you are going to get a myotomy, you will have to

have an endoscopy prior to that anyway. That is the

easiest and cheapest time for a botox treatment. If

you think it is a bad idea, compare it it the

alternative: suffering that could be relieved by a

treatment that would have involved zero extra effort

on your part.

My surgeon told me she saw no sign of any scarring or

damage from the botox during the myotomy when I asked

her about it later. The injection raised my quality of

life a lot. I wish it didn't start to wear off as soon

as it did, but the relief it gave me was huge.

Here's what the author I cite suggests later in the

article:

>>>>>>>>>>>>>>>>>>>>>>>>

This author, for instance, considers that a

laparoscopic myotomy done by an experienced surgeon

offers the single most permanent method of treatment

for young adults. It should be emphasized, however,

that aggressive monitoring and treatment of reflux is

essential for long-term success. For otherwise healthy

patients over 40 to 50 years of age or younger

patients who are averse to surgery, pneumatic dilation

is a reasonable first option, provided that they

understand that there is a significant probability (up

to 50% or even more) of requiring another treatment

over the next 5 years. Finally, botulinum toxin can be

considered for those patients who wish to " temporize "

while making up their minds on a more permanent

solution, those in whom the diagnosis is not clear

cut1

>>>>>>>>>>>>>>>>>>>>>

(ibid.)

As part of the diagnosis, an endoscopy is required. I

see no reason to not jump at the temporary solution at

that time, while getting everything ready for surgery.

Dan

--- <1x2y3z@...> wrote:

> Dan, what newer data are you referring to? Can you

> please

> provide a link to an article with that conclusion?

> I think it's

> very well accepted that Botox causes scarring. The

> only question

> is how much of a problem that poses for the surgeon.

>

> The following two articles, both from 2006, are the

> most recent

> articles I could find that have a lot to say about

> scarring and

> Botox.

>

> #1 -- This 2006 article indicates that Botox and

> dilation

> (especially Botox) make the operation more difficult

> and are

> associated with more perforations, but only until

> the surgeon has

> performed a large number of myotomies. Then with

> that much

> experience, they can perform a myotomy even on a

> scarred-up

> esophagus without

> perforations. However, this study does not look at

> whether the

> eventual outcome is better in patients who never had

> endoscopic

> treatments, i.e. Botox or dilations.

>

> Laparoscopic Heller myotomy for achalasia

> facilitated by robotic

> assistance

>

> C. Galvani, M. V. Gorodner, F. Moser, M. Baptista,

> P. Donahue, S.

> Horgan

>

> Surgical Endoscopy, 13 May 2006

>

> " Particularly after Botox injections, we found the

> operation to

> be more difficult, raising the rate of esophageal

> perforation to

> 13%.

> ...

> " Other investigators, however, have not found any

> differences

> between patients who underwent pneumatic dilations

> and those who

> had Botox injections. Instead, these investigators

> attributed the

> complications to the inexperience of the surgeon.

> ...

> " Although the surgeons were under the subjective

> impression that

> the operation was more difficult, they did not find

> any

> significant difference between patients who did and

> those who did

> not receive previous endoscopic treatment. "

>

>

> #2 -- This 2006 article indicates that myotomy

> outcomes are worse

> after either Botox or dilation.

>

> Endoscopic Therapy for Achalasia Before Heller

> Myotomy Results in

> Worse Outcomes Than Heller Myotomy Alone

>

> ls of Surgery. May 2006.

>

> , C ; Stival, Alessandro; Howell, D Lee;

> Swafford,

> Vickie

> ...

> " Results: Among the 209 patients undergoing Heller

> myotomy for

> achalasia, 154 received endoscopic therapy before

> being referred

> for surgery (100 dilation only, 33 Botox only, 21

> both). The

> groups were matched for preoperative demographics

> and symptom

> scores for dysphagia, regurgitation, and chest pain.

> Intraoperative complications were more common in the

> endoscopically treated group with GI perforations

> being the most

> common complication (9.7% versus 3.6%).

> Postoperative

> complications, primarily severe dysphagia, and

> pulmonary

> complications were more common after endoscopic

> treatment (10.4%

> versus 5.4%). Failure of myotomy as defined by

> persistent or

> recurrent severe symptoms, or need for additionally

> therapy

> including redo myotomy or esophagectomy was higher

> in the

> endoscopically treated group (19.5% versus 10.1%).

>

> " Conclusion: Use of preoperative endoscopic therapy

> remains

> common and has resulted in more intraoperative

> complications,

> primarily perforation, more postoperative

> complications, and a

> higher rate of failure than when no preoperative

> therapy was

> used. Endoscopic therapy for achalasia should not be

> used unless

> patients are not candidates for surgery. "

>

> -- in PA

>

> ----- Original Message -----

> From: " Hoffman " <rp518dan@...>

> ...

> > The data is not that clear or consistent that the

> > botox causes scarring. Some older data suggested

> the

> > scarring and newer said it was not so much an

> issue.

>

>

________________________________________________________________________________\

____

You rock. That's why Blockbuster's offering you one month of Blockbuster Total

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[Guest guest]

Hi Dan,

I agree that there is a place for botox treatment in some

patients who need immediate temporary relief but can't or won't

have the surgery right away. I was disagreeing with your earlier

statement, " The data is not that clear or consistent that the

botox causes scarring. " The 2006 article you cite (by Dr. Jay

Pasricha, who originated the use of botox in achalasia, or so

I've heard) also says that botox causes scarring (fibrosis).

It's good news that the scarring from a single injection was not

significant in your case, but that won't necessarily be true for

everyone.

Scarring from botox and dilations could potentially have two

kinds of effects. First, it makes the surgery more difficult,

but that effect is not so important when the surgeon is highly

experienced. Second, there is a possibility that it might affect

the long-term state of the esophagus, even after a successful

myotomy. That is suggested by the second 2006 article I cited.

(It concludes, " Endoscopic therapy for achalasia should not be

used unless patients are not candidates for surgery. " ) It is

only one study, and I wonder whether its findings would hold up

if studied with larger numbers of patients and multiple

institutions. One hopes not. Still, I think it's probably

better to err on the safe side and try not to get too many

dilations and botox injections if you're going to have the

surgery.

-- in PA

Re: Botox

> Hi ,

>

> Here's what I was talking about:

>

>>>>>>>>>>>>>>>>>>>>

> After a decade of use, BoT-A injections for achalasia

> can generally be considered safe. The low dose of

> toxin used for treatment of achalasia has virtually no

> risk of causing generalized neuromuscular blockade or

> paralysis. Immediate postprocedural transient and

> minor chest pain is reported in up to 25%, and

> heartburn may occur in up to 5% of patients.71

>

> Esophageal wall injury and paraesophageal tissue

> inflammation have only rarely been reported

> clinically,99 and no significant mucosal or submucosal

> changes have been seen during endoscopic ultrasound

> following treatment.100 However, both PD and BoT-A

> injections caused similar degrees of inflammation and

> fibrosis in the swine esophagus.101 The histologic

> changes included acute and chronic inflammation with

> areas of increased fibrosis in the muscle. This is of

> potential concern because of possible interference

> with subsequent surgery, if required. Some surgeons

> have reported greater difficulty in performing myotomy

> after prior BoT-A injections, although this has been

> refuted by others.102, 103, 104 In another study that

> included 15 patients who had received preoperative

> BoT-A injections,105 difficulties in dissection of the

> submucosal plane were encountered significantly more

> often in the BoT-A group (53% versus 7%). However,

> there was no difference in postoperative symptom

> improvement between the two groups, and the operation

> was considered equally successful in both groups.

>

> Although neutralizing antibodies have been detected in

> 10% to 20% of patients treated chronically with BoT-A

> for skeletal muscle conditions106, 107 their clinical

> significance remains unclear. It is not known whether

> this phenomenon occurs in patients with achalasia

> treated with multiple injections, and if it does,

> whether it could limit the efficacy of this approach.

>>>>>>>>>>>>>>>>>>>>>>>>>>

>

> http://www.nature.com/gimo/contents/pt1/full/gimo52.html

>

> It is also worth noting that this article claims that

> balloon dilation has better results if it is done by

> more experienced people. That has shown up in a few

> other places. If dilation is not done correctly, you

> can have problems. I ruled dilation out because of

> that.

>

> If you are going to get a myotomy, you will have to

> have an endoscopy prior to that anyway. That is the

> easiest and cheapest time for a botox treatment. If

> you think it is a bad idea, compare it it the

> alternative: suffering that could be relieved by a

> treatment that would have involved zero extra effort

> on your part.

>

> My surgeon told me she saw no sign of any scarring or

> damage from the botox during the myotomy when I asked

> her about it later. The injection raised my quality of

> life a lot. I wish it didn't start to wear off as soon

> as it did, but the relief it gave me was huge.

>

> Here's what the author I cite suggests later in the

> article:

>

>>>>>>>>>>>>>>>>>>>>>>>>>

> This author, for instance, considers that a

> laparoscopic myotomy done by an experienced surgeon

> offers the single most permanent method of treatment

> for young adults. It should be emphasized, however,

> that aggressive monitoring and treatment of reflux is

> essential for long-term success. For otherwise healthy

> patients over 40 to 50 years of age or younger

> patients who are averse to surgery, pneumatic dilation

> is a reasonable first option, provided that they

> understand that there is a significant probability (up

> to 50% or even more) of requiring another treatment

> over the next 5 years. Finally, botulinum toxin can be

> considered for those patients who wish to " temporize "

> while making up their minds on a more permanent

> solution, those in whom the diagnosis is not clear

> cut1

>>>>>>>>>>>>>>>>>>>>>>

> (ibid.)

>

> As part of the diagnosis, an endoscopy is required. I

> see no reason to not jump at the temporary solution at

> that time, while getting everything ready for surgery.

>

>

> Dan

>

>

> --- <1x2y3z@...> wrote:

>

>> Dan, what newer data are you referring to? Can you

>> please

>> provide a link to an article with that conclusion?

>> I think it's

>> very well accepted that Botox causes scarring. The

>> only question

>> is how much of a problem that poses for the surgeon.

>>

>> The following two articles, both from 2006, are the

>> most recent

>> articles I could find that have a lot to say about

>> scarring and

>> Botox.

>>

>> #1 -- This 2006 article indicates that Botox and

>> dilation

>> (especially Botox) make the operation more difficult

>> and are

>> associated with more perforations, but only until

>> the surgeon has

>> performed a large number of myotomies. Then with

>> that much

>> experience, they can perform a myotomy even on a

>> scarred-up

>> esophagus without

>> perforations. However, this study does not look at

>> whether the

>> eventual outcome is better in patients who never had

>> endoscopic

>> treatments, i.e. Botox or dilations.

>>

>> Laparoscopic Heller myotomy for achalasia

>> facilitated by robotic

>> assistance

>>

>> C. Galvani, M. V. Gorodner, F. Moser, M. Baptista,

>> P. Donahue, S.

>> Horgan

>>

>> Surgical Endoscopy, 13 May 2006

>>

>> " Particularly after Botox injections, we found the

>> operation to

>> be more difficult, raising the rate of esophageal

>> perforation to

>> 13%.

>> ...

>> " Other investigators, however, have not found any

>> differences

>> between patients who underwent pneumatic dilations

>> and those who

>> had Botox injections. Instead, these investigators

>> attributed the

>> complications to the inexperience of the surgeon.

>> ...

>> " Although the surgeons were under the subjective

>> impression that

>> the operation was more difficult, they did not find

>> any

>> significant difference between patients who did and

>> those who did

>> not receive previous endoscopic treatment. "

>>

>>

>> #2 -- This 2006 article indicates that myotomy

>> outcomes are worse

>> after either Botox or dilation.

>>

>> Endoscopic Therapy for Achalasia Before Heller

>> Myotomy Results in

>> Worse Outcomes Than Heller Myotomy Alone

>>

>> ls of Surgery. May 2006.

>>

>> , C ; Stival, Alessandro; Howell, D Lee;

>> Swafford,

>> Vickie

>> ...

>> " Results: Among the 209 patients undergoing Heller

>> myotomy for

>> achalasia, 154 received endoscopic therapy before

>> being referred

>> for surgery (100 dilation only, 33 Botox only, 21

>> both). The

>> groups were matched for preoperative demographics

>> and symptom

>> scores for dysphagia, regurgitation, and chest pain.

>> Intraoperative complications were more common in the

>> endoscopically treated group with GI perforations

>> being the most

>> common complication (9.7% versus 3.6%).

>> Postoperative

>> complications, primarily severe dysphagia, and

>> pulmonary

>> complications were more common after endoscopic

>> treatment (10.4%

>> versus 5.4%). Failure of myotomy as defined by

>> persistent or

>> recurrent severe symptoms, or need for additionally

>> therapy

>> including redo myotomy or esophagectomy was higher

>> in the

>> endoscopically treated group (19.5% versus 10.1%).

>>

>> " Conclusion: Use of preoperative endoscopic therapy

>> remains

>> common and has resulted in more intraoperative

>> complications,

>> primarily perforation, more postoperative

>> complications, and a

>> higher rate of failure than when no preoperative

>> therapy was

>> used. Endoscopic therapy for achalasia should not be

>> used unless

>> patients are not candidates for surgery. "

>>

>> -- in PA

>>

>> ----- Original Message -----

>> From: " Hoffman " <rp518dan@...>

>> ...

>> > The data is not that clear or consistent that the

>> > botox causes scarring. Some older data suggested

>> the

>> > scarring and newer said it was not so much an

>> issue.

>>

>>

>

>

>

>

>

________________________________________________________________________________\

____

> You rock. That's why Blockbuster's offering you one month of

> Blockbuster Total Access, No Cost.

> http://tc.deals./tc/blockbuster/text5.com

>

> ------------------------------------

>

>

[Guest guest]

Hello ,

I wish I could see the entire article and not just the

abstract.

I agree that the consensus is that repeated botox

injections and dilations are not the best solutions

for achalasia patients who are good surgical

candidates. That's a different issue than a single

injection.

I went to the large teaching hospital that is a

referral center for achalasia because my GP is part of

that hospital and because my future sister-in-law used

to be an attending there and she thinks very highly of

the GI doc and the surgeon. I liked everything except

the radiology department and the level of

communication between the surgical staff, who

understood my condition, and the nurses. The nurses

had a harder time answering my questions a couple of

times than I would have liked. That may have made for

more stress, but it didn't detract from my overall

quality of care.

Katz, the GI doc, told me that the scarring issue was

not relevant unless something very unusual went wrong

or I had a reaction to the botox. He said he would not

recommend doing it long term but thought it would be a

useful diagnostic tool and offered me quick relief.

You cannot underestimate the improvement in my quality

of life in the months leading up to surgery. I don't

think the risks outweigh that benefit.

Dan

________________________________________________________________________________\

____

You rock. That's why Blockbuster's offering you one month of Blockbuster Total

Access, No Cost.

http://tc.deals./tc/blockbuster/text5.com

[Guest guest]

wrote:

Hi ,

Here's what I was talking about:

After a decade of use, BoT-A injections for achalasia

can generally be considered safe. ...

I think you and are both right. As has been said before, with

achalasia there are no right answers just good guesses. Doctors do not

agree and studies do not agree. I think the paper from Emory by: C

, MD, et al, is a good one because instead of just giving

numbers or a conclusion that this is better than that, it also

describes what they saw doing the myotomies and why they think others

have reported differing results.

When reading papers like it you have to ask what is meant by success,

failure or that something effects outcome. These terms may have

different meaning in different papers. You could give the same data to

different authors and let them define the terms and end up with papers

that seem to disagree even though the same data was used.

Then there are risks and techniques. Some surgeons may risk higher

morbidity to achieve higher success. This seems to be the case at

Emory. They are willing to risk more perforations, which are usually

fixed in the same surgery, to get more complete myotomies. They said,

"In many of our patients who have had prior endoscopic therapies, there

is a notable difference in the submucosal dissection plane, especially

near the squamocolumnar junction. Often the plane is obliterated, and

it is very difficult to confidently and easily dissect down onto the

mucosa as can be accomplished in those who have not had prior

therapies. We are very aggressive about the myotomy and feel that

pursuit of a perforation rate of zero may lead to incomplete myotomy in

many patients." Other surgeons may not be as willing to risk

perforations. If you study the surgeries those other surgeons do you

could find that prior endoscopic therapies do not lead to more

perforations. If you study the Emory surgeries you will find that they

can achieve complete myotomies even with prior endoscopic therapies.

This sounds good for endoscopic therapies. You could also conclude that

endoscopic therapies leads to either more incomplete myotomies or more

perforations depending on the surgeon. That does not sound good for

endoscopic therapies, but should we care? If a perforation is fixed and

I go home with a great myotomy why would I care. If it makes the job

harder for the surgeon but he gives me just as good of results after

any morbidity, why would I care. I would care if the perforation was

not found and lead to bigger problems. I would care if the myotomy was

not as successful as I wanted or failed because it was not complete. In

the Emory paper it was stated that prior endoscopic therapies resulted

in about twice the failure rate, but they also said they had a generous

definition of failure. Could it be that with a different definition

that the failure rate would not be much different from no prior

therapies? Who knows.

There is a major problem with the way the Emory study was done if you

want to know about something specific like Botox. They did not brake

the prior therapies group into subgroups. You can't compare Botox to

dilatation or one treatment to multiple treatments, or how much time

was between being diagnosed and surgery. It could be that one treatment

with Botox is nothing to worry about. There is no way to know from this

study. However, here is a study that did break them out:

Long-term outcome of laparoscopic heller-dor surgery for esophageal

achalasia :

Possible detrimental role of previous endoscopic treatment

http://cat.inist.fr/?aModele=afficheN & cpsidt=17373067

(Looks like Botox is worse than dilatation.)

Does one treatment of Botox cause scaring? It did in a study on swine.

See:

Evaluation of scar formation after botulinum toxin injection or forced

balloon dilation to the lower esophageal sphincter.

http://www.ncbi.nlm.nih.gov/pubmed/12616390

I think is right that Botox can lead to scaring which can make a

surgery harder and result in a less successful myotomy and higher risks

from the surgery. I think is correct that some people should

consider it anyway. It is a good test for what other treatments could

do. It can also give people time before doing something else. Having a

Botox treatment does not mean a surgery will have problems, just that

it is a possibility.

notan

[Guest guest]

I done a search on WebMD for laparoscopic myotomy with no results...can someone tell me what exactly this is? Thanks, Judy

[Guest guest]

" Laparoscopic " means minimally invasive surgery through the

abdomen, performed using a laparoscope and special surgical

instruments, with only a few tiny incisions.

" Myotomy " means cutting or dividing a muscle. The myotomy for

achalasia is called the Heller myotomy, named after the surgeon

who invented it. In the Heller myotomy, the outer muscle of the

esophagus is cut at and around the lower esophageal sphincter.

Here's more explanation of the Heller myotomy:

http://en.wikipedia.org/wiki/Heller_myotomy

Also, www.onelook.com is great for looking up unfamiliar medical

terms.

-- in PA

Re: Botox

>I done a search on WebMD for laparoscopic myotomy with no

>results...can someone tell me what exactly this is?

> Thanks, Judy

[Guest guest]

Hi ,

There are lots of opinions about Botox on this board. While I agree that it is a

bad idea to have those shots year in and year out for a long time, doing it once

while weighing your options is a very different story. You can buy the time to

make other decisions while under less pressure.

Stress does not help us at all. Worrying about severe achalacia symptoms while

trying to make major decisions adds to the problem almost as much as the

symptoms themselves. Botox can buy you between a couple of months and almost a

year to do something else. I had the shots once and it really helped. I did have

a myotomy last March and feel a lot better than I had-- which is not to say I am

symptom free.

Good luck and best wishes.

Dan

From: lindsaywalk76 <lindsaywalk76@...>

Subject: Re: Newly diagnosed, problems since a childhood.

achalasia

Date: Sunday, March 1, 2009, 7:03 PM

Hi again,

Thanks for the messages. Sorry I left out the intro part. My name is

, I live way up in Maine but transplanted here from Vermont.

As a child I just thought that in order to swallow your food, you had

to drink water. It wasn't something that I thought was abnormal until

about Jr.high school and was something I kept to myself. I never had

any issue with weight or throwing up until I got older. Around the

time I started college, it seems things started getting worse, I would

get food stuck in my throat and I'd start wheezing, but eventually

could " push " it down. Now, 2 years out of college, the pushing is no

longer working. I can still get food down but I eat very little a day

compared to what I used to eat. If I eat more, I end up throwing up.

As far as foods that are hard for me to get down, it seems to be

fruits and veggies. I love apples, but they are one of the worse,

salads go down but seem to be what I cough up the most at night.

Thick breads pose problems, but I just have remind myself to slow down

and take smaller bites. As far as having foods that don't pose a

problem, everything does, even cold cold water i cough back up.

It seems like surgery is the best answers but I just had a baby,

he's barely a month old and even more recently than that, had my gall

bladder out. I just really need to recover from those surgeries

before I go and have another one, not to mention I need to get back to

work.

As far as finding doctors and what not, I haven't yet found a

specialist. It is my family doctor who is the one that is

recommending the botox injections. A gastro doctor is suppose to be

calling me on Monday. Anyone have any questions they would have asked

their doctor?

I am just at such a loss with this thing. I hate surgery and it

scares the heck out of me to think that this isn't a one time deal.

It seems like a lot of people have to have this more than once. It's

also difficult living in a very rural area and not having the

expertise you find in larger areas. I mean I didn't even know a

gastro doctor is who you see for it, who does the surgery? and how do

you find that kind of surgeon? I believe my questions will be endless

To answers a few of your questions, they picked up my weird esophagus

when I was in the hospital due to complications for my gall bladder

surgery, they did a cat scan and noticed it was " sac " shaped. So I am

not sure if that would answers what you asked. After they noticed the

abnormality I explained I had always had a swallowing problem and they

decided they wanted to do barium swallow tests, this was what they

based their diagnosis on. I still need to have the manometry test

performed.

Anyways, I really really do appreciate the help and welcomes.

Thanks so much,

[Guest guest]

How thin are you? Are you so thin that surgery is risky? Botox is not usually

considered the best first procedure by those with a great deal of experience

treating achalasia. You said specialist, I'm assuming you are in Canada or UK?

I'd suggest getting advice from a more experienced physician. Botox can make

scars that makes further treatment less likely to be successful. That is the

general response to botox, there are exceptions.

Have to say, putting on weight while suffering from achalasia, really, isn't

that kind of a DUH!!! thing. If you could you would, wouldn't you, that is the

problem. I think you should have had pretty immediate response if the botox

would have worked, but not sure.

Really, you need a better specialist, probably.

Sandy

>

> I have just had a botox injection done 2 days ago. The specialist recommended

I try something urgently as I have lost a lot of weight and he does not feel

comfortable about referring me for the operation until I have put on some

weight. So far I have not felt any benefit, just some mild discomfort in my

oesophageal/stomach junction, and pain on my right side under my chest when

burping. Please can anyone who has the botox advise me when it is meant to start

working? And also whether they had any discomfort after the procedure?

>

> Thanks

>

> Ana

>

[Guest guest]

Hi Ana. Hi Sandy.

I had a botox shot about six months before my myotomy.

It worked gradually for me. The Botox really made a difference but it was a few

days to a week before I noticed real relief. They started to wear off in about

five months. I agree that they are a bad long term solution but they really

helped me as a short term fix. Setting up surgery, and the loss of work, is not

always easy.

The myotomy made a greater difference though I am still not symptom free and

chew my food well. Have you tried checking the foods that people eat after

surgery? I ate warmed  tuna and cream cheese on toast, which went down VERY

easy. It isn't bad with crackers either. 

Toast works better than regular bread for us. It's not what I expected, but it

doesn't turn into glue in my E.

Good luck.

Have you looked

From: toomuchclutter <sandycarroll@...>

Subject: Re: Botox

achalasia

Date: Sunday, May 3, 2009, 1:30 PM

How thin are you? Are you so thin that surgery is risky? Botox is not

usually considered the best first procedure by those with a great deal of

experience treating achalasia. You said specialist, I'm assuming you are in

Canada or UK? I'd suggest getting advice from a more experienced physician.

Botox can make scars that makes further treatment less likely to be successful.

That is the general response to botox, there are exceptions.

Have to say, putting on weight while suffering from achalasia, really, isn't

that kind of a DUH!!! thing. If you could you would, wouldn't you, that is the

problem. I think you should have had pretty immediate response if the botox

would have worked, but not sure.

Really, you need a better specialist, probably.

Sandy

>

> I have just had a botox injection done 2 days ago. The specialist recommended

I try something urgently as I have lost a lot of weight and he does not feel

comfortable about referring me for the operation until I have put on some

weight. So far I have not felt any benefit, just some mild discomfort in my

oesophageal/ stomach junction, and pain on my right side under my chest when

burping. Please can anyone who has the botox advise me when it is meant to start

working? And also whether they had any discomfort after the procedure?

>

> Thanks

>

> Ana

>

[Guest guest]

hi ana- gi docs also suggested botox for my son when he was finally diagnosed.

we were so excited and thought maybe this would be the thing he would need to be

able to eat and drink again. this was before i discovered this group and so i

consented to this procedure for my son. it was very disappointing in that it

failed to do anything. i have since learned from members here and dr rice that

botox could actually cause complication if a myotomy is indicated. the only

group which seem to benefit from botox is seniors according to research. dr rice

expressed to me how frustrated he is with the gi's use of botox in the les. i

sorry it didn't work for you. after the botox thing, when i was new here. if a

doc told me something, i immediately asked this group to for their input. most

of the suggestions we chose to follow were sound medically. no they aren't

doctors but they have been living with achalasia and have a load of experience

with doctors. this group lead me to an outstanding specialist in dr thomas rice.

i'm so glad your here and asking questions. i hope you can find some relief

soon...angela

achalasia

From: darryll.ana@...

Date: Sun, 3 May 2009 13:12:10 +0000

Subject: Botox

I have just had a botox injection done 2 days ago. The specialist recommended I

try something urgently as I have lost a lot of weight and he does not feel

comfortable about referring me for the operation until I have put on some

weight. So far I have not felt any benefit, just some mild discomfort in my

oesophageal/stomach junction, and pain on my right side under my chest when

burping. Please can anyone who has the botox advise me when it is meant to start

working? And also whether they had any discomfort after the procedure?

Thanks

Ana

[Guest guest]

Hi Ana,

I  know that bloated feeling way too well.  I recall learning to belch from my

upper esophagus after the Botox and that's pretty strange. I don't do that now.

I really can't remember all the details, just that it took a while for the botox

to work and that I was able to eat things again that I couldn't before and that

the spasms were not as bad. Sleep was better for a while too.

I'm sorry to hear that it isn't working out for you.

Even after the myotomy, I have to watch the way I eat and notice that too much

stress can bring on spasms.

The advice to see someone who really has a lot of experience in achalasia is

well worth heeding. Also, though it's really hard to do when you are confronting

real  health problems, stress reduction is something we all need to work on.

It's not a cure, but it reduces the frequency and severity of symptoms.

Best wishes.

Dan

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[Guest guest]

hello there. yes it's sounds like you have achalasia and botox,did me the same

way. made my condition worst. i had the heller myotomy with the wrap,about 6

weeks ago. so far everything is back to normal.eatting everything and gained

back about 15 lbs ,so far. sleeping well,too.this surgery was the best thing for

me. my doctor in michigan offer me a heller7 years ago for free and i turned it

down and moved to florida.did alot of research on my doctor's. the surgn that my

doctor ,picked for me .i turned him down,because he only performed this surgery

30 times. was'nt enough exp. for me .so i started searching for a more exp.

surgn and found my surgn Dr.Rosenmurgy is in tampa gen. hosp. He teaches other

surgn,how to perform the heller myotomy and different ways to do it. he done my

surgery through my naval and no scars.i'm feeling wonderful and eatting very

well,with no complications. so far so good.i lost about 30 lbs before having the

surgery.went from very fit ,to slim/skinny and could'nt deal with my,outer

body.needed my weight/health back quickly. good luck to us all and ,all are in

my prayers. if i can help anyone here,don't hesitate to ask. i'm here to help

,in any way i can. email me @ fks4677@... or leave me a mess. here. thanks

and good luck fam. fred ps My Dr.Rosenmurgy in Tampa,surgery performed @ Tampa

General Hospital his #813-844-7393 achalasia

> >

> > Can someone please help me i was diagnosed with achalasia a couple weeks ago

after about 2 years suffering i went through the botox which made me worse now

im not eating its getting harder for me to drink fluids im getting weaker and

now the latest dr i went to said he doesnt know if its achalasia im getting more

depressed im sick of doctors i need help and it seems like no  one can i have

all the symptoms of achalasia i have been diagnosed but yet another dr shut the

door in my face any one have any ideas because i sure dont have any anymore

> >

> >

> >

> >

[Guest guest]

Botox is a bacteria, not a virus...and CAN be very effective for certain types

of pain. They work only on spasming muscles...when it works. I tried it once

and it did not work for me. This was the end of the line for me before

disability. I went searching for alternatives and found trigger point

therapy...and it changed my life. I know it doesn't sound like it could be the

cause of most people's pain here, but it is a SIGNIFICANT cause of severe and

debilitating pain.

I cannot encoourage people enough to give it a try!

 --- Babbitt

________________________________

From: cathy mccarthy <bbhorsetack@...>

spinal problems

Sent: Tue, January 12, 2010 10:12:23 PM

Subject: botox

 

Hi All

The issue of Botox injections has come up. Has anybody tried it??? It kinda

scares me. It weakens/relaxes muscles and reduces pain and muscles spasms. They

are injecting botulism in the neck, spine, and muscles???

" Although botulinum toxin is a lethal naturally occurring substance, when

carefully isolated and purified, it can be used as an effective and powerful

medication. Researchers discovered in the 1950s that injecting overactive

muscles with minute quantities of botulinum toxin type-A would result in

decreased muscle activity by blocking the release of acetylcholine from the

neuron by preventing the vesicle where the Acetylcholine is stored from binding

to the membrane where the neurotransmitter can be released. This will render the

muscle unable to contract for up to a period of three to four months. " ( from

Wikipeda.)

I dunno, my muscles are weak as it is. Botox is a virus??? My chronic pain

condition was caused by a overeactive (very healthy) immune system attacking a

flu virus. (Attacked my whole body as well... Like me, it never knew when to

shut up and stop). But still, I am curious if anyone has tried this approach???

in NH

[Guest guest]

Hi Ivan.

I haven't been able to get the Botox injections yet (long story) but I can guide

you to a group where you can ask nearly any question about it (or search

the archives) and find almost any answer. It's for people with Cervical

Dystonia/Spasmodic Torticollis, one of the few conditions that are FDA approved

for Botox use.

TheSTZone/?yguid=255823988

There are other groups I've joined for CD/ST; if you'd like those group urls,

let me know.

So, if I may ask, what is your diagnosis? I'm curious because Botox/Dysport is

so far medically approved for various Dystonias (cervical, oromandibular,

cranial, blepharospasm) and nystigmus and extremely overactive sweat glands

(can't remember that medical term).

My great aunt has the exact same disorder I do and has gotten good relief using

Botox for 14 years, though she does have to do it every 3 months.

Good luck to you!

>

> Howdee all,

>   Has anyone tried Botox injections for cervical and headache pain? I got

insurance approval and will try at Jefferson University Hospital.   Thanks

>  

> Ivan

>

>

>

>

>

[Guest guest]

Thank you .  I gto so many thinggs wrong  with my spine, and muscle

spasms and headaches. I'll try most valid therapies.    ivan

From: mamawolf33 <vendetta33@...>

Subject: Re: Botox

spinal problems

Date: Friday, January 15, 2010, 12:52 PM

 

Hi Ivan.

I haven't been able to get the Botox injections yet (long story) but I can guide

you to a group where you can ask nearly any question about it (or search

the archives) and find almost any answer. It's for people with Cervical

Dystonia/Spasmodic Torticollis, one of the few conditions that are FDA approved

for Botox use.

http://health. groups.. com/group/ TheSTZone/ ?yguid=255823988

There are other groups I've joined for CD/ST; if you'd like those group urls,

let me know.

So, if I may ask, what is your diagnosis? I'm curious because Botox/Dysport is

so far medically approved for various Dystonias (cervical, oromandibular,

cranial, blepharospasm) and nystigmus and extremely overactive sweat glands

(can't remember that medical term).

My great aunt has the exact same disorder I do and has gotten good relief using

Botox for 14 years, though she does have to do it every 3 months.

Good luck to you!

>

> Howdee all,

>   Has anyone tried Botox injections for cervical and headache pain? I got

insurance approval and will try at Jefferson University Hospital.   Thanks

>  

> Ivan

>

>

>

>

>

[Guest guest]

I have a question.Is botox a live virus?Has anyone had it while they had RA??

Thanks.

Heidi