Dysport: $50 Rebate This expires December 31, 2011. Dysport is used the same way as Botox. This rebate applies to a glabellar treatment.
Restylane: Up to $300 Rebate This expires December 31, 2011. Purchase a minimum of two cc’s of Restylane and receive a $50 rebate on each cc, up to a maximum of 6.
Radiesse: $50 Rebate Purchase a syringe of Radiesse and receive a $50 gift card toward future purchases from Dr. Apostolakis.
Xeomin: $199 any area Xeomin, the most recent addition to the botulinum products is now available. Treat the glabella, forehead, or crows feet for just $199 each. To learn more, please skip to the bottom of this article. This expires December 31, 2011.
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Michael Jackson, What Happened?
What is the “Michael Jackson Drug”?
With the tragic death of Michael Jackson last year and the recent conclusion of the trial convicting his personal physician, Conrad Murray, M.D., I have been getting a number of inquiries about the drug and how it may relate to their treatment.
The “Michael Jackson Drug” is called Propofol. It is one of the most commonly used anesthesia drugs in the world. In fact, after a manufacturing problem 2 years ago, a shortage of Propofol created quite the crisis as facilities around the world scrambled to keep inventory. Propofol is used alone or in combination with other medications to create varying levels of anesthesia. At higher doses it can produce general anesthesia in what is called total intravenous anesthesia (TIVA). In smaller doses it renders patients unconscious, but not under general anesthesia meaning that they would still wake-up if they were to be stimulated. During general anesthesia cases, Propofol is often used for initiating the anesthesia followed by placement of a breathing tube and subsequent use of gasses for maintenance of anesthesia.
The practice in my operating suite is to have the patients receive Propofol as a means to sedation. Because I use local anesthesia to eliminate painful stimuli, general anesthesia and a breathing tube are not necessary. Patients will continue to breathe under their own power when sedated in this fashion. Propofol is a very comfortable drug for the patient. Patients wake from Propofol and frequently report feeling very good, refreshed in fact. It is possible that Mr. Jackson received Propofol in a hospital setting at which time he came to be familiar with the refreshing sleep and perhaps later requested it for home use. Propofol also does not cause nausea. Nausea and vomiting is common after gas anesthesia and Propofol all but eliminates this problem.
So what happened to Michael Jackson? I, of course, can not say for certain. I can speculate that a simple and easy to correct occurrence known as “upper airway obstruction” occurred. When patients are sedated, they may become so relaxed that if they are positioned on their back, the jaw and tongue may slide back and block the airway. This commonly happens with regular sleep and results in snoring or worse yet, obstructive sleep apnea. With sleep apnea, patients who obstruct will wake themselves up just enough to correct the problem on their own. This results in fragmented sleep and short but repeated drops in their oxygen. Over many years, this causes health issues. When a patient has received a sedating drug, correcting the the obstruction may require external intervention, a simple lifting of the chin for example is typically all that is needed. But, if no one is there to lift your chin, cessation of breathing may continue until the point of injury or death.
Safe use of Propofol requires that the patient is monitored by qualified personnel who are physically watching the patient breathe, listening to the patient breathe, and using the equipment that electrically monitors those and other vital signs. This is an absolute must for anyone receiving any dose of Propofol.
In short, Propofol is probably the single most valuable drug available for both sedating patients and in initiating general anesthesia. It has very few side effects and is very predictable. The tragedy of Michael Jackson is compounded by the fact that it just didn’t need to happen. No one should receive Propofol at home. It should always be administered in an approved facility with qualified personnel who are at the bedside the entire time.
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Xeomin, The latest Botulinum Product is Here
Earlier this year, Merz, the makers of Radiesse, received approval from the FDA for its botulinum product, Xeomin. Xeomin is the third botulinum toxin type A to be approved for use in the United States along with Botox and Dysport. Cosmetically, Xeomin has been approved for use in the glabella (area between the eyebrows) just like Botox and Dysport. Also just like Botox and Dysport it is used “off-label” in other parts of the face. Multiple clinically studies have shown that Xeomin works much like Botox with similar results, onset of action, and duration of action.
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