wilso2ar Posted March 31, 2020 Share Posted March 31, 2020 I am just wondering if anyone is still doing any procedures/injections during the stay at home orders. We have mostly stopped, but are taking some on a case by case basis. For instance I injected Xeomin for Migraines yesterday. I was debating to do this or not, but I am glad that I did. During the visit he told me that his headaches would get so severe that he would not be able to function without it. I wonder where we draw the line, elective vs necessary. Yes, it is not life threatening, but what a miserable way to live. Quote Link to comment Share on other sites More sharing options...
jmj11 Posted March 31, 2020 Share Posted March 31, 2020 Two points (having spent my career in migraine treatment) I have not used Xeomin although a ton of Botox, which is the only neurotoxin approved for migraine prevention. Of course, you may have had better luck or some reason you are using Xeomin (I have used Dysport off label do to a cost issue). But my main point is that migraine is a neurological disorder like epilepsy, MS, etc. Is treating status epilepticus in the ED "elective?" Is treating relapsing MS "elective?" Migraine has had a great injustice of stereotype forever, often even by neurologists. I've heard neurologists say, "No one dies from migraine." Well, I beg to differ. I've seen countless lives ruined by migraine. I've had (as I sit here and think) at least 4 patients commit suicide due to endless migraines ruining their lives. So, my conclusion is, if Xeomin is working to prevent migraine days, it is not elective and certainly should not be lumped into the category of cosmetic treatments. I would advise patients not to seek elective treatments right now, such as cosmetic. But not giving a migraine the treatment they deserve, is different. 1 1 Quote Link to comment Share on other sites More sharing options...
wilso2ar Posted March 31, 2020 Author Share Posted March 31, 2020 That is a very good point and that is going to be my stance from here on out. I've switched quite a few Medicare patients from Botox to Xeomin due to the ease of ordering and storage. (my boss won't keep Botox on hand due to needed to be refrigerated) I have never had a patient mention any difference in efficacy between the two. Medicare does not differentiate between the two. Quote Link to comment Share on other sites More sharing options...
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