Publication date: 06/30/2003

Botox is safe when properly used

BY DR. SCOTT HYVER
Special To The Examiner

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My friend invited me to a Botox party in July. I heard about some problems with Botox, and see that the manufacturer is using full-page newspaper advertisements to explain that Botox is safe. I get very nervous when I see corporations so anxious to drown out public opinion. What is your view on the safety of Botox?

-- Carolyn C., San Mateo

Botox is a purified toxin from the bacterium that causes botulism. Botox injections cause a temporary paralysis of muscle. It was originally used by ophthalmologists to treat crossed eyes and eyelid spasms. A little more than a year ago, the FDA approved the cosmetic use of the drug to treat frown lines that occur between the eyes. Botox is generally considered safe for this application. There are, however, many other common, but non-approved, uses of Botox in the medical community, including for the treatment of forehead lines, crow's feet, fine lines around the mouth, migraines and sweaty palms. While these applications appear to be safe, you need to understand that they have not yet been formally evaluated by the government. If you do decide to have Botox treatments, make sure you're treated by a qualified medical professional in a qualified medical setting, not at a "party."

I saw the passing of Dr. Robert Atkins, and thought I'd write you and ask why his diet approach has been so phenomenally successful. It seems like everyone at work is urging me to try it. But I simply don't understand how you can lose weight eating fried eggs and bacon?

-- Barbara L., So. SF

The Atkins diet calls for severely restricting carbohydrate intake in favor of protein and fat. The idea is to alter your body's metabolism from primarily burning carbohydrate stores to primarily burning fat stores, resulting in greater fat loss. However, critics say the initial weight loss is partly due to water loss, and that the weight will slowly return as the body regains equilibrium. There's also concern about the long-term effects of the diet on heart disease, kidney failure, osteoporosis and colon cancer. The fact of the matter is that no long-term studies on the efficacy and safety of the Atkins diet have been conducted, so nobody knows for sure. Until such studies are made, my view is go ahead and try the Atkins diet for short-term weight loss (e.g. for a class reunion), but in the long run, stick with the American Heart Association recommendations for a low-fat balanced diet.

My mom said I should write to you. I'm a 14-year-old girl who drinks a lot of Mountain Dew. My mom stopped buying it when she found out it had caffeine. I really enjoy it and don't want to give it up. She said that if you say it's OK, she'll start buying it again. Please don't let me down!

-- Melody, Daly City

Sugary, carbonated and caffeinated sodas are extremely popular. There's a lot to recommend them: they're refreshing, taste good and give you a lift. But there's also some things that aren't so good about these drinks, particularly for growing children. Heavy soda consumption can cause dental disease, diabetes and potentially bone loss and fractures. Too much caffeine can elevate blood pressure, produce stress and cause sleep disorders. I support your mom's concern, but I don't agree with her actions to suddenly cut off your supply of the Dew, since this could cause caffeine withdrawal. I suggest you and your mom strike a compromise: she can resume buying the drink if you agree to reduce your consumption to no more than a 12-ounce serving a day.

An opthalmologist and surgeon, Dr. Scott Hyver is the medical director of ScottHyver Visioncare. Send questions to drscott~scotthyver.com