Question: I have excess skin on my eyelids that I would like to have removed without surgery. I have heard that Botox might help, but I don’t know if it is safe or if Botox would affect my vision. Can you please advise? I’m 85.
Name and address provided.
A: When the upper eyelid droops, it is medically known as ptosis. In some people it becomes so severe that they have to tilt their head back or raise their eyebrows to see outside clearly, which is understandably both annoying and disturbing.
Sometimes ptosis develops as a result of a neurological disorder, due to damage to the nerve supply to the eyelid muscles. But in general, ptosis is an age-related problem, as the muscles become overworked and less effective.
I respect your reluctance to undergo surgery, but this provides the most effective treatment available. The correct procedure, called blepharoplasty, can be performed under local anesthesia and does not require an overnight stay in the hospital.
Botox – the brand name for injectable botulinum toxin type A – works by paralyzing the muscles into which it is injected. A drooping eyelid can even be a side effect if Botox has been administered poorly.
Botox – the brand name for injectable botulinum toxin type A – works by paralyzing the muscles into which it is injected (stock photo)
I have seen this as a complication in my own patients, when the injectable botulinum has been over-administered in an attempt to banish stubborn frown lines: the droopy eyelids occur when the Botox migrates downward, due to gravity, impairing function of the eyelid muscles.
Fortunately, the effect disappears after a few months. I know some practitioners offer it as a treatment, but I would not recommend Botox or other topical cosmetic procedures for your problem as blepharoplasty would be the only effective treatment.
Q: One night, several months ago, I woke up with a very bad foot cramp. It bent my foot so much that it damaged my anterior tibialis muscle. The foot became severely swollen, causing me to be unable to walk for ten days. This left me with four hanging toes, despite regular physiotherapy. Will my condition ever improve?
Roger Keen, Luton, Bedfordshire.
A: Foot cramps occur when a muscle contracts involuntarily. This can happen for a number of reasons, including dehydration, low potassium levels, nerve damage and even tight shoes.
They are common and rarely a cause for concern, but in your case the painful cramp was so severe and prolonged that it pinched small blood vessels in the foot muscle, causing them to burst and cause bleeding.
This caused the swelling in your foot that you describe and which takes months to resolve.
The cramp also led to compression or pinching of the peroneal nerve, a branch of the sciatic nerve, which provides movement and sensation to the lower leg, foot and toes via the tibialis anterior muscle, one of the major muscles in the front of the hip. lower leg.
Foot cramps occur when a muscle contracts involuntarily – this can be for a number of reasons including dehydration, low potassium levels, nerve damage, even tight shoes (stock photo)
What puzzles me is why the bleeding in your cramping muscle was so severe. I’m wondering if you are taking regular aspirin or other medications that could be described as ‘blood thinners’ as muscle cramps are a known side effect.
If not, I would also recommend that you consult your GP who may order a blood test to check your platelet count (platelets help form clots that prevent bleeding around the site of the injury – a low count may have led to an increase in bleeding and may explain the cause). severe swelling you have experienced).
In the meantime, you can rest assured that your regular, supervised exercise regimen will strengthen muscles, reverse foot drop and restore normal mobility. This may take up to a year, but please continue your treatment; it will be worth it.
Write to Dr Scurr at Good Health, Daily Mail, 9 Derry Street, London, W8 5HY or email: drmartin@dailymail.co.uk. Dr. Scurr cannot enter into personal correspondence. Answers should be taken in a general context. If you have health problems, consult your own doctor.
I think… Broken promise for people over fifty
Aren’t we all committed to the mantra that prevention is better than cure?
Well, the government certainly doesn’t seem to be.
Osteoporosis is the fourth biggest cause of disability and premature death in Britain, but a commitment to include this in last week’s autumn statement has not been kept.
It was intended to provide more fracture liaison services (FLS), where anyone over 50 should be sent if they have a fracture, to identify – and treat – osteoporosis to prevent future episodes.
Only 51 percent of NHS trusts in England and Wales have an FLS: this compared to 100 percent in Scotland and Northern Ireland. There was a promise that this discrepancy would be corrected, but there was no peep on the subject from the Chancellor.
Leaving aside the personal costs associated with long-term pain, disability and worse, £88 million in the coming year will be spent on treating fractures that could have been prevented, while FLS services would cost just £27 million a year.
Who is responsible for this illogical, costly – and, dare I say, shameful – decision?