Entries in Injections (8)


Epidural Steroid Injection Risks Include Incurable Arachnoiditis

iStockphoto/Thinkstock(NEW YORK) -- Helen Bertelli, a mother of two young girls from Raleigh, N.C., has been crippled with weird symptoms -- electric shocks, muscle cramps and the sensation that water is running down her legs -- all since she received an epidural steroid injection for back pain in 2011.

Three months after a medical "fellow" administered the shot at a pain clinic, she had trouble urinating, then both her feet went numb.

"I had this feeling I was connected to the end of a guitar string and someone was plucking it," said Bertelli, 36, a former runner and hiker.  "My legs just exploded like there were fireworks in them.  My muscles twitched like they were boiling."

For months doctors told her the knife-like pains were in her head, but six months later, Bertelli was diagnosed with arachnoiditis, an incurable condition that can be associated with epidural steroid injections.

Arachnoiditis is not fungal meningitis.  The outbreak that killed 23 and infected 308 patients nationwide was linked to contaminated steroid solution prepared by a Massachusetts compounding pharmacy.

What Bertelli has is a pain disorder caused by the inflammation of the arachnoid, a delicate spider web-like membrane that surrounds and protects the spinal nerves, spinal cord and brain.  The three most common causes are surgery, infection and chemical irritation.

"It's rare," said Dr. Ray M. Baker, an anesthesiologist and president of the International Spine Intervention Society.

But advocates, including Baker, say that the rising number of epidural steroid injections -- many performed by untrained clinicians -- signals the need for better medical and patient education about risks.

There is some evidence linking the preservatives in steroid medication to arachnoiditis, when the medication is accidentally injected into the spinal fluid.  Fluoroscopic (x-ray) guidance is useful with spinal injections, as it confirms needle placement outside of the spinal fluid and allows for safe injection, according to Baker.

"With the right hands, the right skill set and the right patient and the right conditions, they are safe and quite effective," said Baker.  "We don't have a lot of policing or oversight to say what are the standards and the rules."

And consumers don't know what a "quality job" is, he said.

"Although the fungal meningitis outbreak is a horrible tragedy, we need to be looking at lessons learned," he told ABC News.  "If any good can come from this, in addition to shining a light on the need for greater oversight of compounding pharmacies, it might be that the media attention on steroid injections will allow patients to become better-informed consumers.  For patients, it is buyer beware."

A patient group, led by Bertelli, has urged the Food and Drug Administration (FDA) to provide more comprehensive training of the practice, better oversight of physicians and better patient consent forms that include arachnoiditis as a potential complication.

She also wants better tracking of adverse events and better guidelines for doctors on contraindications.

FDA spokesman Sandy Walsh said "the practice of medicine" does not fall under FDA regulation, but is regulated by the states.

"That being said, in a broader sense, FDA does review adverse event reports and notify the public of safety warnings as we learn new information," she told ABC News.  "And we do often work with physicians groups and external partners."

She acknowledged that complications from these epidural injections can include, in addition to arachnoiditis, bowel and bladder dysfunction, headache, meningitis, paraparesis/paraplegia, seizures and sensory disturbances.

Copyright 2012 ABC News Radio


Fungal Meningitis Prompts Fear Among Steroid-Injection Patients

Jared Wickerham/Getty Images(NEW YORK) -- Jim McGuire is unlikely to forget waiting in a hospital bed for the results of his spinal tap, as a doctor walked into the room across the hall and told a stranger he'd met earlier in the day that she had tested positive for fungal meningitis.  The friend he made as they'd waited all day in the hospital was admitted on the spot.

And McGuire was next in line.

"I saw the doctors go in, and I thought, 'They're talking to her for quite a while,'" he said.  "I knew when she got her results that I would be next. "

McGuire, 51, is from Tennessee, the state hit hardest by the recent fungal meningitis outbreak with 44 cases, including six deaths to date.  Up to 13,000 pain management patients nationwide may have been exposed to fungal meningitis if they received compounded steroid injections manufactured by New England Compounding Co. in Massachusetts.  It is not spread person-to-person.

McGuire received his first steroid injection for back pain on Aug. 28, and learned Monday that his injection was among the three tainted batches NECC distributed nationwide, ultimately sickening 137 people in all and killing 12 of them.  McGuire's doctor ordered him to go to the emergency room immediately.  It was 9:30 a.m.

"It was kind of a chaos in the emergency room," he said.  "The triage for this was incredible.  There were beds lined up in the hallway.  As soon as one spinal tap was over, they were pushing another one in."

He sat hours in the waiting room next to the elderly woman who would later test positive, anxiously wondering whether he had the deadly inflammatory infection that affects the spine and membrane surrounding the brain, ultimately causing permanent neurological damage and death if left untreated.

Early symptoms can take weeks to appear and include headache, dizziness and slurred speech, but McGuire didn't have those yet.  The only way to know for sure was a spinal tap, in which spinal fluid is extracted and tested.

When McGuire finally lay down on his stomach for the test, doctors swabbed his back, and gave him one needle to numb the area and another to extract three vials of fluid.  The pain wasn't "ungodly" but he felt it, he said, especially when the needle brushed a nerve and sent an electric feeling down his leg.

When the doctor finally walked across the hall from his friend's room to his, he told McGuire he was meningitis-free.  He could go home.  It was 5 p.m.

Other steroid injection patients were able to avoid the ER, but they panicked just the same, prompting many to call their physicians for peace of mind.

"There's no question that we're getting a lot of phone calls," said Dr. David Kloth, a pain management physician and board member of the American Society of Interventional Pain Physicians.

He said the Connecticut facility where he works has received hundreds of calls from concerned patients even though no meningitis cases have been reported in the state.  Only one facility in Connecticut received the tainted injections.

Copyright 2012 ABC News Radio


More Women Get Preventive Botox By Late 20s

iStockphoto/Thinkstock(NEW YORK) -- In a society that has become obsessed with youth, there is a growing trend of young women, many still in their 20s, taking dramatic and expensive measures to stop the signs of aging before they happen with non-surgical treatments.

Preventive Botox injections and costly thermage, a hot radio frequency treatment that tightens and lifts skin that is all the rage among celebrities, are the latest cosmetic procedures used to stop crows feet in their tracks.

Starting early is one of the top tips Dr. Debra Jaliman, a dermatologist on New York City's tony Fifth Avenue, offers in her new book, Skin Rules. She often tells her young patients, if they ask, that the science is clear: Early engagement can stop the clock.

"If you know you're somebody who's going in the direction of cosmetics and you know that you're going to care about lines, then I say it's better to do it earlier than to wait and do it once these lines have etched into the skin," Jaliman said. "So if you're in your 20s and you start to see lines coming, then why not do it early and prevent it? And to me it's just like exercise."

However, Jaliman also offers less costly, basic advice for any young woman who is looking to fend off the signs of aging. At the top of the list is getting enough sleep and eating right.

"I can't tell you all the people who come to me to correct problems they wouldn't have had if they followed those simple rules," Jaliman said. "They would save thousands of dollars if they did those simple things."

Most importantly, she says, young women should stay away from prolonged sun exposure and tanning beds.

"We know sun exposure is cumululative," Jaliman said. "Even five minutes a day is enough to give you cancer, but it's also enough to break down the collagen."

Thermage treatments jolt collagen under the skin into overdrive, causing the body to produce more, and firm up saggy areas. Patients get the nip-and-tucked look without the surgery, but it comes with a hefty price tag.

"It definitely tightens your skin. There's no downtime," Jaliman said. "But it is expensive. To do a whole face could be $3,500. So it's an expensive investment, so it's not for everybody. But I think it's a good investment."

Jane Curasco, one of Jaliman's patients, is a new mother and aspiring actress, with no overt need for any boosting or filling. She said she decided to make a substantial investment in stopping the aging clock at age 31. While her friends have tried lasers and microdermobrasion, Curasco said she was the only one to invest in thermage.

"I went on an audition recently and I was supposed to portray a young mother, which I am actually, but every young mother that went in looked 19 so I looked way older than the other people portraying what I actually am," Curasco said.

The dermatologist said thermage is so popular in her office that she has seen a new trend of patients who request it as a full body treatment, which costs a whopping $25,000. But if thermage is out of reach price-wise, patients can turn to preventative Botox.

Typically, single Botox injections start around $280 and go up from there, and according to American Society of Plastic Surgeons, Botox usage is up 10 percent among 20- to 29-year-olds in the past year. But Jaliman said she is not surprised.

"Botox has been around now for almost 20 years. We started using it in the 1990s. It got FDA approval in the early 2000s," she said. "It's relatively painless. It's quick. It's easy. It's an office visit. It doesn't require any surgery. So many people are willing to do it."

Katy DeMayo was just 28, with wedding bells ringing in her future, when she said she decided to try Botox. Before getting engaged, DeMayo said she never had any intention of indulging in cosmetic procedures.

"When you are 25 you have that mentality that it's never going to happen to me. I'll always look this great. I won't be one of those people that does that. And then it happens. Wrinkles appear," she said.

Just a month before her wedding day, DeMayo said she wanted her face to have that "extra perk" and to look "sparklier" for her pictures, so she got Botox injections.

She was so thrilled with the results, she said, that she continues to go back to the doctor once a year for maintenance. However, like many young Botox users, DeMayo wasn't that eager to go public about it. She said before this interview, she hadn't even told her husband she was getting Botox.

"I'm not going to look like I'm 25 years old, but if I'm 35 and I can look 30, or if I'm 45 I can look 40, I think that's worth something," DeMayo said.

Copyright 2012 ABC News Radio


Cancer Risk Among Women Taking Contraceptives Measured in Study

Keith Brofsky/Thinkstock(JOHANNESBURG) -- Women who have used injectable or oral birth control in the past are at a significantly higher relative risk of invasive breast cancer, but they are at significantly lower risk of ovarian cancer, according to a new study based on black women in South Africa. As more time passed after a woman stopped using the contraceptives, her increased risk diminished.

The study, published in PLoS Medicine, pulled self-reported data from 5,702 participants with newly diagnosed invasive breast, cervical, ovarian or endometrial cancers.  There were 1,492 women in the study who served as controls. They had other types of cancers, including colon, rectal and non-Hodgkin lymphoma, which are not influenced by contraceptive use.

Among the participants, 26 percent of women had used injectable hormones and 20 percent had used pills. After adjusting for confounding factors, including age, education, smoking and number of sexual partners, researchers found women were 1.7 times more likely to develop breast cancer and 1.4 times more likely to get cervical cancer than women who had never taken the contraceptives.

About 50 percent of women with breast cancer had used oral or injectable contraceptives whereas 26 percent of women with ovarian cancer had used the contraceptives and 17 percent with endometrial cancer had used them.

In women who had used birth control pills or injectable contraceptives, the cancer risk diminished with time after a woman’s last use of the birth control, the authors wrote.

Injectable contraceptives are very common among black women in South Africa, the authors noted. In the U.S., birth control pills are a more commonly used form of female contraceptive.

Hormone medications are among the most commonly prescribed and taken medications in the world. About nine percent of women ages 15 to 49 took oral contraceptive pills and four percent used injectable contraceptives or implants in 2007, according to a 2009 United Nations report. Combined injectable contraceptives provide a monthly dose of hormones to prevent pregnancy in the same way that oral contraceptives do. Brand names include Cyclofem and Novafem.

But despite the numbers, Dr. Diane Harper, director of the Gynecologic Cancer Prevention Research Group at University of Missouri -Kansas City, said women should not necessarily be deterred from using oral or injectable hormones, in South Africa or anywhere else.

The authors of the study in South Africa did not return ABC News’ requests for comment.

“The very large benefit of contraceptives for women of reproductive age in preventing maternal deaths due to childbearing are largely overlooked by this study,” said Harper. "Any increased risk of breast or cervical cancer due to short-term use of contraceptives must be weighed by the quality of the data coming from the self-reports, by the large number of deaths prevented during childbearing, and by the multiple factors in addition to hormone exposure that play into pre-menopausal versus post-menopausal breast cancer and cervical [cancer].”

Copyright 2012 ABC News Radio


‘Black Madam’ Arrested for Toxic Butt Injections

Comstock/Thinkstock(PHILADELPHIA) -- Philadelphia police on Wednesday arrested Padge Victoria Windslowe, a.k.a. the "Black Madam,” who allegedly administered illegal “butt-boosting” injections, which may have caused the death of a 20-year-old British woman last year.

Windslowe, 42, a transgender who identifies as a woman, was taken into custody at 7:30 p.m. at a home that was hosting a “pumping party,” a spokesperson for the Philadelphia Police Department told ABC News.

Police obtained an arrest warrant for Windslowe after a 23-year-old woman was admitted to a Philadelphia-area hospital after the substance Windslowe allegedly injected into her buttocks got into her bloodstream and into her lungs.

The young woman had paid $1,000 for an injection of what she believed to be silicone, the police spokesperson said.

Lt. John Walker, of the Philadelphia Police Department, told the Philadelphia Daily News that the woman was treated and released but would need further medical treatment.

Police have suspected that Windslowe was the person who gave an injection to Claudia Aderotimi, the 20-year-old who died in February 2011 in a Philadelphia hotel room, but she was not charged because police were awaiting toxicology test results for the cause of Aderotimi’s death.

At the time of her arrest Wednesday, Windslowe had needles, Super Glue, cotton balls, paper towels and a pink bag with a 20-ounce water bottle containing what police believe was the substance she would have injected into others at the party. Walker said five other people were in the house at the time, but no injections had been administered.

Windslowe was charged with aggravated assault, simple assault, recklessly endangering another person, deceptive practice and related offenses. Her bail is set for $10 million.

The arrest is the latest in a string of cases in which people have paid for illegal cosmetic injections, some of which have had deadly consequences.

“Plastic surgeons in the U.S. are seeing an increasing number of disastrous complications when patients see someone who is not appropriately trained,” Dr. Malcolm Roth, president-elect of the American Society of Plastic Surgeons, told ABC News at the time of Aderotimi’s death.

In November, Oneal Ron Morris was arrested in Florida for administering a series of “butt-boosting” injections made from a concoction of cement, glue and tire sealant.

In January 2011, Whalesca Castillo, an unlicensed practitioner in New York City, was arrested for running an illegal business out of her home injecting women with liquid silicone in the buttocks and breasts.

And in 2010, a Miami woman, Ana Josefa Sevilla, was charged with a similar crime after one of her clients ended up in the emergency room with complications.

Plastic surgeons continue to warn consumers about the dangers of getting cosmetic procedures in non-approved facilities and from non-certified practitioners. The notion of cutting costs for a typically expensive procedure may be tempting, but the results can be very dangerous.

“There are no shortcuts to safe outcomes,” Roth said.

Copyright 2012 ABC News Radio


Cutting Edge: Joint Injections Heal Baby Boomer Arthritis

iStockphoto/Thinkstock(NEW YORK) -- When doctors told Aviva Gianetti of River Vale, N.J., that she would need surgery in both arms to heal her tennis elbow, she wanted to find a way out of it.

Gianetti, in her late 50s, goes to the gym several times a week and won't pass up the chance to play golf. But the soreness and pain running down both of her arms has left her unable to partake in her favorite game.

Still, Gianetti was adamant against having surgery, so her specialist took an experimental approach: He gave her a shot of her own platelet rich plasma in both elbows. For Gianetti, two rounds of injections were all it took to get her back on the golf course at full swing.

The procedure, formally called platelet rich plasma, or PRP, injections, uses natural nutrients from the patient's own blood to heal the joints. Blood cells are separated from the liquid part of the blood, and then the clotted blood cells -- or plasma -- are inserted into the damaged joint. Previous animal and human studies suggest that plasma can help repair damaged cartilage and joints.

Athletes like basketball star Kobe Bryant and Chicago Bears running back Matt Forte have undergone PRP injections. But this method to alleviate joint pain has grown in demand among baby boomers.

The baby boomer generation has become the most active of any other in that age group, which has led the boomers to become the fastest-growing group to undergo joint replacements. Knee replacement surgeries have doubled over the past decade, and more than tripled in women between the ages of 45 and 64.

But PRP injections have offered many boomers a chance to extend their active years without pain.

But many experts say PRP injections are no proven substitute for surgery. There is only limited scientific data to suggest that it really works to treat as many joint problems as it is currently used for. Some claims suggest plasma injections can stop arthritis progression, and even create new cartilage.

"This is certainly, potentially one treatment option that may be utilized, but it's not the magic bullet," said Dr. Laith Jazrawi, chief of sports medicine at NYU Langone Medical Center. "To offer these things to patients and potentially tell them that we may have the treatment that may prevent you from getting a knee replacement is really silly."

PRP injections are more often given to treat chronic arthritis. Jazrawi, who offers PRP injections in his office, says PRP should not be the first-line treatment recommended for baby boomer patients. Instead, he advises them to maintain an active and healthy lifestyle and diet.

Copyright 2011 ABC News Radio


Man Arrested for Boosting Butts With Cement, Fix-A-Flat

Miami-Dade County Corrections and Rehabilitation/Miami Gardens Police Department(MIAMI GARDENS, Fla.) -- Florida police on Friday arrested a man suspected of administering dangerous and illegal butt-boosting shots -- injecting at least one woman with a cocktail of substances including cement, glue and tire sealant.

And, believe it or not, that man is the person pictured.

The man is 30-year-old Oneal Ron Morris.

Police could not release an official report on the incident, noting that the case is still under investigation. However, Sgt. William Bamford of the Miami Gardens, Fla.,  Police Department said that the procedure took place in May 2010, after the as-yet-unidentified victim met with Morris to discuss the procedure.

“They agreed on the price of $700 for the procedure, which was intended for cosmetic purposes,” Bamford said.

What the woman got for her money was a series of injections containing a bizarre concoction of cement, super glue, mineral oil and Fix-A-Flat tire inflator and sealant, police said.

Bamford said that the procedure was conducted not in a clinic, but in a residential setting in Miami Gardens, and that shortly after the substance was injected into the woman’s body she developed what Bamford termed “severe complications.”

“[A] short time later, she develops very serious pains, abdomen, throughout her body,” Bamford told ABC affiliate WPLG. “She knows something’s wrong.”

Bamford said the woman went to two different local hospitals, finally heading to Tampa General Hospital, where she received treatment, he said.

Bamford said the woman had an infection at the wound site with the drug-resistant bug MRSA, and she had also developed pneumonia. Even then, Bamford said, the woman was not forthcoming with doctors regarding the source of her symptoms.

But doctors at the hospital, suspecting the work of an unlicensed practitioner was to blame, contacted the Florida Department of Health.

Unfortunately, before health officials could learn more about the case, the woman had left the hospital.

It was not until March 2011 that investigators in South Florida were able to piece together enough of what happened to track down Morris and arrest him in North Lauderdale, Fla., a suburb of Fort Lauderdale, Fla. He was charged with practicing medicine without a license and causing bodily harm.

As odd as the idea of cut-rate, illicit, butt-boosting injections may sound, this case is far from the first that has made headlines -- and in some cases, the outcome has been deadly.

In February, 20-year-old British woman Claudia Aderotimi died following a cosmetic buttocks injection administered in a Philadelphia hotel room.

In January, Whalesca Castillo, an unlicensed practitioner in New York City, was arrested for running an illegal business out of her home injecting women with liquid silicone in the buttocks and breasts.

And in 2010, a Miami woman, Ana Josefa Sevilla, was charged with a similar crime after one of her clients ended up in the emergency room with complications.

“We’ve heard of people having caulk or industrial-grade silicone, neither of which is approved for use anywhere in the body, injected into their buttocks,” Dr. Felmont Eaves, a North Carolina-based plastic surgeon and president of the American Society for Aesthetic Plastic Surgery, told ABC News at the time of Aderotimi’s death.  “There are safe ways to augment the buttocks. Fat grafts usually work extremely well, but obviously you want someone who is board-certified to do that procedure.”

Copyright 2011 ABC News Radio


Woman Dies After Injecting Face with Hot Beef Fat

Jupiterimages/Thinkstock(CHICAGO) -- An Illinois woman who injected hot beef fat into her face died Thursday of a bacterial infection soon after she administered the homemade cosmetic surgery. Oddly, doctors say the questionable injections had nothing to do with her death, which was deemed natural by Illinois’ Cook County Medical Examiner’s Office.

Janet Hardt, 63 of Homewood, Ill., boiled beef, extracted the fat and injected it into her face before she went to the hospital complaining that her face felt as if it was burning, according to ABC News Chicago affiliate WLS-TV.

The Chicago Sun-Times reported that Hardt had infections and scarring in her mouth and on her lips, but an autopsy declared her death was a result of peritonitis, an inflammation of the abdomen’s inner wall.

This bizarre story does not come without lessons, experts say.

“There are a lot people out there doing self-injections for wrinkles, but I don’t know of any medical associations that would recommend this,” said Dr. Phillip Haeck, president of the American Society of Plastic Surgeons. “It’s not worth taking a chance with your face to try to save money when it could ultimately cost you a lot more money.”

Hardt reportedly injected her face with the beef fat several times, and she also underwent several legitimate plastic surgery procedures. Because she injected herself multiple times with the animal product, Haeck said she was at risk of developing an allergic reaction.

“One of the injections could cause the skin to erode or ulcerate,” said Haeck. “We know that injections of animal proteins do not cause systemwide failure, but it tends to cause local reactions. A lot of people who have allergic reactions to animal proteins will say that their face is burning like this woman did. That’s probably what was going on here.”

Copyright 2011 ABC News Radio

ABC News Radio