Botulinum Product Medication Guide

Excerpt from April 2009 letter written from the FDA/Department of Health and Human Services in response to the group Public Citizen regarding concerns raisde over the safety of botulinum toxin products (Botox, Dysport, etc.):

“Based on our analysis of reports in the AERS database, relevant clinical trial data, and published literature, we have notified the BLA holders for licensed botulinum toxin products of the need to develop a Medication Guide for distribution by physicians to patients at the time the product is injected. This reflects our determination that a REMS is necessary for these products in accordance with section 505-1(A) (1) and (2) of the Act, as applicable, to help ensure that the benefits of these products outweight their risks, and that a Medication Guide should be an element of the REMS under section 505-1(e)(2)(A) of the act. In accordance with 21 CFR 208.1(c)(1) and (c)(2), we have determined that botulinum toxin products pose serious and significant public health concerns requiring the distribution of a Medication Guide, and that these products have serious risks (relative to benefits) of which patients should be made aware because information concerning the risks could affect patients’ decisions to use, or continue to use, these products. The Agency also has determined that patient labeling for botulinum toxin products could help prevent the consequences of serious adverse events. We consider this Medication Guide to be part of the labeling for which safety labeling changes are necessary under section 505(o)(4) of the Act, as well as an element of a REMS under section 505-1 (e)(2)(A) of the Act.

We have determined that a Medication Guide is an appropriate additional method of communicating the signs and symptoms of the spread of botulinum toxin effect to the patient or the caregiver. ….The Patient Counseling Information section of botulinum toxin product labeling will be revised to state that the physician should provide a copy of the FDA-approved Medication Guide and review the contents with the patient. ”

Were YOU given a copy of the Medication Guide?

Skin burning

Hi All,

Im 18 months out and now my skin is burning again,Im very worried what is going on ,did anyone had hot, burning skin so late? I cant touch my skin it hurts and on fire, I cant take anymore, still so sick and now this again..

Healing thoughts to you all guys

Get Checked for Lyme

Hi All,

I am positive for Lyme. By CDC standards and Igenex. I know this has been discussed on here before, and I think its important to share. My first CDC test I didn’t test positive. Its hard to detect. My doctor thinks that it may have weakened my immune system enough for the infection to show, as some of her patients started having symptoms after injections from vaccines, or even surgeries.

 

Specific Digestion Problem Q’s

Hi All,

What type of specific digestion problems have you all encountered. I am researching a lot and collecting as much info and data as I can. and figuring out if my digestion problems relate to leaky gut from the toxin, or organs being affected by the toxin i.e. Gallbladder. If you wouldn’t mind sharing. For example – mine have been from the beginning lack of appetite for a small period of time, then severe bloating, then diarrhea/constipation. Also I have had bizarre changes in color of stool which correlates to my Gallbladder. (one day it will be bright yellow, the next day it will be black – & no this is not black from activated charcoal – this happened before I was supplementing with it) When you all mention digestion problems in your keyword tags could you please be specific as to what you are experiencing if you are comfortable with sharing.

Thank you

Help – 4 weeks post injections, is this going to get worse?

I received 26 units of Botox injections in my forehead on December 28th. I’ve had botox once a year for about 6 years with no issues. However. within a few days I noticed that my right eye felt a little droopy and numb. I also began to experience night sweats and intense anxiety, followed by tingling/numbness in my arms and legs, muscle weakness, dry eyes, brain fog and pain at the base of my skull. I immediately found this site, which of course scared me to death.

I began eating very healthy, drinking lots of water, sitting in the sauna at my gym, and working out every day – pretty much anything to flush this out of my system. I even went to an IV bar and paid $200 for a liver detox IV, along with Taurine and Tryphtophan for my anxiety. I also began taking neurotransmitter supplements (Taurine, Magnesium, GABA, Typhtophan, B6 and Niacin) at night. At about 2.5 weeks post injections, my symptoms seemed to subside. I felt normal again and thought it was over.

Then, right at about 4 weeks I got my period and holy cow did the symptoms come back worse than before. Intense tingling/numbness and weakness in my arms/legs, brain fog, intense night sweats and anxiety. I felt like my insides were burning, difficulty sleeping and shaky upon waking up. And I swear I’m noticing muscle atrophy around my shoulders and elbows, although this might be in my head.

I read posts on this site and see people experiencing much more severe symptoms and I’m very scared that I’m just at the beginning of this nightmare. I’d love to see some sort of timeline. Meaning, those who experience severe symptoms (having to drop out of work, can’t get out of bed, going to the hospital), did those symptoms come on immediately and then get better? Or were your symptoms mild at first and progress over the next few months?

I guess I’m wondering how much worse this is going to get. If I’m 4 weeks out and the symptoms are mild/moderate, does this mean it’s the worst it’s going to get? Or will things progressively get more severe?

I’m getting married in 8 months and am terrified that I’m not going to be able to walk down the aisle or enjoy my wedding day because of this stupid toxin!

Suggestions for the site

Hi all,

There have been a lot of comments lately around the fact that the site is difficult to navigate around and thats it’s generally a poor experience on the site.

Unfortunately I am not a professional web developer and we have used WordPress to build the site which is a popular blogging site and might be missing some of the rich forum functions.

Anyway the site has not had a major upgrade for a few years, so I am reaching to you all for suggestions and comments. If you have some ideas for the site, please comment here. If there is a site that you think has a better layout post the URL and I will check it out.. Lets collect some feedback over the next week or so and I will “have a go” at rebuilding the site. We are stuck with WordPress as there is so much information on the site now, it would be impossible to switch to a different platform, outside of that we are open to all suggestions.

Thanks for your help in keeping the site relevant and useful !!

Cameron & Annette

Where to find an informed doctor

I live in NY city, but  will likely have to move back to Virginia if this doesn’t get better. Does anyone know of smart doctors in either region?

Here are my symptoms: Tachycardia, trouble swallowing, hyperacusis, weakness, fatigue, brain fog, shortness of breath, extreme insomnia (but not sleepy), neuropathy in hands and feet, headaches, burning at back of scalp, jerking/twitching at night, dry eyes, dry mouth


 

Praying for all of us

Lately I’ve been going back and fourth in my mind what is causing this. Like many of you, I did not have any health problems UNTIL the injections. Is it I had underlying issues? Is it I was actually poisoned. I’m working on solving it and finding the answers for myself. Because I’ve realized thats what most of us need. We all need to go on this journey to understand it, and we have to experience it for ourselves, have every other option looked at before we can believe others. We have to try AC or DE or detoxes or IVS or whatever we think might help for ourselves. Even if I want to accept this is botox, I won’t believe it until I get every test possible. But in the meantime I want to let everyone know I sincerely pray for all of you each night. I mourn what we have all lost. I know God is good and he is teaching me many important lessons from this. We are the strongest. May the miracle we all need be just around the corner <3

Dalio

I have not been on this site for a while. I am 17 months post Botox and am doing awful. I can not work. I have increased muscle weakness, pain, fatigue, confusion. But over the last few months I am noticing my memory is really being affected, long and short term. This is really scaring me. I have read the posts about Lyme disease. I have been tested numerous times and have spent my own money being tested, but I am always negative. I feel like I have the symptoms of Lyme, but I also feel I have had this reaction to Botox. In hindsight, my increased symptoms over the 2 years I had Botox, up until my last set of injections, were perfectly timed with the Botox injections. My Gut tells me it was the Botox. I would love to rule out Lyme altogether, but I have lost my high paying job, have no money and am waiting for disability to kick in. So, that expensive test is out for me. Again, 17 months out and continue to feel worse. I am so depressed which I know doesn’t help, but how cant you be?  My life is ruined because of this.  Very worried about memory. Doctors are no help. Does anyone else have this deterioration of memory, difficulty finding words or spitting out what you’re trying to say? I have been sitting here reading all the recent posts. People need to realize that many of these autoimmune diseases, Lyme disease and suspected reaction to Botox all have related and overlapping symptoms.  We have all been brought to this site because we are ill, don’t know why and need help. If there was a clear cut answer we would all be well. All information is helpful. I believe each one of us are on our own desperate search for wellness.  Any thoughts would be appreciated. This search is a hard one when you continuously feel so miserable.

Botox side effects

I got Botox Dec 3, 2015 for chronic migraines. 200 units. I’ve been getting this for 3 years now.
However. After the injections I noticed my head was Itching profusely. Then my arms. Then my legs. I started breaking out in a rash. That rash after several days went into hives. Daily the hives got worse and stayed on my body for 2 weeks straight. Not even prednisone or atarax would help it. Finally last week they started easing up some.
I’ve seen 6 Drs now. I’ve told them that I am convinced this is a side effect from the Botox. Although until recently I’ve never looked at side effects.
My arms and legs are STILL swollen and the least little thing breaks me out. Laying on my husband. Pressure on mg skin. Etc. I’ve never had a skin issue In my life.
I’ve had HIGH anxiety, insomnia, blurred vision, hoarse voice and burning sensations that feel like my veins are on fire.
Swelling in the back of my neck. Hypersensitive skin.
This has been the absolute worst experience of my life.
My body is so whacked and I’m in overdrive all the time. I never get more then 3-4 hours of sleep a night. My nerves are shot and I am praying this nightmare will end soon.
It’s amazing to me how none of my Doctors except one thinks Botox is a possibility.
I even had to have a skin biopsy done and it came back hypersensitivity hives due to medicine or a bite. I had my pest control come out yesterday and they inspected for “everything” no bugs in this house!
I would love to have a toxicology report done on my blood for the toxin that I believe is in it. But have no idea where to start.
I am losing my mind over this and my nerves are completely shot.
I just want the ole miserable migraine me back. This has effected me mentally and physically. Some days I don’t think I can do this. Other days I try to ignore it.
I will never touch Botox again ever.

New here

Hi. Like many of you, I am suffering. Had Botox/dysport for 5 years and realize now that it’s been making me sick for over 8 months. Of course, I didn’t realize this and had a final injection on the 5th. I had been tapering off of klonopin and thought that it was the klonopin the whole time. Needless to say, this is very upsetting. I have a doctor (integrative medicine-she is an MD) who believes me and thinks she can help. I had a myer’s cocktail drip -magnesium iv drip with b vitamins and vitamin c- this evening and started shaking terribly. However, I feel much calmer for the moment. She also wanted me to do a glutathione iv, but I wanted to see if anyone has ever done these and if they had a reaction to them?  Additionally, she wants to take alpha lipoic acid, ester-c, and asked me to do a 7-day detox, but I wasn’t sure about this. Does anyone have any advice for a newbie? I have been dealing with a lot of neurological symptoms that keep me from sleeping, brain fog, confusion, dry mouth, dry eyes, obviously anxiety and depression, shaking, trembling, difficulty getting food down, etc.

Oxygen in drops anyone tried?

Hi all, just thought I will share with you I have also done bioresonance test now and it has shown botulinum toxin in my system stil.. Doctor who did the test has told me about Oxy Max Oxygen in drops to drink, she said people with Lyme get very good resuts with this and it could also be helpful for botulism toxin. Also I am going for consultation about ozonotherapy and high dosw of vitamin C in drip. Dont know if anyone tried that all yet but I thought it could be very helpful as Vit C is never absorbed fully by our system and terapeutic results are when given intravenously..

Here is link to Oxy drops

http://www.earthsbounty.com/cgi-bin/commerce.cgi?preadd=action&key=1100-OXY_MAX

I will post about it when I get more info.

Sending all healing thoughts xoxo

Don’t Wait. Get Checked For Lyme.

I don’t come on here anymore because of the rudeness and ridiculousness of some of the longtime posters.

But I really feel compelled to tell anyone who’s had neurological or muskoskeletal symptoms past 12 months, and anyone who is new to this board with a severe adverse reaction to get evaluated by an LLMD. Do it right away. Don’t wait.

There is a person on this board who maintains that she’s had neurological sequelae from botox for coming on to seven years. She has Lyme disease and coinfections. She might feel this is private information but I don’t care — the presentation of her symptoms in association with botox only is misleading and could mislead MANY Lyme victims away from the truth about their condition.

Discovering and getting treated for Lyme is hard enough. If you push through your symptoms for years believing you have “botox poisoning” all you’re doing in that time is getting worse and doing nothing about it.

Even if you test negative the first time, keep testing. Don’t put it off or hope it will go away. Get tested and keep getting tested, especially if your symptoms are not clearing up, but even if they are clearing up; keep getting tested. Don’t be relieved by a negative western blot or a clean bill of health from the medical establishment. They don’t know how to find Lyme, and they don’t know how to treat it.

Lyme hides from the immune system and changes your immune responses so that it can shut down antibody production — the antibodies they are looking for on the conventional Lyme tests. Worse, because it suppresses the immune system this sets you up to get things you never imagined such as guillain barre and BOTULISM. Do you have a low white blood count? Do you have a positive ANA? Do you suddenly have white matter lesions in your brain?

These things are all caused by Lyme and its co-infections. Traditional testing has failed again and again to locate the antibodies in the blood of the victims because that is one of the first responses it disables.

You can order testing without a doctor’s order from arminlabs.com in Germany. Order a test kit for the “Elispot LTT” and also order testing for all co-infections of Lyme. Bring the test kit and the instructions to any licensed phlebotomist or lab wherever you are. They will charge you for the blood draw and DHL will pick up the sample and deliver it to the lab via medical express. You can use Armin Lab’s DHL account for an extra charge of 50 dollars.

The Elispot does not check for antibodies, it checks for T cell response to even one borrelia organism in your blood. This is 100 percent accurate. There is no other way to read the results and no ambiguity. When you get your results, the owner of that lab will forward his recommendations for a treatment schedule based on what he sees there if you ask. If you are NEGATIVE on the Elispot you never have to think about it again, you’re clear.

It’s expensive. It’s worth it.

I also asked them if they would check for botulism in the blood if a separate sample is sent. They said yes. So if you *really* think it’s botulism and it hasn’t been too long, they can find it. I don’t know how they do it because I did not do this.

It’s no accident that one of the better treatments for “botox poisoning”is HBOT. HBOT is also a treatment for Lyme and some co-infections and has brought some people back from the brink of death. Some people consider themselves completely healed of Lyme because of HBOT.

Don’t put this off. Find out. If you’re short on cash the Elispot should be enough to tell you something. And yes, my Elispot was positive.

How doctors can lie?????

http://doublecheckmd.com/DrugDetail.do;jsessionid=47D2C9FB6454D8A32580C9D8DEA4E436?dname=Botox+(obsolete)&sid=3351&view=e

Sort side effects by: Most Frequent Body System A-Z

Click on a Side Effect below for detailed information

Common Side Effects
Drooping eyelid(s) occurs in 20.8% of cases
– with doses of 33 unit(s)
Eye effects occurs in 20.8% of cases
Swallowing problems occurs in 19% of cases
Headache occurs in 13.3% of cases
Infection of the respiratory tract occurs in 12% of cases
Respiratory tract infections occurs in 12% of cases
Neck pain occurs in 11% of cases
Anxiety (fear or dread out of proportion to situation – often with restlessness, tension, pounding/rapid heartbeats, or rapid breathing) occurs from 3% to 10% of cases
Back pain occurs from 3% to 10% of cases
Cough occurs from 2% to 10% of cases
Dry mouth occurs from 2% to 10% of cases
Extreme muscle tension occurs from 2% to 10% of cases
Fever occurs from 2% to 10% of cases
Flu or cold-like symptoms (cough, sore throat, runny nose, etc) occurs from 2% to 10% of cases
Inflammation of the nasal passages (rhinitis) occurs from 2% to 10% of cases
Itching occurs from 3% to 10% of cases
Local irritation (skin irritation in the area where treatment is applied) occurs from 3% to 10% of cases
Muscle weakness occurs from 2% to 10% of cases
Nausea occurs in less than 10% of cases
Pain at injection site occurs from 2% to 10% of cases
Word-finding difficulties (trouble finding the right word) occurs from 2% to 10% of cases
Drooping eyelid(s) occurs in 3.2% of cases
Face pain occurs in 2.2% of cases
Achiness/pain occurs in 1.7% of cases
– at the injection site
Bruising occurs in 1.7% of cases
Reddening of the skin due to widening of small blood vessels (differs from flushing in that it is long-lasting) occurs in 1.7% of cases
Skin conditions occurs in 1.7% of cases
Skin redness occurs in 1.7% of cases
Bronchitis (inflammation/infection of the upper airways – may cause cough; sputum) occurs in 1.5% of cases
Sinusitis (infection/inflammation of the sinuses) occurs in 1.5% of cases
Swelling occurs in 1.5% of cases
– at the injection site
Dizziness occurs in 1.2% of cases
Sore throat/throat irritation occurs in 1.2% of cases
Botox (obsolete) has sometimes caused these symptoms, but the percentage of occurrences is unknown. Please note: no drug should be ruled out as causing symptoms, even if the symptom is not listed.
7th cranial nerve disorder (injury to any branch of the “seventh cranial nerve” that controls muscles in the face or forehead, and supplies the tongue, salivary glands and outer ear – can cause drooping of the face and forehead; abnormal perception of sound volume; abnormal tearing, taste and saliva production) (2 case(s))
Absence of the lens of the eye (usually due to cataract surgery)
Achiness/pain
Allergic reactions (may include a sudden severe drop in blood pressure; rapid heart rate; skin rash, itching, hives; itchy, runny, congested nose; red itchy, watery eyes; shortness of breath, wheezing, cough, hoarseness, chest tightness; nausea, vomiting, abdominal cramps, diarrhea; irritation of the stomach and esophagus)
Anterior segment ischemia (a lack of blood flow to certain eye muscles – most commly occurs following certain eye surgeries – can result in an enlarged, oval-shaped pupil and abnormals cells floating in the “anterior chamber” of the eye)
Aphasia (inability to speak or to understand speech – usually due to a stroke or other brain condition)
Bleeding behind the eyeball (“retrobulbar hemorrhage”)
Bleeding into the vitreous body (gel-filled sack that fills the eyeball from the inner surface of the eye)
Bleeding problems
Botulism (a serious, sometime fatal, food poisoning)
– when given by injection
– in people less than 12 years of age
– in adults
– in children
– elderly people with swallowing problems
– elderly people with difficult or labored breathing
– people less than age 16
Brachial plexopathy (damage to the “brachial plexus”/nerves that supply movement and sensation to the arms – can result in weakness or decreased arm/shoulder/hand movement or sensation/including hand or arm numbness or tingling)
Burning, prickling, tickling or tingling occurs in 1% of cases
Cerebral palsy
Creutzfeldt-Jakob disease (brain disease related to “mad-cow” disease – may cause balance problems; unsteadiness; trouble with walking and speech; memory problems; involuntary jerking movements, etc)
Decreased breathing (“respiratory depression” – shallow or slow breathing)
Difficult or labored breathing
– especially in people with nerve damage that affects muscle function
Difficulty breathing
– especially in people with nerve damage that affects muscle function
Digestive tract problems
Dissociated vertical deviation of the eyes (DVD) – condition in which one eye fixes on an object but the other eye rotates upward and outward to gaze in a different direction
Erythema multiforme (a red skin rash with pimples, red areas, and blisters – may begin on arms and legs; may include mouth ulcers – sometimes with target-shaped lesions especially on the back of the hand or forearm; often due to allergic or drug reactions)
Excessive sweating
Eye bleeding
Eye muscle spasms
– can last up to several days after taking drug
Facial paralysis
Fainting/loss of consciousness
Fatalities (1 cases were fatal)
– when given by injection
– in adults
– in children
– people who have significant illness
General feeling of ill health
– when given by injection
– in children
– people who have significant illness
Hand weakness
High blood pressure occurs in 1% of cases
Increased risk of infection
Infection of the upper respiratory tract
Irritation/inflammation
– when given by injection
Local irritation (skin irritation in the area where treatment is applied)
– at the injection site
Lung and respiratory problems
Lung diseases
Miscellaneous changes on the face
Muscle spasms
Muscle wasting (loss of muscle mass)
– when given by injection
Muscle weakness
– when given by injection
Musculoskeletal problems
Narrow-angle glaucoma (one type of glaucoma in which pressure within the eye is increased because drainage of fluid is blocked) – causes redness, severe pain, light sensitivity and decreased vision; may also cause nausea and vomiting
Numbness or tingling (“pins and needles”) occurs in 1% of cases
Paralysis of a limb
Paralysis or partial paralysis of the muscles in the face/eyes
Problems involving the pupil (dark circle in the center of the eye)
Rash that resembles psoriasis (red, slightly scaling, itchy, flat patches on the skin)
Skin rash
Skin tightness occurs in 1% of cases
Spacial disorientation (confusion about or mistaken perception about one’s position or orientation in space relative to the earth)
Stomach/upper abdominal discomfort occurs in 1% of cases
Strabismus (inability of the two eyes to coordinate their movements and move together)
Swallowing problems
– when given by injection
– especially in people with nerve damage that affects muscle function
Swelling of the eyelids
– can last up to several days after taking drug
Tenderness
Tooth problems occurs in 1% of cases
Ulcers of the cornea (transparent circle at center of the eye through which light passes) – may cause pain, redness, light-sensitivity, or excessive tearing
Urinary tract infection occurs in 1% of cases
Use of a respirator
Vision changes
Widespread skin rash
Worsening of myasthenia gravis (a chronic nerve condition with drooping eyelids, muscle weakness and muscle fatigue with exertion)
Rare Side Effects
Abnormal thoughts/thinking (single case)
– when given by injection
– when the drug is stopped or dose is decreased
Anaphylaxis (a severe allergic reaction – that usually occurs quickly and includes flushing or reddening, rapid heart rate, chest tightness, difficulty breathing, or faintness) (rare)
Difficult or labored breathing (single case)
– when given by injection
– when the drug is stopped or dose is decreased
Double vision (rare)
Eye muscle spasms (single case)
General feeling of ill health (single case)
– increased risk in people with a history of talkativeness
– increased risk in people with a history of difficult or labored breathing
– increased risk in people with a history of lung and respiratory problems or difficult or labored breathing
– increased risk in people with a history of swallowing problems
– increased risk in people with a history of muscle weakness
– children with lung and respiratory problems or difficult or labored breathing
– children with abnormal thoughts/thinking
– children with swallowing problems
– children with talkativeness
– children with shortness of breath
– children with voice changes
– children with difficult or labored breathing
– children with muscle weakness
– risk increases as total lifetime dose increases
Heart attack (rare)
Hives (itchy welts) (rare)
Irregular/abnormal heart rate occurs in 0.7% of cases
Lung and respiratory problems (single case)
– when given by injection
– when the drug is stopped or dose is decreased
Muscle stiffness (increase in muscle tone) (rare)
Muscle weakness (single case)
– risk increases as total lifetime dose increases
– when the drug is stopped or dose is decreased
Numbness (rare)
Severe allergic reaction (rare)
Shortness of breath occurs in 0.7% of cases
– when given by injection
– when the drug is stopped or dose is decreased
Speech/language problems (rare)
Stiffness (rare)
Swallowing problems (single case)
– risk increases as total lifetime dose increases
– when the drug is stopped or dose is decreased
Swelling (rare)
Voice changes (rare)
– when given by injection
– risk increases as total lifetime dose increases
– when the drug is stopped or dose is decreased

Such a shame they blocked NHS site – there was even more side effects , including hair loss, brows and lashes. They blocked it 3 months ago… I have emailed them and requested all that info but they refused saying that they dont have this info 😠

Vision issues and more…

Thanks for adding me. I had a second Botox treatment on 12/22/15 by an established dermatologist for migraines, using a relatively small amount (15 units) of Botox between my eyebrows.  (The first time was three months ago with 25 units and it helped greatly with no issues.)  I was very specific that I didn’t want this to change my appearance in any way, which was why I went to my dermatologist and paid privately vs a neurologist where my insurance would have covered it.  About a day later I started having right-sided eyelid drooping and by a few days after that, my right eye was pretty much shut down completely. I still can’t open it more than a few millimeters and can’t hold it open enough to see at all.  Since then, I’ve developed blurry and even double vision (top to bottom double vs side-to-side, when I try to look through both eyes by taping or holding it open).  It’s made me so nauseated, off-balance and disoriented.  I can’t drive, can’t work (I am a writer/editor working with book and magazine deadlines), and am having regular headaches from straining to see.  I’ve seen my ophthalmologist who said the apraclonidine drops this derm doc had prescribed were irritating my cornea so I had to stop trying them.  And although by the time of the eye exam I hadn’t used the drops in about 18 hours, the pressure in that eye had dropped– which was just fine at a regular eye exam about a month before.  The eye doc also said that the derm doc had affected not only the levator muscle causing the drooping but another muscle that’s causing the double vision.  I keep hearing this will all resolve in weeks to months as the Botox wears off, but I’m so upset and scared right now.  And the dermatologist who caused this has been very nonchalant about all of this which just angers me, although she’s been apologetic, saying it should not have happened.  I think she’s being so ‘friendly’ because the admitted they never told me of the risks at this procedure and forgot to have me sign their release/waiver form.  I just want this nightmare to be over.  I’ve been scouring the Internet for answers and possible solutions and am worried that this might be more involved than the ‘normal’ risk of “drooping.”  I can’t imagine this being this bad for weeks let alone months— let alone permanent.  Thanks to everyone for having this forum and for any help or advice.