#70. Smoothing the Wrinkles of Pediatric Migraine and Botox
Release Date: 07/07/2021
#92. Is Physical Therapy, The Panacea of Chronic Pain?
Pedia Pain Focus
Have you ever had any of your patients say that they don't think physical therapy helps their pain? Or that the physical therapy made their pain worse? It would certainly not surprise me, if you said yes. And in that case, this is definitely is the episode you want to listen to carefully. And if your answer to my question was no, this is an episode for you too, my friend. Because sooner or later you too will join this elite club with rest of us. However, this episode will give you the framework and tools to change that in your practice. Learn it from our guest who magically...
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#91. Mental Health and Pediatric Pain; Chicken or the Egg?
Pedia Pain Focus
Pain and mental illnesses coexist, often more than any of other illnesses. Both of them have a profound effect on a child's child’s quality of life, individually. Now imagine the magnitude of impact when they co-exist. In this episode, Dr. Anjana Kundu, with guest speaker Dr. Mirabelle Mattar, a child, and adolescent psychiatrist, discusses the intricate and dynamic relationship between pediatric pain and mental health, likely cause or affect and prognosis for a child with pain in the setting of mental health issues or vice-versa. They also discussed the factors...
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#90. Can We Prevent Pain from Becoming Chronic?
Pedia Pain Focus
Acute pain may be a protective and adaptive phenomenon, but chronic pain is nothing but damaging and a burden in every way possible and for all involved directly or indirectly. So how do we reduce or can we reduce burden? Join me in this episode to learn the factors that contribute to chronicity of pain and whether we can prevent it. Takeaways in This Episode Complexities of pain and its impact for the individuals and the society What differentiates acute from chronic pain and why that is important Various factors contributing to pain and its chronicity Modifiable vs....
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#89. The Pain of Being a Redhead
Pedia Pain Focus
An anesthesiologist or a dentist might tell you that redheads need more anesthesia or local anesthetic. Yet research around their pain perception, tolerance, modulation and response to different pain medications is much more variable and complicated. Join me to learn the recent and emerging evidence about the pain among redheads and what you can do for effectively and safely managing it!
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#88. Pharmacovigilance to Evaluate Efficacy and Net Clinical Benefit in Pediatric Pain Medicine
Pedia Pain Focus
What if you had the lessons from the hindsight AND the foresight while managing children's pain? How would that change your practice? How would that change the outcomes of pediatric pain treatments?
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87. Shifting the Paradigm in Pediatric Pain Medicine
Pedia Pain Focus
Pediatric pain has long been and continues to be neglected for many reasons and because of many challenges. In this episode we discuss those factors and more importantly, the way forward to make the paradigm shift, overcoming challenges and recognizing opportunities.
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#86. Essential Elements of a Successful Patient Encounter
Pedia Pain Focus
A clinical care visit is like flying a plane. It has to be smooth (charming), safe (thorough) yet efficient and on time!
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#85. Pain Amongst Children with Autism Spectrum Disorder
Pedia Pain Focus
Rising prevalence of Autism Spectrum Disorders, contradicting opinions and misconceptions around pain sensitivity and expression among these patients pose unique challenges for clinicians.
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#84. Post-Concussive Headache and Symptom Management in Children
Pedia Pain Focus
Headache is a presenting symptom in 90% of children after a traumatic head injury and for many it may persist for years. It can be extremely debilitating and difficult to treat, posing several unique diagnostic and therapeutic challenges. Join me in conversation with Blake Windsor, MD a pediatrician with a subspecialty in training for pediatric pain medicine, a board certified headache specialist and Chief of Primas Health Pediatric Pain Medicine.
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#83. Reengineering Pediatric Perioperative Care for Optimal Outcomes
Pedia Pain Focus
Postoperative outcomes and success of the interventions is certainly dependent on the analgesia and anesthesia care, but what truly drives the outcomes is a complex interplay of biopsychosocial factors; an alignment between the patients and family's goals and medical as well as surgical interventions. How one goes about achieving that is what this episode is all about!
info_outlineWe all know of Botox use to reduce signs of aging. Approved in 2010 to treat migraines in adults, it’s now also being explored (as an off-label treatment) for management of pediatric migraines.
In this episode, Dr. Shalini Shah, MD, MBA, the Vice-Chair for the Department of Anesthesiology & Perioperative Care and Enterprise Director of Pain Services at UC Irvine Health, shares their clinical and reseach findings, as well as the indications, caution, nuances, and protocol for use of botox in pediatric migraine. Her work on the effectiveness of Botox in pediatric patients experiencing migraines has been published in peer reviewed journals and been featured in Time Magazine and on NBC Nightly News.
We discuss her landmark work, the results of her study, protocols, indications and how you can best advocate for your patients to receive the same treatment.
Takeaways in This Episode
- How Dr. Shah became interested in use of botox for pediatric headaches.
- Findings of her pediatric study including longitudnal data for Botox treatments in pediatric migraine.
- Dosage and protocol for Botox injection for peditaric migraine (Hint: You'll be surprisedby the dosage used in kids!)
- FDA's stance on Botox for children's migrainesand how to navigate the approval of this off label treatment with insurance companies.
- Indications, contraindications and precautions when using OnabotulinumtoxinA for headaches. (Hint: No allergy butuse of caution in certain conditions is crucial!)
- Outcomes and patients' response after the treatment with botox; improvement in all spheres.
- Strategies for preauthorization or approval by the insurance company.
- Dr Shah's message to healthcare professionals treating pediatric headaches
Links
Connect with Dr. Shah - Twitter Linkedin
Dr. Shah’s articles on Botox -
Effectiveness of Botox in Pediatric Migraines
Botox for Prophylactic Treatment of Pediatric Migraines
Proactive Pain Solutions Academy
Clinicians Pain Evaluation Toolkit
Recommended Listening:
Pedia Pain Focus Episode #21: How to Counsel Your Patients on Off-Label Medication Use
Other Recommended Reading:
About the Guest
Shalini Shah, MD, MBA, Associate Professor is Vice-Chair for the Department of Anesthesiology & Perioperative Care and Enterprise Director of Pain Services for University of California Irvine Health. Dr. Shah completed her residency in anesthesiology from Cornell University and a combined fellowship in adult and pediatric chronic pain at Harvard Medical School.
She is the founder of the Pediatric Pain Program at UC Irvine and has previously served as Associate Program Director for the Pain medicine fellowship. Dr. Shah is the recipient of the ASRA Chronic Pain Grant Award in 2017 for her landmark work in onabotulinumtoxinA (Botox) use in pediatric migraine pain. She has been featured in Time Magazine, The Doctors, NBC Nightly News, Business Insider and is a frequent guest on NPR on the topic of safe pain care options. Dr. Shah is an internationally invited lecturer and leads several industry and peer-reviewed NIH funded clinical trials in pediatric and adult pain medicine.
Dr. Shah currently serves as the Founding Chair, Committee of Pain Medicine at the California Society of Anesthesiologists (CSA) and President-Elect, CA Society of Interventional Pain Physicians (CALSIPP). Dr. Shah is strongly committed to pain advocacy and healthcare regulatory reform both in the state of California and nationally to improve healthcare experiences for patients.