Bringing You Botox!

Celebration Family Physicians is excited to offer a new service line:  Botox injections for cosmetic benefits.  Below are the answers to your most commonly asked questions.

What is Botox?

BOTOX is the brand name of an FDA approved drug used in the cosmetic treatment of wrinkles and facial creases.  The drug is an injectable neurotoxin, Botulinum Toxin Type A, made by the bacterium Clostridium botulinum.  BOTOX is the first and only FDA-approved treatment to temporarily smooth moderate to severe forehead lines, crow’s feet lines and frown lines in adults.  There are other brands used for the same purpose, such as Myobloc, Dysport, Jeuveau, or Xeomin.  BOTOX is the term you hear most often because it was the first injectable botulinum toxin.

 

How does Botox work?

Botox blocks signals from the nerves to the muscles.  The injected muscle cannot contract resulting in the relaxation and softening of facial lines and wrinkles.  The muscle paralysis is temporary.

 

How long does it take to see results?

You may begin to see results within 24 to 48 hours after treatment.  It takes 1 to 2 weeks to see the full results of your treatment.

 

How long does Botox last?

The effects will last 2 to 4 months.  Individual results will vary.  Repeating the treatment 2 to 4 times a year help to maintain your results.  The lines and wrinkles will appear less severe with time and repeated treatments.

 

What are the benefits of Botox?

Botox has both cosmetic and medical benefits.

Life brings its share of surprises, smiles and frowns.  These experiences and facial expressions means repeated muscle contractions that may lead to prominent lines.  If you are bothered by these lines, you are not alone.  Botox is a great way to achieve younger-looking skin by helping eliminate or reduce these prominent lines.

Botox is useful in many other ways such as treating migraines, excessive sweating, overactive bladder, lazy eye (strabismus) and neck spasms (cervical dystonia).

 

What parts of my face can I get Botox treatment?  

BOTOX is the only FDA-approved treatment for moderate to severe forehead lines, crow’s feet lines (lines to the sides of the eyes) and glabella frown line (wrinkles between the eyebrows).

 

 

What can I expect during your Botox treatment?

With a very fine needle, Botox is injected into the muscles of the face.  You will feel a minimal stinging sensation.  Most patients rate the discomfort a 1 or 2 on a scale of 10.  The treatment takes about 15 minutes.  You will be able to resume your day immediately afterwards.  We recommend you stay upright for 4 hours after the treatment and take a day off from exercising.  It is bet to avoid alcohol at least 1 week prior to the procedure.  You should also stop taking aspirin or anti-inflammatory medications 1 week before your treatment to prevent bruising.

 

How much does Botox cost?

Botox is priced per unit.  On average, each unit costs about $10 – $15.  Below is the FDA-Approved maximum dosing for each area.

  • Forehead lines: 20 units
  • Crow’s feet lines: 24 units (12 units on each side)
  • Frown lines: 20 units
Unit Dose Price Per Unit
Up to 20 units $12
21 to 44 units $11
45 t0 64 units $10

 

Is Botox Safe?

Botulinum toxin tye A has been used safely for 30 years.  Botox is FDA approved meaning they have successfully proven their safety and efficacy through large scale clinical trials.

 

What are possible side effects?

Some people can get pink bumps at the injection sites.  This can last for a couple of hours up to several days.  You will not lose the ability to show expression.  Other uncommon but potential side effects include swelling, rash, headache, local numbness, pain or irritation, infection, bruising, eye problems, flu-like symptoms, eyelid or brow drooping, and allergic reactions.

 

Who should NOT be injected with Botox?

  • Pregnant women or women trying to get pregnant.
  • Nursing mothers.
  • Individuals under 18 years old.
  • Individuals with dermatosis (such as psoriasis or eczema) or infection in the treatment area.
  • Individuals who develop keloid scarring.
  • Immunocompromised individuals.
  • Individuals with neuromuscular disorder such as Myasthenia Gravis, ALS, myasthenia gravis, Lamert-Eaton syndrome, and myopathies.
  • Individuals allergic to any of the ingredients in Botox or had any allergic reaction to other botulinum toxin products such as Myobloc, Dysport, Jeuveau, or Xeomin.
  • Individuals undergoing treatment for urinary incontinence or have a urinary tract infection.

 

 

COVID-19 VACCINE UPDATE – Eligible Populations

Governor DeSantis issued Executive Order 21-47 (amending Executive Order 20-315) expanding the populations eligible to receive COVID-19 vaccines.  If you are eligible to receive the vaccine and require a form, we are happy to help complete the required form.  Please schedule an appointment today by calling Celebration Family Physicians 407-566-8898.
Populations Eligible to Receive COVID-19 Vaccines:
  • Long-term care facility residents and staff
  • Persons 65 years of age and older
  • Health care personnel with direct patient contact
  • K-12 school employees
  • Sworn law enforcement officers 50 years and older
  • Firefighters 50 years and older
  • Persons under the age 65 deemed extremely vulnerable to COVID-19 (form required to be completed and signed by a physician)**
**Clinically vulnerable patients are under the age of 65 with any of the following conditions:
  • Lung Conditions
    • Severe Asthma: if without treatment, symptoms occur throughout the day and severely limit daily physical activities, nighttime symptoms occur often (sometimes every night), and lung functions tests are abnormal.
    • COPD (Including Emphysema)
    • Cystic Fibrosis
  • Heart Conditions
    • Heart failure with ejection fraction less than 40%
    • Coronary Artery Disease
    • Cardiomyopathy
    • Complex Adult Congenital Heart Disease
  • Kidney conditions
    • End Stage Renal Disease on Dialysis
    • Chronic Kidney Disease
  • Immunocompromised State (Weakened Immune System)
    • Cancer on Active treatment. AIDS with an absolute CD4 count equal or less than 200 within the past six months
    • Solid Organ Transplant
    • Blood or Bone Marrow Transplant
    • Autoimmune Disease on Immunosuppressive Medication
  • Severe obesity (body mass index [BMI] >40)
  • Diabetes
  • Sickle Cell Disease
  • Down Syndrome

 

 

Emergency Use Authorization of Johnson & Johnson’s Janssen COVID-19 Vaccine:
The Federal Food and Drug Administration (FDA) has issued an Emergency Use Authorization to permit the emergency use of the product Janssen COVID-19 Vaccine for individuals 18 years of age or older.
Useful Links:

COVID-19 Vaccine

Coronavirus Disease 2019, commonly called COVID-19, is the name of the disease caused by the virus Severe Acute Respiratory Syndrome Coronavirus 2 also know as SARS-CoV-2.  The first case was reported in Wuhan, China in December 2019.  The virus is contagious and quickly spread around the world.  The World Health Organization declared COVID-19 a pandemic in March 2020.  To learn more about COVID-19, click here.

Vaccines are the best way to prevent the spread of COVID-19.  Several COVID-19 vaccinations are being developed.  Pfizer and Moderna vaccines are currently being distributed in the United States.  We will begin administering the vaccination once it becomes available to Celebration Family Physicians.

If most people receive the vaccination, the virus will stop spreading so quickly.  When enough people are immune from the disease either from receiving the vaccine or recovering from the disease, it provides indirect protection to those who are not immune to the disease. This is referred to as “herd immunity”.  Examples of diseases that were once common but now rare in the United States because of vaccines achieving herd immunity are measles, polio and chickenpox.  The pandemic will end when we achieve “herd immunity”. It would be almost impossible achieve this without a vaccine or allowing a lot of people to get infected (some getting seriously ill and/or dying).

After you receive the vaccine, it will still be important to practice social distancing, wearing a face mask in public and hand washing for now.  The vaccine is not 100% effective.

It is important to get the flu vaccine with the ongoing coronavirus pandemic.  The flu and coronavirus can cause similar symptoms.  Preventing the flu and reducing severity of symptoms can lessen the number of people needing to stay in the hospital.

Where can an individual included in Executive Order 20-315 receive a COVID-19 vaccine?

Please see the table below which contains designated general vaccine providers.  We will administer the vaccination once it becomes available to us.

Eligible Populations Able to Receive Vaccine Under Executive Order 20-315
Primary Vaccine Providers
Additional Vaccine Providers
Long-term care facility residents and staff
CVS and Walgreens
Florida Department of Health and Florida Department of Emergency Management
Persons 65 years of age and older
County health departments
Hospitals and other community health care providers, including a federally qualified health center (FQHC)
Health care personnel with direct patient contact
Hospitals and COVID-19 vaccine providers
County health departments and other community providers, including a FQHC
Hospital providers

COVID-19

COVID-19

Overview

Symptoms

Diagnosis

Causes

Prevention

Vaccinations

Events and Gatherings

Quarantine: Exposure and COVID-19

Treatment

Overview

Coronavirus Disease 2019, commonly called “COVID-19”, is the name of the disease caused by the virus Severe Acute Respiratory Syndrome Coronavirus 2 also know as SARS-CoV-2.  The first case was reported in Wuhan, China in December 2019.  The virus is contagious and quickly spread around the world.  The World Health Organization declared COVID-19 a pandemic in March 2020.

Coronaviruses are a family of viruses that cause illnesses such as the common cold, severe acute respiratory syndrome (SARS), and Middle East respiratory syndrome (MERS).

The U.S. Centers for Disease Control and Prevention (CDC) and WHO are monitoring the pandemic and continue to post updates on their websites.

Vaccinations are the best way to prevent the spread of infection.  Dr. Craig Yunk at Celebration Family Physicians will administer the vaccination once it becomes available.

Symptoms

Symptoms of coronavirus disease 2019 vary from person to person and can cause mild to severe illness and, at times, can lead to death.  About 85% of people have mild symptoms.  Symptoms in children tend to be milder.  About 14% have severe illness requiring hospitalization with about 5% requiring care in an Intensive Care Unit (ICU).

The incubation period ranges from 2 to 14 days. Symptoms typically appear within four to five days of exposure but may take up to 2 weeks for symptoms to appear.  Some infected people do not have any symptoms.

Symptoms may include:

  • Fever
  • Chills
  • Dry Cough
  • Shortness of Breath
  • Fatigue
  • Muscles Aches
  • Headache
  • Loss of Appetite
  • Loss of Sense of Smell
  • Loss of Sense of Taste
  • Other symptoms have been reported include Nausea, Diarrhea, and Rash

Predictors of Severe Disease

  • Older age
  • Comorbidities such as Heart Disease, Chronic Kidney Disease, Chronic Liver Disease, Chronic Lung Disease, Diabetes, Hypercholesterolemia, Hypertension, Immunocompromised State, Obesity, Sleep Apnea, Sickle Cell
  • Low oxygen levels

Complications

  • Pneumonia (an infection of the lungs)
  • Low oxygen levels
  • Stroke
  • Blood Clots
  • Death

Diagnosis

The tests used to diagnose COVID-19 is the Antigen Test and Polymerase Chain Reaction (PCR).  The tests are performed by collecting fluid in your nose using a swab.  The antigen test checks for proteins from the virus and the PCR test checks for viral genetic material (coronavirus RNA).  The antigen test is faster but not as accurate thus more likely to give “false negative” results.  If COVID-19 is still suspected, a PCR test may be recommended to confirm the negative test result.

The antibody test is a blood test that detects the presence of IgM and IgG antibodies.  The clinical significance of these antibody tests is still being determined.

Causes

COVID-19 is caused by the SARS-CoV-2 which is in the family of coronaviruses.  Various coronaviruses cause different illnesses including the common cold, SARS and MERS.

The SARS-CoV-2 is contagious spreading from person to person. The virus spreads by tiny particles when someone with the infection coughs, sneezes or talks.  The particles can easily travel through the air and land in the mouths or noses of people nearby and on surface or objects.  In enclosed spaces where the same air circulates, the virus particles can spread to other people who are farther away.  Touching a surface or object that has the coronavirus on it and then touching your nose, mouth or eyes may be another way of contracting the virus.

The virus can spread even when an infected person is not symptomatic.

Prevention      

  • Social Distancing of at least 6 feet; Avoid crowds; Limit attendance to events and gatherings; Limit eating at restaurants
  • Limit exposure (15 minutes of exposure increases risk)
  • Mask wearing in public
  • Wash your hands with soap and water frequently for at least 20 seconds; if unable to wash your hands have hand sanitizer with at least 60% alcohol readily available
  • Avoid touching your face
  • Avoid Traveling
  • Quarantine for 14 days after last exposure if close contact with a person with COVID-19
  • Confirmed or Suspected COVID-19 isolate at home
  • Clean commonly used surfaces frequently
  • Get Vaccinated

Vaccination

Vaccines help prevent the spread of diseases. Several COVID-19 vaccinations are being developed and becoming available.

If most people get the vaccination, the virus will stop spreading so quickly.  When enough people are immune from the disease either from receiving the vaccine or recovering from the disease, it provides indirect protection to those who are not immune to the disease. This is referred to as “herd immunity”.  Examples of diseases that were once common but now rare in the US because of vaccines achieving herd immunity are measles, polio and chickenpox.

The pandemic will end when we achieve “herd immunity”. It would be almost impossible achieve this without a vaccine or allowing a lot of people to get infected (some getting seriously illness and/or dying).

After you receive the vaccine, it will still be important to practice social distancing, wearing a face mask in public and hand washing for now.  The vaccine is not 100% effective.

It is important to get the flu vaccine with the ongoing coronavirus pandemic.  The flu and coronavirus can cause similar symptoms.  Preventing the flu and reducing severity of symptoms can lessen the number of people needing to stay in the hospital.

Where can an individual included in Executive Order 20-315 receive a COVID-19 vaccine?

Please see the table below which contains designated general vaccine providers.  Dr. Craig Yunk at Celebration Family Physicians will administer the vaccination once it becomes available.

Eligible Populations Able to Receive Vaccine Under Executive Order 20-315 Primary Vaccine Providers Additional Vaccine Providers
Long-term care facility residents and staff CVS and Walgreens Florida Department of Health and Florida Department of Emergency Management
Persons 65 years of age and older County health departments Hospitals and other community health care providers, including a federally qualified health center (FQHC)
Health care personnel with direct patient contact Hospitals and COVID-19 vaccine providers County health departments and other community providers, including a FQHC
Hospital providers

 

Events and Gatherings

The safest way to celebrate is at home with the people you live with and avoiding large gatherings.  If you are hosting or attending a small gathering with family and friends, consider some of the suggestions below to reduce the transmission of COVID-19.

  • Celebrate virtually
  • Keep the celebration within your household
  • Limit the number of guests
  • Avoid direct contact (i.e. handshaking, hugs) from different households
  • Ask guests to avoid contact with people outside of their household at least 14 days before the gathering
  • Host the gathering outdoors (avoid indoor or poorly ventilated spaces); if indoors, open windows and doors weather permitting
  • Shorten the duration of the gathering; a cumulative total exposure of 15 minutes or greater increases the risk of transmission
  • Practice social distancing (at least 6 feet apart)
  • Wear masks when not eating or drinking
  • Frequent handwashing for at least 20 seconds, especially after eating
  • Have hand sanitizer with at least 60% alcohol readily available
  • Clean and disinfect commonly touched surfaces
  • Stock your bathroom with soap and single use towels
  • Limit commonly touched surfaces like serving utensils; consider one person to serve food and/or individually packaged items
  • Offer no-touch trash cans
  • Avoid letting pets interact with guests outside of the household
  • Avoid gatherings in communities with a high or increasing levels of COVID-19
  • Consider the location of where guests are traveling from  as well as the mode of travel (i.e. flying) that may increase the risk of transmission
  • Do not host or attend gatherings if anyone in the household has symptoms of COVID-19, may have been exposed to someone with COVID-19 in the last 14 days, waiting for results, older or immunocompromised, or diagnosed with COVID-19 and has not completed their quarantine period (usually between 10 to 20 days from when symptoms first appeared)

 

Quarantine: Exposure and COVID-19

Exposure – If you were in close contact with someone with COVID-19, you should get tested as soon as possible even if you do not have symptoms.  You should self-quarantine at home for 14 days and monitor for symptoms.

Symptomatic COVID-19 – If you were diagnosed with COVID-19, you can be around others after:

  • 10 days since symptoms first appeared and
  • 24 hours with no fever without the use of fever-reducing medications and
  • Other symptoms of COVID-19 are improving
  • Severely ill or immunocompromised – Extended Quarantine for 10-20 days

Asymptomatic Positive Test – Quarantine for 10 days

Treatment

Most people with COVID-19 will get better on their own within a few weeks.  Management is usually supportive.  Some people have symptoms that persist for weeks to months.  People with serious symptoms need to go to the hospital.

Hydroxychloroquine has not been shown to have clear benefit in patient with mild to severe COVDI-19 symptoms or for post exposure prophylaxis.

Treating the symptoms of COVID-19 can help you to feel better.

  • Sleep helps your immune system fight infection.
  • Drink plenty of fluids. If you are drinking enough, you should pass urine every three to five hours.  Urine should be light yellow to nearly colorless.
  • Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) can relieve fever, headache, and muscle aches. Aspirin and medicines that include aspirin are not recommended for children under 18 years old because aspirin can lead to a serious and potentially fatal condition called Reye syndrome.
  • We do not recommend cough or cold medicine for children under age 6 years.
  • Antibiotics — Antibiotics are NOT useful for treating viral illnesses. Antibiotics should only be used if there is a bacterial complication of the coronavirus such as bacterial pneumonia. Unnecessary use of antibiotics can lead to development of antibiotic resistance.

Happy Holidays and Practicing Safety

Happy Holidays Everyone!  We wish you a warm and cozy Christmas!  For many of us, this is a special and favorite time of year.  Even though it has been a challenging year, we have so much to be grateful for.

 

Our holiday celebrations might look a little different this year.  The safest way to celebrate is at home with the people you live with and avoiding large gatherings.  If you are hosting or attending a small gathering with family and friends, consider some of these suggestions to reduce the transmission of COVID-19:

  • Celebrate virtually
  • Keep the celebration within your household
  • Limit the number of guests
  • Avoid direct contact (i.e. handshaking, hugs) from different households
  • Ask guests to avoid contact with people outside of their household at least 14 days before the gathering
  • Host the gathering outdoors (avoid indoor or poorly ventilated spaces); if indoors, open windows and doors weather permitting
  • Shorten the duration of the gathering; a cumulative total exposure of 15 minutes or greater increases the risk of transmission
  • Practice social distancing (at least 6 feet apart)
  • Wear masks when not eating or drinking
  • Frequent handwashing for at least 20 seconds, especially after eating
  • Have hand sanitizer with at least 60% alcohol readily available
  • Clean and disinfect commonly touched surfaces
  • Stock your bathroom with soap and single use towels
  • Limit commonly touched surfaces like serving utensils; consider one person to serve food and/or individually packaged items
  • Offer no-touch trash cans
  • Avoid letting pets interact with guests outside of the household
  • Avoid gatherings in communities with a high or increasing levels of COVID-19
  • Consider the location of where guests are traveling from  as well as the mode of travel (i.e. flying) that may increase the risk of transmission
  • Do not host or attend gatherings if anyone in the household has symptoms of COVID-19, may have been exposed to someone with COVID-19 in the last 14 days, waiting for results, older or immunocompromised, or diagnosed with COVID-19 and has not completed their quarantine period (usually between 10 to 20 days from when symptoms first appeared)

Christmas Eve

Premier Doctor Recognition

I am so incredibly honored with this recognition through the kind regards of my fellow colleagues.  Thank you to The Orlando Magazine for featuring the physicians in our community.

Thank you to all physicians and medical professionals who have served and continue to serve when the world needed you the most.  You have risen to the challenges and continue to fight something bigger than all of us.  You are our strength.


Click here to read the article in the Orlando Magazine Annual Doctor’s Issue for 2020. 


Click here to read the article in the Orlando Style Magazine featuring Dr. Yunk as one of the Doctor’s of the Year for 2021.  

Thank You!

Happy November!

We want to take this moment to thank ALL OF YOU!  We are so fortunate to have so many wonderful friends and families.   We wish you all a wonderful holiday season and many blessings.

 

Prevent the FLU from Happening to YOU

It’s more important than ever to get your flu vaccine this year.

 

Here’s why:

  • The flu shot is your best defense against the flu.
  • Prevents you from getting the flu, reduces the duration and severity of illness, and prevents complications.
  • Reduces the risk of flu- associated hospitalization.
  • Protects you, your love ones and the people around you.

 

To learn more about the flu, click here.

To view Celebration Family Physician Vaccination Schedule, click here.

Meet Our New Provider – Michelle!

Michelle De Marco, PA-C, is a board-certified physician assistant specializing in Family Medicine, with a strong background in clinical treatment of pediatric and adult patients. She received a bachelor’s degree in Biology with a minor in Finance from University of Central Florida. She completed her physician assistant training at Nova Southeastern University and graduated with a Master of Medical Science.  Michelle is fluent in English and Spanish. She has a passion for taking care of others and prides herself in delivering excellent care to her patients. In her leisure time, Michelle enjoys travel, good food, and frequenting the theme parks.

 

Please join me in welcoming Michelle to Celebration Family Physicians!