USER MANUAL - Bono Electrolysis
Contents
1. 12 13 14 15 Do you squeeze blackheads or pimples on your face 16 Do you regularly take vitamins 17 Do you take Vitamin C on a regular basis 18 Are you a strict vegetarian 19 Are you currently taking any type of hormone If so what kind 20 When you cut scratch burn or abrade your skin do you develop brown splotches in the area 21 Has your skin developed brown spots melasma or splotching during pregnancy or while taking the birth control pill 22 During pregnancy did you develop tiny blush like red spider veins 23 After any blow or trauma to your legs did you ever develop tiny blush like red spider veins 24 Is there a family history of spider and varicose veins or broken capillaries 25 How many years have you noticed your unwanted vascular blemishes 26 Are you still developing new vascular blemishes 27 Have your vascular blemishes ever been treated 28 Do you have a history of scarring after treatment of your vessels SS O Tia err eT 29 Did you develop small red vessels blush like after laser treatment YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO Patient consent form Vascular Blemishes Please read and fill in all 7 pages No medical technique is perfect and no two people are alike Accordingly the treatment of vas cular blemi2. Long From copyright 201OTortoise Press In some cases you may experience temporary darkening of the skin where the vessels have been removed face body and legs We have not yet seen a case where this is permanent but the marking can persist for up to 6 months Indeed we have products available to hasten the disappearance of pigmentation if the need arises On the legs this may appear as brown streaks or brown patches where the vessels were treated On the face this will appear as tiny brown dots As mentioned we expect pigmentation to be temporary but it could be permanent in your case although this would be rare Sores or ulcers seldom occur a result of posttreatment infection Thus you need to carefully follow aftercare instructions and keep the area clean Infection can lead to dot like scarring Infection or other posttreatment problems are commonly treated with anti inflammatorily medications and or antibiotics Finally we have recently discovered that having had prior treatment with sclerotherapy laser or hyfrecator can create treatment resistant blood vessels that may require significantly more treatments And treatment of such vessels my not be successful Please be sure that you discuss any prior treatments with either the physician or technician Photographs are necessary to document the progress of this procedure I understand this and agree to have photographs taken and I also agree to these being used for training a
3. Use 0 2 to 0 3 milliamperes for small to medium telangiectases use 0 3 to 0 4 for large telangiectases NOTE The DC meter on this machine reads in tenths Therefore 4 on the meter is actually 0 4 milliamperes or 4 tenths of one milliampere A few suggestions Over the years I have trained numerous practitioners I have observed both new and veteran therapists and have noticed several recurring errors For the most part the therapist usually performs what I would term a timid treatment That is she uses too little current does not insert the probe deep enough and doesn t produce enough coagulated segments to ensure a successful treatment outcome I think that therapist are inherently fearful of electrical currents and anything that looks like a needle They are fearful of hurting the patient Thus they treat telangiectasia insufficiently They are also not as knowledgeable about the skin as they should be despite having attended school They know very little about the way normal skin heals They often become upset when they see inflamma tion swelling and crusting even though these manifestations are just part of the normal healing pro cess By contrast physicians are fearless They are also familiar with the healing process and can advise patients that most posttreatment manifestations are normal and will resolve without incident If you are a therapist working independently or in a doctor s office I suggest tha
4. aftercare is seldom necessary following telangiectasia treatment However if the area appears exceptionally red and swollen you may use cataphoresis Cataphoresis diminishes edema erythema and reduces posttreatment pain Plug the phoresis roller with accessory cord into the positive jack outlet Plug the hand held ground with accessory cord into the negative jack outlet Preset the DC meter to 0 5 to 1 0 milliamperes 5 to 10 on your meter Place wet cotton gauze on the treated area use tap water or witch hazel Turn on the DC with footswitch and gently roll the phoresis roller over the gauze covered area for about 2 to 3 minutes The lowest setting will be different on different electrology units If you are not cer tain ask the manufacturer where to put the HF dial to have the lowest recommended HF output Remember you need very little current to successfully treat teles Working ranges on a Typical Electrolysis Unit Always start at low on the HF output 4 S S lt HIGH FREQUENCY HF LEVELS C For telangiectasia removal your HF working range 2 is between low and medium ALWAYS start at 7 your lowest HF setting Z START 1 r a Telangiectasia working range on the Telangitron oe oS T xo o 5 10 15 20 oO TREN N eo c zs Qirect Current DIRECT CURRENT DC LEVELS For telangiectasia removal your DC working range is between 0 2 and 0 4 milliamperes
5. hospital will take your full sharps container for certified disposal usually at no cost at all 3 Typical Electrolysis Unit Front Panel DC METER You may glue PROBE CORD CLIP here DC HF INDICATOR INDICATOR LIGHT LIGHT Direct Current High Frequency Dict Current DC CONTROL KNOB HF CONTROL KNOB DC TEST SWITCH L POWER L S7 SWITCH You are supplied with 1 Hand held ground 2 Accessory cords Accessory cord 1 Probe cord 1 Phoresis roller Probe cord Phoresis roller Hand Held Ground Typical Electrolysis Unit Back Panel High Frequency JACK Direct Current JACK EDGE LANGITRON Ess 105 125 Volts 50 60 Hz 0 5 Ampere o Edge Systems Corporation Signal Hill CA 90806 Phone 562 988 1175 FAX 562 988 1195 Direct Current FOOTSWITCH High Frequency FOOTSWITCH SERIAL NUMBER TO REDUCE THE RISK OF SHOCK DO NOT OPEN THIS MACHINE OR REMOVE ANY PART OF THE ENCLOSURE SERVICING AND REPAIR BY AUTHORIZED PERSONNEL ONLY THIS MACHINE MUST BE PROPERLY GROUNDED AT ALL TIMES TO AVOID ELECTRICAL SHOCK HF THERMOLYSIS FOOTSWITCH CORD amp PLUG DC FOOTSWITCH CORD amp PLUG Note The footswitch plugs can only be inserted into the jacks one way If the plug will not go in easily turn it over and try again The plug will lock into the jack when properly inserte
6. reevaluate the area and then treat the remaining telangiectasia For an in depth study of these processes please refer to my main text I have made this drawing large to impress upon you that you MUST coagulate the entire length of each vessel and you MUST be on target 10 A Quick Start High Frequency 3 4 Direct Current 0 5 10 15 20 Ss Am Start on a relatively tiny threadlike vessel on the face Set your HF Thermolysis to low and set the DC direct current to 3 tenths see illustration above Gradually increase the HF as needed HF is correctly set when the vessel coagulates in about 1 to 2 seconds If coagulation is taking longer you are not using enough HF Any faster than 1 second and you may be using too much HF The DC setting will range between 3 and 4 tenths You don t need much DC because you are only using the DC to enter the vessel and to release the needle from the coagulated clot Use the standard Ballet Tel needle 003 I usually bend the needle to a 45 degree angle Bending allows me to insert the needle straight into the vessel not at a low angle Bending the needle is covered in my book Start off by completely coagulating one noticeable vessel Be sure you coagulate the whole thing If you are not sure of yourself treat only a few vessels you can always remove more at another time You will gain confidence as you get more experience Pick the Right Patient Especially when you are star
7. water for 10 minutes Swish around in the soapy water and rinse thoroughly dry and sanitize Clean inside the handle with alcohol and a Q tip If the phoresis roller is badly corroded the DC will not flow replace the phoresis roller Do not autoclave the phoresis roller BANANA PLUG ACCESSORY CORD St 000000000000000000000000000000000000000000000000000000000000000000000uu Now and then clean the banana plugs with alcohol Avoid extensive stretching of the cords Repeated stretching breaks the wire NEEDLE HOLDER PROBE CORD With normal use the probe cord wire eventually breaks or frays If there is intermittent current or no current replace the probe cord Purchase a new probe cord each year because nearly all problems arise from a broken or worn out cord Avoid excessive stretching of the probe cord FOOTSWITCHES D fo 3 Q e 5 Dust buildup can cause the electric contacts inside the footswitches to malfunction Periodically brush or blow out the accumulated dust and wipe the outside surfaces When not in use store footswitches off the floor to avoid dust buildup Don t overstretch the cords 16 Simple troubleshooting meter should rise smoothly METERS d Hold down the DC test switch and turn the DC control knob to 10 on the meter The meter should rise smoothly Release the test switch and the meter should return to 0 Press the test switch again The meter should rise smoothly t
8. USER MANUAL This is the manual that was supplied with the Telangitron I have edited out most T tron references This manual will ap ply to nearly any standard Blend machine Direct Current ELANGITRON REMOVAL OF TELANGIECTASIA Using Blend Electrology Equipment Mike Bono 1310 San Miguel Avenue USER MANUAL Santa Barbara CA 93109 USA User Manual P N 19095 A TELANGITRON phone 1 805 962 5431 Copyright 2010 Tortoise Press Registered USA Trademark email mikebono cox net All rights reserved Please read this e Do not operate your electrolysis unit without proper training e You should not perform telangiectasia removal without having read Telangiecta sia Procedures to Remove Dilated Blood Vessels Using the Blend Method by Michael Bono Hands on training is highly recommended and may be available at a nearby electrology school Individual training is available by Mike Bono NON PHYSICIAN DISCLAIMER In the United States a physician or technician working directly under medical supervision may legally remove telangiectasia with an electrolysis unit Presently laws are rapidly changing that allow independent American therapists to perform this procedure Several States have added telangiectasia removal to the list of appropriate esthetics procedures However it is up to you to find out the legalities in your area In Europe Australia New Zealand South America and Canada nonmedical t
9. ause she was afraid of hurting the patient C Even though she has made these errors the immediate swelling from the low current and the probe entering the skin causes the telangiectasia to disappear The patient is happy but within a few days the telangiectasia reappears as the swelling diminishes blood vessel not just treat here and there Sometimes you will discover that as you treat a vessel much of it disappears When this happens you must remember where the vessel was and coagulate the entire invisible length Indeed you will see redness swelling and tiny crusts after the treatment and it may take a few days for the skin to calm down However you must perform successful treatments without being fearful of normal skin reactions Typically this techniqueTechnique will cause some localized inflammation After the primary edema swelling subsides say in a day or so the inflammation process will continue as the skin heals The inflammatory process itself causes tiny blood vessels in the area to dilate to carry more blood to the healing tissues Therefore is it very normal for the patient to experience more pronounced blood vessels in the area for up to 2 weeks or so in some patients You must inform the patient that this phenomenon is part of the normal healing process Do not retreat the area too soon in an attempt to diminish these normal inflammation caused dilated vessels Wait at least 3 to 4 weeks until the inflam mation is gone
10. d Typical Electrolysis Unit Accessories NEEDLE HOLDER PROBE CORD 1 a The needle holder is specifically sized to take the standard telangiectasia needles CLIPS FOR PROBE CORD amp HAND HELD OUTLETS 2 You are usually supplied with two 2 black rubber clips for your needle holder and hand held ground and a tube of super glue Just glue the clips to the machine wherever you want them BANANA PLUG ACCESSORY CORDS 2 St Sl VFLOVALUAUUIGUUKUVUCOHUOCOKULGUMULUONUAUILONUONCAUONUALUINNCLUCONUTAUION Vos gt You are usually supplied with two 2 banana plug accessory cords The cords are similar to a coiled telephone cord coiled to avoid accidental pulling and wire breakage The plugs look like bananas hence the name Use the accessory cords for the hand held ground and the phoresis roller HAND HELD GROUND 1 You are usually supplied with one 1 hand held ground This is a simple metal cylinder that plugs into an accessory cord and is then plugged into the RED or Black positive and negative jacks outlets You will use the same ground for telangiectasia removal and for cataphoresis Simply plug the ground into the respective RED or BLACK outlet for the specific operation PHORESIS ROLLER enm You are usually supplied with one 1 phoresis roller The phoresis roller looks like a tiny paint roller and is used to perform cataphoresis You will only be performing cataphoresis with your Ble
11. formation regarding the legality of this procedure may be your insurance company DISCLAIMER Please be aware that the information on page 2 is meant as a guide for you We are unable to answer specific legal questions because laws are different in each State and locality However it is important that you seek qualified legal opinion HISTORY CLIENT CONSENT FORM Always have patient client fill out the History Patient Consent Form Two sample forms are provided on the back of this manual NOTE Different State laws require added information not covered by this sample form It is your responsibility to follow State law requirements e PATIENT INSTRUCTIONS Always have patient client follow pretreatment instructions A sample form is provided see the last few pages of this manual e Do not use on patients with the following condition unless physician authorized e Patient with heart or cardiovascular problems pacemaker etc e Patients with communicable diseases e Patients with metal implants or braces Do not treat pregnant women unless physician authorized e Do not unplug components by pulling on the cord always pull from the connector e Needles are single use Dispose of used needles according to appropriate sharps disposal procedures Use an FDA approved sharps disposal container Check with your local authori ties for proper disposal of the full sharps container You cannot simply toss needles or the sharps containe
12. g treatment Elevate your legs and just relax 3 YOU MAY take Advil or Tylenol after the treatment but this should not be necessary 4 DO NOT apply make up right after If you want make up please allow us to apply it for you Application must be done carefully to not interfere with the treatment 5 DO NOT exercise until the next day No yoga sauna hot tubs and stay out of the sun 6 PLEASE wear sun block on the area for the next two weeks or so Apply this very carefully and do not rub the area 7 PLEASE just go about your regular routine after about 48 hours No special care is needed and extraordinary procedures are unnecessary You will notice tiny crusts but his is normal and they will fall off in 7 to 10 days face and body and about 2 to 3 weeks legs Copyright 2010Tortoise Press
13. herapists such as estheticians are allowed to treat telangiectases However each regional authority has specific rules governing what can and cannot be done by nonmedical therapists Unfortunately in the United States most of these laws are extremely vague Some States have no licensing or rules governing this practice In most American States the subject of telangiectasia removal has rarely been discussed by governing bodies However if you are not a medical doctor or not working under medical supervision you should check with laws and medical authorities Check these legal issues before purchasing any device or treating telangiectases with any electric needle device Additionally whether or not a needle is actually inserted into the skin has little bearing on the legality of this procedure Do not be fooled by the touch only techniques these are still destroying tissue In fact the touch only techniques destroy more tissue than the fractionally inserted Technique Touch only techniques are MORE dangerous see DVD and Textbook INSURANCE Be aware that if this procedure is specifically prohibited by law for nonmedical practitioners your liability and malpractice insurance will probably not cover this procedure We have found however that in States that allow this procedure and in unlicensed States with no rules insurance companies ordinarily cover this practice at no additional cost In fact your best source of in
14. in C on a regular basis YES NO 29 Are you a strict vegetarian YES NO 30 Do you occasionally eat red meat YES NO These questions are for our research Several clinicians have noted that strict vegetarians appear more prone to develop telangiectasia Vitamin C may help reduce telangiectasia formation by strengthening blood vessel walls Your answers will help in creating a larger body of data for our researchers ALLERGIES 31 Are you allergic to tape If yes what is the reaction to tape on your skin circle blistering rash redness other 32 Do you develop hives from cold or ice 33 Have you had any unusual reactions to local anesthetic If yes what is the reaction circle light headedness nausea fainting other excitation 34 Do you suffer from hay fever seasonal watery eyes amp nose hives or itchy rash 35 Have you ever suffered a severe allergic reaction swollen eyes asthma difficulty breathing MEDICATION 36 Are you currently taking any type of hormone If so what kind premarin injection pill
15. is we can remove the make up for you just before the treatment If you are having vessels on the body or legs removed we suggest washing with Hibiclens before coming in for treatment This will reduce bacteria and help against infection not likely in any case 2 DO NOT take aspirin before or after the treatment 24 hrs Aspirin causes unnecessary bleeding 3 YOU MAY take Tylenol or Advil before treatment if you think you will be sensitive to the treatment Advil is preferable because it will slightly diminish swelling after the treatment Take this with food 4 PLEASE eat something before treatment We recommend a small meal with carbohydrates to raise you blood sugar This helps relax you and minimizes treatment sensitivity 5 PLEASE come in one hour early if we are going to use cream anesthesia 6 DO NOT drink coffee or other beverages with caffeine this increases your pain level and causes nervousness 7 PLEASE wear comfortable clothing If you are having leg vessels treated wear loose fitting pants Do not wear hose of any kind you will not be able to put them on after the treatment AFTER YOUR TREATMENT For the most part just do as little as possible after the treatment Just leave the area alone 1 DO NOT stretch your skin in an attempt to see what has been done 2 DO NOT wash your face body or legs until the next day Just leave it alone Keep the ace bandage in place legs for at least 24 hours followin
16. ly move the roller over the treated area to help calm the skin and remove posttreatment redness Feels good ges SET UP Plug the ACTIVE electrode roller in the positive out iti let Plug the hand held electrode in the negative outlet Set the DC to between 5 and 10 on the meter Press down on the DC foot switch and roll over the treated area for about 5 to 10 minutes Ditec Current OO Pe pe 5 10 active roller electrode agen don owt TEST Aa 14 Copyright 2003 Tortoise Press Skin Tags Benign epidermal hyperplasia Removal with Blend unit SKIN TAG a benign not cancer overgrowth hyperplasia of the epidermis the outermost layer of skin Skin tags are common on areas that experience friction such as the underarm and neck Because they are epidermal they are totally bloodless and lacking melanocytes appear white in color Skin tags also have very few nerve endings again because they are an overgrowth of epidermis LEGALITY As with any tissue removed from the skin biopsy should be performed Furthermore re moval of skin tags while very easy probably constitutes the practice of medicine in the United States These should not be removed without medical supervision Although in Europe Australia and New Zealand the practice of skin tag removal is legal for therapists PROCEDURE Use high HF power and set the DC to 5 or 10 meter reading Firmly grasp the top of the skin tag
17. nd educational purposes I have read the above and understand the potential benefits limitations and risks of treatment Understanding these risks I consent to have this procedure performed Patient please sign and print your name Date Witness Date 1 Last name 2 Age Sex If referred by whom 4 Have you eaten within the last few hours sometimes patients who have not eaten become dizzy after treatment 5 Are you pregnant or planning to get pregnant in the near future __ 6 Do you have a history of please circle any that apply Infection septicemia HIV allergy to aspirin hepatitis lupus collagen vascular disease 7 Is there a personal or family history of the following please circle any that apply bruise easily bleeding or clotting problems prolonged bleeding If so for how long If so how many packs per day First name Height Weight x amp S YES NO a eG a YES NO YES NO heart problems migraine headache low blood pressure high blood pressure diabetes pulmonary emboli any known allergy thrombophlebitis blood clot with or without swelling Pa g YES NO ae yee ey YES NO 10 After walking have you ever noticed please circle heaviness tiredness fatigue swelling leg cramps restless legs throbbing other symptoms NO oo Ye o XW 9 11 Are you required to be on your feet for long periods of time YES NO 12 After standing d
18. nd unit Therefore your phoresis roller will always be plugged into the positive jack outlet FOOTSWITCHES 2 a o D 3 Q 3 ie 3 You are usually supplied with two 2 footswitches one for the HF and one for the DC The footswitches plug into the back of the unit The unithas one 1 electrical AC power cord attached to the machine 6 Telangiectasia removal Setup for Telangiectasia removal t Attach the probe cord to the BLEND outlet Plug the hand held ground with accessory cord into the RED positive outlet Place a wet baby wipe or wet towel around the hand held ground Use regular tap water not distilled Loosen the tip of the needle holder and place a needle in the holder Tighten securely Recommended needle size Standard Ballet Tel 003 needle for all telangiectasia removal applications Basic Procedure Preset the HF current to your lowest setting for small to medium telangiectases You may use more current for larger vessels Preset the DC current to 0 2 or 0 3 milliamperes for small to medium telangiectases You may use more current for larger vessels but usually no more than 0 4 milliamperes is needed Follow instructions found in Bono s book Telangiectasia Be sure that you understand both the Basic Procedure and the Modified Basic Procedure as explained in the book These techniques are your primary operating procedures Cataphoresis t t t Cataphoresis
19. nk of this as a POSITIVE treatment in that it feels good makes the skin look less red and calms the skin You can think of petting a cat which makes you feel good CAT a phoresis Technically term refers to cathode lontophoresis Esthetics term Using the positive electrode various products are forced into the skin Used for sensitive aging skin Anaphoresis Using the negative as the active electrode Think of this as a NEGATIVE treatment in that it feels irritating makes the skin red and stimulates the skin You can think of this as that nasty old Ana that mean old aunt of yours ANA phoresis Technically term refers to anode Disincrustation Esthetics term Using the negative electrode for acne prone skin The negative pole liquefies sebum and makes comedo extraction easier Irritates and increases blood flow to skin In some acne prone cases treatment can worsen the condition MICRODERMABRASION Use cataphoresis after microdermabrasion the DC current Put a Vitamin C product on the skin and gently work it in with the roller no pad neces sary This is sometimes called iontophoresis or ionic treatment The current forces the Vitamin C into the skin and also greatly soothes the skin after microdermabrasion TELANGIECTASIA You may also use cataphoresis after a blood vessel treatment Place a wet 4 X 4 cotton pad on the skin use Witch Hazel or other soothing product Gent
20. o 10 Erratic movement on the meter indicates a problem Contact the manufacturer distributor bend here FOOTSWITCHES E Preset the DC Dial to 10 Plug each footswitch one at a time into the DC jack receptacle Depress the DC footswitch and gently bend the cord back and forth at the plug and at the base of the footswitch If the DC meter stays at 10 without fluctuating the footswitch is good metal pin vise bend here 1o PROBE CORD M Preset the DC meter to 5 Attach the probe cord to the BLEND outlet Plug the hand held ground and accessory cord into the RED positive jack outlet Wrap the hand held ground with a moist towel Remove the tip of the needle holder and place the metal pin vise on the towel Depress the DC foot switch the DC meter should rise smoothly to 5 With the DC current on and the pin vise on the towel bend the probe cord back and forth at the outlet and at the needle holder If the meter does not fluctuate the cord is good If the meter fluctuates there is a break in the wire Replace the probe cord HAND HELD GROUND Preset the DC meter to 5 Plug the hand held ground and an accessory cord into the BLACK negative outlet Plug another accessory cord into the RED positive jack outlet Touch the banana plug of the accessory cord to the bare metal ground Turn on the DC with the footswitch Press the banana plug firmly to the ground and randomly slide it over the enti
21. o your legs ache YES NO 13 Do you have a history of swelling in the legs or feet _ _ _ YES NO 14 Do you do any type of exercise that causes violent physical pounding in your legs such as aerobics or running YES NO 15 Are you menopausal YES NO 16 Do your veins get worse during your periods YES NO 17 Is your face or body exposed to excessive sunlight YES NO 18 Do you usually wear sunscreen YES NO 19 Do you commonly engage in winter sports such as skiing YES NO 20 Are you blond and blue eyed YES NO 21 Do you work play outdoors YES NO 22 Do you wear a hat when outdoors in the sunlight _ YES NO 23 Do you use Retin A YES NO 24 Do you regularly have aesthetic treatments YES NO 25 Do you use a puff buff or other skin exfoliating device YES NO 26 Do you squeeze blackheads or pimples on your face YES NO 27 Do you regularly take vitamins _ YES NO 28 Do you take Vitam
22. patch progesterone other How long Months Years What dose How long What kind What dose When did you stop taking hormones YES YES YES YES YES YES YES NO NO NO NO NO NO NO PIGMENTATION 38 When you cut scratch burn or abrade your skin 39 Has your skin developed brown spots melasma or splotching during pregnancy or while taking the birth control pill YES PREGNANCY 40 How many pregnancies have you had 41 After which pregnancy did your vascular blemishes occur or worsen most noticeably 42 During pregnancy did you develop tiny blush like red spider veins YES 43 After any blow or trauma to your legs did you ever develop tiny blush like red spider veins YES FAMILY HISTORY 44 Is there a family history of spider and 45 Do or did the following people have vascular blemishes circle all that apply mother father sisters uncle children brother aunts 46 Has anyone in your family had breast cancer or ovarian cancer __ YES VASCULAR HISTORY 47 How many years have you noticed your unwanted vascular blemishes which are these please circle varicose veins legs upper body capillaries spider veins on legs mole like red spots facial broken capillaries 48 Did your veins occur please circle before pregnancy after taking birth control pill after pregnancy premarin or
23. porary and caused by the inflammation Redness depends on your skin type Some people show little redness and others get quite florid from treatment You will also get tiny crusts on the face and body that will last 7 to 10 days or longer body crusts last longer up to 3 weeks As mentioned success on the legs is not as good as on the face or body However in most cases some improvement will be seen Indeed posttreatment risks are substantially less with the our process than with either sclerotherapy injection or with laser In most cases we have seen that the leg vein will return but about 50 thinner than before treatment It may take several weeks for the vessel to diminish after your treatment Elimination of all leg veins is seldom ac complished We must use more current to remove leg veins so crust size will be much larger than on the face and crusts will last longer up to 3 weeks or so We may elect to use local anesthetic for treating your leg vessels and you will wear an ace bandage for at least 24 to 48 hours following treatment It is possible that the veins will look worse before they appear better although once crusts fall off there should be a noticeable difference Bruising is uncommon but possible and swelling should be expected particularly if you have large numbers of vessels to be treated In some cases the leg vessel will be replaced by a visible scar although the scar is usually preferable to the vessel itself
24. progesterone after an accident facial resurfacing fall facial injury broken leg Retin A other 49 Are you still developing new vascular blemishes If yes are your veins circle remaining stable getting worse 50 Have your vascular blemishes ever been treated with circle injection sclerotherapy electrocautery electric needle laser ligation stripping surgery When was your last treatment How many treatments did you have if so how soon after 51 Do you have a history of scarring after treatment of your vessels 52 Did you develop small red vessels blush like after treatment if yes where were they located How soon did they appear after the treatment HOSIERY AND OTHER 53 Do you wear please circle prescription support hose Hanes Alive light support hose Jobst Sheer etc 54 Do you note that the hosiery helps 56 Do you have trouble with your feet circle bunions foot surgery corns diabetic feet sores cO Na YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO PATIENT INSTRUCTIONS VASCULAR BLEMISH REMOVAL BEFORE YOUR TREATMENT The treatment you will be receiving is comparatively simple but a few suggestions will make this more comfortable and successful for you 1 PLEASE wash your face of make up before treatment use your normal cleanser If you don t want to do th
25. r in the regular trash Used needles must be disposed properly according to your local approved health regulations ELECTRICAL SAFETY e Your electrolysis device operates at 105 125 Volts 50 69 Hz 0 5 Amperes e To reduce the risk of shock do not open your machine or remove any part of the enclosure e Servicing and repair by authorized personnel only e Your machine must be properly grounded at all times to avoid electrical shock A grounded electrical cord is provided with your unit e Do not operate this device close to water Do not spill any fluids on the unit TEL Needles The Ballet telangiectasia needles are STERILE These are SINGLE USE needles ONLY Use one needle on one patient Do not touch the needle with your fingers Do not touch the needle to any surface other than the patient s skin If you accidentally touch the needle dispose the needle and get anew one After using the needle dispose of the needle in an approved sharps container Do not throw used needles in the regular trash doing so is a violation of law Collect used needles in the sharps container It may take years to fill the container When full you cannot just throw the container in the trash again this is a violation of law The sharps container must be properly discarded by a certified medical waste handler A good idea is to have your cooperating physician dispose of sharps containers for you since he she already has a certified handler Also your local
26. re surface of the ground If the DC meter fluctuates considerably the ground has dead spots and may need to be cleaned or replaced BANANA PLUG ACCESSORY CORDS Preset the DC meter to 5 Test an accessory cord by plugging one end into the RED positive jack outlet and the other end into the BLACK negative jack outlet Depress the DC footswitch The meter should rise smoothly With the DC on jiggle the accessory cord up and down to detect a partially bro ken wire If the meter does not fluctuate the cord is good If the meter fluctuates replace the entire cord 17 Patient consent form Vascular Blemishes Our technique should improve your vascular blemish condition Treatment is more successful with facial and upper body vascular blemishes than legs We may not be able to remove all the unwanted vessels at one appointment A few treatments may be necessary You may be predisposed for vascular blemish formation and may develop more in your lifetime You may have to see us every year or so to keep up with the new blood vessel formation You should not expect 100 removal of all of your vessels particularly if you have a large number of vascular blemishes You will experience some redness following treatment that may last 24 hours or longer For a few days after treatment the area may appear to have dilated vessels remaining in the area this is temporary and caused by the inflammation Some people show little redness and others ge
27. shes broken capillaries and spider veins with the electrolysis unit technique should improve your condition but will not produce miracles Generally we have found that treatment is more successful with facial and upper body vascular blemishes than on the legs Blood vessel removal on the legs is only about 50 successful with less success the lower you go on the legs We may not be able to remove all the unwanted vessels at one appointment this is done for your safety Thus a series of treatments may be necessary usually 2 to 4 You may also be genetically predisposed for vascular blemish formation and will develop more of them in your lifetime You may for example be fair skinned and spend a lot of time outdoors and thus de velop more vascular lesions In such a case you will probably have to see us every year or so to keep up with the new blood vessel formation You should understand the disadvantages before you undergo this procedure First a few treatments may be necessary and you should not expect 100 removal of all of your vessels particularly if you have a large number of vascular blemishes With facial and upper body telan giectasia results will be seen rapidly In most cases the vessel will disappear immediately You will however experience some redness following treatment that may last 24 hours or longer For a few days after treatment the area may appear to have dilated vessels remaining in the area this is usually tem
28. t quite florid from treatment Tiny crusts will form that will last 7 to 10 days or longer In some cases you may experience temporary darkening of the skin where the vessels have been removed These will appear as tiny brown dots In rare cases marking can persist for up to 6 months but always disappears Indeed we have products available to hasten the disappearance of pigmentation You must carefully follow after care instructions and keep the area clean Understanding these nominal risks I consent to have this procedure performed Please sign here Date 1 Last name First name 2 Age Sex Height Weight 3 Have you eaten within the last few hours YES NO sometimes patients who have not eaten experience a bit more treatment pain 4 Is there a personal or family history of the following please circle any that apply bruise easily thrombophlebitis bleeding or clotting problems blood clot with or without swelling prolonged bleeding 5 Do you smoke YES NO 6 Is your face or body exposed to excessive sunlight YES NO 7 Do you usually wear sunscreen YES NO 8 Do you commonly engage in winter sports such as skiing YES NO 9 Are you blond and blue eyed YES NO Short From Copyright 2010 Tortoise Press 10 Do you work play outdoors 11 Do you wear a hat when outdoors in the sunlight Do you use Retin A Do you regularly have aesthetic treatments Do you use a puff buff or other skin exfoliating device
29. t you read litera ture dealing with the skin s healing process Focus on the inflammation process the normal way skin heals following injury The inflammation process is a minor miracle that you should know about in depth Educational material is readily available in your local medical library You might ask your coop erating physician to suggest a title for you Most importantly you must sufficiently treat the telangiectases Here s the problem that you must understand You can just touch the skin with the probe in a few places and completely miss the vessel You can use insufficient current or no current at all In spite of these errors the localized edema swell ing from your poking will cause the telangiectases to temporarily disappear In this way you think that your treatment was successful However within a few days the inflammation subsides the vessels reappear and the patient thinks the treatment failed Review the DVD to see proper skin treatment You must use enough current to see some reaction to the skin s surface Although you seem to be just touching the skin with the needle you must insert deep enough to actually enter the blood vessel yes this is a mere fraction of a millimeter Furthermore you must coagulate the entire length of each A Normal telangiectasia before treatment B The technician has completely missed the target She inserted near the blood vessels but not into them She used too little current bec
30. ting out pick cases that will be easy and successful The Blend unit works best on tiny threadlike vessels on the face and upper body Larger vessels are also effectively treated especially the dot like hemangiomas on the face and upper body Additionally the American Academy of Dermatology has Stated that requests for telangiectasia removal is the number two requested treat ment number one is acne treatment So why waste your time or risk treatment failure by treating leg vessels If you think you cannot treat a vessel because it looks too daunting don t treat it Start conserva tively and learn what you can and cannot do Limit yourself to common solar telangiectasia found on light skinned people that were environmentally caused by sun and temperature extremes Other treatments with the Blend unit Yes you can do other procedures with the Blend unit such as milia skin tag and brown spot removal However there are better treatments for these lesions Performing such tasks may be very much outside your scope of practice You may perform galvanic facials with your blend unit if that is your specialty 11 Quick Reference Card Photocopy or tear out this card and keep it in your work area Use it as a quick reference until you become completely familiar with all the procedures ee 003 stainless steel telangiectasia needle MACHINE low for thread size POWER medium for larger vessels 0 2 to 0 3 milliamperes for thread si
31. uces heat at the needle The HF causes tissue to coagulate and forms a barrier to blood flow that ultimately eliminates the telangiectasia Although the hand held ground is not necessary for HF current it is a good idea to use the hand held ground at all times during the treatment even if you are using the HF alone HF causes most of the tissue destruction Therefore be sure your working range is properly selected not too high It is better to start with too little HF than too much Average HF working range should be low Cataphoresis CATA Cataphoresis is the application of the positive pole of DC to the skin Cataphoresis reduces posttreatment pain and diminishes edema and erythema Anaphoresis ANA Anaphoresis is the application of the negative pole of DC to the skin Anaphoresis increases pain and erythema Anaphoresis is used in some beauty therapy procedures to force chemicals into the skin by electro phoresis Anaphoresis is never used following telangiectasia treatment 13 CT INE a a lam Masts linntslales x Galvanic means DC direct current a stream of electrons moving in one direction from negative to positive The Unit also provides galvanic skin treatments Using DC is greatly beneficial after microdermabrasion DC also calms the skin after telangiectasia removal with the Blend Commonly Used Terms Cataphoresis Using the positive as the active electrode Thi
32. with your tweezers you may hold hard because the patient cannot feel the tweezer no nerves remember Hold both currents ON and use the tip of the needle like a scalpel Use a back and forth motion and cut through the skin tag About half way through you may encounter some tough elastin fibers just cut through these fibers and remove the entire skin tag APPEARANCE AFTER TREATMENT There should be no bleeding at all There should be little skin tag material left You should leave a cut out depression in the skin where the tag was removed The epidermis will quickly bridge this wound gap epithelization and in most cases the skin tag will not grow back In predisposed patients new skin tags will eventually form in other areas HF HIGH DC 5 10 Copyright 2003 Tortoise Press 15 Easy maintenance Plug Receptacle hole HAND HELD GROUND Periodically buff the surface of the hand held ground with dry steel wool to avoid corrosion and dull ing Clean inside the ground the hole Clean inside the hole with alcohol and a Q tip If the ground or plug receptacle is badly corroded the DC will not flow You may have to replace the entire hand held ground Reassemble the ground by reinserting the banana plug accessory cord Plug Receptacle hole PHORESIS ROLLER Every so often buff the phoresis roller with dry steel wool to avoid corrosion and dulling Periodically soak the phoresis roller in hot soapy
33. ze 0 3 to 0 4 milliamperes for larger vessels e BASIC Insert with DC only PROCEDURE Coagulate with HF and DC Remove needle with DC only MODIFIED Insert with DC BASIC PROCEDURE Coagulate with HF only Remove needle with DC only EXTENSIVE Insert with HF and DC CONDITION Coagulate with HF and DC Remove needle with HF and DC SPIDER TELANGIECTASIA Use basic procedure unless bubbles seen DOT Use basic procedure unless bubbles seen TELANGIECTASIA Coagulate as spider center BLOOD MOLE Use basic procedure unless bubbles seen RED BLOTCH Treat randomly DC ONLY Try for extremely small vessels only PROCEDURE DC 0 2 to 0 3 milliamperes 12 Blend method the currents Please read the summary below to familiarize yourself with the HF and DC currents for telangiectasia removal Direct Current DC Direct current DC produces NaOH Sodium Hydroxide lye at the needle The lye chemically dissolves tissue and allows the needle to easily penetrate the skin and blood vessel during insertion The lye also dissolves material around the coagulated clot and allows you to easily withdraw the needle from the clot The patient must hold the hand held ground with a wet cloth around the ground Do not use distilled water use tap water You may use a baby wipe disposable towel A dry hand held ground will not correctly conduct the DC current High Frequency HF Thermolysis High frequency HF prod
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