I had a patient, a young Colombian girl about 14-15, who was visiting for about 4 weeks and came in with her divorced mother, who was living in the USA, for Botox injections in the axilla to treat excessive perspiration. Recognizing the potential for conflict, being the parents were divorced, now in different countries, and that this treatment for many in the established medical community is not well known, I contacted or had the mother email contact the child's physician in Colombia (as he had apparently made this recommendation for treatment) and also requested permission from the father (which was forthcoming). With this "foundation" we did the treatment. The young girl had relief for several months, and when she returned to the USA many months later she with her mother sought reevaluation/treatment. Communication doesn't hurt.