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Friday, July 5, 2013

Bob's First Botox Treatment

On Tuesday, I wheeled Bob over to the new neuro doctor's office for his first Botox treatment for cervical dystonia. Of course, it was raining cats and dogs that day, but we were going--come hell or high water, because it had taken 3 months to get in to see this guy.

Before we left, I glanced through the "Botox for Cervical Dystonia" brochure that the neuro doctor had given us three months ago. I guess I just wanted to be informed. Unfortunately, it only ended up scaring the living daylights out of me. All those side effects, including "problems breathing which can be severe and result in loss of life".  Jeepers...... For a few minutes, I actually considered cancelling that appointment. But then I reminded myself what Dr. Doom had said about Botox being "one of the safest drugs around" and coming from Dr. Doom, that really means something. So I sucked down my fears and we went.

We got there early. And the doctor was running late.

So we sat a full hour and half in the waiting room, which gave me plenty of time to worry about things like "problems breathing" that can "result in loss of life" and to contemplate grabbing Bob and bolting for the door.

Then Bob's name was called and we went in.

Botox works because it basically paralyzes the muscle it is injected into, thereby loosening up the muscle contraction. It is injected into the muscles via a prefilled syringe with a very, very long, thin needle. This needle/syringe is connected to a computer which measures the muscle contraction. Basically, the doctor sort of pokes around in the target area to find the tightest spot of the muscle and when the computer makes a horrendous noise indicating a tight spot, the doc plunges in the Botox. He did three injections on one side of Bob's neck and two on the other side and one near his shoulder.  Then he attacked Bob's hamstring, which is also contracted from dystonia (Bob can no longer unbend that knee) and injected Bob two more times.

All this time, I sat across the room watching and worrying. And though I worried about side effects (and still do, believe me, I am watching him like a hawk), I also worried Bob might drop over dead on the spot. This because Bob's old neuro doc said it was a dangerous procedure to do on the neck as the needle could slip and hit his spinal cord causing immediate death.

But the procedure went fine.

And so far, not a single side effect.

And fingers crossed, the doctor said we should see some positive results in two weeks. At which point, he will order at home PT/OT. 

Next on our agenda: foot surgery on Monday...


J.L. Murphey said...

Diane, Wahoo! progress! Yes, you need to be aware of side effects, but I keep telling you "Don't borrow trouble, honey."

The maximum they are allowed to inject into the body at one time is 300 ml. It really takes some strong math skills to do multiple sites.

You may see the beginnings of improvement in range of motion in as little as one week but two is a good rule of thumb for therapy for max benefit.

Hasna said...

How long will the benefit last, Murphey?

Tami said...

I am so glad I started reading your blog!! LOVE YOUR WRITING!!! Rob has gotten two rounds of botox in the arm...waiting on approval for the leg (not for range of motion - but to hopefully help with clonus!). The best part of the botox in the arm so far (yes it did help with movement) is the fact that it helped SO MUCH WITH PAIN!!!!!!! Here's hoping you see results QUICK with Bob!!!!!! :)

J.L. Murphey said...

Diane, I could have sworn that's what my neurologist told me but that may be a different case. Could be a weight issue too. I image Bob weighs a tad bit over me.

Hasna- It depends on the person. On average 3-6 months and sometimes longer. For me about 3 months. The doctor tried five months with me last time. It lasted about 3 1/2 months and then I was miserable with the spasticity coming on stronger drawing my arm up in a locked fetal position for the last month. She agreed every 3 months so we don't repeat that.

Tami- Botox has not helped my clonus because clonus is not stemming from the muscle itself but from the brain. Never impulses trying to break through the dead area.

Diane said...

Tami, thanks! Hasna, I was told it would 3 months or so... Jo, the doctor gave him 375 ml, yikes! Hope the doctor is right...

Hasna said...

Thanks for the info... We caregivers are becoming so knowledgeable! :)