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Old 09-03-2008, 03:31 AM   #1
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batty HB User
Walking ability immediately after botox and casting - any experiences?

HI

My son usually has botox every 3 months - doesnt last long but works quite well although never been able to get flat footed totally. This time we tried 3 weeks of casting immediately after botox on both legs -
casts came off yesterday and we got profound results - nearly totally flat footedness and loosened hamstrings too, plus much more upright but the problem being, my son can't walk very well at all now compared to before this round of botox/casting when he was on his toes!!! He is not so bad in his AFO's and boots - they must provide some support and he can tolerate these boots for 3 hours at a time now without any red marks compared to about 20 minutes previous to botox! He can walk holding on to one of our hands for support, albeit a lot slowly than usual.
But in bare feet, he has huge trouble, pulling down on our hands for lots of support, excruitatingly slow and knock-kneed, like it is causing real pain, but nonetheless very flat footed!
I wondered if anyone else has gone through this , and if this is only temporary while he learns to walk this new way? And also, if the flat footedness lasts, or eventually moves back to where they were at previously.
It is sort of a catch 22 situation, we have gained flat footedness but lost walking ability!!!!!

Thanks in advance...

 
Old 09-03-2008, 05:59 AM   #2
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Leaciesmum HB User
Re: Walking ability immediately after botox and casting - any experiences?

Hi Batty, wow sounds harsh. Does his PT say he'll improve with time? Does he get intensive physio after his botox? My girl has just had her first lot of botox, I'm just starting to see results now. We didn't have the casting, but my girl doesn't have the tight ankles, she's tight everywhere except the ankles, it's bizzare, I can bend her feet up to touch her shins. She is also no where near walking yet. I hope that your boy does relearn how to walk. Please let me know how he goes, I'm really interested.
Take care.

 
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Old 09-03-2008, 09:53 AM   #3
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annie777 HB User
Re: Walking ability immediately after botox and casting - any experiences?

My son gets Botox to get down from his tip toes as well and is casted for 4 weeks after. Yes he too has trouble walking after the casts are removed especially barefoot. The muscles have been isolated in the casts so they are weaker. If you think of walking up on your toes to have to pitch your body forward slightly to balance so once the foot is flat your balance and body alignment is totally different. My son used to fall straight backwards when he was bare foot after the casts were removed.

He is much better at it now as we have been casted 5 times - every 6 months.

For him the results do fade and he is back up on his toes again. He retains a little of the range gained but definitely not all of it.

 
Old 09-04-2008, 03:25 PM   #4
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batty HB User
Re: Walking ability immediately after botox and casting - any experiences?

thanks for your replies- nice to know I am not alone!
Annie - how long does it take on average before they get muscle strength back?? 1 week? 2 weeks?? I could handle this long, but not longer! It is really hard to see my son trying to walk like a bent over little old man, each step slow and labourious - whereas before,even though he was on his toes, he would walk fast holding on to one of my hands! We really dont want to have to go back to using the wheelchair if we can possible help it!
Leaciesmum - he is having twice weekly physio at his conductive unit at school from a PT who visits there from the hospital - she says she has seen this before in other kids but I am not so sure of the length of time he will be like this!!! Isnt it funny how you become grateful for what they could do before, when at the time I was wishing he would walk with a better gait!!!
Many thanks
Batty

 
Old 11-01-2008, 07:13 PM   #5
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jesse4 HB User
Re: Walking ability immediately after botox and casting - any experiences?

my son gets botox in his left leg and left arm, it works well, lasting for about 4-5 months. He is getting ready to do it again, but we will have to cast this time, i am terrified for how he will deal with it. Any advice on the casting for the young ones?

 
Old 11-03-2008, 12:04 PM   #6
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batty HB User
Re: Walking ability immediately after botox and casting - any experiences?

We are about to do botox and casting again in 2 weeks
Surprisingly my son handled the casting very well. It did take about 3 to 4 weeks for him to go back to walking the way he was before, but his left foot is a lot flatter than it used to be so he ended up learning to walk again in a different style.
Good luck

 
Old 11-06-2008, 12:23 PM   #7
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mommie2codybug HB User
Re: Walking ability immediately after botox and casting - any experiences?

Jesse4-

In reply to your post about casting for little ones, most of the people who work in the casting area will know how to deal with kids. My son has spastic diplegia (both legs) cerebral palsy and has been doing botox with casting since he was five. He'll be 9 at the end of the month. His casting the first time was only for 2 weeks, which I thought was too short of time, they then put casts back on him for another 2 weeks. A couple of times when they cast him they did serial casting and he was in his casts for 5-9 weeks at a time. But in serial casting you go back every week and they cut off the cast, check his foot/feet and then cast him again. The longest my son had to do serial casting was 9 weeks. Some things I have noticed when he gets casted. Sometimes he's ok, but other times he cries out and says it hurts. Which when you think about it they cast him right after the shots so there is no way the botox works that fast. I always thought it was from them forcing his foot into a position that would stretch him and bother him until the botox kicked in. His PT has told me that older teen patients of hers have told her that the botox burns at the shot site. The time is different for each child. So this could be why my son was in pain. Some suggestions for you during the casting...
At the hospital my son has the botox at they have Child Life. a rep from there shows up with a bag of toys to keep your child entertained. If they don't have this you can do exactly what they do...

1. bring a portable dvd player (don't forget the dvd's!)
2. have your child bring his/her favorite stuffed animal/blanket. Even wear their favorite pj's.
3. bring any games your child likes ie; uno, cards anything that's small and easy to take along.
4. bring a mirror. Someone from Child Life brought one last time and he lay there and watched them in the mirror so he could see without trying to turn over.
5. bring a cd player with a favorite cd. you could even burn your own on the computer!
6. take lots of pictures so that your child can look at them later on. be sure to get u and ur child in some of the pictures too!

Good luck

mommie2codybug

 
Old 11-09-2008, 11:12 PM   #8
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batty HB User
Re: Walking ability immediately after botox and casting - any experiences?

our botox gets done under G.A because supposedly it hurts so much so everyone has it routine after being knocked out. Quite a big event then, for every 3 months!!

 
Old 11-20-2008, 06:12 PM   #9
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nwmom HB User
Re: Walking ability immediately after botox and casting - any experiences?

Jesse4, My son was two the first time he was casted. He loved the casts, because he got to pick which color he wanted. They took them off in a week and checked his feet for redness and immediately casted him again for one more week. He took his first steps without holding onto anything while in his casts. I think the casts gave him a somewhat safer feeling of more stability. Good luck!
nwmom

 
Old 01-18-2009, 05:55 PM   #10
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BURAK HB User
Re: Walking ability immediately after botox and casting - any experiences?

In last December my son (3.5 y.) had a casting on his 2 feet. And they were taken out on January 12. On that date the doctor told me that initially he was planning a serial casting but, after 5 weeks it seemed that it was not necessary for my son. After reading your cases I saw that periodically the casting was checked and the angle adjusted. This was not done with my son during 5 weeks and actually we were expecting it to be done when we went to take them off. But when doctor told that there's no need anymore we thought it's a good stuff! However, after coming home Burak started walking very very slow. Following 3 days he quitted walking. Now he can't walk and his feet looks very week. Yes, they look flatter, but does not work. Even in casting he could almost run and we were having difficulties to stop him. But now he doesn't move.

Do you think it's normal? The doctor told me that we should show patience, however we were not expecting such a thing. Do you think it's a temporary problem? And how long can it maintain?:

Thanks

 
Old 01-19-2009, 02:13 PM   #11
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mommie2codybug HB User
Re: Walking ability immediately after botox and casting - any experiences?

I think being patient is something that is extremely hard for us mom's to do especially when it comes to our kids. We want the change to happen NOW!
I would recommend that you talk to your child's physical therapist as well as the doctor. The therapist will be a good person to go over any issues with your child because they work with your child on a regular basis than the doctors do.

You might also find out if there is anything you can do at home to help... like stretching your child's legs and so on. If you work with the therapist they could show you one new stretch each visit so you are not overwhelmed.

Also keep in mind that the botox relaxes the muscles in the legs (or wherever the shot is given) and it takes up to 14 days to take affect. With my son I noticed that he didn't walk as far or as long, he would get tired very easy. If you think about the fact that their little leg muscles are always so tight, it takes awhile for them to get used to that tightness not being there anymore.

Good luck and keep me posted.

Mommie2CodyBug

 
Old 03-03-2009, 11:52 AM   #12
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fikidoll HB User
Re: Walking ability immediately after botox and casting - any experiences?

my son had botox twice when he was 2 and 2 and a half and in cast both times ,at 3 he had a selectif dorsal rasotomi and at 4 had his hamstring and calf muscels cut .He has cp in both legs ,is six now walk with crutches and is attending a mainstream school where he is doing extmeeemlyy well.
fikidoll

 
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