Barbelle... - Multiple Sclerosis Message Board

curious11 · 04-05-2006, 09:19 AM

Hello! I remember you posting (or responding to one of my posts) on Botox for spasticity. I was wondering how you were doing with that? I go for an evaluation at a pain clinic on Friday and I am anticipating the possibility of trying the Botox! I remember we discussed how your insurance covered the procedure etc. and I got in touch with my primary insurance. The woman on the phone told me there was a long list of Botox procedures that they do cover, and a long list of ones that they do not. I had her read some off for me and the few that she read had to do with "dystonia". I am not sure what spasticity would be classified under, but I am hoping it will be covered! How many treatments have you had? Have you noticed a marked improvement in your spasticity? I am hoping they can inject the muscles around my knee and allow my joint to move more freely- as of right now it is very stiff and makes it hard to walk. Well, thanks for any information you can share! Take care

Barbbelle · 04-05-2006, 01:18 PM

Hi Curious!!!

Glad to hear from you!! Hope you are doing better! I had Botox injected one time (with 5 vials) in November, 2005. It didn't hurt at all because the needles were so thin. I noticed almost immediately that my spasms in that ankle and foot were better. They told me beforehand that it would probably last around 3 months....Well, almost to the day, I started noticing that my spasms were coming back, slowly at first and now are completely back. What happens is I have a foot drop, but wear an AFO to keep my foot from dragging. Well, even with the brace on, my foot/ankle/calf tightens up so bad that it drives my foot down and I can't seem to clear my foot while walking...I hope that makes sense. To control that, I had the gastrocxnemius muscle and the anterior tibial muscle injected. So, if you are having knee issues, they may go higher than your knee in the quad or hamstring.

So, after discovering that the spasms were back, I called the pain dr and scheduled another appointment. THEN, she had to send all of the paperwork in and get approval again and I am set to go again on 4/22. I will say that the last time I had the injection, I was a little off my game for a day or so. Can't explain why...could just be the regular ups and downs we go thru, but I just wasn't sure if it was the Botox.

I hope this helps! Best of luck to you and please let me know how you are and if you get the Botox!!! God Bless & Good Health to you! Barb

curious11 · 04-05-2006, 02:54 PM

Thanks Barb! I also have drop foot and was wondering if they would use Botox there too? But my ankle is also very weak (not sure if that's common with drop foot) and I think relaxing those muscles would only make it weaker? I don't know. That is my theory but I am sure these doctors know what they are doing... so we'll see! My neuro did mention that they would have to inject the hamstring muscle to help with the knee stiffness... and because it is such a large muscle, it would take more Botox and I may build up a quicker immunity to it.

Regardless I am anxious to try it and hope it helps with the stiffness! I am glad it gave you some relief and hopefully you will get back to that point with your next treatment! Good luck to you, and thanks again!

Barbbelle · 04-06-2006, 05:09 AM

Hi Curious!!
I know that there is a maximum amount that they can give you, so you are right that they may not be able to inject both areas, but maybe you could consider a lace-up ankle brace for a while. I have used that in the past for a few weeks and when it comes off at night...do stretches and ankle rolls to help strengthen it. That really protected my ankle and I noticed that after a while I was able to give up the ankle brace. I was having a problem of rolling my ankle and falling. It really protected those tendons, etc.

Anyway, hope the Botox helps you also and I wish you great luck!!! Let me know how you are doing!! Barb

curious11 · 04-07-2006, 06:24 PM

Well... I went to my evaluation. The doctor I saw was not convinced that my stiffness is due to MS for a few reasons... 1) I am taking Baclofen for spasticity, yet my knee remains stiff and it is unusual for MS to target one specific area, like the muscles around my knee. 2) The muscle mass around both my knees are the same, and there are no tender areas?

Anyway... to make a long visit short, he wants to rule out other issues like arthritis. I had an x-ray taken a year ago (when these symtpoms first started) because my original thought was "Maybe this stiffness is arthritis!" But the x-ray was clear, which led me to an MRI... an ultimately to the dx of MS. So he said alot could change in a year, so he wants an MRI of my knee. If it is arthritis, or something involving the tendons, he says I will benefit from cortisone shots into the joint. If it is indeed muscle related, he thinks I will benefit from Botox. So either way, he sounded confident that there was something we could do to "fix" this!

When I asked about insurance, he pretty much said that if he writes the order up thoroughly for Botox, I should have no problem getting approved. Insurance companies just don't like to pay $800 a vial or whatever it is. But he didn't think it would be a problem.

So as of right now, he put me on Relafen, an anti-inflammatory, to see if I have any benefit from that while I am waiting to get an MRI done etc. So I will see him back in 1 month and determine what is the cause of the stiffness. It is not getting done as quick as I would like... but I have dealt with it this long... what's a few more weeks!