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    Old 10-20-2003, 11:38 AM   #1
    c0nnie
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    Question botox injections

    my son has received botox injections for the 3rd time in his calve muscles
    1. injections calves + 7 weeks serial casting
    2. injections calves
    3. injections in ham string muscles
    4. injections calves + 8 weeks serial casting
    after this latest round of serial casting he has pain in his feet and has significantly decreased tolerance of weight-bearing - it has been 2 weeks since the casts came off and he has shown very little improvement in returning to his previous walking skills prior to the casting
    does anyone have experience with botox injections and casting? did it help you? i find the whole process very disheartening (too much pain, too little compassion from professionals, limited results, and short-lived results)

     
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    Old 10-22-2003, 05:52 PM   #2
    mojonator
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    I am not a big fan of injecting bacteria in my body. I have enough problems without doing werid voodoo like medicine to my body But if it works for your son then I guess it is all right.

    Kurt

     
    Old 10-23-2003, 06:39 PM   #3
    lastramy
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    Well I can't really help you with serial casting but I have had botox injections, infact today was round 4 for the year! I received them in the posterior tibialis, the gastrocs, the achilles tendon area, and several in the hamstrings. I also wear a brace. My CP is very mild and only effects my left side. I am 38 yrs old and hey I will be back in the office in 3 months for more. It is my assumption that the injections are not a cure but a release so that surgery can be tolerated better or to provide so ease with the casting. The botox temporarily weakens the target muscle so that other muscle groups can then be used and strengthened. I am no doctor and so I can't say that I am 100% correct, but I have seen good things come from botox and I have had times when it wasn't quite as effective. I don't have any problems with it and the amount of toxin used in the injection is far far less than anything that can harm you otherwise. It really is safe and yes it is temporary which is good. We certainly wouldn't want to be injected and then find it doesn't work at all and so it will wear off and that is that.
    Well I don't know if any of this helped.
    Take care, and good luck

    Lastramy

     
    Old 10-26-2003, 05:19 PM   #4
    vicent
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    Hi
    I'm 35 year old,and I have mild cp.my cp is mild it only effects my legs.I am thinking of having my achilles tendon streched.lastramy how often do you get bottox injections?CONNIE what is a serial casting?and do you need to get a casting if you get a bottox injections.
    my questions are probable somewhat child like to some of you,but is just that I recentlly found out that i have cp and what it is.
    THANK'S
    VICENT



     
    Old 10-27-2003, 06:25 PM   #5
    lastramy
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    Vicent,

    I get the botox injections (4-8 of them) every 3 months. I had my achilles tendon lengthened when I was 17. That helped quite a bit then, but now I have other problems to deal with. I could be wrong, but the serial casting I think is done mostly with children during their growing years and NO you do not have to have casting to get the botox shots.
    My spasticity is very mild, but I was having trouble with my foot dropping and dragging so the botox has helped with that.
    Good luck!

    Lastramy

     
    Old 10-28-2003, 02:42 PM   #6
    vicent
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    LASTRAMY,
    howlong after getting the botox injections can you walk?or is it something that you need help getting around after is done?
    thank you for the information!
    vicent

     
    Old 10-29-2003, 05:00 PM   #7
    lastramy
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    vicent,

    I just got my last set of injections this past Thursday. They administer the first to my posterior tibialis by way of an EMG needle. NOT a pleasant feeling at all! Then I get another to the achilles, and two in the gastrocs. From there I get the last 4 in various spots in the hamstrings. Besides the first shot hte others are like a regular shot.
    I can walk without the botox just with a more pronounced limp and a drag in my foot. I get the shots then go right back to work. The effects take hold anywhere from 3-10 days. This time it took 3 days and I could feel my calf muscles easing up and the drop was less pronounced. Keep in mind this botox doesn't guarantee perfect results. My last round wasn't very effective and didn't last as long.

    By day 10 I can feel the hamstring effect which means I can straighten out my leg without much difficulty and my stretching gets more tolerable. With the release of muscle groups you also then have the ability to strengthen muscle groups that otherwise would stay weak because of the spasticity. It might not hurt to ask your docs about the botox and see what they say. I have also heard from some that it did absolutely nothing for them. My results aren't dramatic but over the long haul I am finding that they are helping.

    Keep me posted!
    Lastramy

     
    Old 11-03-2003, 04:32 PM   #8
    vicent
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    botox injections

    what type of doctor is use to get botox injections?
    vicent

     
    Old 11-03-2003, 05:23 PM   #9
    lastramy
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    Vicent,

    I see a doctor in the Physical Medicine and Rehabilitation department. He works mainly with peds patients with cerebral palsy but he also has his botox clinic. Botox is used for spasticity issues in MS, strokes, and other spinal cord issues. I would guess that contacting a physical medicine doc would lead you in the right direction. Good luck and keep me posted!

    Lastramy

     
    Old 11-04-2003, 03:40 PM   #10
    vicent
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    botox injections

    thank's lastramy for answering my questions.
    lastramy in one of your reply's you mention that you have had your achilles tendon lengthened when you were 17,and that it helped you quite a bit then,but that you had other problems to deal with.are the other problems that you mention related to the achilles tendon lengthened?I don't mean to get personal I am just trying to get as much information as possible.
    to anyone that has have there achilles tendon lengthened do you recomended or not. if not why not?
    vicent

     
    Old 11-04-2003, 04:54 PM   #11
    lastramy
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    Vicent,

    I got the tendon lengthening to help try and correct the "toe walking" I did with my left foot. It did bring the heel down to a more normal gait, but it tore up the ankle joint. With the increase in flexion at the ankle I started to wear away the joint that instead of being a nice round shape was actually squared off. I had to then get bone spurrs removed from the joint space and it then progressed to more weakness later with tendon shifts and arthritic symptoms.

    Most of my recent problems are all "age related" or so I am told. I plan on getting some questions answered when I go back to the docs at the spine clinic. Lets just say I'm not leaving until I get better answers.

    From what I have heard and read and witnessed different surgeries are different for each person. Some of us tolerate them well, while others get little benefit, and still others who end up with further problems down the road.
    I would take your questions to a CP doctor before consulting with an orthopedics doc unless they are well versed in the area of cerebral palsy.
    I would rather you have all your bases covered before you make a decision.
    And even though I had some problems after the lengthening, I feel the surgery still did some good so I am not sorry I had it done. My opinion though would be to have these surgeries early rather than later in life. But that is just my opinion, as I said I am no doctor.

    Hope this helps and once again keep me posted on what you decide to do.
    Good luck! Hang in there!

    Lastramy

     
    Old 11-19-2003, 11:37 PM   #12
    alinch
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    Re: botox injections

    My son is 16 months old and has CP. The only place botox has been metioned to us is in his thumbs. I have read a lot of people having botox for their legs and feet, has anyone ever had injections anywhere else, like you thumbs. I am so undecided about this. My own fear of needles doesn't help. But I am so gungho about doing anything that might help my son, however on the other hand I hate putting him through everything.

     
    Old 12-02-2003, 10:31 AM   #13
    Zagreus
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    Re: botox injections

    My son's had botox therapy several times. Once he did receive injections in the forearm. It worked remarkably well. The OT was able to make good progress with him while the botox lasted and it seems to have had a very long term benefit in his case. Typically, though, he's received the injections in the calf.

     
    Old 12-06-2003, 09:58 AM   #14
    LionKat
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    Re: botox injections

    Lastramy, Hi
    Can you explain botox more please? I never heard it as a treatment for CP. How exactly does it help? And does it hurt when they put it in to your tendons? It sounds like it would. I'm interested

    Last edited by LionKat; 12-06-2003 at 10:08 AM.

     
    Old 12-06-2003, 12:28 PM   #15
    lastramy
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    Re: botox injections

    Hi again LionKat............

    My CP is very mild and nonprogressive. I started out with just a little limp on the left side and thatwas it. Basically I had the weakness on the left side my whole life, but my other muscle groups did a good job of compensating for the weak muscles and so my walking was pretty good.
    It wasn't until 2 years ago that I noticed my left hip and back started hurting. I also had a problem with my foot "dropping" when I walked. So I started tripping on things and falling a lot. I went to the doctor and was sent to PT for some exercises. Of course the muscles in that left leg were very hypertonic and so they gave me stretches for that and then sent me back to the docs for the dropping foot. They suggested a brace or botox.
    Well I didnt like the brace issue so I opted for the botox.

    Now.......I go every three months to a rehab doc for the botox. THis is Botox A. There is also a botox B but that is a second choice if type A does not work etc. etc.
    I get 4 shots in the lower leg and 4 shots in the uppr leg. Of the 8 shots total only one of them hurts. I get the first one put into the posterior tibialis muscle and the injection is guided with an EMG needle. They apply electrical current to the area as they inject to make sure it is going into the right muscle region. It is not very comfortable, but I have managed 4 treatments so far.

    Right off the bat you won't see much notice. The botox takes 7-10 days or so to reach peak performance. When the botox is at its best what I feel is a relaxation of the muscles and the foot can come back up without dropping. I feel like I am walking as normal as I can. The limp is less pronounced and things are very nice. My stretching routine becomes easier and I have regained some muscle mass back (just a little) in my calf where I was told I wouldn't get anything back.

    The dropping foot was a aresult of that compensation mechanism finally giving up. Adults with CP have different issues than children because we are dealing with the aging process. The CP progression is not there but the symptoms are increased because of the continued use.....thus aging.

    I do wear a "toe off" brace now to help with my gait as botox cannot 100% relax the spastic muscles. What it essentially does is interrupt the messaging from the brain to the muscle and therefore keep the muscle from continually being in a contracted state. The botox allows the muscles to relax and then PT and stretching become more effective.

    If you are interested I would talk to a CP doc or a rehab doc. I am not a physician so my comments are only from what I have learned through my own experiences.

    Now even with botox and a brace under stress and fatigue I still have trouble walking and no matter what I do I still have a limp. I have decided to use a cane to help out with the strain that walking puts on my back and to help keep my balance in check. I don't like splattering in public places. That is more embarrassing than anything.

    I am in a dilemma now over getting diagnostic injections in my back to help out with some of the pain that I get. Don't know what to think of that.

    I also see a massage therapist twice a month and she has been really excellent with bringing pain levels down. Needless to say she was put at the very top of my CHristmas shopping list.

    Well Lionkat, I hope some of this information helps. And actually I know that England has physiatrists who do botox injections. You may have to look into a major medical center for them.......London????

    One more thing.........children.........
    Yes, I am married to a non CPer and we have a great 6 yr. old daughter. She is the best thing I have ever had happen to me and no I never worried about her getting CP because it is not something that can be passed down. I got it because I was born 3 months premature under a stressful delivery.
    My daughter was born very healthy although the delivery was horrible. THe pain during delivery went straight into my bad leg and I had lots of issues. I opted not to have anymore children partly because I didn't want another delivery experience like that again and because I got the job done perfectly the first time. I love spending all my time with her.

    Okay I am writing a novel here. But keep in touch. Like I said before Prisc1125 and I are on the "battling fatigue" thread pretty regularly so we can chat together all you like. There are plenty of people here who understand you.

    Take care,
    Lastramy

     
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