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Leaving no rock unturned


Rose Smith

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A few weeks ago I started seeing a new OT, and she suggested that I investigate Botox because she felt that any progress in my left arm and hand might be helped with Botox. Today I was evaluated by a Physical Medicine and Rehab doctor at UNC here in Chapel Hill. She checked out my spasticity and my range of motion and announced that she thought I'd be a good candidate for Botox. Now we wait and see if Blue Cross/Blue Sheild feels like helping to pay for it. Hopefully I'll get my first injections in several weeks. I thought it might be of interest if I wrote a blog about this experience in case others find themselves in my situation; or if others have been through Botox, I'd love to here about it, I'm hoping to try to lessen the spasticity (I used to cringe when I heard that word from therapists, but now it doesn't scare me as much, now it's "contractures" that gives me the willies) and put up some resistance to the flexion, while hopefully strengthening the extensor muscles. It may be unrealistic to imagine typing a letter (or a blog) with two hands, or plonking out a tune on the piano, but I'm allowed to dream, right? Until next time, take care all, Rose

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Rose: Bruce will be undergoing his second round of Botox on his affected leg tomorrow and the affected arm will be next month. Botox may be injected every three months and that wil be how his MD orders it. Bruce's is 90% covered so we are very lucky. As to results: it can take up to a week to kick in. Bruce noticed it at day 10. It can wear off as soon as one month. We noticed Bruce having increasing "tone" at about 10 weeks. He was able to go from a long leg brace to an AFO at 8 weeks. While it is slower going, good news is he is not depending on the upper portion of a brace-he is strengthening his own thigh muscle and knee. The spasms reduced and were less painful. The right arm was the bigger issue. It had been in a sling far too long and his pec was frozen. With the OT (and she's very aggressive), the shoulder finally returning to its socket and the Botox, the arm is considerably improved. We knew frm the start he may never regain use of the arm-hand, but it now has improved circulation, swells less and can be moved so he can get onto his side or stomach=a major improvement. He has recently been able to move his thumb and the arm he can extend by himself but not flex yet. All in all we would recommend the therapy and are going to continue to receive it as long as it is mostly paid for. If we no longer see results or if we have to pay for it entirely, we will review the course of therapy. Side effects: watch the injection sites for signs of infection or inflammation and of course, any allergic reaction to the Botox itself (swelling, rash, difficulty swallowing, etc). Very exciting time for you. Let us know how it goes. Debbie

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