Botox

[lharrison]

oh yes i get botox as well for my spasticty that i have n my leg and on my arm in particular and it helps me deal with the tightness so i end to get it doe lots it is expensive but my insurance will cover it asit is considered tobe for medical reason not for a wrinkles which is what it is bet known to help it is considerd to be a muscle relaxer

[dreinke]

I went to get 12 Botox injections in my right arm (7) and hand (5) yesterday. Hurt like hell, especially my hand.

I would be concerned about injections into the hand muscles, the only muscles within the hand itself are the intrinsics and my OT has only seen one person who had spastic intrinsics. If you have the usual spasticity of the finger flexors, meaning your hand is in a fist. Those muscles are located in your forearm. But then I am only a stroke-addled survivor who knows nothing, your doctor can't possibly be wrong.

Dean

[merichsen]

Dean,

 

I'm inclined to agreed with you on the hand.

The dozens of times I've received injections for my hand, I've never gotten one in my hand. My forearm is always injected for my hand.

 

This is a quote of what you had written about botox injections in a previous discussion:

 

"Your doctor should have hooked up some kind of electrical reading machine with a computer that by the sound it makes tells them if they hit the right spot. It really does sound as if your doctor has no clue on how to properly inject botox for stroke patients, it is completely different than for cosmetic purposes. My opinion only, I am probably not worth listening to since I am not in the medical profession. When I got mine it was between 300-400 units and was only injected at the sites where the nerves entered the muscle. I would ask why the botox was given directly in the hand , the only muscles there are the intrinsics and they usually are not a problem with spasticity. The finger flexors are located in the forearm, these are the ones that usually need botox."

 

You most certainly are worth listening to. It is from first hand experience. I had written a very similar description of what it is like, but can not find my post.

 

Thank you for your participation and support. It is very helpful and much appreciated.

 

Maria

[phildogg]

I went to get 12 Botox injections in my right arm (7) and hand (5) yesterday. Hurt like hell, especially my hand.

I would be concerned about injections into the hand muscles, the only muscles within the hand itself are the intrinsics and my OT has only seen one person who had spastic intrinsics. If you have the usual spasticity of the finger flexors, meaning your hand is in a fist. Those muscles are located in your forearm. But then I am only a stroke-addled survivor who knows nothing, your doctor can't possibly be wrong.

Dean

 

Dean,

I went to my doctor and he said that I needed in the injections in the fleshy part of my hand where the phalanges meet the hand. And far be it from me to question the doctor, who had been treated me through my recovery. He said because my fist was so tight, that I needed the injections in my hand. He had to tell me where the injections went in because I had my eyes closed. I wish I could show you where, but if you hold your hand up to your face, its the part of your hand that connects to the fingers, the fleshy pads underneath where the fingers attach to your hand. I'm agreement with you about the flexors. I received six injections in my flexors and one in my pectoral muscle. But after only about four days, I can't hold the gripper my brother made me. It keeps falling out of my hand. Before, that wasn't possible before. I had to apply force with my other hand to release the object. So, I guess it worked.

-phildogg

[lharrison]

oh my apology to you ocdean it wasn"t in the hand it was in fact in the forarm left side and in the leg calf area

[thejule1]

I went to get 12 Botox injections in my right arm (7) and hand (5) yesterday. Hurt like hell, especially my hand. The doctors injected my pectoral muscle too. Anybody have any luck with this type of therapy? I received injections of Botox about four months ago. The doctor told me at the time, I wouldn't be able to come back for at least three months. I was planning on returning until I received a letter from my insurance company questioning the "medical necessity" of the procedure. The doctor went to bat for me and I got a phone call from his office saying I got approved. Thoughts? Comments?

ps. I know this ain't the right forum, but I figured I'm a newbie and I can get away with it.

[thejule1]

Larry just received his third session of Botox yesterday. This time 2 injections in his hand, as well as shoulder, forearm and inner thigh. I squint everytime he says "oooh, ouch". I think the fact that the rehab doctor is an attractive female helps, but before the last two, he said "ARE WE ABOUT DONE"? I was surprised the hand got it as Phil mentioned that's where he received it before. Anyway, we shall see how it helped.

 

Happy to only be a bystander,

Julie

[phildogg]

I'm sad to report that the Botox they injected in my hand has worn off. I think my body has no longer gained the benefits in my hand. I still feel the effects in my arm. I can hear oc1dean echoing in my ears. But I don't blame the doctor, but I just wanted to last a little bit longer than 40-something days. My wife said it isn't worth going back to have it done again. She doesn't know that any relief from fist being so tight is good relief. But still I question, "Is it worth it?"

-phildogg

[lharrison]

hi afinch, yes i had it done on me as well and yes it does seem to work quite well for removing the spasticity i got it done on my left forarm and on my left calf leg and even though it is very expensive if you can get the insurance to cover for the cost it is defitly worth a try

[Ethyl17]

Phil: If it is paid for, just do it. They can't inject for 80 days anyway and you will go back for your arm, so just give it another round. Good news is you know now that the hand won't last as long, so step up for exercising after the injection when you have some relief. The hands are the last to come back.

 

After the next round, consider Estim unit for the hand. I have watched a stroke survivor at Bruce's Rehab work his hand two hours every single day for months. His Botox allowance had run out, but he knew that is where he needed to spend time and did it. Open clothes pins, place them on a wire, then remove them: pick up cones, move them to another spot, then back; they gave him that child's toy where you have square, rectangle, ball etc and holes to put each into. He did that for hours. As he fine tuned it, he used M&Ms and then got to eat the ones that didn't hit the floor. Yes, often times he needed his left hand to help his right hand, at least get into position and sometimes to release the fingers, but he did it.

 

Take advantage of anything that is paid and then make note of what you can do when you will finally run out of insurance paid therapy. Best, Debbie

[merichsen]

Phil,

Each series of injections almost seems to build upon the previous and have a longer lasting effect. The cold winter weather may also be a contributing factor as well as the amount of exercise you are doing to keep the muscles loose. You should easily get 3 months benefit from a series of injections, which is absolutely worth it.

 

Keep us posted on what you decide.

 

Maria :friends:

[phildogg]

Phil: If it is paid for, just do it. They can't inject for 80 days anyway and you will go back for your arm, so just give it another round. Good news is you know now that the hand won't last as long, so step up for exercising after the injection when you have some relief. The hands are the last to come back.

 

After the next round, consider Estim unit for the hand. I have watched a stroke survivor at Bruce's Rehab work his hand two hours every single day for months. His Botox allowance had run out, but he knew that is where he needed to spend time and did it. Open clothes pins, place them on a wire, then remove them: pick up cones, move them to another spot, then back; they gave him that child's toy where you have square, rectangle, ball etc and holes to put each into. He did that for hours. As he fine tuned it, he used M&Ms and then got to eat the ones that didn't hit the floor. Yes, often times he needed his left hand to help his right hand, at least get into position and sometimes to release the fingers, but he did it.

 

Take advantage of anything that is paid and then make note of what you can do when you will finally run out of insurance paid therapy. Best, Debbie

 

I'm not complaining it just the fact that it didn't as long as I would hoped it would. I'll definitely go back for more Botox treatments. Even if my wife won't take me, I'll have to call a favor from one of my friends. It is covered by my insurance. I would be a fool to not try again, especially, when it's covered. Good suggestion about the Estim units. I saw one advertised for under $100.00 on Amazon.com. These fingers couldn't even picked up M&M's so I'll nothing to eat and I love M&M's. But, I'll keep trying, never quit, it's not an option!

-phildogg

[phildogg]

Phil,

Each series of injections almost seems to build upon the previous and have a longer lasting effect. The cold winter weather may also be a contributing factor as well as the amount of exercise you are doing to keep the muscles loose. You should easily get 3 months benefit from a series of injections, which is absolutely worth it.

 

Keep us posted on what you decide.

 

Maria

 

 

Thanks for the encouragement! I didn't think the cold weather factored into the equation. But, thanks for pointing out to me. With the warm weather just around the corner I'm sure it'll lift my spirits. And then, I could walk my 200 foot driveway again.

I saw a picture of you. You're quite easy on the eyes.

-phildogg

[khiggs]

My husband gets botox and it really seems to help. It takes about 7 to 10 days for me to see the results and then it wears off after about 3 months. His Nuerologist gives him 400 units in his arm, hand and fingers and then the next time he gets 400 units in his leg. It is expensive but seems to help.

 

I am 1 1/2 years post stroke. I have a question for anyone getting botox. Does the spasticity ever seem worse than before when it wears off? I am scheduled to get it at the end of the month. I have been using the saeboflex at home 2 hours a day. I'v gotten to the point where I can pick up the balls and relax my fingers enough to drop the ball. I have tightness in my index finger which I'm hoping will get better after Botox. I can lift the last 3 fingers but if I yawn or my hand gets into a fist I can't open any fingers. Very Frustrating to say the least. My hand isn't always that tight So I'm hoping the Botox does the trick. I had Phenol injections which didn't do much and the saeboflex for a few months now, just this friggin' hand won't cooperate yet. I can make a fist fine, just can't get it open. Has anyone had an easier time opening their hand after Botox? Thanks. Keith

[mlp]

I went to get 12 Botox injections in my right arm (7) and hand (5) yesterday. Hurt like hell, especially my hand. The doctors injected my pectoral muscle too. Anybody have any luck with this type of therapy? I received injections of Botox about four months ago. The doctor told me at the time, I wouldn't be able to come back for at least three months. I was planning on returning until I received a letter from my insurance company questioning the "medical necessity" of the procedure. The doctor went to bat for me and I got a phone call from his office saying I got approved. Thoughts? Comments?

ps. I know this ain't the right forum, but I figured I'm a newbie and I can get away with it.

[mlp]

I went to get 12 Botox injections in my right arm (7) and hand (5) yesterday. Hurt like hell, especially my hand. The doctors injected my pectoral muscle too. Anybody have any luck with this type of therapy? I received injections of Botox about four months ago. The doctor told me at the time, I wouldn't be able to come back for at least three months. I was planning on returning until I received a letter from my insurance company questioning the "medical necessity" of the procedure. The doctor went to bat for me and I got a phone call from his office saying I got approved. Thoughts? Comments?

ps. I know this ain't the right forum, but I figured I'm a newbie and I can get away with it.

[Ethyl17]

Bruce's right arm was put in a sling day one post stroke in the hospital to keep it supported during therapy. His shoulder had subluxed almost 6 cm. This was the only solution at the time. As the brain recovers, the shoulder will only recover about 1/2 cm per month. With his arm out of the shoulder cradle, there was great concern of permanent muscle damage.

 

His insurance only paid for 30 sessions of "therapy" and after working with him for six sessions, home OT was professional enough to say he needed more agressive therapy on the arm than she could give him, so gave over her time slots to PT, who was getting good results. Off to Out Patient and the pros with the equipment and pool-lol. It was Bruce's OT who set him up for Botox for the Pec specifically, but at that point Bruce went over-spastic. They did not order enough Botox for both the leg and the arm and I had to choose the leg as we could not get his long leg brace locked and with the new AFO, he needed relief in the thigh. It was almost one year before his arm was injected and we had three sessions before new insurance kicked in and Botox was no longer covered. The difference in those 9 months was incredible.

 

Shoulder finally returned to the cradle and aggressive therapy continued. They could tie his hand to the bike and he could actually move the wheel forward and backward with the arm. We continued therapy, private pay, even without the Botox, but finally after year two, OT said lets give it a rest. We underwent the Baclofen pump trial which took months as they could not find a spot to insert the sample.

 

That brings us to now. In September Bruce will be on Medicare and we will reapply for the Botox. His Physiatrist has upped his Baclofen oral and already three weeks into, Bruce is feeling the difference in both the arm and the leg. I have held some money back for after the Botox decision to allow for more therapy if we get approved.

 

I will say Bruce's spasticity did not seem worse as the Botox wore off, but Bruce has an incredible immune system and his Botox kicked at about day 10 and lasted for about two weeks. However with an aggressive therapist who recognized this, the progress made in that two weeks was considerable. I know this restart will take time. In the meantime, Bruce continues his pool therapy, exercising the hand/arm, wearing his night splint and his Estims. If your therapist and Physiatrist agree to give it a go and it is paid for, I say give it a shot. It won't make things worse and after three months, if it did not help, reconsider. Debbie

[Wild Bill]

I went to get 12 Botox injections in my right arm (7) and hand (5) yesterday. Hurt like hell, especially my hand. The doctors injected my pectoral muscle too. Anybody have any luck with this type of therapy? I received injections of Botox about four months ago. The doctor told me at the time, I wouldn't be able to come back for at least three months. I was planning on returning until I received a letter from my insurance company questioning the "medical necessity" of the procedure. The doctor went to bat for me and I got a phone call from his office saying I got approved. Thoughts? Comments?

ps. I know this ain't the right forum, but I figured I'm a newbie and I can get away with it.

[Wild Bill]

I had 4 botox injections into the underside of my left forearm. I returned to see my OT this morning, which

is two weeks after the injections. I really didn't notice any change, but he said my very stiff left wrist

was much looser, and he was able to strech it much more than normal. Right now, I'm wearing a brace on my

left forearm to keep the wrist stretched. I have exercises to do at home, and I'm supposed to see my OT,again,weekly for the next two weeks. It's my understanding that the Botox really doesn't kick in and have any effect for about 2-3 weeks after the injections. I have an appointment with my doctor next week, for her to check it out. I know that I didn't answer your question, but the medics say it does. Medicare paid for mine. Wild Bill

[JakesMom]

I have questions about Botox treatments. My 31 yr. old son, Jason (Jake) had a major stroke in July 2011. He has paralysis on his right side and, because the stroke affetcted his left cerabellum, right mid-brain and the brain stem, he has tremors in his left side as well. He is currently at the Polytrauma/Brain Injury Center at the V.A. in Palo Alto, CA after being at their Livermore center for 6 weeks. His new Doctor at Palo Alto has mentioned Botox treatments for Jake's right hand, as he cannot open the fist. He has mobility in his shoulder, but not the elbow or hand. It's weird because he can arm wrestle me with his weak arm and almost beat me, but I think the resistance is mostly from his shoulder and upper arm. Anyway, we had not heard of Botox used in stroke patients, but I have read all of the posts related to it in this forum (thank you!). My question is: will using the Botox to temporarily stop the spasticity allow him to regain use of his hand?

(Edit: his right hand can be opened manually and he wears a splint on the hand/wrist which helps keep the hand in an open/resting position, but will return to a tight fist that is hard to open).

[Ethyl17]

Jakesmom: I just posted a response and apparently it went off into cyberspace, so if this gets repeated, I apologize.

 

Muscles work in twos. In Jake's hand, for instance his Flexor is over-working (the clenching shut) and the Extensor can not overcome the strong flexion. The use of Botox will ease the Flexor, allowing movement from the Extensor, thus getting signals sent to the brain that yes, this muscle still exists. The main pathways to the brain are broken. Object is to get other areas to pick up the work and they will not if they do not get a signal from the muscles themselves. Therapy may also try some Electrical Stimulation and add another drug: Baclofen, along with the Botox and Jake will have to contine to use his splint and will be expected to flex and extend his affected hand with his good hand, throughout the day. Botox will make this easier. Will it give him his elbow and hand back? Hopefully, the final answer is in the brain, which Botox has nothing to do with. If the brain will find some area willing to take over the new chores, very good chance. In most stroke, arm and hand come back last and take a long time, so one never gives up.

 

Jake's shoulder functions with the muscles that run along the shoulder blade. Elbow and hand from muscles in the arm. But good news thee is the initial pathways at the shoulder are open and functioning. In my Bruce's case his shoulder was also affected. He finally has some extension back-no flexion yet, but we continue to try. His Botox was initially injected into his pec to release his shoulder. We have yet to get to elbow and hand, but are hopefully starting again in October (Insurance change). I hope thishelps, Debbie

[Guest furiawill]

My spouse has had two Botox injection sessions and the third one is coming up. He has not tolerated needles too much so he is brave to do this. He has spasticity in his hand and arm and has had injections in his shoulder as well for this. It takes about 10 days or so to kick in and then 3 months before another can be given. It helps the muscles in his arm and hand to relax. I think he would have a lot of trouble with his hand curling up otherwise. It is expensive but Medicare covers his treatments.

Julie

 

Thanks for letting me know that Medicare covers the cost of Botox. We're in a transition phase trying to weighing out the costs and coverage that Cobra allows us and what the medicare/medicaid will cover. I've been on my old insurance until it ran out in November. I've been on Cobra for the past month and not sure if we're gonna pay another month. Like your spouse, I don't like needles. I feeling the effects after only four days. I would hate for it to kick in ten days. But some people feel the effects of Botox, differently. I like to report that I am feeling the effects already. The relaxing of my arm has made the elbow movement much smoother and the shoulder movement is much more relaxed. And where they injected my hand I can't even hold my gripper I hold to keep my hand open. I guess I'll to report to my doctor it does its intended effects.

-phildogg

I HAD THE BOTOX INJECTIONS FOR MY CURLED HAND AND THEY DID WORK FOR ABOUT 3 MONTHS. ALL MY INJECTIONS WERE IN THE FOREARM, BECAUSE THE DOC USED AN EMG MACHINE TO FIND OUT WHERE TO INJECT FOR THAT MUSCLE GROUP. THERE ARE NO MUSCLES IN THE HAND ITSELF THAT CONTROLS THE FINGERS. THEY ALL SEEM TO BE IN THE FOREARMS. MINE IS PAID FOR THROUGH V.A. SINCE I AM RETIRED MILITARY.

-WILL

[Guest furiawill]

My spouse has had two Botox injection sessions and the third one is coming up. He has not tolerated needles too much so he is brave to do this. He has spasticity in his hand and arm and has had injections in his shoulder as well for this. It takes about 10 days or so to kick in and then 3 months before another can be given. It helps the muscles in his arm and hand to relax. I think he would have a lot of trouble with his hand curling up otherwise. It is expensive but Medicare covers his treatments.

Julie

 

Thanks for letting me know that Medicare covers the cost of Botox. We're in a transition phase trying to weighing out the costs and coverage that Cobra allows us and what the medicare/medicaid will cover. I've been on my old insurance until it ran out in November. I've been on Cobra for the past month and not sure if we're gonna pay another month. Like your spouse, I don't like needles. I feeling the effects after only four days. I would hate for it to kick in ten days. But some people feel the effects of Botox, differently. I like to report that I am feeling the effects already. The relaxing of my arm has made the elbow movement much smoother and the shoulder movement is much more relaxed. And where they injected my hand I can't even hold my gripper I hold to keep my hand open. I guess I'll to report to my doctor it does its intended effects.

-phildogg

I HAD THE BOTOX INJECTIONS FOR MY CURLED HAND AND THEY DID WORK FOR ABOUT 3 MONTHS. ALL MY INJECTIONS WERE IN THE FOREARM, BECAUSE THE DOC USED AN EMG MACHINE TO FIND OUT WHERE TO INJECT FOR THAT MUSCLE GROUP. THERE ARE NO MUSCLES IN THE HAND ITSELF THAT CONTROLS THE FINGERS. THEY ALL SEEM TO BE IN THE FOREARMS. MINE IS PAID FOR THROUGH V.A. SINCE I AM RETIRED MILITARY.

-WILL

[Maxine]

I went to get 12 Botox injections in my right arm (7) and hand (5) yesterday. Hurt like hell, especially my hand. The doctors injected my pectoral muscle too. Anybody have any luck with this type of therapy? I received injections of Botox about four months ago. The doctor told me at the time, I wouldn't be able to come back for at least three months. I was planning on returning until I received a letter from my insurance company questioning the "medical necessity" of the procedure. The doctor went to bat for me and I got a phone call from his office saying I got approved. Thoughts? Comments?

ps. I know this ain't the right forum, but I figured I'm a newbie and I can get away with it.

 

 

Newbie here also - I was waiting on medical neccesity also and got the ok - my appt. is in april - when talking to my dr. - i wasn't to concerned except for the pain of the injections but of course i got online and now am scared to pieces....did the injections do any good for you and would you do it again?

[Ethyl17]

Maxine: Bruce is on round six-just yesterday he was injected in both the arm and the leg. It makes a great difference for Bruce. Bruce has a wonderful immune system, so it will take about seven days to really kick and then will only last for him about 10 weeks. It is hard to see it wear off on him. Just last two weeks, his leg was rock hard, almost like it did not belong to him. He still has no response on the arm-hand, so that is not so noticeable.

 

I do understand that after some time, effects will not be as effective as they are now, but both his Physiatrist and Therapist support that he continue at this time.

 

Yes it is painful. Bruce has a high tolerance to pain. After his injections, he walked to brace clinic and then to Xray. Yes, he napped as soon as we got hoe, but most of that was due to five hours at the Rehab and Clinic. Today, he was sore at the injection sites only-common with puncture.

 

Bear down and go for it. You can decide if you want to continue after you see the effects and weigh whether that was worth the injections. Knowledge and experience will tell you. Please do let us know. Debbie