Yes, Botox. It’s not just for rich, older ladies anymore! It has been used for a few decades on the muscles of patients who’s muscles are stiffened to help them relax. In Jacob’s case, he has high tone. Which means the nerve impulse fires rapidly between the muscles and the brain- and they are always “on”. Try to squeeze your fist tightly. It feels tight and not bendable, right? This is what Jacob feels normally throughout the day.
He has had difficulty walking for a few reasons, one of them being that his adductors, (or inner thigh muscles), were really tight and this caused him to scissor step. When he walks, sometimes his ankles cross over the others. How far could you get walking this way? We have tried a few pieces of equipment that physically stop him from crossing over, but botox allows him to have more control over it. He also has issues with his hamstrings being tight, which causes him to sit on the floor with a rounded back. Stretching is a daily activity to help him stay as limber as possibe.
On August 22, 2008, we went for our first botox injection. Botulinum toxin (Botox) , is a medicine that has been used for decades in the medical field to decrease tone and unwanted spasms in a specified group of muscles. Botox, is essentially the same toxin that is linked to botulism- which is a type of food poisoning. However, in small doses can be extremely benefitial to patients. The results typically can last from 3-6 months.
Researching on the internet made me so nervous. People in Web groups that I belong to have posted many negative effects from Botox. (There are some scary things on the internet if you go looking for them). The worst effect being death. We debated for months and even put it on our back burner for a bit while we learned more. I spoke with our therapists and eventually felt more comfortable doing it. Our doctor explained that they identify which muscles need the relaxation and they find the weight of the person. The problems occur when doctors exceed the dosage recommended for the patients weight. They then distribute the correct amount of Botox into the of muscle. For example, Jacob had 4 spots; left adductor, left hamstring, right adductor, and right hamstring. They found his weight and figured the correct dosage for him. They also believe that he could benefit from his calf muscles as well, but our doctor worried that it would not be enough botox to spread to 6 injection sites. She also determined that his right side is tighter (all over his body) and gave a little more botox to his right side than his left.
Positive Effects – Wider range of motion, ability to stretch further, stronger gait when standing or walking, ability to crawl, walk, etc. In the hands – turning doorknobs, holding pencils, etc.
Negative Effects – Some sites that I have been on have noted no negative side effects whatsoever. However, I have read on message boards that some have expeirenced difficulty swallowing, difficulty breathing, and even death.
Often, in conjunction with Botox, serial casting is used. This is a process where a patient’s limb is immobilized into a cast. The main objective is to broaden the range of motion in the specific area after the botox lessens the tightness. The feet and legs are most often done. The patient is seen weekly, while re-assessing how much more range to set- and then recast. This typically last from 4-6 weeks and results have been great. Can you imagine how far you would be able to strecht your hamstrings after a month of this?
We are extremely pleased with the results on Jacob. It seriously has been a miracle what it has done for him and I see such a bright future for him! If this is something that you are interested in… please talk to your therapists, doctors, or even specialists to see if this would be a route for you.