Monday, November 21, 2011

On pins and needles... but mostly just needles

Will is having his first Botox treatment tomorrow. No, he isn't getting his crows feet taken care of... he's having injections directly into his hamstrings (back of thigh) and hip adductors (inner thigh).

Botox reduces the transmission of nerve signals, which causes the surrounding muscle to relax. In your face, this allows your muscles to relax and thereby reduce the look of wrinkles. In larger muscles, the Botox causes the muscles to lose rigidity.

This would be bad for most of us, whose muscles tighten and relax when we want them to. But for someone like Will with spastic cerebral palsy - when the muscles are uncontrollably tight all the time - the ability to loosen muscles can be a God send. Imagine trying to walk around all the time with the worst Charlie Horse in both your thighs. Think that might be tough?

Will's last x-ray revealed that the tight muscles that he has in his hamstrings and hip adductors are causing his hips to deform slightly and pushing his knees closer together. This really makes walking difficult, and if left untreated for a long time, would make it impossible for Will to ever walk. We can treat this now and the Botox will release these muscles - allowing Will's hips to continue developing normally.

In recent months, Will has made enormous strides in physical therapy. He is clearly motivated to walk with assistance, and is initiating steps on his own. He knows what to do. But because his muscles are so tight, he can't seem to stop his legs from getting tangled up in each other. His doctors and physical therapists all agree that if we can loosen Will's legs, his progress in PT will increase dramatically. And with success comes confidence. It is a win-win.

Of course there are risks with Botox injections. It is a toxin, after all. There are a lot of strong opinions about its use in medicine because of this. But before you pass judgment, I ask you which is worse? Using small amounts of Botox to allow Will to feel walking success and less pain OR allowing his tight muscles to continue to stress his hips to the point where he needs painful surgery to correct it?

The treatments last 4-5 months on average and results are best in the first couple of years. This is not a "forever" fix. But this is a critical time in Will's bone and joint development, and we need to do what we can when we can.

Please keep Will in your thoughts and prayers tomorrow as he very bravely undergoes 4 long needle pricks. It won't be the most comfortable thing for him, but in discussions with other mothers of children with CP who have gotten Botox injections, there have been nothing but positive comments and smiles from their children (smiles with the results... no one really likes getting the shots of course).

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