Botox, OnabotulinumtoxinA

I would never think a procedure would be in your mind, as one to look forward to.

But Botox, or  OnabotulinumtoxinA t is used o treat dystethia, or muscle stiffness, muscle cramps, spascisity, walking problems, movement problems.  
A treatment which people with Multiple Sclerosis get.

Botox can be used to treat many symptoms associated with multiple sclerosis. Patients who have spasticity affecting their arms or legs may be good candidates for botulinum toxin injections to relieve painful spasms and improve mobility.

I have had botox treatments since being diagnosed  of multiple sclerosis. I had maxed out  baclofen  early on. My Neurologist, was a old timer, with no computers. He worked as a stand alone neurologist, with a staff of two office gals, one who did your appointmens, in her hand written book.  She had your paper file for Dr to go thru, ready for him.. The other gal had a real old computer, she could obtain the necessary forms on, and Bill the insurance. I am sure another gal took down info for billing outside of his clinic.

He used the old time scrypt, decypherable by him and a few Drs I talked with. Looked like scribble marks, but so does shorthand.  Dots of injection sites, other records were transcribed, like the sleep study.  EMG, was always followed up on how fast nerves responded. Record keeping in each patients file, as Dr would do before electronics came out.

A fax machine was used to fax prescriptions, but the new pharmaceutical companies did not like.  The neurologist would fill my Gabbapentin and Provigil.  I found a way around this by sending in original prescriptions for mail order to them, as faxes kept getting lost, or the insurance company would say, we've tried to contact your Dr multiple times, with no response. This happened by the insurance computer calling at 2am, not saying what was needed from the dr. It became a a problem for his staff, their limited time, and hours listening to messages, and hours I spent trying to find where the problem was. It was the insurance companies computer not recognizing the Drs Faxes.

There were a couple other part time gals, who ran the emg machine, sleep study, and other test.I

Botox works by blocking the release of acetylcholine from nerve endings. Acetylcholine is a neurotransmitter required by muscles for muscular contraction. By eliminating the ability of a muscle to contract, it relaxes, thereby decreasing spasticity and tone.

Spasticity is a condition in which muscles exhibit almost constant contracture or activity, leading to loss of range of motion, decreased function, and even pain.

Spasticity occurs after an area of the brain or spinal cord has been injured, leading to weakness and increased tone.

When an arm or leg which is affected by spasticity is moved by an examiner, there is involuntary resistance to that movement.

Often, this spasticity is made worse when the speed (or velocity) of the movement increases.

Spasticity is often seen after a stroke, traumatic brain or spinal cord injury, or in cases of multiple sclerosis.

In some cases, spasticity can be associated with development of involuntary tremors.

The blockade of acetylcholine does not occur immediately. Most patients do not begin to see the effect of a botulinum toxin injection for a few days, and it may take a few weeks for the maximum benefit to become apparent.

This neurologists was quite informed on latest developments, what was working, and what did not.  He could do a spinal tap right in his operating room, and send labs out, have results quickly.

This he did with my botox injections every three months, as that's all the insurance would pay for is every three months. My botox lasted 62-64 days, I would record in my book I brought in.  Botox day was describing muscles inside the leg, or outside ones. This would include stiff muscles in the neck, Charlie horses.
Or how the toes were curling in our out.
He knew where to inject the botox, the debth, and feel the muscle spasms.

Three weeks later was the follow up, where he would ask me what was in my book note book of questions, comments, and research. I had done.  A question answer period, sometimes a booster shot for botox, but lots of questions answered, and items to try to help.

Botox has a Black Box  warning.
From their site"

https://m.youtube.com/watch?v=4x9yRjrN0iQ

IMPORTANT SAFETY INFORMATION

BOTOX® may cause serious side effects that can be life threatening. Get medical help right away if you have any of these problems any time (hours to weeks) after injection of BOTOX®:

Problems swallowing, speaking, or breathing, due to weakening of associated muscles, can be severe and result in loss of life. You are at the highest risk if these problems are pre-existing before injection. Swallowing problems may last for several months

Spread of toxin effects. The effect of botulinum toxin may affect areas away from the injection site and cause serious symptoms including: loss of strength and all-over muscle weakness, double vision, blurred vision and drooping eyelids, hoarseness or change or loss of voice, trouble saying words clearly, loss of bladder control, trouble breathing, and trouble swallowing

The black box warning continues an can be read at botox.com

BOTOX® may cause loss of strength or general muscle weakness, vision problems, or dizziness within hours to weeks of taking BOTOX®

The dose of BOTOX® is not the same as, or comparable to, another botulinum toxin product. .

Other side effects of BOTOX® include: dry mouth, discomfort or pain at the injection site, tiredness, headache, neck pain, eye problems: double vision, blurred vision, decreased eyesight, drooping eyelids, swelling of your eyelids, dry eyes; and drooping eyebrows.

For more information refer to the Medication Guide or talk with your doctor.

My Neurologist went on a "medical leave" just before botox was to be injected. This left me with the last injection being August 2019. My calves were tight, hard as rock before I was able to see a new Botox Neurologist. His First opening being late February 2020

The University Hospital used a EMG guidance computer to assist the neurologists and his student. A special chair to sit it that allowed easy access to multitudes of muscle names the Neurologist rolled off as he injected The multitude of sites.  The machine had sound, I could not see the graph. I just knew he was injecting the proper muscles and depth, from having them from old neurologist.   Both calls were hard as rock, some pulling on toes, or the top and bottom of the foot. This causes a lift problem with the foot.

My neck muscles had spasmed extensively. These muscles control the arms, which had signs where muscles were pulling you could see the indent near the elbow. Muscle names rolled off the Drs mouth as injections went deep into the muscle. I recognized the trapeze muscle, controlled by the neck, but had no idea of the names, or how deep these other muscles were. These were all injected into the neck location, on both sides.  The Doctor was more complete with more botox used into all the problem areas.

I will see him back in three months, keeping track in my book, of side effects, 

helpful and hopeful for great results.

I hear it helps for migranes and more.

Have you had Botox? And your story?  Chime in!
Cheers
JoeY