One of the serious problems Pete has been experiencing is muscle spasticity or toning. Think about when you've slept "wrong", you wake up all stiff, and your arm takes a while to loosen up. This is a much more serious version of the same thing. Pete's Achilles tendon, hamstrings, pectorals and arm tendons have gotten tight and short like I mentioned before. To describe how it looks, when he stands up, his left leg looks sort of like a flamingo's leg. Sort of bent at the knee with the foot up and hanging.
So, we go to the TIRR outpatient clinic at the end of January to get Pete shot up with Botox. When we started, his blood pressure was a little higher than I'm used to seeing, but I have to guess, a little apprehension is pretty normal. So while we wait (and wait and wait) I look at this poster on the wall. It has pictures of patients with various types of spastic muscles. The first picture is an older man (based on the picture of chest and arm) with an arm like in a sling across his middle. It goes all the way to people with arms and hands in very unnatural and painful looking positions. I pointed out to Pete the guy with the sling look and told him he was a lucky man, because that's as serious as his was.
The way this is done is pretty fascinating, I guess if you're the one not on the table. The nurse brings in like 15 syringes, and the doctor pulls over this computer. She takes the needle off the syringe and replaces it with a more flexible needle (kind of like the thing they use for an IV) and attaches it to an electrode that is attached to the computer. She says, "stick" and puts it into his pectoral muscle on the left side and you hear this crackling noise, and she looks for the spot that has the worst crackling, and starts shooting it there. She moves and goes from spot to spot on his left arm. You could tell when she hits someplace not toned, because there's no noise. She also got right into muscles and tendons going into each finger. She put some electrical stimulation onto the needle so his fingers moves and she knows when she's got it. There was just enough botox left to do a couple of shots into his left leg. He gets to come back for the leg stuff.
Botox takes about 10 days to get to "full potency". Over this last weekend, I could move his arm to about 90 degrees away from his body to the side. The bad thing is that the drug that releases the toning, also relaxes the muscles so he doesn't have much strength in that arm. I am able to do a bunch more stretching on him than I was before.
Last Wednesday, he went in for Phenol injections. Yeah, both of these medications are poisons so they're pretty careful how much they use, and they couldn't do both at one time. This time the left leg was the focus. The toning is much better, but the muscles are weak. The PT is working on that, and the OT is working on the arms. His wrists, which had no range of motion outward can now bend to about 45 degrees, I can bend his ankle much better than negative 10 degrees.
Tonight we ditched the transfer chair for Pete's shower. Let's just say we did some fancy dancing in the bathroom. He did take a few little steps, but really, those weren't real steps, more just moving inches at a time around in a circle. It's a start.