Sunday, September 27, 2015

Sunday Stroke Survival: Botox Again and the Benefit of a Teamwork Approach

Had my usual round of Botox injections last week. Still at 400CCs of the poison for my spasticity. My hopes of doing away with them entirely with dry needling is still a distant hope. There's just too much high tone in the muscles to do without it totally yet.

In talking with most of the stroke survivors I know, they complain that their neurologists or therapists are useless. Offering little or no help at all. I'm happy to say that I cannot relate to this.

 Part is due to, I believe, is God's blessing and part in my attitude of looking at care/recovery providers as employees. If you have a medical provider that is not on the same page as you are in your recovery, why are you paying them. Yes, even if you are on Medicare or State Assistance, you are still paying them with your tax dollars. Now if you are in a small town, you may not have a choice, but where I am there are four or five of each specialty to choose from. Even if there only two, there is the lesser of two evils in a choice. Keep searching for a health care provider who thinks that it is possible to recover. That's what you really want, isn't it? I know I do.

I've often sung the praises of my neurology and therapy teams here on this blog. They believe like I do that nothing is impossible. They show they care about me and listen to what I have to say. This is important. It's called teamwork. Everyone is on the same page to get Jo to recover as much as possible. So what if my brain is telling the muscles to move in the wrong way. How do we fix it? How do we make it behave like it should? What can each one of us do to have a successful outcome? When I'm with my doctors or therapists (in this case) THIS is what we are talking about. When one of us hears something new, we bounce possibilities around. This is what I expect from my health care team and will accept nothing less, and why should I? Get on the same page or get out. Isn't this the way it should be?

This time around we had a change up. I asked both my therapist and my neurologist if the other could be present at my Botox session. Even though doctors get reports on their patients in therapy, it's not always the same as seeing it. My doctor was curious about dry needling because she hadn't heard of it before I started talking to her about it the beginning of this year. My therapist had never seen EMG driven needles for Botox before. So both were curious.

Shameless plug
My therapist is also supposed to make marketing calls on doctors to boost referrals for his company also. I understand the marketing aspects companies can demand and have often discussed this with my therapists not to mention achievable goals or progress for patients for insurance companies to keep patients on the roster. It pays to think outside the box when dealing with paperwork. It can cause them to pull most caregivers' hair out.

For me, being able to hold and carry things with my affected arm is a positive achieved goal, even though it is still not voluntarily mobile. For me, it's a huge achievement. To have limited control to do that is a giant leap forward and I can do it at will now almost all the time.

So my therapist marked the time of my appointment as a marketing call, but I benefited from it greatly. My therapist was able to discuss what he was doing with me and goals that he'd like to work on in the coming months. My doctor bounced ideas off him in order to hit the right spots with the Botox to make it possible.

While previously the main concentration of spasticity in my arm was in my upper bicep and pectoral muscles, the dynamics have changed with the dry needling. It is now the lower bicep and forearm that is the most spastic. The upper bicep and pectoral muscles have shut down in spastic movement. So guess where most of the injections took place. You got it.

Now, I know I'm extremely fortunate to get the meeting of the minds for my benefit. It all comes from the approach and being able to look at a problem from outside the normal. I make a point of surrounding myself with the outside-the-box thinking folks. Not so far out of left field to be truly strange, just a little avant garde. So who won? All of us. The neurologist learned first hand how to help her patients. The therapist was able to get a new referral source and learned more about patients having Botox. And lastly me, everyone is on the same page as far as goals and procedures for my benefit. It's a team effort.

If your doctor or other medical personnel are not working for you, find ways to work in your benefit. If you can't, replace them. Don't you deserve the best possible outcome? Can I get a "HELL Yeah!"? It may not happen overnight. For me, it took six months worth of schedule juggling to make it happen. But I think it was worth it. All you have to do is ask.

Nothing is impossible.


  1. Hi Jo - sounds like an excellent idea - that really helped one and all ... well done and hope you feel easier after the treatment - take care - cheers Hilary

  2. Well, it's helping marginally as always. Spasticity does not handle stress well and my life right now is full of it.

  3. Yes! Go, Team Jo, Go! {{{{hugs}}}}

  4. I hope the Botox combined with dry needling produces a good result. No one deserves it more.

  5. Thanks for the advice on choosing a provider that cares. Healthcare expenses are at all time high for stroke victims. Recovery is very difficult on your own. It would be nice to know that a qualified specialist at least some hope for your recovery. So I do agree with you about paying someone who is optimistic. You deserve that much.


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