Sunday Stroke Survival: Spasticity Treatments and Results

Well, I had my latest round of Botox this week. This time with my new neurologist. He had mentioned in our initial meeting that he may try something different than my old neurologist. After a little discussion, he decided not to be adventurous because my maximum dosage was only 400 mg. Better to hit the spots that work.

I must admit I was a little bit disappointed, but he explained that even though he was basically hitting the same spots, he wasn't my previous neurologist. His technique and depths may be different. You can read what others have done (general areas) and still perform it differently. He did add that he was going to request/argue to get a higher dose of Botox out of my insurance carrier. He'll have a fight on his hands, but as my momma used to say, "never say never." After all, my insurance company also had a steadfast policy against another AFO within three years, and we know how that turned out from my previous blogs.

Although personally, the idea of putting even more of this toxic chemical in my body is not my first choice. But with the relaxation of the spasticity, I improve in function and ability. If another 50 or 100 mg. of Botox will reduce my spasticity enough to improve my elbow flexion, my index finger and thumbs mobility, or even straightens the inversion of my foot where I'm able to take even five steps without my AFO, it's worth it.

I've been doing dry needling for over a year now. In the beginning I was having treatments three times a week (upwards of 100 needle sticks between my arm and leg a session). The effects last 25 minutes to a couple of hours. Speed forward a year and a half, I have needling done once every two months on my leg (often only 3-5 needle sticks) and lasts for almost two months depending on where I'm at between Botox sessions. It's lasting that long and my foot is flat on the floor each step instead of the increased pressure and weighted step towards the outside edge of my foot. (This is what caused all my pressure sores the first two years after my stroke) 

A year and a half ago, my arm was clenched into my chest, the wrist was greater than 90 degrees, and the fingers didn't move. Again, fast forward to present time. Right before my Botox session, My arm rested at 45 to 60 degree angle. A far cry from at almost 180 degree angle it had before a Botox session. Even better, I was 5 degrees off from full extension at the elbow the day before the Botox. The wrist is still stubborn, but mostly because of the wrist contractures. The same goes for my ring and bird fingers, but my thumb, index and pinky fingers can be straightened into a sign language "I love you." I can even hold that position now for about 5 seconds after a good stretching session. I can move my thumb and index fingers together in a pincer form although it takes me a few minutes to do and a whole lot of concentration. I'm pretty well exhausted after doing it twice. The spots that get dry needling now, my steel traps (trapezius) once a month, my bicep twice a month, my pectoral and shoulder blade every four months, my triceps about every three months. My lower bicep, my elbow extenders, lower arm, wrist, and hand now only require WEEKLY visits. (Less than 25 sticks) How's that for progress?

My drugs have been a consistent juggle. Between 40-60 mg of Baclofen a day instead of the 80 mg I was up to. It depends on when my Botox wears off. Most days, it's 40 mg. I tried to drop the dose down to 20mg a day because I felt so good, but my body let me know the extra 20 mg per day. The Zannaflex is down to 8-12 mg per day instead of 16 mg. Again, it depends on how my Botox levels are. Most nights, it's 8 mg because it helps me sleep more comfortably. I eliminate the daytime dose. The Valium, I was on 5-10 mg. I can't even remember when the last time I took it. The really good thing, I was on Cymbalta and Lyrica for my fibromyalgia. Now, it's just Cymbalta. So less drugs and less pain is always a great thing. Better for my body and my pocketbook.

Yeah, it's been a while to reach this point. But like everything about recovering from stroke loss... it takes time. How much time? Who knows, but what else have I got to do? Anyhow...

Nothing is impossible.