Announcement

Collapse
No announcement yet.

Botox for spasms

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

    Botox for spasms

    I have been reading that many people have had success with Botox for increasing volume the bladder can hold. I don't use it for that. I use it for spasms. The theory is that the spasms from the bladder trigger a damaged spinal cord to signal muscle contractions to the rest of the body.

    I had good results for about 3 months and the spasms all over from T8 down are coming back stronger and stronger each day now. I have a baclofen pump (~250ug/day). I am trying to decide if I should turn up the pump or go for more Botox.

    I hesitate to turn up the pump because I feel drowsy and tired for weeks. Even after the drowsiness wears off, the weakness stays on. Botox has no side effects that I can detect. But I don't know if its safe to use too much too often.

    I am seriously considering another DREZ. The first one in 1993 was the best thing I did for my injury. I took no medications for over 10 years and I felt great. Just the psychological relief of being able to relax in itself was worth it.

    Any feedback is appreciated.

    #2
    Wow lots of information DREZ, Baclofen pump, Botox for bladder spasms?

    What is the question you want an answer to? Is is spasms? Pain? or a combination of both?

    DREZ is a last resort type of surgery, it is not always successful. Having it repeated is your choice, you should get the statistics on success rate a repeat time.

    It is also not uncommon to have a baclofen pump and need oral baclofen to help with the spasticity/neuropathic pain.

    None of these treatment options are going to completely get rid of pain or spasticity. It is not uncommon to have some pain, some spasticity.

    It would be a good idea to have guidance from a pain team and a pain clinic psychologist to look at your treatment options, goal of therapy and your coping skills.

    pbr
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

    Comment


      #3
      I can deal with the pain. I just keep active, eat well, drink lots of water, and it drops or even goes away. My concern is spasms. They are interfering with everything, decreasing my quality of life, and forcing me to decrease activity. As a result I slow down and the pain gets worse.

      First question is can Botox alone rid spasms or is that unrealistic and baclofen is still required as a baseline? If so then why bother with Botox (for me) and why not just increase my Baclofen dose?

      Second question is can DREZ the second time around eliminate spasms like it did the first time?

      Comment


        #4
        DREZ (dorsal root entry zone) surgical procedure is targeted for chronic pain. I believe that relief of your spasms was a by product result. http://wiki.cns.org/wiki/index.php/DREZ

        Botox targets specific muscle groups for spasticity, paralyzing that muscle (temporarily) and thereby the nerve firing that muscle to spasm is inhibited. The procedure, if successful is repeated every 3 months, as that is how long the treatment lasts.

        If you are reluctant to increase your baclofen pump dose then I would suggest that you try oral baclofen. Talk to your provider.

        From your description, it sounds like you do have chronic pain and chronic spasticity. It is not uncommon for them to appear together. I would again recommend talking to your provider and getting support from a pain psychologist.

        pbr
        The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

        Comment


          #5
          Bladder botox

          I had the bladder botox procedure last summer --about 20 shots. Volumes increased significantly (from avg 350 to 500-550 avg/ max 700ml). Also my episodes of autonomic dysreflexia seemed less frequent and less severe. Urodynamics testing showed volume is still good but dysreflexia benefits have declined. Planning on my 2nd procedure in the next few weeks. I'll report if volumes increase further.

          Comment


            #6
            My immediate question is how do I know if I should be turning up the pump or going for more Botox? Sometimes I can tell that the bladder is firing first and the legs are following in which case that may indicate Botox. Other times the spasms don't show this pattern or at least not that I can detect.

            Longer term question is who do I go to coordinate the two? My urologist does not treat Baclofen pumps and my Neurosurgeon and pain doctors don't treat Botox for bladder.

            Seems like I may need to get three doctors involved. Should I go to my physiatrist and have her coordinate the two drugs with the two other doctors?

            The DREZ was so nice. No problems, no guesswork, just relief for over 10 years.

            Comment


              #7
              I agree to talk to your physiatrist, NP or PA to help medical case management between all the providers.

              pbr
              The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

              Comment


                #8
                Originally posted by SCI-Nurse View Post
                The procedure, if successful is repeated every 3 months, as that is how long the treatment lasts.

                pbr
                I am reading that others have gone 6 months or longer between injections. Please clarify.

                Comment


                  #9
                  How long Botox injections, either into smooth or striated muscle, last, is very individual. It works best on smaller striated muscles rather than large ones. The skill of the person doing the injections, and the dosage used are two factors, but there are other variables that are not clearly identified that may impact how long the injection effect lasts.

                  (KLD)
                  The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                  Comment


                    #10
                    That makes sense. When then did you say the treatment lasts 3 month?

                    Comment


                      #11
                      Originally posted by Axle View Post
                      That makes sense. When then did you say the treatment lasts 3 month?
                      That was another SCI-Nurse, not me, but for some it can be as short as 3 months.

                      (KLD)
                      Last edited by SCI-Nurse; 23 Feb 2013, 9:35 AM.
                      The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                      Comment


                        #12
                        The good news, according to my Uro, Medicare will now pay for it every 3 months. Back when I was paying for the Botox myself, ~$1200.00 retail price, I would stretch the treatment as long as I could. Problem is it wears off so smoothly it is hard to pinpoint a specific time, and it does vary even with same Uro doing it.

                        Be interested to see my Medicare statement in the future, curious how much they pay for the drug.
                        "a T10, who'd Rather be ridin'; than rollin'"

                        Comment


                          #13
                          I have had the botox injections in my bladder 4 times now. It lasts 9-12 months for me. It has changed my life. I use to leak all the time and had constant spasms. Now, I rarely leak, usually only if i have an infection or am sick. I only have to take an Enablex 15mg ER to help with spasms. Much better than wearing a pad or depends all the time.

                          Comment


                            #14
                            Dysreflexia "wonder drug" ???

                            I've battled chronic autonomic dysreflexia since 2006 after removal of a baseball sized bladder stone via lithotripsy. I tried most prescription and non-prescription approaches with limited success. Three bladder botox procedures proved less and less effective. I was constantly charting my erratic BP. I made notes of every possible trigger I could think of in order to find some sort of cause/ effect. Even so, my BP routinely reached dangerous levels (daily). Emergency meds (vasodialators, etc) often caused the bottom fall out --so much so I would have virtually fainted save for my being in a reclining wheelchair.

                            Earlier this year, my PM&R doc referred me to their university's cardiac/ blood pressure clinic. After reviewing my case she stopped one med (Labetelol) and added DILTIAZEM ERC (180mg) 1x daily. I quickly experienced positive results. Based on my report during a follow up 3 months later, she upped me to 2x daily. My BP has been absolutely golden ever since! It's a bit higher before rising (lying down all night) and drops after getting up (110/75+). However I'm rarely above 120/80 and steady as a rock for the most part. This despite urine volumes as high as 900ml that still didn't trigger AD!! Most typically range 500-700ml.

                            Other meds I take are DOXAZOSIN, BACLOFEN (3x daily) and OXYBUTYNIN (2x daily). I'm soon to turn 60, I'm 6'0," weigh 220 and have been a C5/6 incomplete quad (tetraplegic) since 1972.

                            I thought I was at the end of my pharmaceutical (and botox) rope. I can't explain how or why this med works but it's been downright miraculous for me.
                            Originally posted by Randyman View Post
                            I had the bladder botox procedure last summer --about 20 shots. Volumes increased significantly (from avg 350 to 500-550 avg/ max 700ml). Also my episodes of autonomic dysreflexia seemed less frequent and less severe. Urodynamics testing showed volume is still good but dysreflexia benefits have declined. Planning on my 2nd procedure in the next few weeks. I'll report if volumes increase further.

                            Comment


                              #15
                              It is great to hear that this is working for you. I am concerned that you are having volumes as high as you are. Even 500 is a bit on the high side. My concern is for the overstretching of the bladder and the possibility that the urine could be pushed by upwards into the kidney.
                              CKF
                              The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                              Comment

                              Working...
                              X