Thursday, April 15, 2010

Botox Follow-up

(NOTE: there are 2 new posts today... there's another one right after this that covers the last couple of months and has lots of pictures!)

Last month, on St. Patty's Day nonetheless, Emily received another series of botox injections in her calves. For those of you new to the blog, Emily has been getting these every 3 months for the past year or so. Emily is almost 4 years old and has cerebral palsy. Her version of cerebral palsy causes her to leg muscles to tighten up and she walks on her tiptoes as a result. The botox is used to weaken the tight muscles and she wears leg braces (DAFOs and AFOs) on her calves and feet to keep her from going up on her tiptoes and to help retrain her muscles. She also wears a similar brace that we call a "night brace" on her left leg. It is more padded and able to be adjusted so she can get more stretch in her heel cord while she sleeps and her leg is relaxed. There are pictures of these and a better description in this old post from last July.

Sooo... Em's been wearing her braces every day for the most part since the end of September '09.

We are always scheduled to go back to Children's Hospital 3 weeks after her botox injections because that is when the results will peak and we can see how well it's working. Our doctor was very excited by our last visit a few months ago and was very excited again today to see how well Em is doing.

As I've mentioned before, Emily's doctor is in a wheelchair and has an assist dog, named Travis. It works out great because at each visit, Emily gets to walk down the hall to the doctor's office to get Travis and then gets to take him for a walk down the hall a few times. She's more focused on the dog than working her runway walk so we get a better idea of how she's really walking when she's not thinking about it.

Today, I opted to let Em wear her dress shoes and bring her braces in a bag instead of having her wear them. She stayed flat-footed nearly the whole time and popped up on her toes only a little bit when she was excited to see Travis. When we took her shoes and socks off, it also looked like she was starting to use the muscles in her feet correctly.

Dr. Kaitz is happy with the results and has given us good news for the next several months. Emily has grown quite a bit since she was initially fitted for her braces and Dr. Kaitz is worried that they are starting to get tight on her. Instead of getting fitted for new braces right away, Dr. Kaitz would like us to stop using them for the next 3 months AND skip the next botox injection and see how she does. She feels that as long as we keep stretching and flexing Em's legs and ankles that we might not need shots or braces any more. She also mentioned that we need to make sure we're getting a really good stretch on her heel cords because she's starting to get the beginnings of a bunion on one foot which I believe she said is the result of an arch falling and a tight heel cord.

Only time will tell! When I asked about continuing PT twice a week, she smiled again said that was overkill and that we could drop back to once a week. We will check with our physical therapist for her opinion as well since she is also working on getting her whole body working smoothly together (trunk rotation, spinal mobility, shoulders, wrists, etc.)

Needless to say, we are really pumped about this news and Emily is pumped about no more shots! We're going to keep working hard and our hope is that in 3 months we still have the same, if not even better news.

(Don't forget... there's another post after this one... with pictures!)

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