Botox

From Jenny Sue Got Married, originally posted on July 27, 2011.

Al continues to have increased tone and spasticity in his muscles, specifically in his left arm. The correct term would be "hypertonia": the increased stiffness of muscles, and the resulting inability to stretch. Spasticity is related to tone, and what it means is that trying to stretch muscles in a state of hypertonia often results in the muscles rebelling and contracting excessively. Sometimes, if a muscle is stretched too fast, it can lead to clonus, which is when the arm or leg shakes uncontrollably.

Here is the frustrating part: we usually loosen up stiff muscles by stretching them. For a stroke survivor, though, the stiffness is not only dependent on the muscle itself. It is actually compounded by the damage to the brain. So the brain is not communicating with the muscles so that they behave correctly. I can bend and flex Al's arm repeatedly, and instead of loosening up, it tightens more and more as I go on. It's very frustrating because I want his muscles to behave like muscles should.

Botox would be a remedy for the stiffness in his muscles, but it would also likely weaken his muscles. It seems that every medication available for stroke damage offers the same 2-edged sword - yes, it will help control the tone and spasticity, but it will most likely cause muscle weakness at the same time. SO frustrating, since we obviously want Al's strength to increase, without having to overcome the muscle stiffness.

We're not at the point that he will be taking botox injections, but herein lies the difficulty of stroke rehabilitation. Not only do we have to hope and pray that Al's brain can reconnect with the left side of his body, but he has to work extra hard against the rebellion of his muscles.