Last weekend Monica and I went to see "Ned Durango Comes to Big Oak" at the Vagabond Playhouse at Queen's Park in New Westminster. My brother Barry and his wife went with us. The Vagabond Playhouse is quite small and the company looked to be small as well. But the production was well done. The play was a comedy about the town of Big Oak which hired an aging western star, Ned Durango, to bring some pizzazz to the Tomato Festival Parade. It was really quite funny. After the play we went out to dinner at the White Spot and then went back to Barry and Sharon's for tea.
Monica had to miss the Tuesday balance class because I had to attend a course but went to the class on Thursday.
On Friday, Monica had her long-awaited (8 months) appointment at the Spasticity Clinic at G.F. Strong Hospital in Vancouver. Once again we were impressed by the physicians and staff. Initially 5 people descended on us in a small examination room. The examination was led by the physiotherapist and occupational therapist who had examined Monica on her first visit there in July. A young lady doing research, a physiotherapist visiting from Australia and a representative of the drug company which makes
Botox were there to watch. Monica's arm, shoulder, elbow and wrist were given a very thorough examination.
The nerve damage caused by Monica's tumour has interfered with the signals given by the nerves to the right side of her body and, in particular, to her arm. The muscles which allow Monica to contract her arm, elbow wrist, hand, etc are stronger than the muscles which allow her to extend those her parts of her body. So, because the muscles aren't getting signals, the stronger muscles dominate and cause those areas to contract. For example, her hand wants to close and her arm wants to contract across her upper body. This "spasticity" is very uncomfortable and even painful and makes it even harder for Monica to deal with not being able to use her arm and hand. So, we have been looking forward to finally getting this appointment at the Spasticiy Clinic.
The examination of Monica was very detailed. It seemed to have two purposed. Firstly,they were trying to identify which muscles were most affected so they can inject the Botox in the correct muscles. Secondly, they were trying to establish a "baseline" for Monica so that they can judge how effective the treatments have been and/or how to modify them in the future.
All 5 of these people were very nice and treated Monica very well. The Australian physiotherapist was particularly nice and knowledgeable.
Once the examination was finished, the Doctor joined us. He examined Monica as well to confirm the results of the examination. Apparently, they only want to administer a certain (safe) amount of the Botox. So, they had to decide which muscles into which to inject the Botox. Once the decision was made, the Doctor wired Monica up with a device with a small electrical charge. This device allowed the Doctor to cause certain muscles to twitch thereby confirming that he was doing the injection where he wanted.
All in all they injected Monica in about 5 places. The injection won't cure the problem but will relax the muscles to decrease the pain and to make her arm more mobile. We are hoping that it will allow us to move Monica's arm (for exercises) more and generally make her more comfortable. The Doctor advised that it will take a week and a half for the botox start to work. We will return in 6 weeks to see how it has worked etc and get a follow up treatment in February. It may be our imagination but we think that Monica is already holding her arm slightly differently.
We plan on going to the balance classes again this week and Monica gets another
Bev treatment on Wednesday.
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