Botox and Serial Casting

Hanging out waiting for the Dr.

As many of you know today was the day Evan was scheduled

to get Botox in his left let/foot at Shriners. We were a little nervous about this due to the news story that came out on Friday. We decided to go in to the Dr. and ask him about it and go from there. We knew that we would most likely go ahead with the Botox because the benefit of Evan walking on his left foot flat is great, not doing so will likely cause long term affects in his hips and back. So we talked to the Dr. and he felt that it was ok to go ahead with the Botox and that the children who passed had received Botox but it was not certain that it was the cause of death but could have aggrivated an already ill child.

After the Dr. examined Evan he explained that Evan had a contracture which in our case means that he was not able to straighten Evan's leg and get his foot into neutral. (think 90 degree angle)The Dr. mentioned that there was a study done on children with contractures and using botox, serial casting or a combination of the two. The study showed that the serial casting alone brought a longer lasting and better affect than Botox alone or Botox combined with serial casting. So we decided to go ahead with the recommendation of the Dr. and do just the serial casting with the option of Botox at a later date if we were not getting desired results with the casting alone.

The technicians are getting ready to wrap Evan's leg in a cotton wrap


The technician is stretching Evan's foot

The cotton wrapping

The finished product. Evan also got a cast shoe to go over this so he can walk on it. I have arranged for him to use his wheelchair on the bus and at school if needed for the time he is in the casts.

I should explain a little about serial casting. Basically, each week they will take the cast off and stretch his foot more and then put another cast on and this will go on for about 6 weeks as I understand it. While we were there we also had an analysis done in the motion lab which is basically a video of Evan walking and using his left hand and then when we are all done we will do another one so that the Dr. can keep track of his progress. I am hoping that I will get to see Evan walking flat footed on both feet, that would be such a miracle for us and for him. So I will be spending a lot of time at Shriner's over the next few weeks and probably over the next few years doing this to keep Evan from toe walking.

We will be doing Botox on his left hand on May 26th so we are not away from Botox all together. I feel like good things are happening and I am really glad to be working Evan's spasticity and gait. And with the serial casting Evan will get to have a different color cast each week, well they only have 3 boy colors so it will be blue, red, green and then repeat.