This is a summary of what I discussed with a doc about Botox(Got referral from a patient)
My trigger points are mostly in anterior levator ani and some in external anal sphincter. Got eval from a PT in the presence of a doc
First lidocaine injection in the ischiocavernous / external anal sphincter and anterior levator ani. Then go to PT and confirm that the muscles are loosened up..
Then on some other day he will inject 100 units of Botox. 10 in ischiocavernous / 10 in external anal sphincter 80 in anterior levator ani.
I will have to be awake during the procedure. It will be EMG guided with the help of X ray fluroscopy.
PT /SP has to be continued after the injection also.
Risk factors:a) Nerve injury to the sciatic nerve. That is why I have to be awake since if the needle hits the nerve I will react and the doc will withdraw and reintroduce
b) Risk of infection - if the needle goes into the rectum and is then withdrawn through the muscle it may create infection / abcess.
Other points: Less than 100 units is usually too less for pelvic muscles. Trigger point injections in pelvic muscles are usually superficial and therefore this is not a trigger point injection
Am concerned with the risk factors. I expected Botox to be a safe procedure. Does not look like that anymore. Anyway PT is not working that well. Still going along with it though and hoping for the best.
Inputs welcome
Botox injection info
-
ramana
- Old Hand
- Posts: 343
- Joined: Thu Jul 05, 2007 2:48 am
Botox injection info
Age:36 | Onset Age: 31 (chronic incomplete evacuation since 29) | Symptoms: Anal fissure (3); Pain in the rectum. Left Testicular pain started in August 2007. Professional PT (5 sessions) in June 2007. Stanford/Wise-Anderson Protocol in July 2007. Back to professional PT from Dec 17 2007 onwards twice a week; Dry needling once a week since March 06 2008. | Helped By: Sleeping; lying down; Thermotex infrared heating pad | Worsened By: Any activity; Medications Lyrica 75 mg* 2, Elavil 10mg Supplements; Cod liver oil ; Natural calm started 02/15; Vitamin B12 started 02/16;Vitamin D 1000U 03//08;Glucosamine+hyaluronic acid+MSM 04/08 Bed ridden since August 2007; Working from bed since Dec 2007 ;Botox done 100 units 04/03/08;RAST for wheat/rye/oats/milk -ve. Dairy free since 04/20/08. Gluten free since 04/25/08;Tried without success so far: Baclofen, PEMF machines, pranic healing reiki ;