Friday, March 19, 2010


After years of trying Allergan has FDA approval for Botox for spasticity for the upper extremity. However, this does not mean Botox will be any less expensive, at least in the short term.

Would Botox be helpful to you? A neurologist or physiatrist would help you make that decision. Occupational and physical therapists can help you mak
e the decision as well. But understand, Botox is just a Band-Aid, and a temporary Band-Aid at that. You can get injected, and have relief for a few months. That's great, but will not help you resolve the issues that created spasticity in the first place.

Sometimes, if you're super lucky, Botox allows heretofore hidden extension to emerge. For example Botoxing the finger flexors may allow the finger extensors to extend the fingers a little bit.

If you and your doctor decide on Botox, make sure a script is written for therapy. Have the therapist work specifically on recovery options that will help you take advantage of the opportunity that Botox provides.

Imagine if your hand is locked pretty tightly into a fist. The Botox may provide just a little bit of movement into extension. Thi
s will provide you an opportunity to use repetitive practice to reestablish cortical (brain) control over the extensors.

Botox is expensive but they do provide help in some cases. Click on either picture to find out more.


Sunday, March 14, 2010

The Ultimate Crystal Ball?

It turns out the the speed you walk (gait speed) is predictive of so many things that folks are now calling it "The Sixth Vital Sign." But here's some funny: everybody is calling everything the sixth vital sign including:
  • Urinary continence
  • End-tidal CO2
  • Emotional distress
  • Spirometry
  • Glucose
  • Functional Status
  • Intracranial pressure
  • Shortness of breath
  • Molecular Genetics, in Oncology
Who will become the sixth, who knows? Some of these require a test in which the tester needs to be trained. Others are self-reported and we lie. But gait speed requires a stopwatch and 2 meters of hallway. Then just read the gait speed tea leaves! 
Here's a full explanation I wrote recently!
Here's another version!

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