BY SCOTT HADDOW
Steve Thompson needs a moment to catch his breath. He just finished running up and down a hallway at Sudbury Regional Hospital chasing after his four-year-old son Ethan. It is impossible for Thompson not to smile as he picks up his boy and holds him high in the air as they embrace.
Prior to last summer, Thompson couldn’t enjoy the satisfaction of running alongside his child. Ethan was born five-and-a-half weeks premature and with cerebral palsy. From the moment Ethan could stand and walk, he was on his tippy-toes and his mobility was limited.
Last summer, hospital staff told Thompson and his wife about the benefits of Botox injections. They were both skeptical at first, but after the initial procedure, they were believers as the injections made an impact on their son’s mobility.
“We had to hold his hands wherever we went because he could fall. Now, he can do almost anything by himself,” Thompson said. “It means everything to us. He’s almost like any other kid and he’s getting better and better every day. We’re looking at putting him in sports. We noticed the difference right away after the first injections. He gets injected in his hamstrings and calves, three in each. It was huge for him, like night and day. It’s changed how he can walk, run and pedal his tricycle.”
100 children
Ethan is one of approximately 100 children from Greater Sudbury and the surrounding area who receive Botox injections to improve conditions associated with cerebral palsy.
“Botox has been a revolution for children with cerebral palsy,” said Dr. Sean Murray, medical director, Family and Child Program. “You see children free of pain and with increased mobility. This particular part of my job is very rewarding. It stretches muscles, ligaments and tendons, allowing them to grow properly. The results are quite tangible. There are not too many children who enjoy the treatment, but as they grow older and understand the benefits and live more normal lives, they actually ask for it when they’re nine and 10.”
For the past nine years, Sudbury Regional Hospital has been conducting Botox clinics for pediatric patients with cerebral palsy and acquired brain injury, as well as for idiopathic toe walkers (kids who walk on their tippy-toes). When the clinics began in 2002, only a handful of patients were receiving injections. Since then, the program has grown to 25 clinics a year for a total of about 250 visits annually.
The treatment team at the clinics includes a pediatrician, physiotherapist, occupational therapist and registered nurse.
Botox therapy involves the injection of therapeutic doses of purified botulinum toxin protein directly into the affected muscles. Two-thirds of the patients receive doses in their legs, while others receive them in the upper extremities. The Botox inhibits the release of acetylcholine (a neurotransmitter) from nerve cells, blocking the signals that promote involuntary muscle contractions. The treatment needs to be re-administered every three to four months depending on the individual patient.
Motor function
The benefits include improved overall motor function/gait patterning; improved upper limb function; improved hand use for play, communication and self-help skills; increased tolerance of bracing, and the avoidance or delay of orthopedic surgery to correct joint/muscle problems. Children receive injections until they’re 19. The drug itself is covered by private insurance and under the Ontario provincial government health plan for children with a severe disability.
“Some parents tell us their children are able to finally sleep through the night for the first time ever after getting injections,”said Sally Spence, clinical manager, Children’s Treatment Centre. “It’s a paralytic agent, so there can be weakness after injections. Children receive an injection in their calves and a week later we stretch them and they get a cast and they walk. A week later, we do more stretching and cast them again. We do it again a week later and then they start an exercise program and strength and gait training. Parents are shown how to do the strength and gait training because the children have to do it every day. The kids are brave. The families and children are inspiring.”
Children from Sudbury are the primary patients, but kids from Timmins, Kirkland Lake, North Bay and Elliot Lake have also been receiving treatments.
Quality of life
“I call it Botox beyond beauty,” physio-therapist Mary Sabo said. “It changes the children physically, emotionally and socially. It improves their quality of life.”
The dedicated professionals who staff the clinic are able to do their jobs and help children more effectively thanks to generous donations. The Sudbury Shriners Club and the Rameses Shriners of Toronto are donating approximately $54,000 to the clinic this year. Over the years, both clubs have contributed more than $200,000 to the clinic. In addition to direct financial support, an outreach doctor from the Shriner’s Hospital in Montreal travels to the Children’s Treatment Centre for assessments. Children can be referred to the Shriner’s Hospital in Montreal for further treatment or orthopedic surgery. The Shriners financially sponsor the children and their families for these trips.
Scott Haddow is a Sudbury-based freelancewriter.
