Published October 20, 2020
THE VIEW FROM MY SEAT
Let me try some of that Botox, phenol
By Ernie Williamson / The Bulletin
It’s come to this.
In an effort to relieve the discomfort caused by my spinal cord disorder, I was injected with a toxin. That didn’t work.
Before you think I am some kind of nut, let me assure you that both procedures were recommended by my doctor and are widely used. I share these treatments with you to show that in modern medicine potential treatments come from strange places and in many different forms.
Let me explain.
Those of you who have followed this column know that eight years ago I was stricken with transverse myelitis, a disorder that damages the spinal cord in such a way that signals from my brain are interrupted.
As a result, I am burdened with spasticity, a condition in which muscles stiffen or tighten, preventing normal movement. I have spasticity from just below the ribs all the way to my toes.
Despite years of physical therapy, I cannot walk and depend on a wheelchair.
Currently, I take oral baclofen, a muscle relaxant. Because the oral baclofen has produced only modest results, it has been recommended that I have surgery to attach an internal pump filled with baclofen to my spinal cord. The doctors say this is more effective than the oral baclofen.
At 73, the thought of a two-hour surgery involving my spine is not appealing, which brings me to the alternatives: two types of injections.
I opted to try the toxin first.
The toxin I tried was Botox, a medication derived from a neurotoxin produced by bacteria (Clostridium Botulinum). In its natural form, this toxin causes botulism, a severe condition that can be fatal. The botulinum toxin medication is designed to be used safely without causing botulism.
Normally, the brain sends messages to the muscles so they can contract and move. These messages are transmitted via the nerves to the muscles by a substance called acetylcholine. Botox blocks the release of the acetylcholine from the nerve to the muscle, therefore the muscle relaxes. I suspect some of you know of Botox from visits to your dermatologist.
The most common use of these Botox injections is to temporarily relax the facial muscles that cause wrinkles in the forehead and around the eyes.
Allergan, the producer, says Botox pulled in $2.3 billion in U.S. revenue in 2019. Not bad for a toxin.
In my case, I had about 10 injections in my legs and hip area in hopes of blocking the acetylcholine from the nerves.
The treatment takes several days to take effect and lasts between two and 6 months. Treatments can be repeated every three months.
Next: I am scheduled to try injections with phenol.
It seems strange that this organic compound with a dreadful history will now be used to bring me some comfort.
Concentrated phenol injections to the heart were given to thousands of Jews during World War II. Maximillian Kolbe was one of them. He was killed with a phenol injection at Auschwitz when he volunteered to die in place of a stranger.
Today phenol is primarily used in the production of resins and in the manufacture of nylon and other synthetic fibers. It is also used as a disinfectant and antiseptic and in mouthwash and throat lozenges.
Phenol, which is given to those of us with spasticity in only about a 5 percent concentration, works much like Botox. It serves as a nerve block.
Unlike Botox, it lasts longer and works better on larger muscles.
Coincidentally, I am scheduled for the phenol injections on Nov. 3.
Isn’t there something else happening on that date? Should be an interesting day.