Tuesday, February 24, 2009

Botoxic Avenger

My dear fellow neurologically challenged compatriots, a word of warning... Although just a few months ago I was singing praises to all things Botox, but I feel I must add a crucial caveat: Botox is a wonderful tool for dealing with residual effects of facial paralysis, like asymmetry of features or expression, tics and muscle twitches and spasms. HOWEVER, much in the same way that all haircuts are not equal, neither are two different Botox treatmets equal. As some of you may remember, back in the summertime, I discovered that my insurance would cover Botox treatments for the neurological problems in my face. My wonderful neurologist gave me some injections, and my left eye opened up to the same size as my right, the left side of my forehead was rendered as smooth as the right, my eyebrows were leveled with each other, and the little twitches were eliminated. The only thing he refused to inject was my chin, where a crumpled dimple the size of my thumbprint had appeard on the right side of my chin. I had read that crumpled chin dimples could be fixed with Botox, but he seemed to think this would not work for me. I didn't believe him. I wanted more.

Then I moved. I did not have a new neurologist, but I did have a friend of a friend who worked at a plastic surgeon's office. I ran into her at a party, and she told me to come on in, they would fix me right up. After all, if a nurologist was good at Botox, I thought a plastic surgeon would be even better. He even agreed to do the chin, "No problem," he had said. No problem until the effects began to show. I am guessing that people who have had paralysis to part of their face likely have a good deal of muscle atrophy, which means they would need fewer units of Botox to relax the muscles. Instead of opening up my left eye, the injections closed it even further, my upper eyelid was heavy, and my left eyebrow sagged well below the right. This was not the worst part. The injections did not fix the dimple in my chin, it actually made it worse, and so much Botox was injected that for four months, I could only smile with the left side of my moulth. On the left, my lower lip could not even strech below the edge of my front teeth, which meant that when I spoke, ate or chewed gum, I would bite my lip with such force that my canine teeth pierced my lip through and through on several occasions. It was constantly purple,bloody, and swollen (thus making it more prone to future biting.) I saw a friend soon after getting the treatment, who, knowing about my AVM, became very alarmed and thought I had had a stroke.

This was almost as traumatic as my post radiation hair-loss bad hair cut. Almost. After all the progress I had made, all the physical therepy, here I was with self imposed pseudo Bell's Palsy. I am not sure if it has completely worn off yet or not. I don't really know what I am supposed to look like anymore. I am not back to the way I used to be before the initial paralysis. I look strange, I feel hideous, and I am desperate for more Botox, but this time from a neurologist.

Well, this is awkward...

Like running into someone you once dated, who one day, without explanation, just stopped calling. Everything seemed to be going so well, and then--Poof! You see him at the farmers market one Sunday morning, walking hand in hand with someone who is not you, buying flowers for their table, or some stupid arugula for the salad they will later prepare together, and maybe you just want to snatch their Venti lattes and scald the smugness right off of their pretentious little life. Believe me, I understand, but please, before you cause a scene, hear me out and give me a second chance! It's not you, it's me!

Doing the blog was really getting me down. It was a very long year, filled with periods of deep anxiety and depression. The more I thought about or talked about the AVM, the more anxious and depressed I became. Waiting 12 months to have my first post-gamma MRI, with no (medical) encouragement was driving me mad. Every day I feared that the gamma knife was not working, that I was going to have a bleed...I had to stop thinking about it for a while. Like a prisoner, I had to do my own time. A year has passed, and I am eagerly awaiting my appointemnt to ge before the parole board (otherwise known as the MRI tech, radiologist and neurologist.) I am hoping that they will give me life.