My First Botox Injection

As most of you probably already know, one of the experimental treatments for Gastroparesis is a Botox injection into the stomach through endoscopy.

According to the Mayo Clinic, Botulinum toxin A (BOTOX) is a powerful inhibitor of muscle contraction. Botox is a nerve toxin most commonly known for its use in treating skin wrinkles but is experimental for Gastroparesis. Botox can be injected through an endoscope to relax muscles in the GI tract, including the lower esophageal sphincter (end of the esophagus) in achalasia, and the pylorus (end of the stomach) in patients with Gastroparesis. Researchers have found that Botox injections relax the pyloric muscle in some people, thereby allowing the stomach to release more food into the small intestine. The benefits are temporary, however, and more studies are needed to determine the overall usefulness of this treatment.

I've read about it, did research on it, and asked people I knew who had it done questions about the procedure and if they would recommend it. Everyone I talked to had a great experience with it, so I decided that it couldn't hurt. Besides that, I was miserable and desperate.

So, I'm going to walk you through the botox injection procedure, step by step in what I went through today.

I have to admit I was nervous when I arrived at the hospital because I didn't know what to expect since I've never done this before. As soon as I walked in, I checked into the GI department. After I registered, I sat in the waiting room for a while.

The nurse called me back and put my fancy ID bracelet on. She gave me a gown and told me to put all of my stuff in a plastic bag. I had to strip down to my underwear for the hospital gown. After I was ready, she came back in and placed my plastic bag under my stretcher so that it could ride with me. She also logged all of my valuables.

She went ahead and applied the electrodes to monitor my heart rhythm, applied a blood pressure, and an oxygen sensor to take my vital signs. She tried to stick me for an IV, but missed the vein. So, they had to call in the IV team. Thankfully, the nurse on the IV team got me on the first try but had to use a really tiny needle for the IV because of my tiny veins. I was actually impressed because it usually takes them about six tries before they get it right.

The nurse gave me Zofran through the IV because I was extremely nauseated (since I couldn't eat or drink after midnight nor take my medications) while I was waiting.

I had a visit from the anesthesiologist and the doctor to make sure I didn't have any allergies, adverse reactions, etc.

Then, it was time to take me back for the endoscopy. If you've never had an endoscopy, the doctor uses an instrument to examine the interior of a hollow organ or cavity of the body. Unlike most other medical imaging devices, endoscopes are inserted directly into the organ and in this case, my stomach.

Below is an endoscope, image from Wikipedia:

Once I was in the room, the nurse had me lay on my side, facing away from the screen that the camera projects on to. She put oxygen in my nose and told me to open my mouth and bite down on a solid green circle, which would hold my mouth open for the camera to pass through.

The top picture is the bite block for an endoscope and the bottom picture is where the bite block goes. Source HERE.

The anesthesiologist then began to push the medications to put me to sleep for the endoscope. The first medication he pushed into my IV made my ears ring like crazy and made me a bit dizzy. The second one he told me would burn, and it did! It burned all of the way up my arm, so much so that I had tears in my eyes. It didn't hurt for very long because I woke up in recovery after that.

In recovery, the doctor visited my husband and myself. He said that if this doesn't help me, he would refer me to Augusta to a motility specialist there. After he left the room, the nurse came in, took my vital signs, and readied my discharge papers. She disconnected my IV, I got dressed, and she wheeled me out to my husband in our waiting car. That's all there was to it!

I was still groggy when I got home so I slept most of the day. I will tell you that I'm having stomach spasms because of the injection today. I was told it would take a few days to subside. So, I will keep you updated on my progress. In the meantime, check out some pictures my husband took of me in recovery. I look so thrilled!

Second Easter with Motility Issues & Vitamin Deficiencies

I just got a call from my doctor a week ago - my vitamin levels are really low and my lipase (liver enzymes) are REALLY high still. I'm basically malnourished, and starving. He said for me to take 800mg of Vitamin D, 1200mg of Vitamin C, and he's going to call in Vitamin B injections for me to take 1ml for 1 week for 4 weeks and then monthly after that.

The issue is that I can't take pills because they usually don't stay down, so my husband bought me dissolvable tablets to take. The problem is that the Vitamin C has such a low dosage that I have to take twenty of the dissolvable tablets to make it work. It's not very efficient.

I just don't know what to do. No one will listen to me when I tell them I'm starving. Just because I'm not 90 pounds yet doesn't mean I'm not malnourished. I can't take pills because they have a hard time staying down. I don't know if those vitamins come in injection form, and overall, I'm just exhausted both mentally and physically. I'm worried about my liver. My enzymes have been really high for over a year and they can't figure out why. The doctors don't seem to be very concerned and it's worrisome. I'm worried that I'm going to get sucked down into a hole of deficiencies and then not be able to claw my way back up. It's hard for me to keep food, or even liquids down right now. When I get into these attack cycles, I can't seem to break them.


Step 1: Find needles for a sub-q injection.




Step 2: Get medication ready.



Step 3: Fill up syringes with 1ml of medication.




Step 4: Injection medication.


I have to repeat this process weekly for another two weeks and then I need to do it monthly for a while. I still need to remember to ask my doctor about other injections since needles don't bother me. I would rather inject the vitamins than try and ingest them. It makes my arm a bit sore but I'd rather have that than violently vomiting later.


Also, it was also my second Easter with motility issues. I managed to cook for my family but I couldn't manage more than two bites of food. It made my family feel bad but honestly, I was just SO happy that I could cook without an issue. I was very thankful for that. I had to sit down for a bit when the stomach spasms started, and my mother could tell when they started, because she said that I became incredibly pale. I felt almost overheated when they started. I took a muscle relaxer and then the spasms became a bit more bearable. I ate a bite or two of potato salad, which I probably shouldn't have.

Today, I feel a bit better but I haven't eaten much in the past few days. I have not been hungry and I am trying to ignore the nausea. I managed to drive today. It was good to leave the house for a bit but I was worried about vomiting on the side of the road again. I manage to make it through driving without an issue but the day isn't over yet. I'm trying to take it easy and take care of myself so that I can go back to Mayo. I need to call the doctor and schedule my next visit.