Thursday, April 19, 2007

Writer's Cramp Episode

Yesterday I interviewed for a position as a clinic adminstrator (interview went well, but not sure if I will move to that position...not enough compensation to justify it) and I noticed, much to my chagrin, that I was required to fill out a four-page application that included, among other things, a half page on which I was to write a paragraph about myself and my aspirations, goals, etc.

As I've indicated here before, I make all attempts to avoid having to write anything due to the complications that arise (including pain) from my medical writer's cramp. Ordinarily I am completely unable to get past about a line or two without serious cramping in my hand and wrist and the writing rapidly begins to fall down into illegible scribbling.

Since I didn't want my application to appear to have been written by a mental patient, I focused every bit of energy I could into keeping my hand as steady as possible, and each word as neat as I could make it. Writing that paragraph was so difficult that by writing's end, I was actually sweating and my hand ached so that even this morning, the middle of the back of my hand between the tendons still feels bruised and sore.

I found this article on the treatment of writer's cramp using Botox injections...and it reports a significant improvement in the symptoms and can provide relief for up to 6 months:

http://www.medicalnewstoday.com/medicalnews.php?newsid=59603

"Botox"' the popular anti- wrinkle treatment, can also ease writer's cramp, suggests a small study published ahead of print in the Journal of Neurology Neurosurgery and Psychiatry. "

I am thinking of speaking to the neurologist who diagnosed me...to see if this treatment is available to me. I also read that acupuncture can provide relief for some patients...but I've always been a little skeptical of it.

I also read that pain and aches from writer's cramp are not common...and, according to Dystonia Foundation at this site: http://www.dystonia-foundation.org/pages/more_info/54.php, pain symptoms associated with this form of dystonia may be more frequent when the dystonia is SECONDARY.

Thus: "Cramping or aching of the hand is not common....If the writer’s cramp is secondary, there may be a greater frequency of pain."

And: "Secondary: Those forms of dystonia that are attributed to an outside factor such as physical trauma, exposure to certain medications, and additional neurological or metabolic diseases.

That means, if I am reading correctly, that the writer's cramp dystonia may simply be a by-product of some other neurological condition that the patient already has. In my case, perhaps it's the Essential Tremor neurologicaly condition I was also diagnosed with.

The Dystonia Foundation also reports that Botulin injections may be the best route for relief. The best results they found for drug therapy is about a 5% improvement:

"A multitude of oral drugs has been studied to determine benefit for people with writer's cramp, but none appear to be uniformly effective. About 5% of people's symptoms improved with the use of anticholinergic drugs, such as Artane® (trihexyphenidyl), Cogentin® (benztropine).

Botulinum toxin injections into selected muscles are helpful in treating writer's cramp, especially when significant deviation of the wrist or finger joints is present. Although this treatment is not effective for all people, significant improvement in writing and reduction of pain is seen in at least two-thirds of those persons treated."

I think all of this information justifies my exploration of the Botulin route of treatment.

1 comment:

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