The first day of Spring Break and where am I? What kind of glorious day am I having? What exciting trip out of town am I having? Well, I'm in Ft. Worth doing a trial run of Intrathecal Baclofen on Miles. You can read and see what in the world it is. It's such a strange feeling to be praying that Miles will hurry up and grow a little more so he can get this done to him. Right now he's chubby enough to get it done. He just has to grow a little bit longer. His nuerologist wants him to have it done as soon as possible. Kids Miles' age hardly ever get it done this early. He just needs some freedom in his body!
What is baclofen?Spasticity is a motor disorder characterized by tight or stiff muscles that may interfere with voluntary muscle movements. Baclofen is a muscle relaxant medication. It is commonly used in adults to decrease spasticity related to spinal cord injuries or multiple sclerosis. Baclofen is also used to treat children who have cerebral palsy.
How does baclofen work?
Spasticity is caused by an imbalance of excitatory and inhibitory input in the spinal cord. This imbalance causes hyperactive muscle stretch reflexes. These reflexes result in involuntary spasms and increased muscle tone.
Baclofen works by blocking the release of excitatory neurotransmitters in the spinal cord. Ideally, baclofen restores the balance of excitatory and inhibitory input to reduce muscle hyperactivity. In this way, it also allows more normal motor movements
What is the baclofen pump system?
The baclofen pump system is the intrathecal (directly into the spinal fluid) method of delivering the medication. The system consists of a catheter (a small, flexible tube) and a pump. The pump--a round metal disc, about one inch thick and three inches in diameter--is surgically placed under the skin at the level of the abdomen.
The pump stores and releases prescribed amounts of medication through the catheter. The pump has a 10-mL fluid capacity and can be refilled by inserting a needle through the skin into a filling port (called the diaphragm) in the center of the pump.
THIS IS WHERE I AM TODAY!!!!!!!
How will my doctor know if the baclofen pump system will work?
If your doctor recommends the baclofen pump system, you will have a trial of the intraspinal therapy to test the potential effectiveness of the medication. During the medication trial, a small needle is placed near the spinal cord in the lower back. The medication is injected into the spinal canal and you are assessed over 8 to 10 hours to determine how well the medication treats the spasticity. If your muscles don't relax during the first trial, a larger dose may be given the next day to determine its effectiveness.
This procedure causes minor discomfort. You may experience temporary muscle weakness due to the relaxing effect of the medication. This is caused by receiving a large dose of medication all at once during the trial.
Patients who experience positive results with the intrathecal medication can decide with their doctor if they should have a baclofen pump system implanted.
What are the potential advantages of the baclofen pump system?
Typically, the intrathecal baclofen pump:• Effectively reduces spasticity and involuntary spasms, promoting a more active lifestyle, better sleep, and reduced need for oral medications.
• Continuously delivers baclofen in small doses directly to the intraspinal fluid, increasing the therapeutic benefits and causing fewer and less severe side effects than that seen with the oral medication.
• Can be individually adjusted to allow infusion rates that vary over a 24-hour period. It can be turned on or off or programmed to infuse different levels of medication throughout the day, depending on your needs. For example, people who find their spasticity helpful in maintaining leg extension for standing or walking can have a lower infusion rate during the day.
• Can be turned off if spasticity reduction has shown no benefit.