Although Paul has been working extremely hard on his walking, he continues to have severe spasticity, which is a form of muscle overactivity caused by his brain injury. Basically, it is an involuntary increase in muscle tightness (tone) through much of his body. The spasticity occurs because of damage to the neurons, or nerve cells, that send signals from the brain to the muscles that cause movement.
Paul is fighting that spasticity all the time and this has affected his ability to progress in his walking but also has affected his trunk strength and the use of his right hand and arm. Because of this, it has been determined that Paul would benefit from a baclofen pump, a surgically implanted programmable pump that delivers medication directly to the intrathecal space where fluid flows around the spinal cord. Paul was tested for this treatment last week during a 24-hour stay at the hospital where the doctor gave him a shot of the baclofen directly in that area. Within just a few hours, a physical therapist could see dramatic changes in Paul's spasticity so we are very excited about the possibilities. Of course, changes won't happen overnight. In fact, Paul may take a few steps back in areas of strength because muscles overpowered by the spasticity haven't been used since his accident in June.
The pump, which looks like and is about the size of a hockey puck, stays permenantly in his hip area and will need to be refilled about every three months with baclofen. This is done by inserting a syringe through the skin and directly into the pump. All of this is a little scary but knowing that Paul could continue to progress makes it seem worth it.
Paul's new physical therapist already has told us that she is impressed by how strong Paul is despite the spasticity he is fighting. She also has seen his competitive spirit in action. She shared a story of how they were practicing his walking and passed another patient who was practicing walking but had the benefit of another type of treatment (not the baclofen pump) that the therapist also plans on using with Paul. She was talking to Paul about it and telling how he could soon walk that well too. Paul then spelled out on his letter board, "I'm going to kick his ass."
We expect the baclofen pump surgery to be in the next couple of weeks but we are pushing it for sooner than later as the first year of Paul's recovery is the most important. Please continue to pray for Paul. He is determined to keep working and stay optimistic but does experience many moments of confusion, sadness and anger.
Thank you all again and I will keep you posted on the baclofen pump surgery.