It has now been about six weeks since Paul got the baclofen pump and, although we do see a decrease in the tone, he still is not where we want him to be in his standing, walking and balancing. The amount of baclofen he receives through the pump has been increased twice now and we'll go to the doctor again this week and, most likely, the dosage will be increased again. This is called titrating the dosage, is normal and could take a few months to figure out the optimal dosage for Paul.
His physical therapist also has said that Paul has to now, in a way, relearn how to use the muscles on the right side of his body, not just physically but mentally as well. It is complicated but, for someone to make the smallest movement, it takes a lot of neurons sending messages through pathways to the muscles. The therapist explained that, basically, up until now, Paul was using many, many neurons to send messages through many pathways with the goal that he'd be on target and eventually something would trigger his leg to move or him to be able to pick up his foot. This is not only exhausting for him but also counterproductive as Paul ends up using opposing muscle groups to perform simple tasks. For example, he may be using the correct muscle to lift his leg while an opposing muscle is pushing it back down. As I said, it is all very complicated and I think I only understand it enough to know that Paul still has a lot of work ahead of him. He'll need to retrain his brain to only use the correct neurons he needs for specific movements. The therapists plan on trying biofeedback, a computerized technique which will measure particular muscles being used during certain movements, to help determine where he is "misfiring." He'll then be given certain exercises or thought processes to utilize to try to help him use only the correct muscle groups. Again, this will be a challenge for Paul as he still has a severe memory deficit. But, as I have said in the past, this continues to slowly improve.
His speaking continues to slowly improve as well. His speech therapist, Megan, is great with Paul. She makes him speak as often as possible, works vigorously on his writing, and she has a great sense of humor too. She and Paul joke around and I know that helps him stay motivated although he is in the last place that he would have ever choose to be.
The really good news though is that cognitively Paul is getting better and better all the time. I feel like his mind is improving and his body just can't catch up. In fact, Saturday night, some of Paul's friends (Ed Schafer, John Hampton, John May, Tom Dennis, and my brother-in-law, Dave Proudman) brought dinner over and the group played several rounds of blackjack afterward. Ed even brought his professional blackjack kit, which is something he also brought on annual golf trips Paul used to go on with the same group. Paul had a great time Saturday night and everyone commented on how well he was able to play and how he held his own against the other players. The idea of a night of blackjack was Ed's, who reminded us that Paul was so into blackjack during the golf trips that he once showed up at Ed's house for a private lesson. As silly as that is to me (I don't ever remember any big "winnings" after the golf getaways) it is another reminder to me that Paul will go the extra step to succeed.
Paul has been sketching more and more, watches golf constantly, and also has been reading quite a bit. He also maintains his sense of humor. The other day, he, Beth, and Buzz were talking after watching the movie Surf's Up. Beth commented that she wondered where the term "Holy Mackeral" came from and why no one ever said "Holy Sardines." Then Buzz started saying "Holy Sardines" and Paul spelled out, "C-o-d D-a-m-m-i-t." Of course, we told Buzz that he couldn't repeat that phrase but we all got a good laugh out of it.
Although my updates haven't been regular (I think I was avoiding updating it until the "miracle" baclofen pump started working but I found that, with most things following a traumatic brain injury, progress is very slow), I hope that you will continue to check the blog often and keep Paul in your thoughts and prayers.