I spent a day last week in the hospital doing a test of intrathecal baclofen, in preparation to becoming one with a baclofen pump. I’d done this test about 4 years ago, and came away with what I thought were negative results. What was supposed to be a day of outpatient care turned into an overnight, including 3 (three) catheters. Not something I ever want to repeat. I tabled the idea, my neuro and I agreeing we’d revisit when the leg cramping, Charley horse, jimmy leg, whatever, got too bad.
It has gotten that bad. The oral baclofen doesn’t seem to work any more. I’m routinely taking more than the maximum prescribed dose, and Jimmy is still keeping me up all night, often arriving mid-morning. With reluctance, I offered myself up for another test. The last time, they squirted 50 mcg (or “mikes,” in the hip doctor parlance) into my cerebrospinal fluid (CSF in doctor-speak), which left me immobile late enough into the afternoon that they admitted me for the night. 50 mcgs., I was told, is on the low-end of the usual dose, but apparently I am more sensitive to baclofen than most. So this time, I insisted that they only give me 25 mcg., so as to avoid the dreaded catheter. After clearing up some confusion about the dose, a team of nurses gathered around me and the affable Dr. Darby. Leaving any thought of modesty aside, they managed to roll me up onto my left hip and began probing my lower spine searching for the best place to attack. I apologised to the members of the team who drew the short straws and had to come face to face with my big white posteriors. They graciously kept their gasps of horror to themselves, and we proceeded.
Dr. Darby and his assistant worked to wiggle some sort of needle into my spinal area (I had told them that the less I heard about they were doing, the better.) They’d given me “the numbing medicine,” (why they don’t just call it Novocaine, I don’t know) so aside from one or two small bee stings, the whole thing was painless. After 15 minutes or so, I was able to recover a modicum of dignity and roll onto my back with a blanket draped across my nether regions. A physical therapist came by (I am not one for remembering names under even ideal circumstances) to get a baseline assessment of the tone and tightness in my legs, and I was left to my own devices, as long as those devices could be had on my back on a gurney in the recovery wing. Not much trouble to get up to.
The PT lady came by after an hour to get another assessment. I was able to get up, with the assistance of several nurses, and stumble a few steps (my open johnny flapping like a sail behind me). Back on the bed, lunch, and more waiting. PT lady came back 2 hours later and pushed and pulled my legs and arms, and pronounced the test a success. They eventually moved me into a recovery room one level closer to the exit where I was reunited with my street clothes – much to everyone’s relief. And just like that, I was sprung, out into the life-affirming elixir of the evening air.
Not, in the end, a very dramatic day. It could have been, and frankly I was expecting it to be, difficult and maybe even traumatic. Anytime someone goes rooting around into my spine with a pointy object, it is hard not to anticipate the worst. For a few days after this procedure Jimmy was far less of a bother. But he’s back now, making up for lost time, and I just have to wait another month for the actual implantation of what Dr. Darby called, “a $10,000 hockey puck,” into my insides. After that, it’ll take a couple of days -maybe a week if I’m lucky- in the rehab hospital to get my cyber-implant adjusted. To tell the truth, I’m kinda looking forward to that. It’ll be my version of a spa treatment. I wonder if I can order a mani-pedi.