Ryan’s at it again today. He is getting another reduction to his baclofen dosage early this morning. This one comes just fifteen days since the last in late-December. I continue to push the limits with an aggressive schedule; by incrementally taking the daily volume down by 12.9%, from 155 mcg to 135 mcg. Of note, last year at this time he was at 400 mcg (being just reduced from 425 mcg).
Baclofen (BAK loe fen) – Baclofen is an extremely powerful muscle relaxer and an anti-spastic agent. It is used to treat muscle symptoms, including spasm, pain, and stiffness. Baclofen can severely impair thinking and/or reactions.
For new readers to this site (and as a refresher to others), Ryan has a surgically implanted pump — about the size of a hockey puck — in his abdomen. It continuously delivers baclofen directly into his spinal column. This method, as opposed to oral/g-tube ingestion, is the most consistent and effective means of delivering the drug since it doesn’t cross the blood-brain barrier. The spinal fluid carries it directly to the brain.
So, it’s the same old story. I’ll closely monitor him over the next seventy-hours for negative effects from the reduction. Meanwhile, I’ll also be watching for signs of increased alertness (or, even better, awareness). It’s always a stressful few days. Especially the first twenty-four hours.
Next Step: If Ryan tolerates today’s reduction well, my plan is to take him down at least 15 mcg next time. This is likely to happen in two or three weeks. I might even go to 115 mcg, thus reducing by 20 mcg.
To me, getting him to 100 mcg is a huge milestone, second only to weaning him completely.