Puerto Rico Pumping

Tomorrow, my hubby and I will hop a 90 mile flight for a one day trip over to Puerto Rico so I can pay a visit to Dr. Edwardo Ramos Cortes, who is the director and owner) of the Institut de Rehabilitacion in Santurce (part of the San Juan sprawl). We make this trip once every five or six months so that Dr. Ramos can write refill prescriptions for my pain medications and refill my pump.

The pump is a device that's implanted in the left side of my abdomen, just below the bust line. Manufactured by a company called Medtronic, which is the king of all medical device producers, this hockey-puck sized device is connected to a catheter that is inserted into my lumbar spine. The catheter feeds directly into the intrathecal area of my spinal cord, which means that whatever is delivered through the catheter circulates directly to the spinal nerves below and just above the catheter level via the cerebral spinal fluid.

Some pumps are used to deliver morphine to control lower back and leg pain. Mine, however, contains an anti-spasticity medication by the name of baclofen. Before getting the pump put in, I was taking an oral version of baclofen. Even at the maximum daily dose, the drug was doing almost nothing to relieve the pain in my legs and right hand that comes along with severe muscle spasms and tone (aka rigidity because of the blood-brain barrier. (This barrier is a natural safeguard that keeps the brain from absorbing 100% of a substance that enters the blood stream. With the pump medication feeding directly into the spinal fluid, 1/1000 of the oral dose can be up to 1000 times more effective.

The intrathecal baclofen therapy has been a life saver for me, relieving about 90-95% of my spasticity. In fact, before I had the pump I thought that the strength and control problems that had be getting worse in my right hand were from arthritis. But after the pump was placed in September of 2001 (just two weeks after a plane crashed into the Pentagon, one-half mile down the road from our last house), I regained both strength and dexterity in my right hand, meaning my problems were the result of muscle problems. I love this technology.

So every six months or so, we go through all of the hassles of air travel for a crip (the hand searches, the lift, the skinny ass aisle chair, and the banged up legs that goes with using an aisle chair to board the plane) to fly over to Puerto Rico so Dr. Ramos can stick a needle through the skin over the pump and top me off, and up the dosage if I need it (and this time I do). It's an expensive pain in the ass that wears me out, but I'd be a hell of a lot worse off without this wonder medical technology.