Beating Multiple Sclerosis Severe Spasticity: Baclofen Pumps

[@AaronBosterMD]

Got Spasticity? Don't like it? Wanna fight back? In this video I teach you about intrathecal baclofen pumps, a powerful tool to combat severe spasticity. Please leave your comments, questions and share your personal experiences below! #WeHaveMS

[@TheGreen123forest]

Hi doctor how about person who can't sit or bent can they take baclofen

[@GdGodGaribaldi]

Does the pump need to be flushed (like an IV port)? Have you encountered someone using the pump long enough to regain strength in legs/core and not need the pump any more? What happens if you fall on it? What level of sustained damage would justify the pump removal? Do you find that intrathecal baclofen prompts a stronger drug dependency than if taken orally? What research has been completed regarding long-term organ health taxation due to the direct unadulterated dosages vs. oral 4% dosage strengths? Thanks very much for this video :) your insight is appreciated.

[@vanhorne9376]

GET BACLOFEN!!! Believe me It Helps Very Much and the Baclofen Pump WORKS

[@leonas2060]

I got a baclofen pump in 2017. It’s fantastic! I’m at 115 mcg/day and it’s made a huge difference.

[@TanyaMarieP]

Can you work out with it ? Is it intrusive in your daily living? I'm going to talk to my Dr about it next week. Does it help your mobility?

[@nikkino2363]

The baclophen pump looks very helpful. Yes,I would like to learn more about it.

[@tinaj910]

Great information. I just asked my neurologist for a referral to see a doctor that specializes in the baclofen pump. Would be interested in knowing more about the rehabilitation therapy after getting the pump.

[@germanshepherdoskar2538]

really? I seat in another country, my English is not good at all and I understood everything doktor told us. Thank you so much for your hard work with all this info, you are such a good teacher and of course a dream doctor. I wish all doctors was like you- with passion for their jobs.

[@aliciat1532]

This video was just what I needed to make my decision. Thank you so much. I'm going for it!!!

[@GdGodGaribaldi]

Feel up to an update?

[@ccgt6667]

Oh, what a relief and blessing to hear your inputs. Sooooo much clear. Can be so frightening when one doesn't know what's going on. I got all messed up and confused when I first tried it. No more thanks, I'd rather put up with it... Thanks dr. B!

[@AaronBosterMD]

#WeHaveMS

[@syazwanimohdsabri91]

Thanks for the video! I'm dealing with pain clinic at the anesthesiology department where the pain clinic doctors question the baclofen that my MS Specialist prescribes. This explains most things.

[@AaronBosterMD]

YW Syazwani! I'll make more content on this topic!

[@beatle1956]

Thank you Dr. Boster...this video is extremely informative. I have chronic spasticity in both my legs since July 2015. My neurologist prescribed oral baclofen. The baclofen made me extremely tired and caused crying spells and deepened my depression. It also had no effect on my spasticity. He switched me to flexeril for a week and I found it to cause extreme drowsiness. Also, no improvement in my legs. My dr then performed a lumbar puncture to see if I have MS. I'm waiting for the results (my original diagnosis was Guillain Barre Syndrome). I'm thinking that the baclofen pump might be the answer. Thanks again for your helpful videos.

[@AaronBosterMD]

TY WesMan

[@lisatodd3420]

Love your analogies!

[@maggiemae2585]

11:41 - River decided to pose for the camera! ❤. Great video! I was on oral baclofen when I was first diagnosed,but never heard of getting it via pump. Good to know!

[@AaronBosterMD]

+Maggie Mae Howdy Maggie! River was actually upset her water bowl was empty. If you listen you can hear her pick it up and drop it (clank!) behind me. Not very subtle of her lol!

[@clockset9403]

This is Nick, your sons friend. Amazing video! You’re a really great youtuber.

[@AaronBosterMD]

Howdy Nick! Awesome to see you here on YT! I dig your gaming channel and can't wait to see more from you!

[@fundraisertravel3589]

This was great information. Yes more please.

[@AaronBosterMD]

More to come!

[@veroblabla]

I wish my life helpers could understand English and watched your video. So that they may stop telling me that if I,suffer from spasticity it is because of the cloudy weather and everyone is,like that. 🙄🙄🙄 Thank you so much for all these clear explications. Thank you so much from MS Véro from France.

[@AaronBosterMD]

Howdy Vero from France. C'est vraiment dommage mais mon Francias n'est pas aussi bien pour moi do faire une video seulement en Francias pour vous. :( Is there a function to translate or to create french subtitles I wonder? Does anyone reading this know if that's possible? hmmm

[@veroblabla]

Aaron Boster MD i donnot know but however English is not a problem for me.I really like your videos I live in Cherbourg at the seaside. My best medicine is music and chocolate......my lazy cat and my books.....and your videos as well. 👍😀☀️

[@AaronBosterMD]

#WeHaveMS

[@sherylleatherman3186]

I would love to have more information about after the pump is installed.

[@AaronBosterMD]

Howdy Sheryl! Thanks for the feedback, I'll add this to the list!

[@kimmiller1198]

This is very good information! 2 years ago Dr thought I had MS, brain MRI showed nothing, so neurologist sent me to spine specialist. 2 months ago finally got MRI of cervical spine, showed VERY bad cord compression and I had surgery less than 2 weeks after that. Since then, the muscle spasms are horrible and I walk with a cane. Even hard to sleep through them at night. Nobody wants to take over my care of this spinal cord "injury", and I feel PCP does not know how to deal with something this big. I mentioned baclofen, and she asked me how much I thought would help. Crazy world we live in. Lol. I'd love to see a video with examples of different degrees of spasticity!!!!. Maybe I need to get back in to see spine specialist at OSU???

[@AaronBosterMD]

You could start by talking to the spine guy. You could also get a spasticity evaluation. We offer them at the MS Center at riverside, for example.

[@jplopez489]

Im in the same boat 😢

[@hupfer7047]

Awesome, sound is much better and the video very informative.

[@AaronBosterMD]

wonderful and wonderful! Thanks Hupfer!

[@maximetrudel9815]

I really liked your video, I started baclofen, botox and tizanidine, I still have not found it helped me, I was wondering how long it could take tizanidine to work, and I was wondering where I was in the process to fight spasticity?

[@AaronBosterMD]

I'll put out a video later this weekend about "who is right for an ITB pump?" please let me know if that upcoming vid answers your question!

[@megd7593]

Aaron Boster MD Looking forward to that video!

[@AaronBosterMD]

awesome!

[@lw5682]

Very informative👍. Thank you

[@Damian6Robin]

This video is really really good, I'm on the baclofen pill my doctor put on the instructions 2 to 3 times a day but I been taking only mornings and nights but I see now why she put in the bottle to take another on midday if need it, I went to physical therapy and I got a very bad experience to a point I decided not to go anymore I only went once and that was enough, funny thing to mention is that place is gone and out of business, yeah my weak point is from my knees to my foots and I no longer trust myself to walk with my cane so either my walker or my wheelchair but overall thank you doctor this one is a very good video

[@AaronBosterMD]

Howdy Damian 6 Robin! Thank you for watching and I'm glad you find this helpful! Would you be interesting in similar content on intrathecal baclofen?

[@msenit4lifepattylong76]

I think you just went to the wrong place for physical therapy. I went 3 places before finding my PT home. The first one caused me to fall, the 2nd wanted me to do things I knew better than to try, the 3rd I asked some questions and got out of there. The 4th I went to for over 2 years. Plus they went out of business. You might want to give it a try again. Just saying. 🤗🤗❤️ #WeHaveMS

[@AaronBosterMD]

Don't stop fighting!!

[@lesarosacarway5456]

Going for my trial tomorrow, very scared. Especially bc when I had my spinal tap during diagnosis; I wound up leaking spinal fluid for weeks and needed a blood patch. I remember it being a horrible headache.

[@mofo.jones77]

Please do more videos about this! I'm considering it because all of the meds have done zippitty doo dah! Spasticity is my main issue and I'm in a wheelchair due to it! Thanks

[@AaronBosterMD]

Will do Ashley! #WeHaveMS

[@hackett1181]

Very interesting! I suffer from spasticity and oral baclafan is only so so.

[@karenpny]

Thanks for the information Dr. Boster. Hi River!

[@AaronBosterMD]

Howdy Karen! YW! #WeHaveMS (River is sitting right next to me!)

[@tjlwolf]

I’m a spinal cord injury c4c5 incomplete. Was finally talked into the pump. Worked great 1 month or so and here we are 5 months later and I’m worse than I’ve ever been. Like I don’t even have one. They raised & raised dosage from 100 mcg to 475 mcg. It made me worse. Had dye test….looks fine. They cannot figure out why I’m not responding. We’re trying bolus dosing starting tomorrow.

[@markabt7581]

Mr Dr wants me to consider this. One of my biggest concerns is I'm also type 1 Diabetic and currently wear an insulin pump. The idea of having multiple medical devices attached to me 24/7 is overwhelming. In addition I also have neurofibramatosis, and the tumors on my body is another concern.

[@juliebarwell8387]

I am on Baclofen 10mg tablets. For 5 days so far, it not working that well yet. I have RLS in my legs really bad. I like in UK.

[@panagiotiskapodistrias9817]

Really nice, thank you!

[@AaronBosterMD]

Glad you like it!

[@GdGodGaribaldi]

Does the pump need to be flushed (like an IV port)? Have you encountered someone using the pump long enough to regain strength in legs/core and not need the pump any more? What happens if you fall on it? What level of sustained damage would justify the pump removal? Do you find that intrathecal baclofen prompts a stronger drug dependency than if taken orally? What research has been completed regarding long-term organ health taxation due to the direct unadulterated dosages vs. oral 4% dosage strengths? Thanks very much for this video :) your insight is appreciated.

[@lefteyeblindbookslebb3719]

Hi Dr. Boster, My pump is defective but we won't be able to do anything until after the pandemic. Right now I take tizanidine but it's not enough. I can't tolerance oral baclofen and have even failed a trial of cyclobenzaprine. Do you have any recommendations for me to present to my neurologist for a drug I could take until I can get a new pump?

[@lefteyeblindbookslebb3719]

Dr. Booster, I welcome any suggestions you may have for someone who is bed bound after receiving a baclofen pump. PT gyms no longer accept me, when I can get home PT they can't stay long enough to get me out of bed, and my aging parents try to help but it's not working. Can you think of excises I can do in bed on my own? Keep in mind that I can't move my legs due to muscle weaknesses. Please help. Dr. Shanya Edwards😅,

[@randholtham8493]

Is the trial dose given under general anesthesia or local, typically?

[@Deis1up]

Very expensive disease to have. I love science but none of this is a very easy fix. Need a cure. Because right now I feel like I’ve bought a super car that doesn’t run but forced to sit in and stare into what could have been. Tough road to go down knowing there’s just a wall at the end 😢

[@AaronBosterMD]

whereas in 2018 we can't cure the condition, we most certainly can make it boring and provide normal/near normal life expectancy and life quality. #WeHaveMS

[@aditya50499]

@@AaronBosterMD with all due respect Dr. Boster, I don't see if MS has been made boring. At least, for me it is way too bothersome for me to call it boring. It's 2020 and I haven't yet got my walking ability and bladder control back. Eagerly waiting for drugs/therapies that could restore function and give me my life back.

[@baldipkaur7475]

@@aditya50499 Hello Aditya. Haven't you followed various dietry things? My relative just got suspected with MS and since then I am exploring this disease.... and many say that many diet plans may stop this disease and sometimes reverse as well. Have you tried any such diet? I am skeptical if they work?

[@mrs.p.studge4349]

Yes please, I'd like to see more videos on this topic. I have a question. Prior to getting the pump placed, do you ever send a patient to get a psychological evaluation? A few years ago I started seeing a psychologist because I needed to grieve for the loss of the body that I once had. My psychologist interviews people prior to getting, I believe, a pain pump so I'm not sure if a baclofen pump would be in the same category. Is it typical to get a psychological evaluation for baclofen pumps? Thanks Dr. B

[@AaronBosterMD]

Howdy Mrs. Studge. Some places ask for a psych eval. We have never and don't plan to (just our approach).

[@mrs.p.studge4349]

@@AaronBosterMD Thanks for the reply. That's good to know. 😁

[@AaronBosterMD]

[@davezay5933]

Hello Dr. Boster, , I appreciate you and all of your video materials they really are helpful thank you! what I’m going through right now doctor is I’ve been off tie Sabree for a little over a year and I haven’t been on any other therapy partly because insurance and certain doctor is not taking specific insurances, to make a long story short what I’m going through right now with my new doctor we’re trying to find a therapy or do I go back on tie Sabree he’s educated me about them trailer and other ones but doesn’t seem to care which when I take? As long as I take something and I appreciate that but at the same time i’d like to go and have an opinion like I get when I just watch your short videos but it never happens I don’t know why? They’ve educated me his staff on lemtrada i’ve watched you speak highly and excited about that drug so I am seriously considering it but my family is scared of it and now I don’t know what to do? I would appreciate any input you could give thank you and God bless you!!

[@AaronBosterMD]

Howdy Dave, I'd encourage you and your family to watch my YT playlist called "picking a therapy" and also the videos I've done on specific therapies. I hope that these videos will help you have meaningful discussions with family and your MS providers. Here's a link to that playlist: ow.ly/NrYD30m8JP8

[@joseperez-fw1vp]

I have been on baclofen for years and recently 6 months ago started tizanidine before that l had to be take to the ER to got a shot to relax my legs duo to complete tightness from the waist down. l have an apointment set for the middle of June next month and a fear how painful is it going to be month after that looking at the actual surgery if everything goes right with the trial. can anyone ease my mind as to the level of pain to expect? thank you

[@raulruizruiz9608]

this pump, has no interuption in present medications currently being taken??

[@elirai70]

I realize this video is a number of years old. I am currently scheduled for a baclofen pump implantation. My concern/question is that my spasticity is almost entirely in one leg. however, it is quite severe in that leg. What is the experience with the pump in the situation? Does it make the non-affected leg too weak?

[@donnamoore8479]

Is there a baclofen patch or have any been tested? The expense of pump and the lack of desire for surgery causes me to not really like the pump. Very good information.

[@AaronBosterMD]

No FDA approved patch. Insurance covers pumps for MS as the indication. Just FYI. At any rate, I'm really glad you watched and TY for the comment and question Donna!

[@dramalover4961]

I have an IB Pump. I don't know what the right amount should be or how to optimise its usage. I feel I am missing a massive trick.

[@megd7593]

During a particularly bad flare that caused contractures in both arms (as well as affecting both legs), I was put on oral baclofen. Even after titrating the dose up to a high level, I didn’t get relief. It just made me sleepy. Could this be because the liver was filtering so much out, I wonder? When the flare got worse, I titrated to the maximum dose of tizanidine instead. While it also made me sleepy, it actually worked on spasticity, so I continued on it for several months while doing PT and OT. Now I just take an occasional 4mg PRN during the day and 8mg every night. Spasticity is always there, but it’s greatly reduced, and I think switching from Rebif to Tysabri has also played a role in this. Two years after that flare, I’m wondering why my neuro never even talked about a baclofen pump! Hmmm. Maybe the communication wasn’t as good as I thought it was. 🤔 Thanks for this video. Now I know about another option that is available! Makes me curious about whether treatment of spasticity is actually being optimized for me.

[@AaronBosterMD]

I'm also glad you now know about an option to help! Yay! I'll probably put out a few more video on this topic, I hope you find them helpful too! #WeHaveMS

[@raulruizruiz9608]

yes stroke survivor here with severe spasticity, this pump would be my last resort, don't want the oral baclofen due to the side effects and botox only lasts so long and would have to go back for more injections cause botox eventually wears off and may even weaken muscles and sometimes spasticity is used in a positive way to what stand up straight but leaves you walking like a zombie or walking dead,ala Frankenstein?? also this pump will in no way interrupt sny current medication being taken for high bp or any other medications??

[@lefteyeblindbookslebb3719]

Dr. Boster, can I use a pilates ring with a Baclofen pump?

[@AaronBosterMD]

Sorry but please explain what a pilates ring is and how you use it.

[@lefteyeblindbookslebb3719]

@@AaronBosterMD It's a flexible plastic ring about the size of a hub cap you squeeze to strengthen your core. You can squeeze it between your thighs, place it around both your legs and try to open out, or even place it under your arm and squeeze.

[@danielsuttles1960]

First of all sir, thank you for all your hard work and informative videos. I have an effacement of the thecal sac at c4/c5, c5/c6(with intervertabrae disc space narrowing and ostephyte complex) which has created tremendous weakness in both arms with a constant(never ceasing) tightness along the sides of my spine leading up alongside my neck. It feels like I have two sensitive balls of muscle on the inward part of the neck muscles next to my shoulders. My question now is would the B injections really be helpful in relieving that? Is the effacement of the thecal sac really preventing my muscles from relaxing and giving me that much weakness?

[@AaronBosterMD]

Worth discussing if botox would be helpful with your provider.

[@tjlwolf]

I want to hear more. I had a pump installed over a year ago and I’m receiving no benefit from it. When increasing dosage above 400 mcg my body becomes so stiff I can’t move! The surgeon put my catheter almost to my shoulder blades and I believe that’s why it’s not working.

[@IB_Trader01]

My right leg is weak, when I try to shorten and lengthen my right calf muscle it shakes uncontrollably. I don’t know if that constitutes as spasticity. Great Video again!

[@AaronBosterMD]

Thanks for watching John. What you describe could be a muscle spasm of the calf. #WeHaveMS

[@kapluchi194]

I had a baclofen pump put in last October. My legs are my major problem, my arms are once in a while. My legs are very rigid and I get painful spasms. We are still trying to find the right dose. I find that klonopin helps control them.

[@AaronBosterMD]

Howdy Kapluchi! Congrats on getting a pump. It can take some time to optimize them. Do you think a video on how to optimize a pump would be interesting?

[@kapluchi194]

I do

[@AaronBosterMD]

Cool then I'll work on that!

[@AnneMarieVandenbulcke]

I tried oral Baclofen and Rivotril. Both have the result that I have no more strength to stand up straight. I just fall through my legs. they both make so tired also. I also tried Sirdulad and that was better, but my bloodpressure then went extremely up and down. Last week I was in hospital to try the Baclofen pump, but it had the same result: even with the smallest dose I fall through my legs. What else can I try to reduce my spacticity?

[@beatle1956]

What is my total out of pocket cost for the implantation of the intrathecal baclofen pump with medicare coverage?

[@AaronBosterMD]

call your insurance and ask them, it is different for different kinds of medicare products.

[@jonplaud]

My girlfriend got the operation for the pump. The oral baclofen got her too loose. The pump works better.

[@lamoore987]

May I ask where your Neuro clinic is located?

[@AaronBosterMD]

I'm in sunny Columbus, Ohio! Where are you located La Moore?

[@Venger26]

I definitely would like to hear more. My left leg has spasticity so I’m thinking that this might help a little. But I am wondering are there any conflicts with medications being taken and Baclofin. My last experience with Baclofin was with an oral dose. I had a side effect of dizziness and I immediately stopped but it was with the oral form. Willing to try again but I’m a little timid were dizziness is concerned.

[@AaronBosterMD]

side effects with oral baclofen are different than what we see with IT baclofen. with IT dosing you're using micrograms delivered right to the right spot. With oral your using milligrams and it's spread throughout the body and brain.

[@Venger26]

Thanks, Doctor. Definitely going to look in to this!

[@AaronBosterMD]

YW Kentae

[@lorifoster8637]

Hello Dr. Boster! So, I have left leg spasticity with hemiparesis. I am interested in ITB therapy. My tight leg seems fine. Would the ITB effect both legs, or just the spastic one??

[@lorifoster8637]

* right leg

[@MsCmeehan]

My neuro wants me on Baclofen pump. His office staff wasn’t willing to learn so he sent me to UNMH. Where docs laughed when I asked about risks and said MS only affects skeletal muscles. So I thought if these docs know so little about MS forget them. I live in NM. Yes, it’s a forgotten outback, like a third world country.

[@leroyperkins6766]

Wife had pump and they had to take it out,now they say it not agreeing with here body Any help

[@doctorken2k]

Good. Good. Must do more research. 👍🏾

[@AaronBosterMD]

[@doctorken2k]

Aaron Boster MD #Bumps back

[@akcreamhorn]

Brilliant video Dr Boster Quite something to have spasticity and pump explained in such way; The pump recommended by my Neuro…but not for me at the moment, after considered thought... if I’m correct in saying baclofen is a very old drug and still it’s first line of treatment offered by professionals.... do we know if research is still being done in this area of trying to lessen spasticity suffered? To find oral anti-spasticity medication more tolerable and effective?Hope this is a reasonable question?! Thank you again

[@AaronBosterMD]

Howdy Mr Knowles. Yes there is ongoing research into better controlling spasticity. There are other oral drugs, but in my experience, they often worsen sedation worse than oral baclofen.

[@akcreamhorn]

Thanks for the response Dr Boster

[@akcreamhorn]

I no longer feel minded to try every anti spasticity medication until I find the right one that suits me… Knew there would be a sound reason why baclofen is pushed - dantrolone, tizananine shan’t bother… Especially after seeing your latest baclofen pump video

[@AaronBosterMD]

right on Mr Knowles

[@AaronBosterMD]

YW Mr Knowles

[@dianaramirez5262]

Get sounds cool

[@AaronBosterMD]

They are cool devices for sure