Beth, 

Thank you very much!  There's hippotherapy available through our local
program for folks with developmental disabilities, and half the staff
where we work used to work there, so we'll check into that.  Someone
suggested that for me about a week ago anyway....  Maybe we can talk 'em
into giving us a family discount, as it's fairly pricey for people who
aren't affiliated with the provider.

Reading Ken's comments about Botox and yours about the pump make me
wonder... would it be possible/advisable to use Botox for the neck, PT
and baclofen for the trunk and lower extremities, and OT for the upper
extremities, possibly with some specifically targeted Botox in the arms?

Kendall and Janet Corbett

An unreasonable man (but my wife says that's redundant!) and a
reasonable woman (unless she hurts too much!)

The reasonable man adapts himself to the world; the unreasonable one
persists in trying to adapt the world to himself. Therefore, all
progress depends on the unreasonable man.

-George Bernard Shaw 1856-1950

-----Original Message-----
From: Elizabeth Thiers [mailto:[log in to unmask]] 
Sent: Thursday, July 07, 2005 4:42 AM
To: [log in to unmask]
Subject: Re: CP and the baclofen pump

 While not the most balanced information, you can get ahold of Medtronic
Neurological Technical Services.  They can also give you some of the
pros
and cons.  Pros are that the sleepiness is decreased remarkably as the
Baclofen is directly admiinstered to the spinal cord via a pump.  Cons,
you
have to keep the pump filled and that requires going back to the doctor
as
in rare cases withdrawal can cause side effects.  It's longer lasting
than
botox.  Botox can be used in conjunction with aggressive therapy (my
personal bias is OT) and splinting to pull out contractures that haven't
become permanent.  It sounds like Janet has a lot of trunk and neck
involvement, especially with the thoracic outlet syndrome and upper
extremity pain.  Unfortunately, the baclofen doesn't get there as well
but,
since upper extremity sits on lower extermity, she could do exercises
that
would strengthen her trunk and hips.  Good neuromuscular massage and
therapy
in the pool or on a horse help out a lot.

Beth t.

-----Original Message-----
From: St. John's University Cerebral Palsy List
[mailto:[log in to unmask]] On Behalf Of Kendall David
Corbett
Sent: Wednesday, July 06, 2005 6:30 PM
To: [log in to unmask]
Subject: CP and the baclofen pump

Does anyone have any experience with using a baclofen pump (either
personally or professionally?).  Janet and her neurologist are having a
hard
time getting her spasticity under control with oral baclofen, Dantrium,
and
Valium.  It looks like the next best option is probably the pump.  We'd
like
to hear about any of your experiences, good or bad, to help her/us with
that
decision.  She's presently getting PT, including iontophoresis (sp?) to
help
with the spasticity in her arms.
Her doc has diagnosed a whole bunch of syndromes in her dominant (left)
hand/arm, including thoracic outlet syndrome and cubital tunnel
syndrome.
The ionto seems to be helping with the pain somewhat, and the PT is
somewhat
helpful, but our insurance limits PT for something not related to a
specific
injury to 10 in a calendar year.  As she's using her right arm more to
compensate for decreased function in the left, it's starting to hurt,
too.

=20

Kendall and Janet Corbett =20