After Surgery – ITB Therapy
Active involvement with your healthcare team is extremely important following surgery. Your doctor will be your main resource for any questions you might have about recovery, checkups and monitoring, and your daily activities.
Recovery
Shortly after you begin receiving Medtronic ITB TherapySM (Intrathecal Baclofen Therapy) for severe spasticity, you’ll be able to resume your daily activities. Once your incision has healed, the pump site requires no special care.
You may find that wearing loose clothing is most comfortable. Depending on your size and body type and where the pump is placed, it may not show at all under your clothes.
Your doctor may recommend that you restrict activity for 6 to 8 weeks after surgery. As you become more active, discuss your level and type of activity with your doctor. Follow his or her suggestions about work, sexual activity, travel, recreation, hobbies, and exercise. Let your doctor know if you perform any excessive or repetitive activities that may damage your programmable pump and catheter.
Checkups and Monitoring
Active involvement and cooperation with your healthcare team is extremely important. You will have regular follow-up visits so your doctor can check the pump to make sure it’s working properly, and provide refills and dose adjustments.
The frequency of follow-up visits varies from weeks to months, depending on your medication doses. During a typical refill appointment, the programmable pump will be emptied and refilled by a needle inserted through your skin. This is a relatively short and painless procedure.
Tips for Family Caregivers
As a family caregiver, your support is indispensable to making this treatment successful.
What you can do:
- Learn about your loved one’s goals related to ITB Therapy
- After surgery, help monitor wound healing and report any side effects or complications to the doctor
- Help your loved one keep a self-assessment journal of his or her symptoms
- Help your loved one attend follow-up visits and refill appointments
- Provide encouragement and moral support during recovery and daily life
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch, or call
IMPORTANT SAFETY INFORMATION ON ITB THERAPY
Please follow your doctor's instruction closely because a sudden stop of intrathecal baclofen therapy can result in serious illness (baclofen withdrawal symptoms) such as high fever, changed mental status, muscle rigidity, and in rare cases multiple organ-system failure and death. It is very important that your doctor be called right away if you experience any of the above symptoms.
It is important for you to keep your scheduled refill visits so you don't run out of medication (baclofen) and to understand the early symptoms of baclofen withdrawal. Some patients are at more risk than others for baclofen withdrawal; consult with your doctor.
People who suffer from severe spasticity resulting from cerebral palsy, multiple sclerosis, stroke, brain injury, or spinal cord injury may be a candidate for ITB Therapy. If you have spasticity due to spinal cord injury or multiple sclerosis you must first fail oral baclofen. If you have experienced a traumatic brain injury you must first wait 1 year after the injury to be considered for ITB Therapy. A screening test will help show if you will respond to the intrathecal baclofen. You should not receive ITB Therapy if you have an infection, are allergic to baclofen, or your body size is too small to hold the implantable pump.
The implanted pump and catheter are surgically placed beneath the skin. Surgical complications that you may experience include infection, meningitis, spinal fluid leak, paralysis, headache, swelling, bleeding, and bruising.
The most common and/or serious drug-related side effects of ITB Therapy include loose muscles, sleepiness, upset stomach, vomiting, headaches, and dizziness. Pump failure may cause overdose or underdose of intrathecal baclofen. The signs and symptoms of overdose include drowsiness, lightheadedness, dizziness, respiratory depression (difficulty breathing), hypothermia, seizures, loss of consciousness, and coma. Once the infusion system is implanted, device complications include catheter or pump moving within the body or eroding through the skin. The catheter could leak, tear, kink, or become disconnected, resulting in underdose or no baclofen infusion. Symptoms of underdose include increase or return in spasticity, itching, low blood pressure, lightheadedness, and tingling sensation. These symptoms are often early indications of baclofen withdrawal. The pump could stop because the battery has run out or because of component failure. The pump will sound an alarm when the pump needs to be filled with baclofen, replaced or if there is a problem with the pump. Always inform any healthcare personnel that you have an implanted infusion system before any medical or diagnostic procedure such as MRI or diathermy.
For more information, please read the Lioresal® Intrathecal (baclofen injection) Full Prescribing Information and the SynchroMed Infusion System Information.
This therapy is not for everyone. Please contact your doctor. A prescription is required.
Lioresal® is a registered trademark of Medtronic, Inc.
USA Rx Only Rev 0911
Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.
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