Frank’s story TDD therapy for severe spasticity

This story recounts the experience of one individual who has a TDD pump. Medtronic invited him to share his story candidly. Please bear in mind that the experience is specific to this particular person. Not everyone who receives the treatment will receive the same results as the patient in this story. Talk with your doctor to determine if TDD Therapy with intrathecal drug is right for you.

Close-up of Frank.

Life with multiple sclerosis

Frank's first symptom was difficulty walking. Over time, his mobility became increasingly compromised. It wasn't long before he was diagnosed with multiple sclerosis.

For about 10 years, Frank took oral medications four times a day to control his MS-related severe spasticity, but his symptoms continued to worsen. His ankles and feet would often flex out and his calves would tighten when he was sitting at work or watching TV. He also experienced unpleasant side effects from his medications, including fatigue, lethargy, and disorientation. In addition, he would often forget to take his pills, which would make matters worse.

Getting a targeted drug delivery pump

Frank's doctors worked with him to find the right treatment, and ultimately recommended that he try a Targeted drug delivery pump. To determine if the therapy was right for him, Frank first had the screening test. It was successful, and he went on to have the pump and catheter placed.

Frank's procedure went well and he did not experience any complications. After the surgery, in 2009, while at an appointment to have his pump dose adjusted, a blood clot was found in his leg. His doctors were not sure if it was related to his recent surgery. Blood thinners resolved the situation.

Surgical complications, side effects of the drug, or both, can occur with treatment with a Targeted drug delivery pump. There are risks associated with treatment with a TDD pump. Some of these risks include meningitis, spinal fluid leak, infection, paralysis, headache, swelling, bleeding, and bruising. Drug-related side effects may include loose muscles, drowsiness, nausea/vomiting, headache, and dizziness. 

Life with a targeted drug delivery pump

Since having the pump placed, Frank no longer has to deal with the burden of taking oral medications four times every day, and his calves don't tighten up as much. He has been able to maintain his focus, allowing him to be more productive in his career as an engineering project manager.

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.

Patient important safety information for TDD therapy with drug injection

When receiving TDD Therapy with drug injection make sure you follow your clinician’s instructions closely. A sudden stop in therapy can result in serious medication withdrawal symptoms, such as high fever, changed mental status, muscle stiffness, and in rare cases, may result in the loss of function of many vital organs and death.

It is critical that your clinician be called right away if you experience any of these symptoms. Make sure you keep your scheduled refill visits so you don’t run out of medication. You should also know the early symptoms of prescribed medication withdrawal. Some people are at more risk than others for medicine withdrawal; speak with your clinician about this.


Q: What is severe spasticity?

A: Severe spasticity is a condition that results from an injury to or disease of the brain or spinal cord. Spasticity may make your muscles feel tight, stiff and difficult to move. With severe spasticity, you can experience stiffening of the muscles that makes your muscles feel like they are locked, or even jerk uncontrollably when you try to use them.

Q: What is TDD Therapy?

A: Targeted drug delivery is a treatment using prescribed medication that is delivered into the fluid around your spinal cord (intrathecal) to help manage severe spasticity. For long term treatment, the drug is placed into a pump that is surgically placed under the skin of your abdomen. The pump delivers prescribed medication through a small tube (catheter) into your spinal fluid. Your doctor can program the pump to deliver the appropriate daily dose for you. Before you can be considered for long term treatment, you must have a test dose to see how you respond to the drug when it is delivered in this way. After the test dose is done, your doctor will discuss the results with you and determine if you are an appropriate candidate for the therapy.

Q: Who is a candidate for TDD Therapy?

A: People who have severe spasticity resulting from conditions of the brain or spinal cord (such as multiple sclerosis, cerebral palsy, stroke, brain injury or spinal cord injury) may be candidates for TDD Therapy. If your spasticity is due to spinal cord injury or multiple sclerosis and is not controlled with medication taken by mouth or you have side effects that are not acceptable from oral medication taken to treat your spasticity, you may be a candidate. If you have had a brain injury due to trauma, you should wait for one year after your injury to be considered for TDD Therapy. Safety and efficacy in patients under the age of 4 has not been established.

Q: What are the most common side effects of intrathecal medication?

A: The side effects of intrathecal medication can include drowsiness, lightheadedness, dizziness, nausea and vomiting, low blood pressure, headache, seizures, and loose muscles. As with most medications, you can experience overdose (drug dose is too high) or withdrawal (drug dose is too low). Your doctor will discuss the possible effects of intrathecal medication and what to do if you experience any of the symptoms or side effects. Sexual dysfunction in men and women including decreased libido and orgasm dysfunction have been reported.

Q: What do I need to know if I am using intrathecal medication?

A: All patients and caregivers should receive information on the risks of the treatment. Your doctor should give you information of the signs and symptoms of receiving too much or too little medication (overdose or withdrawal) and what to do if you notice those symptoms.