My enigmatic, elusive lucidity simply explained

Today will be my first day in 9 months when I will not be medicated for treatment of on-going problem with spasticity - a condition caused by injury to area of brain [basil ganglia] that controls transmission signal via spine to muscles. In my case, the problem is "too much" signal or "tone" such that muscles on my left affected side are in a constant flexed or contracted state. Over the course of the day, the results can be both distracting and painful - the symptoms are very similar to an advanced case of Sciatica: radiating pain and numbness from hip through to the toes. The most common treatment for stroke-induced spasticity is a drug called Baclofen. Baclofen [most commonly prescribed for patients with MS or spinal injuries]- acts on the central nervous system (CNS) to produce its muscle relaxant effects [in theory via an amino acid GABA]. Its actions on the CNS inevitably causes some of the medicine's side effects: both cognitive (severe drowsiness, confusion) and physical (diminished reaction speed and loss of coordination). As with any medication, one weighs the benefits of the relief against the complication/consequences of the side-effects.

After six months of unsatisfactory relief from Baclofen therapy, the complications and consequences of the side-effects forced my hand to seek alternative paths. The alternatives were few [handful of other meds that had comparable, significant cognitive impact; some were impractically invasive [e.g. surgically implanted baclofen pump]. After consulting several neurologist I've received the same opinion: the nature and extent of injury based on brain scan images--as well as my limited progress to date with oral baclofen therapy-- is such that I should not expect improvement along the lines I have enjoyed with recovery of motor control of left leg, arm, and hand.I have repeatedly been told me that the best I might expect is 5-15% reduction of intensity of problem and that almost all mainstream oral therapies (like Baclofen and zanaflex) will have the side effects I'’m experiencing, as they all impact the central nervous system in a fairly indiscriminate way. This was not encouraging news. [Note: I've read some theories re differences in potential for recovery between "new" and "old" regions of the brain - theory being that the most recently evolved lobes of the brain are comprised of more highly evolved more "adaptible" cell types- must admit: "basil ganglia" sounds primordial doesn't it?]

Meanwhile....Trying to reconstruct some semblance of the life I left somewhere around mile 24 of the Chicago marathon on October 9, 2005, I had decided to return to speech/cognitive therapy to address "performance deficits" noted in testing --as well as problems I've ’experienced with losing cell phones, glasses and keys or at bank machines, some websites and my god damn cell phone navigating menus and processing visual instructions in new or distracting environments. The therapist with whom I had worked previously quickly arrived at the conclusion that my levels of energy and attention were significantly impaired by the medication based on comparison to performance on similar or same tasks last Februaryary before I started taking higher doses of baclofen for treatment of spasticity. The challenge now: differentiating between residual cognitive deficits from stroke, the side effects of the anti-seizure medication [Kepra] I will be taking indefinitely and the [now] escalating pain and distraction from my body's reaction to withdrawing from several months on high doses of medications that suppressed irregular signal from a (permanently) injured area of my brain. It may be a "white-knuckled" quest - but I'm on a better path - of that, quite simply, I'm sure.