Results so far are promising. I do weight training twice a week, ride 100-200 miles/week, and have trimmed my diet. My weight is down a few ticks, and should drop more quickly as my muscle build/burn rate amps. With the weaning, my pain (mostly left peripheral with some spasticity) is increased but tolerable for now. In a couple weeks, I meet with the folks at Georgetown to discuss an intrathecal baclofen pump -- an implanted device to push a low-dose into my spine. Given my current tolerance, I think this may not yet be appropriate, but it's good to understand the option.
Life is good. I feel bad that this pain stuff has taken some engagement off the table -- fewer good days to enjoy with Care and the boys, lost athleticism. The human condition.