Hey Alan, I can't recall te othe meds and doses you have tried, But yu ask about a ump and if this doc is offering a pump, I wouldn't have any reason t believe he would manage a pump any better than he's managing oral meds. You certainly have room with Duragesic if if the side effects aren't lmiting you. I know we have talked about this, befoe but if a doc won't agressively manage your pain with oral meds, I doubt he's going to be more agressive with intrathecal meds. I think it's time to get that list from medtronics and consult with some pump docs that practice PM. They may be more than willing to work wit the oral meds before doing a pump if they think the orals haven't been given a fair shot. I wouldn't let someone that's uncomfortable with my oral meds manage my intrathecal meds. Opiates are opiates. Your going toget a speach about how IT meds are 100 times more potent so the 1 microgram per hour he has the pump set on is equivelent to the 100ugh patch. You have more receptors In your spine so you should be getting even better relief. IF YOU CAN MAGIN YOUR PRESENT DOC SAYING THAT, FIND A NEW DOC.
A doc can be a jerk about adjusting a pump too. I know one lady that took 5 different docs to finally get to a level that managed her pain and she's doing very well now. If Doc 1 will only go to 2 mgs of morphine a day and Doc 2 won't go above 5, Doc 3 won't go above 8, etc etc. why put a pump in and leave you in pain? Getting another doc to take over your pump is even harder than changing PM docs when all you needed was oral meds. Her dose isn't outragous, it's actually within a couple mgs of mine.

Sorry to hear things are still so bad.
Take care, Dave