mcp3554
08-10-2007, 03:20 PM
I have a question...I currently have an nuerostimulator implant that has been pretty ineffective for peripheral nueropathy of the feet and lower legs. I am meeting with my doctor today to discuss removing the stimulator and replacing with a morphine pump. The PA I saw had never been asked this. Has anyone out there heard of this being done?
Sponsor
Shoreline
08-10-2007, 05:13 PM
Hi MCP, Some docs use pumps for nerve pain but the general concensus is that nerve pain simply doesn't repond as well to opiates as other pain. If the stim relieves 20% of your pain, why not use both, what are the negative apects of the stim that require it to be removed in order to do a pump trial. You could certainly do a trial with the stim still in, but you may find the stim helps more than you think, one way to find out would be to do one trial with the stim on and one trial with the stim off. If you get better relief with the combined methods why not use both.
Expectation is also a big factor, the best relief I get is about 50%, and that's considered a succesful pump. 50% brings my level of pain down into the 5 range from the 8-9 range , but even with the pump, when screws pull out and hardware shifts or bone grinds on bone, nothing relieves that pain.
Have you tried LA oral pain meds and all the other methods to relieve nerve pain. It's trial and error for everyone. There are dozens of anti seizure meds and antidepressants that may also help. I would hope your doc has given you a chance to benfit from any and all of those meds or methods to manage pain.
Good luck at the doc and let us know what he thinks.
Take care, Dave
Expectation is also a big factor, the best relief I get is about 50%, and that's considered a succesful pump. 50% brings my level of pain down into the 5 range from the 8-9 range , but even with the pump, when screws pull out and hardware shifts or bone grinds on bone, nothing relieves that pain.
Have you tried LA oral pain meds and all the other methods to relieve nerve pain. It's trial and error for everyone. There are dozens of anti seizure meds and antidepressants that may also help. I would hope your doc has given you a chance to benfit from any and all of those meds or methods to manage pain.
Good luck at the doc and let us know what he thinks.
Take care, Dave
VIRGINIA77
09-17-2007, 11:48 PM
In our pain clinic we have several people with both stimulators and pumps, typically pumps are placed when stimulators have failed, or a patient has maximized his oral medications out, however as i said we do have patients that use both. Please keep in mind you can talk with patients that have had very good success with pumps. The physician that is recommending this should be able to let you speak with other patients he takes care of that have pumps. Morphine pumps are not only used for morphine there are several other medications that can be added to pumps to help your condition. There is morphine, dilaudid, clinidine, marcaine, baclofen, and a couple of other medications. You need to speak with your physician as to what he intends to put in your pump. Some of these medications may very well help your neuropathic pain when used in combination. Please be sure you want the pump if you decide to have it put in, it is very expensive and refills do run about 900 dollars a refill. There are improved pumps now that allow for 3-6 month refills. Your physician will decide your titration schedule for dosing and very often patients still require breakthrough medications. Good luck in your search...
Shoreline
09-18-2007, 08:04 AM
Hey VA, Medicare covers pump refills under part B , It's treated just like an extended office visit. My portion is about 40 bucks every 75 days. 900 bucks sounds like the cash price after the fee is negotiated. If someone is going too worry about paying 900 for refills because they don't have insurance, they better worry about the 30K for the pump and implant surgery first. You are absolutely right, be sure because it's considered a life time commitment. Docs aren't going to do an implant just to see how it goes, that's what trials are for.
Take care, Dave
Take care, Dave