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Old 08-17-2005, 02:23 PM   #1
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Hey Dave (Shoreline)..........

Just got back from the hospital having Pam's pump replaced. Her original was implanted in June 2000 and was doing fine, but the Medtronics Rep said when they go out it can be quick, so after 5 years they automatically replace ASAP.

They put in the new Synchromed 11, 40 ml capacity resourvoir. Same size, just larger fuel tank...LOL. Also it has a "funnel to use to fill it with that guides the needle so some nurse doesn't have to go poking around to find the diaphram . Sounds good to me, it looked neat.

I think I told you, she had hers moved from her abdomen to her hip. The Dr. couldn't figure out why the first one wasn't put there as it is less noticeable and more out of the way and most like it better.

Also, they are not using the synthetic pouch (sock, gortex I think) to hold the pump anymore, said they found it was unnessary and just another foreign object in the body. Also, the pump is not as apt to "roll" on you.

Also, they used the same catheter, just rerouted the pump end to the new location. Blew me away.

Anyway it was a 45 minute procedure and two Dr.'s did 4 the morning we were there. Medicare requires you stay overnight, which is good in case of complications.

All went well and she was given some hydrocodone 7.5 for postop pain which is working well. It is amazing, you think with the concentrated drugs in the pump a small dose of other narcotic would have no effect but she says it really helps.

Anyway, wanted to update you. Hope you and yours are doing well. By the way, the Pain Dr. wasn't even there, the Medtronic Rep and neurosurgeon took care of everything. The Rep said after he filled the pump he "primed it" by increasing the flow for 24 minutes to get the mede to the end of the catheter then returned to normal flow.

Good luck my Friend,
Mike

Last edited by mdclark; 08-17-2005 at 02:28 PM. Reason: add to

 
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Old 08-18-2005, 09:52 AM   #2
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Re: Hey Dave (Shoreline)..........

Hey Mike, Sorry it's taken so ong to get back to ya, I saw your post a couple weeks ago and didn't know how to answer. I'm glad things went so well with the new pump, I'm still trying to magne ho sitting or laying on the thing isn't uncomfortble when placed on the back side. It's a famlily trate that we don't have much in the way of backsides, so when I loose weight Ithere isn't much to hold my pants up. Lol

The pump is by far a better way to manage pain as far as having a clear head and restoring color to a very grey world of oral high dose opiates. I didn't realize just how much of an impact oral meds had on me untill I had the pump put in. They switched me from morphine to Dilaudid a few months ago. Within a few adjustments, I felt like I was getting as good as relief as I could get and not feel impaired. I know I'm at more than an equianelegesic dose or what some chart says the conversion is. But it seems like my pain is getting worse or I did better with morphine.

The risk of developing a cyst at the cath tip and 28 day refill day increments is why we switched, which was logical. I go 85 days now between refills and I'm at a weaker concentration of dilauid in the pump as far as mg per ml. It's cheaper, more convenient, but I don't know if it was worth messing with something that was working.

I don't know if it's the dilaudid or if things have changed, meaning more broken hardware, fractures at the screw insertion points in my back but I have had pain for a few weeks that nothing seems to touch. Somedays it just seems like the meds don't help. I guess I need to have the hardware looked at again.

Last time I talked to a surgeon they determined only about 10% of what they wanted to fuse actually did, the screws on my sacrum toggle in the holes and pull out, I had some stress fractures around seveal screws from the hardware bearing all the weight, Slippage at L5- S1, where it's the most unstable and a few other problems. We talked about Bracing, surgery to repair and stabalize, or wait and do nothing untill something happens that forces me to have surgery.LIke more broken hardware, nerve impingemnent, or the pain just cant be managed because my spine and hardeware are so unstable. I may be at that point.

It's very possible this is just how it's going to be which is very depressing.

I have a pump refill at the end of the month and will see a doc then, I wouldn't say this is an emergency yet, but things have been better. Maybe this is just some knd of flair from moving some furniture around in my daughters room, but it would be nice if it ended soon, the flair that is. I really don't want an increase in the pump, I kinda like having a clear head.

Sorry for the cut and paste from yorlast post but I wasn't sure you got a chance to see it snce it tok sevral days to respond. I'm glad she's doing well.

As far as the lortab for post op, that's not hat surprising. Someone might ssume that with all the opiates on board other pain would require equally high doses, but Tylenol still works for headaches and Vicodin still works for toothaches.

Thanks fo sdtaying intouch. I actually moved up my refill to have the baclofin reduced, I was havng problems with side effects that cleared up ina couple days after decresing it 50%. I told the doc if it was upp to me I would go back to morphine which may be the nxt step. I really don't want to go through the trial and tiration of fentanyl particulrly since duragesic never worked on my pain. I'll keep you osted, I have an eval with the neruologst/PM at theend of the month now to discuss my options or perhaps order some tests to see what's going on. Say howdy to Pam for me and stay in touch.
Take care, Dave



Take care, Dave

 
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