Re: Pain Pump
Hi Diane, I had a medtronics pump put in a about 2 years ago. True the medtronics is batery driven but it's also operated by a computer and a dose increase can be done with a telenmetry unit VS a continus flow pump that delivers a costant rate. Any adjustemtn in dose is made at the time of refills by increasing the concentration of morphine, dilaudid or Fentanyl and the adjunct meds. Medtronics also makes a presure pump like the codman called the Isomed.
Go to the medtronics web site and you see your options and check out the codman simply by dong a search.
It sounds like a big deal to replace a pump, but they are implanted under the skin, not under the muscle and compared to soine surgery it was a breeze. They don't have to change the cathater when they change pumps, just take out the old and slip the new one back in and reatach the catheter. I guess I'll seee if I'm singing the same tune after my first change.LOL
If my pain levels were constant or the pain in the evening and night could be controlled by BT meds it wouldn't be a big issue, But the Synchromed pumps allow you to increase the dose at night, morning or whenever. You can set up to 4 flow rates that change throught the day which is a major advantage not to mention the ease in adjusting the pump vs waiting for the next refill to increase the concentration of meds per ml.
If you have to set your pump to control your worst pain, you may find you feel over medicated if you pain has patterns throughout the day. I hurt more at night simply from the activity of the day. IF my pump was set on a single rate and my goal was to make the pain at night bearable, I would be over medicated during the day time. Right now I have 2 rates set, One from 7pm untill 8am and a lower rate from 8am to 7pm
The pump implant is the easy part, the risky part is catheter placement but once that's done, you may use the same cath for 20 years.
It's only a tool though and not a cure all. The goal of a succesful pump is 50% relief. Some folks may do better and some may struggle depending on the stability of their condition.If your spine is unstable and will continue to get worse, it does get harder and harder to manage regardless of the method, pump or med they use.
You also have two things going on, spine pain and nerve pain. It may work well on your spine and do nothing for the nerve pain. Nerve pain is notoriously tough to treat and isn't anywhere near as responsive to opiates. However most folks with nerve pain usually take something in addition to opiates to manage it. Anti seizure meds and antidepressants are the curent standard for nerve pain and can't be delivered through a pump. Only preservative free specfic meds. Morphine, Dilaudid, Fentanyl, Suffentanyl , Prialt, and Bupivicaine, clonodine and baclofen.. The pump won't be the delivery method of all your meds but ideally if your having pain that can't be managed orally due to side effects, there is a good chance the pump may help. That's the advantage of the trial.
My first trial failed due to a spinal fluid leak the entire time I was in patient which was cut short and spent throwing up.
It took about 8 months to get the courage back up to let them stick another needle in my spine but this time they did a single bolus injection which helped quite a bit, Enough to call it a success. The biggest difference between oral meds and IT meds, is how clear your head feels. Oral meds circulate through your entire body where intrathecal meds pretty much stay iin the spinal cannal where you have exponentially more opiate receptors.
You may not even have a choice as far as pump brand, I have a feeling docs pick a brand, purchase what they need to manage that brand of pump and probably stick with it. IF my doc used Codman pumps, I doubt he would purchase thousands of bucks in high tech telemetry units to program a medtronics pump just because I was sold n the programability of a medtronics pump.
Medtronics was great when I was doing my research. I talked to their R & D dept and knew of both battery and vacuum pumps and talked to the local rep prior to implant to make sure all my questions were answered. The trial is where you will either be sold and say yes or not. It does turn complete control over to your doc so you have to trust he will keep working with you to maximize the benefit of an expensive tool. Dosages have to be titrated which could take weeks or months.
Good luck with your trial and it doesn't have to be your only trial should you have an adverse reation to a med they use and they have to stop the trial. They can always try again with another opiate or use the single bolus injection trial method.
Good luck, Dave