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Old 10-30-2007, 04:13 PM   #1
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I have a morphine infusion pump can doctors refuse to fill it?

I have a morphine infusion pump can doctors refuse to fill it, I just moved to a new state and they will not help me here?

 
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Old 10-30-2007, 06:07 PM   #2
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Re: I have a morphine infusion pump can doctors refuse to fill it?

When you say they won't help you, do you mean they won't accept you as a patient? Why do they say they can't help you? Can you expand on your post? There are several folks on this board who have the pump and I'm sure they will respond. Memere

 
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Old 10-31-2007, 02:41 AM   #3
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Re: I have a morphine infusion pump can doctors refuse to fill it?

Hi Leila, As Memere said, we realy need more info. A doc doesn't have to take anyone on as a patient they aren't comfotable with. If it's a medtronics pump they "medtronics" can give you a list of every doc in the area and you can call everyone and ask to be taken on as a patient. It certainly would have been wiser to ask your old doc to make some of those calls before you actually moved. It If you are accepted by a practice, a doc is no way obligated to manage a pump that's delivering more medication than they are comfortable with and they mayy may adjust your pump downwards or change meds but this is something you probabaly should have looked into and aranged months before moving.

Just showing up in a new town and expecting a practice to accept you, evelauate you and fill your pump all within a 30 day time period is alot to ask. Most practices have a protocol for who they accept as pump patients and what meds and doses they would be willing to continue to manage your pump at.You may also have to consider driving to a more populated area if you have moved out to the boonies so to speak. A 2 hour drive is still better than running out or having to fly across country back home for someone to continue to manage it.

If you find someone willing to accept you but they won't continue at your present dose, anything is better than just running out. If you need to return home for one last fill to give you more time your doc can reduce your dose or change you to a more potent med that will last longer and give you more time and perhaps make some calls to help find a doc at your new location.

But I wouldn't assume anything as far as simply moving and finding a doc within weeks before an alarm date and expect a practice to change their protocol to accept you if you made no arangements and put yourself in this situation. If and when it runs out, I would go to the ER because there are meds like baclofen that can be life threatening if stopped abruptly, however an opiate alone isn't lethal to stop abruptly. You do have the option of in patient rehab to make coming off the pump a little eaiser if you can't find anyone to manage your pump.. Hopefuly an ER can find someone in their anesthesiology or PM dept capable of continung your care, it may not be to your satisfaction, but again anything is better than nothing at all if you made no arangements ahead of time.

Is it a problem of not being able to see you iN time, not willing to continue your dose or did you just assume the first person you called would be obliged to take you on and you haven't found your asumption to be true? Which pump do you have, "how big is the resevoir" what med are you on, what's the dose, and how far did you move?

A pump certainly doesn't gaurentee meds no matter where you go and no matter what the dose. It's really no dfferent than having a pump that delivers insulin for diebetes, you have a responsablity to make sure someone in that area can manage it befoe you show up in town. It's something you look into just like the housing market and schools, especially for special needs children before moving.
Good luck, Dave

Last edited by Shoreline; 10-31-2007 at 11:01 AM.

 
Old 11-06-2007, 03:02 PM   #4
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Re: I have a morphine infusion pump can doctors refuse to fill it?

Can you tell me about be weaned off my pump. How long it will take, how often I will need to have the pump reprogrammed and side effects that I will be going thru? My pump had been filled with Morphine, Clonidine and Bupivacaine and I have had it for 7 years now and would like to wean off it and give my scs (of 5 years) a fair shake. Thank you for any info you can give me, Jennifer . by the way, I go every 6 weeks for a fill

 
Old 11-06-2007, 10:29 PM   #5
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Re: I have a morphine infusion pump can doctors refuse to fill it?

Hi Jennifer, As far as weaning off a pump it really depends on how often your doc is willing to see you as far as how long it take. A 10% decrease really shouldn't cause a huge amount of discomfort. More than likely the first couple decreases if kept around 10% won't feel too significan't. As with any other opiate taper, you will likely hit a wall of sorts where a 10% decrease per week may go fine untill you hit a point where one of those decreases really does make you feel bad. That's when you have to decide how long you want to stretch it out. I would rather be sick as dog for 2 weeks than feel like crap for 6 months, but that's just me.

If he would see you weekly, 10% seems very reasonable. It really comes down to how long do you want to stretch out feeling yucky. Your doc may also choose to remove the opiate completely and do a methadone or suboxone/subutex taper. He can increase the cloniidine and that will help the withdrawal and you don't have to give uop the marcaine. You may want to speak to both your PM doc and an addictionologist. Not because having a pump makes you an addict, just that an Addictionologist is going to have much more expereince in dealing with the effects of discontinuing opiates. A joint effort makes the most sense.

In thoery it seems a pump should be easier because you have precise control over the incremental decreases versus the availablity of the strength an oral med comes in.

Withdrawal is withdrawal and there is no reason a pump should be any worse or different than oral or IV use. Cold turkey is cold turkey and 10% is 10% so delivery method isn't the big factor. The size of each step down is really the big factor. If anything your docs have the abilty to make it much smoother, but there is no such thing as comfortable withdrawal. Unless you plan on spending a year doing it, your going to feel it.

Good luck to you and I hope Leila has found a doc to work with her locally.
Take care, Dave

 
Old 11-09-2007, 02:53 PM   #6
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Re: I have a morphine infusion pump can doctors refuse to fill it?

is the pump iv or intrathecal? because intrathecal pumps are supposed to have little if any withdrawl symptoms because the drugs are not in your bloodstream, and such a minute dose is needed when its being put straight into your spinal canal

 
Old 11-09-2007, 10:06 PM   #7
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Re: I have a morphine infusion pump can doctors refuse to fill it?

JAMESY BOY AND DAVE, Thank you both for getting back to me. My pump is an Intrathecal...will this be easier to wean off from? I have had it for 6 or 7 years and have Morphine Clonidine and Bupivacaine in it. Thank you, Jennifer

 
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