Hi Ice cream. The big thing that jumps out at me is thet Ive been told by several docs and a medtronics rep that although they can put enough meds n a pump to last 6 months it should never be done because all meds have to be preservative free. Ive had a pump for 9 or 10 years, Just had it replaced 18 months ago with the new larger resevoir pump that can hold enough to go that long it should never be done. My PM doc, The surgeon that implanted the pump, the medtronics rep I met at both implant surgeries and the Home healthcare pharmacist that compounds my meds and that does my refills have all told me this and never allow me to go more than 90 days between refills. Who knows how the meds have broken down or how bad they have gone in in 6 months. Her symptoms sound as much like withdrawal as they do an OD or some type of poisoning. She needs to find a doc that follows protocol and going 180 days with meds being delivered to the spine without any preservative sure doesn't sound like protocol. I would start lookng for a doc immediately to take over the pump care and settings.
You have to be certified to implant a pump, but not to manage a pump. What are her docs qualifications. My doc got his med degree from GWU, completed an internship at Mass general in Internal medicine. In addition he completed a residency in neurology at the Mayo Clinic in Rochester, Minn., where he also earned a fellowship in clinical neurophysiology. Additionally, he holds a fellowship in neurointensive care medicine from Johns Hopkins Hospital in Baltimore, Md. I have no doubt he is absolutely qulified to make this decsion. I would love to go 6 months but its simply not safe without a preservative and you can't use preservatives in pump meds.
Find a better doc. Not every doc is as qualified as the next and nobody under her doc or that he is associated with is going to contradict him. 180 days is absolutely absurd. Did they draw any of that med and have it tested while in hospital or did she just get better when they changed the OLD stuff.
I also have dilaudid and clonidine in my pump. Morphine is the only opiate a clinical trial was done on as far as being FDA aproved, But their are only 4 opiates that can be used in a preservative free state. Morphine, Dilaudid, Fentanyl and Suffentanyl. Their is nothing wrong with using diluadid, it's safer and more soluable in water than morphine.
I'm not saying you need an IVY league doc to manage a pump, but what are her docs qualifications and why are his thoughts so radically different than everyone involved in my care.
Good luck, Dave