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pebblebeach3 01-12-2013 01:23 PM

Surgery done I'm HOME
Hi all. I had the intrathecal pain pump done yesterday 1/11/13 and stayied overnight. I am home.

Here is how it went. This time the registration went smoothly. No complications.

I was taken in the OR at 1:45 which was my scheduled time. After getting the IV"s set up etc, the surgery started.

They firs did the catherter part of the surgery so I was lying on my stomach. This was a difficult position for me because it put a lot of strain on my neck and entire back. I was in that position for quite awhile. I know I was awake for this portion since they were talking to me and asking me how I was doing.

Then they flipped me and I was lying on my rights side. I think I was awake for part of that surgery but some of it was kind of blurry. They put the Medtronic system on my left side in the abdomen area; just to the let of the belly button and maybe slightly higher. Then the catheter was attached at T-10 level. I think it lasted longer then I expected. I was told surgery would last upto 2 hours. But I went in at 1:45 and didn't get taken out of recovery until 5:30 pm.

As to how I am feeling. First of course I am feeling quite sore from the surgery. As to the pain I think it is helping my mid-lower back area which it is suppsed to do. My neck though is bothering me.

But as a result of the sugery this is the first time that I can say I am feeling nauseous and threw up twice. Also feeling weak we I can understand.

I told the nurse of the nauseaos feeling and she said it could be from the anesthesia and could last 24-48 hours. Once the nausosuness passes I am fine until the next round.

I was put on an antibiotic.. I have bandages until I see the doctor. I have to call Monday to set up an appointment for in a about a weeks time.

I was given a remote control to control the dosage. But for now I can't do that until I see the doctor. I am receiving 0.48 mg of Dialuadid and Bipuvacaine. I think that is every hour but have to verify that information with the doctors office.

Wiill keep you posted on how I am doing in the long run.

I am glad it is over and that I am home.

gmak 01-12-2013 02:06 PM

Re: Sugery done I'm HOME
Hi pebble, Hooray!! Im so glad its over & you have the pump now! Hopefully all the surgery effects will subside. Im not clear on the medicine being released above & below the pain generator site b/c ive heard of so many that the pump worked for all the pain as in neck & lumbar, so im sort of confused about that.Do you have someone to help you? Bless your heart, you surely deserve to be better b/c youve done "everything" to try to get better. Im grateful for the update & hope when the dr adjusts the meds that your relief will be similar to the trial that was successful in reducing your pain. Praying for you my friend, keep us posted on your recovery, get well soon!

pebblebeach3 01-12-2013 02:19 PM

Re: Sugery done I'm HOME

Thank you for your post. As to help, I live alone. I had a friend from a neighboring town take me and pick me up from the hospital. In the event I need help I am sure I can call him or his wife for help.

Or one of my neighbors who took care of my cats while I was away overnight.

When I had the trial done I found that while it was implanted at the same level as it is now I was getting neck relief as well. I mentioned it to my doctor. I cant recall exactly what he said but it appeared to be a 2ndary benefit from the medication. I dont think it was intended to work all the time on the cervical area.
Not sure if there is more of an answer to why it will or wont wokr above the levels of the implant.

I never had problems with anestheisa before. So I was surprised when I was getting scik. Had to stop at pharmacy on way home for some anti-biotics and had to run out of the store because I was getting sick in the middle of the store. Im hoping its nothing more to the problem and that it passes quickly.

Not sure how long it will take for the soreness to pass from the surgery. Then when it passes I can really see how well the implant works for me. Right now I am so tired.Need rest. More later.

teteri66 01-12-2013 05:55 PM

Re: Sugery done I'm HOME
Welcome home. Glad the procedure is over and the worst is over. Hope you begin to feel the benefits very soon and that the nausea is over.

Furrymom 01-12-2013 08:46 PM

Re: Sugery done I'm HOME
Hi Pebblebeach, I'm brand new here,and I saw your post. It has been recommended to me to get an intrathecal pump, so I will be anxious to see how you are doing!! I've had an SNS placed, and the trial was AMAZING, but I don't think that the surgeon placed the device correctly. you can see on my x-rays that it is slightly crooked, so when I tried to use it, it never helped my lower back, never even touched it!! This has made me quite depressed, as I now have surgical problems. Now, they want me to get the pump as I originally stated.

I hope that you feel better soon, and am looking forward to your healing, and post surgical posts!!

pebblebeach3 01-13-2013 01:58 AM

Re: Sugery done I'm HOME

You stated that your surgeon placed a "SNS." Is that the same as the SCS, The Spinal Cord Stimulator?

If so, then I had previously had the SCS for 5 years. It did not work for me. I ended up leaving it in 5 years and I was fooling my self and it should have been removed years before.

As to the Intrathecal pump, I had the trial done on December 10th, 2012. I was admitted to the hospital from 12/10/12 to 12/13/13. They relaesed me earlier then expected because it worked so well on me. I was walking a lot more then I had in years and really felt it worked. The medications that they used in the trial and now the permanent was a cocktail. There were 2 medications: Dilaudid which is sort of like morphine and the other one is Bupivacaine which is an anesthetic/nerve block/epidural type of medication from what I understand.

The permanent implant was just done. I went in on Friday 1/11/13 and stayed overnight. Normally it is a same day surgery and you are released from what I was told. But I was admitted because the doctor was concerned that I have some other health issues that he just wanted to monitor overnight.

Here it is Sunday morning and I feel great as of now. Friday night and Saturday yes I was sore a lot from the surgery itself and was told that I would be sore.

I had some problems during the surgery. It at least in part was done as a local and I remember because of my poistion my neck was really bothering me.

Yesterday after I arrived home I was still sore from the surgery. I did have some neck pain and some mid-back pain.

Just for your information so you know I have severe problems throughout my entire spine. I have had numerous surgeries to my neck which included Harrington Rods that ran from the cervical to thoracic region. I also have some bulges in the thoracic region. Plus I have lumbar issues and have had several surgeries to the lumbar as well. That also included Harrington Rods.

I have severe nerve damage; peripheral neuropathy in my legs, weakness in my arms from cervical issues etc.

My pain doctor put the Pain pump where he felt and I did too where it would do the most good. The entire spine was not an option for some reason.
So we put the catheter at T10 level and the device in the stomach area to help the mid-low back issues as much as possible.

My next step is to deal with the cervical area. Not sure what my options are now since I have severe issues.

I know with the implant it is not a cure. Will I have relief 100% of the time. I tend to doubt it. I went into it hoping that I would get sufficient enough quality of life to even reduce overall pain by 50% or more if possible. Again right now I can say my low back feels great. I dont think it helps peripheral neuropathy but I do feel that it is not as bad as usual either.

I cant predict what the long term effects will be. That I will keep you posted on. If I dont post please ask me and I certainly will tell you.

Before I had the permanent implant and after the trial pain pump I spoke to a woman who had multiple lumbar surgeries. She was at the end of her rope with pain. And from what I gathered at least nothing else was working for her. But with the permanent implant in she was extremely happy with it. I dont know how long she had the permaennt implant done, but I don't think it was that long ago.

The amount of medication you require from the pump is far less then what you would take in oral medications. Right now I am getting either .40 or .48 mg of medication. I think that is per hour. BUT I see my pain doctor in about a week and have to verify the dosage that I get and if that is per hour or not.

You do eventually have an option of regulating the amount of medication you get each day depending on how the device is programmed. You are given a remote control to adjust the amount of medication you get as programmed into the system by your doctor. And you don't want to overmedicate so thats why the doctor programs it.

In the beginning you dont have the ability to increase or decrease the medication. I guess they want you to get used to what is set in the pump for now. Then you are given the chance to increase or decrease the medication somewhere along the line.

Not sure what else to tell you at this point in time. I am sure I will think of more as time goes on.

If you have any questions please ask. Will gladly answer if I can.

gmak 01-13-2013 08:05 AM

Re: Sugery done I'm HOME
Dear furrymom, I just wanted to say that that I am considering the morphine pump at this time also and wanted to say hi & welcome you. Im sorry that you have been through so much & must still pursue more medical treatment just to try to function. I know what that is like and know that you just want to be normal and live your live. Glad to meet you. Hope the SCS can be fixed so that it benifits you somewhat.

Pebble, thanks for this great explanation. Hope you are healing well.

gmak 01-13-2013 08:20 AM

Re: Sugery done I'm HOME
Dear furrymom, I just wanted to say that that I am considering the morphine pump at this time also and wanted to say hi & welcome you. Im sorry that you have been through so much & must still pursue more medical treatment just to try to function. I know what that is like and know that you just want to be normal and live your live. Glad to meet you. Hope the SCS can be fixed so that it benifits you somewhat.

Pebble, thanks for this great explanation. Hope you are healing well.

pebblebeach3 01-13-2013 08:37 AM

Re: Sugery done I'm HOME

Good morning. Well its Sunday, 2 days after the surgery. I am NOT nauseous any more from the anesthesia. So thankfully that has cleared up.

I am not as sore as I had been after the surgery was done. I do feel relief in the mid back and low back area. Which is where the pump was directed. I do have some pain/pressure in the neck area, but the neck is a separate issue for me. I did take some hydrocodone to deal with that pain.

I have to schedule an appointment with the pain doctor tomorrow for sometime I think in the next week as a followup for the surgery.

I am limited on activity such as bending; twisting lifiting. Also I was reading the information that they sent me home with. It included the remote control for the dosage that eventually I will be able to use. But in looking over the booklet I can do things like the hottub/sauna because of the heat. Especially the sauna. I can't use something over 102 degrees. I had liked the sauna since the heat seemed to help my arhtritis. But now it is out of the question since the heat can affect the medication/implant.

Cant do the gym just yet feel it will be too strenuous. When I see the doctor I will see from him when I can return. will see about returning to the pool therapy but for now I cant even shower or get the area wet. Still have the bandages on.

Anyway, more later in the way of an update and input. Thanks all for listening.

pebblebeach3 01-13-2013 09:02 AM

Re: Sugery done I'm HOME
Just some additional information. When I was going in for the "trial" portion of the pump I was told that sometimes they aren't always succesful in getting the right spot that would do the most good for you on the first attempt. I was told it may take several attempts.

I wanted you to be aware that it maybe a trial and error before you get it right.

It's like when I was in for the trial, first of all I was lucky that we hit the right spot right away.

But there was a man at the other end of the hall from me. We would see each other as we passed each other in the hallway walking as we were required to do. I could tell or thought from what I saw that he had the pain pump medication as I thought and I was right.

But in his case, I don't have all the details on what his history is, but when I was in the hospital in December this was his THIRD attempt at the trial portion of the pain pump.

I dont know what happened to him after I left the hospital in December so I cant comment on an update.

But wanted anyone who is considering the Intrathecal Pain Pump they need to know what may or may not occur if they go for the implant.

Good luck to those who are considering it.

More later.

gmak 01-13-2013 11:10 AM

Re: Sugery done I'm HOME
Oh pebble, Thanks so much, i really value all the information that you have from you're experiences b/c i am considering the pump. Im really scared b/c i would have to change drs. My dr a physical medicine & rehab cant refill pumps. All the pm/anes drs i have seen lied or tried to coersively promote esi's which are contraindicated in my arached out position. Making appt Monday morn & i will keep you updated & im relying on your updates as well. I know that you understand what im going through , b/c i will never forget the time i said "Im hurting" & you said "Me, too", as it was the first time i felt understood instead of pitied. Thank you friend for being there for me as well as Many others!

lginfl 01-13-2013 11:18 AM

Re: Sugery done I'm HOME
WELCOME BACK PB!!! You sound a lot better! Just want to quickly address your pump. The amount you get is in micrograms not mg or milligrams. The pump works in a constant flow and your dose is very, very low right now! Also, it won't take care of your neuropathy, sorry. When you see pm doc, he will keep raising it as needed. I was in his office two days post-op to have it adjusted.
Does it feel like you have a "hockey puck" in your gut???
There is sooooo much you will learn about in the coming days, especially when you see your first print-out! A lot of info., ask them to explain it to you. If you have any questions, feel free to ask! I'm sure I've been thru it all with the pump & then some!!!
Take care!!!!

pebblebeach3 01-13-2013 12:48 PM

Re: Sugery done I'm HOME

Thanks for the information. I know I typed "MG" for the dosage and I knew that was wrong. I wasn't totally sure what the correct measurement was so I used that till I found out the correct term. Thanks for letting me knowing what it is.

As to the dosage yes I know it is at the low end for now. I have to schedule an appointment with the pain management doctor. Hopefully I will see him within the next week at the latest.

For now I can NOT use the remote control to change the dosages. I don't know what he will set the limits at ---- the upper and lower end of what I can use. But I will find that out hopefully soon.

As for now I still feel pain in the neck but that is NOT where the device is targeted. So for now I will have to rely on the hydrocodone for some relief. My lower back feels pretty good and some, but mild level of pain in the thoracic area. But better then where I was before the implant.

I did't think the pump would help the neuropathy. Something came up about using Lyrica for that , but time will tell if thats what I end up using.

As to how it feels having the device in me. Right now I really cant say that I feel like anything is there. I still have the dressing on. But even when I had the spinal cord stimulator in years ago, I cant say that I noticed it being there. Sure if I put my hand where the implant is or was I could feel the device, but it never bothered me having it there.

Its funny you should say "hocky puck." I can't remember when my pain doctor said this but said its the size of a hockey puck.

I know there are 2 different sizes of the pump. I think there is a 20 ml and 40 ml if memory serves me. And I know I got the larger pump implanted. And I know when the bandages are off if you look at me you would be able to see this bulging device underneath the skin. It's a lot like the cardiac pacemaker, you can see when someone has it implanted under the skin.

LG, I am so glad the procedure is over with. I am really looking forward to see how it works in the coming weeks; months and hopefully years.

Will post more especially after I see the pain doctor as a followup visit.

Take care and again thanks everyone for the support and words of kindness.

deanh 01-13-2013 12:55 PM

Re: Sugery done I'm HOME
Hi pebble,

Just saw this posting. Glad ur home, the best is yet to come for you. Great to read how well ur doing. If I can help in any way, let me know. Keep having the positive attitude.

pebblebeach3 01-13-2013 01:01 PM

Re: Sugery done I'm HOME

Thank you for the post. Yes "attitude" is extremely important. After the trial was done, while waiting for the permanent implant, I admit my attitude was something that needed to be improved. The waiting was part of the issue in that I went back to the way I was feeling.

Still dealing with other health issues, but will have to learn patience there too and how to handle it in a better way.

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