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    Old 09-27-2006, 12:17 AM   #1
    CoyoteBound
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    Morphine Pump

    Has anybody had any dealings with a Morphine Pump? I posted a few days ago about my husband and his back trouble that he was having. He has already had surgery done on his back and every kind of injection done on his back that can be done. He went to his Doctor this past Friday and the Doctor said that beings the shots didn't help, there was no need to keep repeating them. He said that my Husband had 2 options! One of them is to keep taking his Hydrocodone and Muscle relaxers and sleeping pills or to have a Morphine Pump put in him. He told my Husband that he would be taken to surgery and they would put the pump in. Does anyone know anything about the pump and if so, where do place the pump at and how often do you have to go in to have the medicine changed out? Any other information that anybody could give us would be greatly appreciated because we don't have a clue about how this works other than what the Doctor told my Husband. We would sure like to hear from someone thats already been thru this.

     
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    Old 09-27-2006, 09:10 PM   #2
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    Re: Morphine Pump

    Ive had my pump since 2003 and its wonderful. It has been the best thing Ive ever done for my pain. My husband has one also and wouldnt give it up for anything. I had to convince him to have it put in. First they will do a trial test to see if the medicine will work. If that works than youll be ready for the pump. Its implanted usually on the right side of the abdomen and a catheter runs around your side to the spot in your spine thatll bnenfit you the best for your pain, the catheter drips the drug down your spine. I beleive it was a day in the hospital if everything goes ok. Youll start out with only a miligram at a time until you get used to it and then youll go in for pump adjustments about once a week. Im having my pump refilled now about every two and a half months. Just remeber the possibility of infection. I had to go through alot because of massive infection, catheter came loose, and catheter became twisted but even after all of that I wouldnt want to not have the pump because at leaset Im able to move around and walk, so its worth it. Theres a possibility of break through pain which your doctor can give you something but at least you wont have to keep taking oral meds all the time. Everything else Ive taken orally hasnt worked as well as the pump. My pump is a medtronic, for a better understanding and pictures check it out at medtronic.com

     
    Old 09-28-2006, 01:32 AM   #3
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    Re: Morphine Pump

    Patti,

    I really do appreciate you responding back to me! That sure helps out a lot and kinda explains to us what to expect. I will not call any names in this message because I guess it's not allowed but as long as you and I know whats going in then we can discuss it. My husband is very skeptibal about having the **** put in and I told him what the heck, it couldn't be any worse than the pain he is in now. He can lay down in the bed or recliner and he can fall a sleep and about every 3 seconds he kicks his legs and moves them around and this has been going on for years now. I can not understand why the Doctors have not done a test on the nerves yet in the calves of his legs. Back years ago when I was in and out of the hospital so much with my back trouble, it seems like they done one of them test on my nerves every time I turned around good and that test hurts. It's the one that they stick the needles in your legs and they stick all up and dowmn you and when they hit a bad spot, you feel like coming off the bed because it hurts so bad. Getting back to the ****. After you and your husband had it implanted, did it help the pain more than the pills did, or was the pain about the same? You said that it would drip down the spine, would there be a chance that this would help my husbands leg pain at all? He just can't get any rest because he constantly kicks his legs in his sleep and it wakes him up. I really do thank you for all the info you have given to me. It really helps to talk to someone thats been down that road before and that way we know what to expect too.

     
    Old 09-28-2006, 01:36 AM   #4
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    Re: Morphine Pump

    Sorry to see you are up so late..or is is it so early? It's 3:30 AM.......I'm not alone..It sure feels good to hear you say you've had your pump for three years and it is wonderful...........I hope to get on real soon

     
    Old 09-28-2006, 04:03 AM   #5
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    Re: Morphine Pump

    To jump from hydrocodone to a morphine pump is way way premature. There are many other more potent medications that should be tried before implanting a pump system that costs around $25,000. If the doctor insists on the morphine pump or limiting the medications to hydrocodone, you may want to consider finding another pain doctor that will work with your husband to try to titrate other potent medicines. The morphine pump should be the last option.

     
    Old 09-28-2006, 11:12 AM   #6
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    Re: Morphine Pump

    Hi CapCity
    I've had my pump for several years now and will be glad to answer any questions I can for you.

    There are two different pumps and if your hubby decides to go ahead with having one implanted choosing one will be an important choice. There is the Medtronics which Patty has and I have the Codman (used to be Arrow). I'll let Patty explain the Medtronics if you have any questions about it. The Arrow is about the size of a hocky puck and the pump resevoiur is implanted in the belly. Then there is a cathetar that goes around your side and is attached to a port that goes into your spine. It delivers a constant flow of morphine. Mine works by hydralichs (sp??) and will hopefully never need to be replaced. The Medtronics is run by a battery and the entire pump needs to be replaced every 5-7 years (I believe). I go approx. every 2 months to have my pump filled. The morphine does not have an preservatives in it so whatever is left is drained out and new put it. The refill procedure isn't bad - about the same amount of pain as having blood drawn.

    I am not a huge success story with the pump, but it has allowed me to lower the amount of meds I take orally. I still have to take oral narcotics for breakthrough pain, I can't work, can't sit/stand/walk for long periods, can't drive, etc.. But allowing me to take less oral meds because of the pump has been great. Most people have a much better pain control from the pump, so I will stick to answering more of the technical questions for you.

    Your husband will start with a trial version of the pump. This allows the doctors to make sure he has no adverse side effects and that he tolarates the morphine well. If that goes well then they can go ahead with the permanent pump. It takes a few months to get the dosage up to where ever it needs to be because they can't just start him out on a huge dose, it has to be increase gradually.

    Is there anything more specific you would like to know?

     
    Old 09-28-2006, 02:29 PM   #7
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    Re: Morphine Pump

    I have to agree with Donaeis completley. It is far too premature to even consider having an morphine pump installed considering your husband is on a fairly low level of medications. There are a vast amount of medications to be tried first such as Morphine, Oxycontin, Methadone and even Fentanyl. Any doctor who suggest a patient get a morphine pump only after being on Vicodin needs to be reviewed. I would run as fast as I can to a new doctor.

    You indicated your husband just had back surgery, have you given it time to see if it will get better? It can take up to a year if not longer for a back surgery to even be deemed sucessful.

    Sorry for seeming harsh but your husbands doctor is not doing him any favors by pushing him into getting a pump at this stage. It's like going from tylenol to Oxycontin because tylenol no longer works, completely bypassing the effective medications in between. Add to the fact if he's not taken anything stronger than Vicodin for any measureable amount of time he would not be opiate tolerant and putting a pump in him may cause some severe problems with side effects.

    Remember, a pain pump is for life. It isn't something you can switch on or off at will. When you no longer need that pump it must be surgically removed. It is a huge commitment. Individuals who get pain pumps are often on high levels of pain medication, for example 400 mgs of morphine a day. These individuals who get pumps get no relief from such level of narcotics or very little. A pain pump is the last option when it comes to controlling pain, not the second or even third. I'm saddened to hear lately the rash of individuals who are opting for a pain pump without even trying different medications or higher levels of medications first. I personally have a difficult time trying to grasp the reasoning behind it.

    I suggest your husband seek out a Pain Management specialist or a new one if his current one is the one to suggest such proceedure. He really should be trying the other long acting medications instead.

    As far as would it help his legs at night? probably not. Morphine or narcotics do not control spasms, they stop pain. The mechanics of spasms is better controlled by muscle relaxors or even medications like valium. Additionaly narcotics very rarely ever help with nerve pain. Each medication has a different effect and purpose. The key it to try to find the ones that work best for the specific pain. Has he tried Nuerontin or other nerve type medications? He may find them to be far more effective.

    The last thing to keep in mind, the goal if pain management is not 100% relief, it never has been. Most patients can expect 50-80% reduction as most. The rest of it is something the patient must learn to cope with.

    I really do hope you do a vast amount of research and that your husband really considers the other options before rushing out to have a pump implanted. I would ask the doctor about other medications FIRST, give them a try. There's no real ceiling on the maximum amount of schedule II medications. He may find that something as simple as 90mg of morphine to be far more effective than the Vicondin he is currently taking. I would question the doctor as to why he thinks there are no other options. Apparently he is closed minded or is money hungry. Doctors get paid quite well for putting the pump in and for the monthly maintenance. I honestly think some doctors are going this route because they prove to gain more financially as opposed to trying oral medications.

    Good luck

    Last edited by Kissa; 09-28-2006 at 02:38 PM.

     
    Old 09-29-2006, 12:34 AM   #8
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    Re: Morphine Pump

    donaeis,

    My husband has tried every kind of pain medicine there is I think. When he had his back surhery they even sent him home with Oxycontin and he said that is one drug that he does not want to take. For one, it makes him not think right, it makes him have bad dreams what little time he does sleep. That is one medcine that he won't take. He has been thru all kinds of therapy, surgery, and now he is going to Pain Managment and they are the ones that suggested the pump. They said there is nothing else that can be done for him. My husband is 52 years old and the doctor said that he had a back of a 92 year old man. My husband just don't know what to do, but he knows he can't keep on living like this either. He is so depressed, it's sad because he is always a happy go lucky person. But thanks to all that has replied. It does kinda giive him some idea of what he is looking at.

     
    Old 09-29-2006, 05:03 AM   #9
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    Re: Morphine Pump

    There are many opiates that can be used:
    Long acting or sustained release: morphine CR (Avinza, Kadian, MS Contin, Oramorph), methadone, levophanol, oxycodone CR (Oxycontin), oxymorphone CR (Opana), buprenorphine (Suboxone, Subutex), fentanyl transdermal (Duragesic)

    In addition there are several short acting drugs: oxycodone, oxymorphone, hydrocodone, hydromorphone, tramadol, meperidine, propoxyphene, morphine, codeine, dihydrocodeine, pentazocine, fentanyl transmucosal (Actiq), etc

    If he has tried a number and had intractable side effects then he may be a candidate for a pump. The only way to find out for sure if one is to have side effects with a pump is to have a intrathecal catheter placed for a trial. Most doctors do these as inpatients, but some now do them as outpatients for 4-14 days. Be careful not to let the pain doc do a "one shot" trial where a single shot of morphine or hydromorphone (dilaudid) is given...this does not tell whether there will be any significant and sometimes pump limiting side effects on day 2-4 of the trial.

    There are two types of pumps: constant flow (Codman3000 and Medtronics Isomed) and programmable (Synchromed EL and Synchromed II). Both are very useful but the constant flow pumps rarely require replacement. The Codman is easier to fill, but has a bump on the top that can cause erosions of the skin. The programmable pumps require replacement every 5-10 years. The Synchromed II pump has available as an accessory a bolus device where the patients can give themselves a bolus or extra shot of medicine a couple of times a day, thereby eliminating all oral medications.
    Both constant flow and programmable (can go up and down during the day to match your activity level through pre-set programming) contain freon gas that pushes against a chamber containing the drug. The programmable pump then uses a rotating pump to slow and control the drug delivery while the constant flow uses a coiled internal catheter, whose length determines the flow rate. The pumps explode during cremation, so removal is advisable after death if cremation is in the works.

     
    Old 10-10-2006, 10:40 PM   #10
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    Re: Morphine Pump

    Here is just a few of the drugs that the Doctor has tried my Husband on.
    Darvocrt, Ultram, Sephadine, Hydrocodone, Soma, Nuerontin, Clonazapam, tomazame, Zanaflex, Flexerill, and the Lidoderm Patch. There is more that I can't think of. But please keep giving us some advice because he can't figure out what to do. Thanks!

     
    Old 10-11-2006, 07:45 PM   #11
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    Re: Morphine Pump

    I have had a Codman Morphine pump since Dec 20, 2004. The medicines that you just mentioned that your husband had been prescribed seem relatively mild medicine. My brother in law doesn't do well with Oxycontin as well, he said it makes him itch like crazy. I was taking a great deal of Oxycontin/Roxicodone/Soma/Restoril/Xanax and still thought that I was going to die due to my blood pressure was out of sight from PAIN and I had been taking the medicine for like 5 years so I am sure I developed a great tolerance to it.My pain doctor also recommended the Pump to me. I went through a 7-10 day trial with an external pump and I got a dramatic reduction in pain (65%) so he scheduled me in for the surgery about 2 weeks after the trial. I have had no side effects from it but some due such as urinary retention or getting sick to your stomach. (naseau). I still take breakthrough pain medicine when I really hurt but overall I am pleased with the results. My advise to you is too explore each and every option you have. I feel the pump is the end of the line in Pain management, it is just a tool for doctors to deliver a more concentrated medicine directly to the affected area. The drug does not get ingested therefore doesn't go through your liver and kidneys etc. and I feel that is a good thing. I have mine filled every 45 days and have had two increases in 2 years. As long as I took the pain medicine I had a TERRIBLE TIME SLEEPING, it was like I wouldn't go too sleep for sometimes 3 days. Since I have reduced the oral meds that has mostly gone away (Thank GOD) I hope this helps you out. Have a nice day. Jeff

     
    Old 10-12-2006, 06:26 AM   #12
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    Re: Morphine Pump

    Jeff,

    Thanks for the reply and I wanted to ask you what would be a good pain pill that my Husband can ask for. He does not want the pump unless it is the last thing he can try but like you said he can't sleep for hurting. He can lay down and he is lucky if he sleeps an hour at the time and his legs just kills him all the time. When he is in his recliner and if he doses off, his legs constantly jerks and it wakes him up. If any one could help us out with some information it would be greatly appreciated. I am glad that the pump has worked well for you. We thought that after his surgery he would be better but we were wrong and he said he can't keep going through the pain all the time!

    Jan

     
    Old 10-12-2006, 08:13 PM   #13
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    Re: Morphine Pump

    Like one member said it would probably be a mistake to jump from Hydrocodone to a pump. Your husbands PM doctor surely will prescribe him a long acting opiate such as Oxycontin, Methadone, Duagesic, Kadian,etc and maybe some Percocet or Lortab (hydrocodone) for BT (breakthrough pain) if needed. I have never heard of anyone having back surgery where thier legs twitch or jump violently but I am sure it is possible. Does he have RLS (Restless Leg Syndrome)? I have seen on TV where they are advertising a medicine called REQUIP for this RLS. Try to exhaust every medical resource and procedure before deciding on the pump. I feel that having a pump implanted should be the last resort as it is usually for life.There are two models a Codman and a Medtronics (you can search both of them on the internet. I have a Codman 3000 (no batteries) it is from Johnson & Johnson Co. There are differences in the Medtronics vs the Codman, my doctor installs both, and has a VHS tape on both that he gives to potential patients so they can hopefully make an informed decision. I knew nothing about pumps when my doctor implanted mine back in 2004 and I was only offered the codman. I was in so much pain and no amount of oral meds would take away the hurt as I am sure I had developed a great tolerance to the narcotics. The tolerance issue was so true for me and I am sure we all get tolerant to a medicine within time. I have even had to have 2 increases in the medicine that goes in my pump over a 2 year period as I have got some tolerance to it. Make sure you have a good doctor, and it never hurts to get a second opinion. Talk openly and honestly with your husbands doctor, I always get my wife to go with me so we both fully understand what is going on. Just explain to the doctor how bad the pain is and his insomnia problems. I think pain and insomnia go hand in hand as I have always had sleep problems since I have had bad back problems. My doctor used to prescribe me Restoril for sleep, but won't anymore. It worked wonderfully but he wouldn't write the script for me anymore. I pray that you all have a doctor that will listen to you all, if not find one that will. Good luck and best wishes. Jeff

     
    Old 10-13-2006, 06:37 AM   #14
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    Re: Morphine Pump

    Sorry for taking so long to respond havent been on my computer lately. The leg pain and jerking we havent had much luck with. My leg pain isnt so bad but my husbands is more painful than his back. Hes got this numbing medicine they put in the pump with the dilaudid. Helps some but not much. Make sure you think long and hard about the pump. I dont know what all they have tried orally for your husband but yes there are alot of drugs that can be tried before the pump but I think they push the pump because of all the controversary over people having control over there meds. If you have the pump they ahve control over the narcotics. Our government judges all of us the same when it comes to narcotics so doctors are scared to give out large amounts of pills. Im sorry for going on but Ive been going through some problems with my pain drs PA. Im having side effects with my pump well the drugs going in actually and the PA just told me that I cant decrease my pump. I feel shes dictating now what I can do with my body. Ive been trying to go down on the meds because as the years go by my side effects are becming a medical concern. Make sure you find out from the doctor all the side effects of the drugs going into your body. No one ever told me and now Im suffering for it. Ive gained about 80 pounds, high blood pressure, very bloated stomach, slightly enlarged liver, extreme swelling in my legs, personality change. Im still so angry about the PA that Im going to stop here and Ill write later after Im calmed down.

     
    Old 10-14-2006, 02:21 AM   #15
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    Re: Morphine Pump

    Thanks Jeff and Patti for your response. It is really helpful when you don't know which way to turn. My husband did go back to his pain Managment Doctor and he raised the dosage from Hydrcodone 7.5 to 10/325. It has not made a change at all for his pain. I am like ya'll, I think this Doctor is jumping the gun on this pain pump deal because he has not tried him on different medicines to see if anything will help him. Now the Doctor told my Husband that there are so many medicines that will do interior damage and that he would change him to the 10/325 because it has less Tylenol in it.

    He has a lot of trouble with his legs though. The pain is so severe that he can not sleep. Like I said in a earlier post, he can be in the recliner and his legs jerks just every few seconds and it wakes him up. He can't stay a sleep for the pain in his legs. I have also got back problems and have had since I was 21 years old and I am now 50. They tried to pull that pump stuff on me and I never went back to that Doctor. The reason why was the Doctor I was seeing at the time was letting me give my own self Morphine injections and I got hooked on that stuss and was on it for around 4 years and I finally said no more. I can't go on like this and I dropped the Morphine like a bad habit and never had anymore of it.

    What I can't understand is when I would be in the hospital they did test on the lower part of my legs and I can't remember the name of the test because it's be so long but it was the test where they would hook you up to a machine and they would stick needles up and down your legs and when they would hit a bad spot, I would come unglued because it hurt so bad. They have never mentioned doing any kind of test on my Husbands legs but I would like to mention that he is also a Diabetic and that may have something to do with the leg pain. I know the next time he goes to this Doctor I am going with him and I am gonna have a lot of questions for this man.

    The Doctor that did his surgery back in January did have him on Oxycotin and Morphine both while he was in the hospital and then he sent him home with a script of Oxycontin and then that was all of that. But I agree with everyone that this is just too soon to jump to the pump because I think there is other medicines he can try him on to see if it will work. Sometimes I can't help but to think is it the money the Doctor wants because you know that doing the pump would be a good check for that Doctor. But thanks alot to everyone that has helped us with our questions. You have all been a great help to us.

     
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