Hi Beulah, I've had a synchromed 1 pump for about 2.5 years. I spent about 4 years on oral meds. The only thing that seems odd is that your oral dose is so low to go from minimal dose to the most advanced pain system available. There is a lot they can do as far as increasing and changing meds if more morphine would just make you sicker. If you can't find anything with less intolerable side effects, maybe the commitment to the pump is worth it.
It's a personal decision. Your expectations of pain relief. Pump management, how quickly you expect it to be doing the job. It took 6 months and 16 adjustments to get back to wear I was pain wise with orals but my head stayed clear which is it's major advantage. These are all things you should bring up with the psychologist if your doc follows medtronics plan and recommends at psych eval. It's not to see if your crazy
, it's to see if your doing it for the right reasons.
Side effects were the biggest determining factor for my switch. My doc would have increased my oral dose, which was 600 mgs of kadian per day before the last switch back to methadone when I lost insurance again. I couldn't stand the way meth mad me feel and if you can't stand the way orals make you feel, that's another point on the positive side of the column.
I'm glad I made the decision because the biggest difference is feeling impaired and seeing life in color Vs a very gray and depressing world of pain and meds. I still have the pain but I know Ihave control over my life, not the pain. I do see more people dissatisfied with their pumps than you did 5 years ago. I think surgeons are more prone to offer a pump than to continue to prescribe. My last back surgeon offered a pump before I went through the last of 3 pain clinics where I was introduced to long acting pain meds.
I think dissatisfaction is from great expectation and/ someone had problems with their pump. It is a risk something mechanical can go bad or break.
I guess I can just bring up all the questions you want the answer to. I would say do it for the right reasons with the right expectations and you will likely be happy. If you think there are options you have been denied or want to try by your present doc. You should investigate those. ie If you wanted to try another drug and he's not comfortable or has an excuse not too try the Duragesic patch or any other med to resolve and bypass your tummy problems. I would suggest finding a PM doc willing to give them a try before you make that kind of commitment to a pump. Morphine is notoriously harder on your stomach than synthetic opiates.
The folks I know, I mean really know, swear it saved their lives or made their last weeks on earth humane. If I hadn't done it, all I could afford would be methadone and I doubt I would have had the clear head, lack of blahs .. what ever you want to call it to exercise daily and get to wear I could return to part time work or even think about the future without horrible fear.
After 4 years on oral opiates and 18 months to find the right med and dose with tolerable side effects the pump allowed me to exercise and do more rehab than I any PT ever could have asked or I ever could have done. It takes a long time to rebuild strength from years of a sedentary lifestyle where my primary focus was to minimize pain. I still have bad days, I still have days wear I dread going to work because I somehow was scheduled a 9 hour shift. But I know I'm gooing to have flairs when the weather changes and have bad nights anyway, so far, pushing myself hasn't cost too high a price. I'm sure I grouchy and no fun the day after working 9 hours, but the money and feeling of sacomplishment is well worth it.
I've lost 30 lbs since feb and returned to work at a new job part time that suites my ability to stand and walk.. However at best I would say the pump relieves half my pain and the nights after work are pretty bad. It's worth it though just to get out and have some sort of normal life. The pretty much shoots for 50 reduction wwith a pump and That also happens to be about all I can tolerate and not loose function and control of important parts of my body. More medication would be too sedating and ause other dysfunction I'm not willing to trade for pain relief. I may finally sleep more than a few hours, but that’s probably all I would do If I felt drugged.
I guess it shouldn’t matter what dose your on now if you don’t like or can’t tolerate the feeling. Some of the side effects do go away from oral meds, but it’s not the same as being sobor and seeing every color on a beautiful day. The pump is better side effect wise, but it does have some, nothing is free.
Bottom line is, it's up to you. It's been offered. It doesn't mean it will never be a choice again, but your next doc may have you try every med available before he decides to make that kind of commitment to the patient. There may be plenty of docs willing to try all the different oral meds if you want but they may not be able to offer the pump. If your doc isn't wiling to try other methods and you feel you should, try to leave the door to his practive open and say I know there are some things you simply don't offer or don't belive in, but you should have the right to make your own decsion.
Knowing you have tried everything is comforting on those bad days where most people question their own decsions. I can say on your dose, with the new pumps, you will have the longest refill interval possible, which is a major plus. You have plenty of room to increase if anything catastrophic ever happens, but you will have docs uncomfortable with treating you and the whole idea of opiates having a positive side..
Sorry, I can't be more help other than remeber why I did it and what I thought about it and what I think now. It can be a great tool if it's the right fit for the circumstance. It's not something people should want because it's the newest thing on the block and everyone deserves the best.
Anyway, Jusat my thoughts, I do remeber ya, glad you came back.
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Take care, Dave
