It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Pain Management Message Board

  • pain pump questions

  • Post New Thread   Closed Thread
    Thread Tools Search this Thread
    Old 01-21-2010, 06:43 PM   #1
    sajones
    Newbie
    (female)
     
    sajones's Avatar
     
    Join Date: Oct 2004
    Posts: 7
    sajones HB User
    pain pump questions

    Hi,
    Just need some info on pain pumps. Considering getting one for chronic back pain due to failed surgery. Can anyone give me the pros and cons of implanting one. Thanks.

     
    Sponsors Lightbulb
       
    Old 01-22-2010, 08:20 AM   #2
    Executor
    Inactive
    (male)
     
    Join Date: Jan 2008
    Posts: 3,998
    Executor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB UserExecutor HB User
    Re: pain pump questions

    I have sent a message to Dave (Shoreline) to see if he can help. He has a pump and knows quite a bit about this area.

    Regards,

    Ex

     
    Old 01-22-2010, 10:50 AM   #3
    sajones
    Newbie
    (female)
     
    sajones's Avatar
     
    Join Date: Oct 2004
    Posts: 7
    sajones HB User
    Re: pain pump questions

    Thanks for your help.

     
    Old 01-22-2010, 01:15 PM   #4
    Shoreline
    Senior Veteran
    (male)
     
    Join Date: Jun 2003
    Posts: 3,519
    Shoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB User
    Re: pain pump questions

    Hi SA, I've hasd a pump for almost 7 years, Which means it's about time for a replacement pump. I also have failed back surgeries and failed fusions with broken hardware. After 3 fusions failing and getting longer each time, It's highly unlikely I will let them go back in and try to revise a 6 level fusion and turn it into a 10 level.

    You have to keep in mind that pumps are just another tool. It's a different delivery method that alows the docs to use use 1/100th to 1/300th the amount of oral meds you are taking. The biggest benefit is pretty much the same pain relief I got from orals with substantially less side effects and less cognative impairment. Once at a level that relieved enough pain, My head was clear enough and I was motivated enough to makes some changes and I started excercising, l lost 30 lbs. I found a part time job that got me out of the house which is really depressing. The pump was great for me, but not everyone has the same results or same motivation. Some people would never choose a pump because it means turning control completely over to the docs and trusting they will find a level of relief that is acceptable.

    I spent 7 years in PM beforte they even started using long acting opiates to treat chronic pain. OxyC wasn't even invented untill '96 and at the time it was very limited in use. MScontin had been around for a few years longer but unless you were dying of cancer, no doc was going to prescribe morphine for chronic back pain back in those days.

    From watching things progress over the years my biggest concern would be who is going to manage the pump. I had several Surgeons suggest it early on when their surgeries had failed but we never got serrious enough to talk about who was going to manage it after the surgeon put it in. Surgeons had suggested it but none of my PM docs had nor had I met a PM doc that was even qualified to manage a pump. The bulk of PM docs don't even mess with pumps and spinal cord stims so these are things that aren't offered to everyone.

    We had a memeber last year who had her pump removed because her doc was tired of the poor reimbursement for medication and the refill process. The meds are very expensive and by the time he bought meds from a wholesaler and took the time to do the refill and programming, They were actually loosing money. My present PM group suggested it after 3 years of trying to balance pain relief with side efects at the high dose of meds I was on. After the implant it took 6 months and 16 adjustments just to get back to where I was relief wise from orals. They managed it for the first 6 years and about a year ago, They turned over the refills to a home health agency that has their own compounding pharamcy. The abilty to compound themself allows them to actually make money.

    The doc implanting the pump makes the most. A neuro or ortho surgeon certified by medtronics can make a quick 3 -5K doing the implant, but their really is very little profit in the management of these devices. My PM group still has control of the settings, Meaning if I need an increase I talk to my PM doc, They send an order to the Home health agency and they do the increase by swinging by and simply changing the programming using a telemetry device. They also swing by every couple months and refill it for me. My copays actually went down, so all in all it worked out. However If I lived in rural area, or smaller city, I would be concerned about continued maint if their is only one doc in town that implants pumps. My first question would be who is going to manage it and what gaurentee do you have they won't decide to stop because they are loosing money doing it.

    Docs that implant Medtronics pumps are certified by the manufacturer. I would call medtronics if that's the pump the doc uses. Their was another manufacter of a pump years ago, the other pump was made by Coddman, they may have been bought by someone else or may still be in Biz, just do a quick search for IT pumps and see what you find. If your doc sugested medtronics I would contact them and find out how many docs in your area are certiufied to implant their pumps. Medtronics will be happy to provide a list of docs in your area. If your seeing the only pump doc in a 200 mile radious I would be a bit leary for a couple reasons.

    #1 is maint. who is going to maintain the pump. #2 is, not all docs have the same comfort level with pumps as far as dosing. I've met people that have changed pump docs 5 times to find someone willing to adjust it to a level that actually worked. Just like some docs have limits on what they feel comfortable prescribing, there are docs that have limits on what they will allow a pump to deliver. The woman that it took 5 docs to find one to manage her pump ran into that very problem. Her first doc never ordered more than 2 mgs of IT morphine a day. That didn't even begin to touch her pain nor would it touch mine. I was fortunate that my doc isn't like that but I knew that well before having the implant.

    If a doc is suggestng a pump because you hit some magic number with orals that he isn't comfortable prescribing beyond, He porbably has a similar magic number with pumps. His oral prescribing is a good guide as to what he may be willing to do with a pump. You also want to exhaust your options with orals before doing anything as invasive as implanting a pump. If it's your surgeon who is simply tired of prescribing enough vicodin or percocet to get by and thinks the pump is the way to go to get you off his prescribing charts isn't the ideal situation for a pump. Going to a pump because a doc isn't comfortable with orals just means you need to find a real PM doc that is willing to agressively manage your pain with whatever method may work. I pretty much exhausted every option in PM before deciding I wanted to do a trial and before my PM doc was willing to take on the responsability of managing a pump for life. I still have med counts, pain contracts, UA's etc. If I fail to comply with any part of the process he can still dismiss me as a patient which means no order to refill the device next month.

    As far as effectiveness, They aren't miracle devices or cures. A succesful pump is one that rellieves 50% of your pain, Once your pain is decreased substantially the rest is really up to the paitient. If you expect 90 relief and your entire life back when you wake up, that's not realistic. That's why part of the process of getting a pump includes psych evals, trials where placebos may be used to rule out candidates that have unrealistic expectations or simply respond to saline being injected in their spine because they believe they are getting something more potent. The power of plecebos is pretty impressive when you read a clinical trial.

    The trial is certainly important, If a large component of your pain is nerve pain or neuropothy, radiculopothy, sciatica, etc. Nerve pain doesn't respond that well to opiates, regardlesss of how they are delivered. I know medtronics says it's for both types of pain, but most docs will lean towards a spinal cord stim and the adjunct meds that are better proven to work on nerve pain. Fortunately my leg pain/nerve pain was resolved in surgery. I had so much nerve damage during the last surgery that I'm now numb instead of feeling anything at all in the areas once lit up by nerve pain.

    I would guess that if your thin and like sun bathing in a bikini, Having a tuna can slipped under the skin of your lower abdomin may be a little more concerning. After 7 years it still freaks my wife out a bit when my wife comes in contact with it. It doesn't bother me and and my wife could hang a plant from it if she wanted, but body image is certainly an issue to talk about. The more body fat you have the more it conceals the pump. Having lost 30 lbs since the implant, Mine pretty much looks like a tuna can just above my waist line. It doesn't stop me from going to the beach and enjoying the sun, but it something to consider and discuss with your doc or the Psych during the eval process.

    As much as it seems to offend people when someone suggest any type of link between the mind and pain, Docs aren't going to ignore the mind body connection. That's why they do the eval. Mine consisted of taking the MMPI, Minnisota multi phasic personality inventory for the 4th time in 10 years and another interview with a PM psychologist. I've worked with several PM psychologist over the years and found them to be very helpful. They tought me bio feedback, self hypnosis and guided imagry, All of which are tools I still use to get through harder times and flare ups Before calling a doc during BT pain or going to the ER. In fact I have never gone to the ER for BT pain in 17 years. That's not what I was toight to do nor what I feel would be worth my time. Spend 3 hours in an ER waiting room only to be given an injection of something weaker than I'm already on that is going to wear off in 3-4 hours. That's just my thoughts on the ER.

    I have a lot of thigs to try from stretching to self hypnosis and BT meds. The more tools you have the better equipped you are to deal with life altering or break through pain. I say life altering because life has changed, but it doesn't mean any chance of happiness or a fullfilling life has been taken away. It's the cup is half full/half empty mentality that determines how people respond to change, disablity and adversity. Yes my life has greatlty changed, There are many things I will never be able to do, I'm disabled and can't work full time, But I still appreciate all the good things In my life. Getting out of the house a couple of days of week and the social interaction with others does wonders for depression when our primary focus has been on everything that we have lost. I've even heard of some docs insisting on some type of volenteeer work for people in pain as part of their overall treatment plan. Getting out of the house is a good thing, Surprisingly it's very disrtracting,. When I work I never take BT meds at work and the thought never crosses my mind.

    Anyway, if you have anything specific I would be happy to answer. I would like to know where you are in the PM process. Have you tried oral LA meds, have you ever been to a pain clinic. I ask because I have seen others that have never even tried LA pain meds end up with a pump and problems that may have been prevented had they simply tried something else. It's like skipping from C to Z and not trying anything in between simply because a pump is the most effeciant way to deliver opiates. However when nothing else is being offered, It's hard to say no to the only thing that is.
    Good luck, Dave

     
    Old 01-23-2010, 11:48 AM   #5
    doaback
    Newbie
    (male)
     
    doaback's Avatar
     
    Join Date: Jan 2010
    Location: Denton,Texas,USA
    Posts: 1
    doaback HB User
    Re: pain pump questions


    This is my first day with HealthBoards. I am seeking people that have had problems with their pumps, specifically Codman 3000. I will share my experience with any responders. Thanks
    __________________
    LTSJ

     
    Old 01-23-2010, 12:31 PM   #6
    Shoreline
    Senior Veteran
    (male)
     
    Join Date: Jun 2003
    Posts: 3,519
    Shoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB User
    Re: pain pump questions

    Hi DOA, Start a new post about it, I would love to hear about the coddman since I'm getting ready to have mine repoplaced. I've been happy with the medtonics and the programability is a nice feature that allows a higher dose to be delivered at night Vs the day.
    Welcome, Dave

    Last edited by Shoreline; 01-23-2010 at 12:32 PM. Reason: grammer

     
    Old 07-04-2010, 02:53 PM   #7
    corgigirl
    Newbie
    (female)
     
    corgigirl's Avatar
     
    Join Date: Jul 2010
    Location: MD
    Posts: 1
    corgigirl HB User
    Re: pain pump questions

    Dave: this is my first day and I know you wrote this response months ago, but I wanted to thank you for the info. Was wondering how you and your pm md decided on pain pump instead of scs? I am just beginning to think about pumps and any info would be helpful. Thanks so much for taking the time to write such a great response! Pam

     
    Closed Thread

    Related Topics
    Thread Thread Starter Board Replies Last Post
    Medicare/Pain Pump L5S1 Pain Management 20 01-30-2009 02:37 PM
    Pain Pump Patients on Medicare! TonySak Pain Management 16 10-23-2007 10:05 PM
    Information and advice needed for Implanted Pain Pumps. WannaBeFreeToRoam Pain Management 8 08-12-2007 04:19 PM
    Medtronic Pain Relief Pump with no relief PhiPhilip Pain Management 7 05-16-2007 11:57 PM
    Morphine pump or Electronic pain relief? mergatroy Pain Management 34 08-17-2006 10:01 AM
    Pain relief thru implants? Any of you tried this? mergatroy Pain Management 6 08-08-2006 09:02 AM
    Intrathecal Pain Pump Removal Advice Over50butactive Pain Management 5 03-25-2006 03:01 PM




    Thread Tools Search this Thread
    Search this Thread:

    Advanced Search

    Posting Rules
    You may not post new threads
    You may not post replies
    You may not post attachments
    You may not edit your posts

    BB code is On
    Smilies are On
    [IMG] code is Off
    HTML code is Off
    Trackbacks are Off
    Pingbacks are Off
    Refbacks are Off




    Sign Up Today!

    Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

    I want my free account

    All times are GMT -7. The time now is 08:14 AM.





    © 2020 MH Sub I, LLC dba Internet Brands. All rights reserved.
    Do not copy or redistribute in any form!