Discussions that mention morphine

Pain Management board


Hi, I had a Codman Morphine Pump implanted 2 years ago.The doctor that did my surgery was accused of sexual assault on one of his female patients and fled the country to his native homeland Syria. I was transferred to a Doctor 1 mile away. I go too him every 45-60 days for a fill and if my pain level wasn't tolerable I would let him know and he would adjust my medicine. He added Clonadine with the Morphine and Baclofen as well. After 3 increases I reached a level where my pain is manageable.He also prescribes me breakthrough pain meds, but I find that I rarely need them any longer (thank the Lord). I would communicate with your doctor and let him know of your pain. Did you have the trial before implant of the pump?Did you get relief (50%) or better from the trial? If so, your medicine probably needs adjusting. I was offered the Codman 3000 pump by Johnson&Johnson, it is a non battery operated pump, it operates off of gas(freon) so no batteries to go dead as in the Medtronics.I have found that this method of pain management was the best for me. I had spinal fusion in L5/S1,the surgeon said that the fusion was sucessfull, but the pain he couldn't understand. Boy I could, after surgery the pain was worse. Oral Meds in large doses would take care of the pain,but I was in a constant fog and slept all of the time. Just the opposite with the pump, alot less pain and way fewer side effects.
thanks for your advice.i figured it would probably take awhile to get it adjusted.i have the medtronics pump and as far as i know all thats in it is fentenal.i am allergic to morphine.you are right about the fusion and your pain getting worse i had mine at the same spot you had yours.they had put metal plates in my spine and took those out thinking that caused my pain to stay.after those were removed my pain just got worse and worse.i wont give up on the pump tho.thanks for your advice.its good to talk to someone that has had it done.
donna
Hi Donna, I had a medtronics pump implanted about 2 years ago. I'm not sure of all the features of the Codman, if it's programmable or simply delivers meds at a constant rate and the strength is controlled by the concentration of medication. A pump is just like titrating any med. It may take 1 or 2 adjustments or it may take a dozen. I started with morphine at 2mg a day, 6 months and 16 adjustmants later I was getting better relief without the head fog.

They switched me to Dilaudid last year to give me more time between refills and got that right within the month after 3 adjustments. Because of the potency of intrathecal meds, docs tend to go slow but they should expect to have to make some adjustments. I was on a high dose of oral meds prior to the pump and the typical 2mg starting dose of morphine just wasn't comparable even delivered by pump. I ended up somewhere around 12.4 mgs per day. The big advanatage of the synchromed pump, is the ability to program the pump to deliver different rates throughout the day. If you have more pain at night, it can be programmed to deliever a higher rate at night, AT one point I had 4 different settings that increased or decreased throughout the day.

Baclofen, Bupivicaine and clonodine are not opiates but they can increase the effectiveness on pain. They do have their own set of side effects that may limit their use, but they don't noramlly start adding adjunct meds untill they have you in the right ballpark. It's just logical not to start 2 meds at the same time , if you have a side effect like UA retention, it makes it harder to pin the problem on one med or the other.

I'm also post fusion X 3 and they all failed, I've broken every set of hardware and more surgery just isn't an option. So don't be discouraged that a starting dose isn't effective. I ended up needing 6 times the dose they started me at, but I was well assured and confident they would continue to work with the me and the pump to get to 50% relief.

50% relief is different for everyone though, just like the numbered pain scale. 50% may allow some folks to return to work and for others 50% means they won't have to spend the rest of their life bed wridden. If your only 2 weeks post op and your not having intolerable side effects it's time to adjust the pump if your not getting relief. The first 6 or 8 weeks I was getting it adjusted every week.

You don't earn any points for being a marter so call unless you have been told otherwise. They can't adjust it if they don't know it's not working. The only ceiling on dose is the side effects you might experience.

Fent is much stronger when you compare it to other opiates, so don't feel slighted that you using much less Fentanyl than I was morphine. Your med is measured in micrograms VS mgs, but it can be just as effective.

Good luck, Dave
Hey Donana, Just a tip, If your doc didn't recomend an abdominal binder to hold iit in plce after the implant it's worth spending 20 bucks on one. It's a comfort thing as far as it not bouncing around when you walk or ride in the car and it will also hold iit in place while it becomes encapsulated in scar tissue. Occaisonally a pump can flip which makes rfills difficult, unpleaseannt or impossible. I've only met one person who's flipped, but THe elastic 12 inch wide binder just holds it so you don't ave to when you hit a speed bump. The first few weeks or months when mine bounced it felt like little tears each time.

Becky, It tok me about 6 months to get my first med adjusted, but I was na a fairl y high dose of meth. I stopped that prett much cold turkey. I was glad to be off he stuff but it was the only med I could afford without insurance.

Everyone is different, I have met folks that spent months adjusting morphine, then dilaudid , then fentanyl and then suffentanyl.18 months later the were still tinkinging with meds and adjunct meds. Clodine, Bupivicaine and Baclofen can also be delivered Va pump and can help with spasm, pain and add a little numbing agent directly t the site of the cath. It's just a mater of how you respond to each med and how agressive and available your doc is. But once you ahave a comfortable working dose, it's pretty smooth sailing, especially with the larger resevoirs in the new sychromed11 pumps where you can go months between refills even with weaker meds like morphine. Sufentanyl is the strongest per microgram, Fentnyl is also measured in mcrograms due to it's potency and then you have dialuadid and morphine measured in mgs.

MY implant was a 23 hour breeze too. The tthe first traial was 4 days in patient with a spinal headache though. I eventually did a single bolus injection months later and just hung out and walked around the clinic for a few hours after the injection and it was great relief, but that was in addition to the meth in my system that you can't jst clear out by skipping a dose or two. They normally want you to stop or at least decrease the oral meds while doing a trial to get a better reponse. As the decrease Donna's Patch strength, they have to increase the flow rate. Unfortnately there isn't an exact conversion from Oral to pump or from patch to pump, so it takes a few adjustements to get it right but the only reaon to give up on amed is if you can't tolerate he side effects, so don't think your off track if your still adjusting months longer than Donna. My doc had Me DC meth when hey put the pump in, so I was starting from scratch, where Donna still has to replace her other meds with IT meds and work towards the level of relief she's recievng from a patch and whatever the pump delivers.

AS far as visabilty, Unless you go to work showing off a six pack, nobodyy will notice a thing. I guess swim suites would be different and how much tummy you have to hide the pump makes a difference too. I've lost some weight since the implant and mine is more prominant, but at 40, I really don't care anymore. I'm pretty sure it's kinda strange for my wife to feel and my daughter feels it when she hugs me. But it's a small price to pay for a clear head.

Good luck, Dave
Hi all -- I have back problems pretty similar to what Bill described above. I am very curious about this pain pump. I just started going to a PM specialist, I was already on Percocet and now he is trying different drugs for nerve pain (amitryptiline, Cymbalta, etc.) but they are all having bad side effects. I asked him about the pump and he said he's seen mixed results. Some pts. have asked to have it removed. Overall, he didn't sound very positive about it. However, I'm still curious about it, especially as it does sound as if it's helped some of you. How does it work? Does it send the medication to a specific site in your body that's generating the pain, or does it just go into your bloodstream like any other IV drug, or what? Does it affect you the same way an IV dose would? (For example, I get nauseous from IV morphine.) How big/visible is this lump in your side or wherever? Thanks for any info you can provide.
Hi Avalon,

My doc told me that they will cut out some fat so that the pump doesn't stick out as much. He also said he is using diluadid instead of morphine. You don't have to use morphine in those anymore. Wish you luck.
Becky
Thank you, Bill, that is very helpful info and I will also check that website. I am not taking anywhere near that much morphine. I am taking Percocet but trying to control it so I don't get too addicted. It never completely takes the pain away but it takes the edge off. But I'm concerned about addiction and building up a tolerance so I need more and more. I've been on it 3 years and can see my dose gradually increasing. I like the idea of something that sends medication directly to the painful area. I'll check it out and keep you posted if I decide to pursue it. Thanks again.