Discussions that mention morphine

Pain Management board


It would appear I have a choice. Lumbar Fusion according to ONE young surgeon (who is supposed to be good) or a Morphine Pump in the opinion of 4 older doctors. One of the four is not a surgeon.

I am scared of surgery. When you mention surgery I think of moving to the south pacific. When you mention a morphine pump, I get uncomfortable and wish I could just get it over with quickly.

My PM&R doctor sent me to the young surgeon to discuss putting the morphine pump in. Young surgeon throws PM&R dr. a real curve ball. Young surgeon says he thinks there is a good chance HE can repair most of the damage. PM&R dr. is NOT happy, made out a new prescription wherein he specified morphine pump.

Please, WHY did YOU decide to get a morphine pump? Emotional decision like mine would be? Or something else made you want the pump?

Surgery? Why did you elect surgery? Hate pills? Tired of feeling “dopey” on the drugs?
I have tried to rationally decide between the two, but any discussion of major back surgery is complicated by another problem with my back. There is a yellow streak that runs the full length of it. I guess I am not convinced the surgery will work and if it does work the results will be. I know there are no guarantees.

So WHY did YOU make your decision? Any answers appreciated.
Hi Dllfo !! I can understand how torn you must feel. Maybe hearing other's stories will help. I was 38 years old and for 7 years did the chiropractor thing then finally went to a surgeon. He layed it on the line for me... if I didn't have surgery NOW my nerves would be completely cut off in 10 years and I would be in a wheelchair forever. So you might want to think about that . Will NOT having surgery do you harm in the long run. I for one feel the morphine pump would be advised for people who had had surgery and are not better or perhaps worse now. Yes surgery is very scarey and the recovery for fusion is very long but if it is to have a positive out come it may make the rest of your life more productive. I for one was not ready to slow down or not be able to in the future dance at my kids weddings. Yes I took the chance and it was very intense and a tough recovery but if I had to do it all again I would go through it all again just to have my life somewhat back. Morphine is a very serious drug and keep in mind if you don't have fusion you may eventually lose the movement you have now. good luck with you decision.... and we will be here if you need us.....
dllfo,

I have had 2 lumbar surgeries.I was 33.I had no choice but to have them.With ever surgery there's risk.The nerve damage I have was a result of delaying my surgery by 7 years.
First does the young surgeon have a spinal fellowship.This is where they devote 90 % of there time on the spine.My first surgeon was not,my second was.
You need to out weigh both cenerios.Your age for one.Morphine is a strong drug,do want to rely on that the rest of your life,what happens when that stops working.If the surgery is not as successful as you hope the pump is available.
A fusion surgery can be a long healing process for some,others breeze right through it.
It depends on where you want to be in a year ,5 years,10 years.And what caliber of life you want down the road.
I made the choice to have the surgeries,for a better quality of life,I had 4 young children,my age and I wanted to be productive and didn't want to rely on meds for the next 50 years.7 years later do I have discomfort and pain ,yes,but nothing compared to 7 years ago.It has slowed me down to some degree.
Maybe another opinion from a younger DR.Techniques have changed through the years.
Harming myself by NOT doing the surgery? I had not thought about that one.
As for the dr. credentials...I do not know. I have not made it that far. I did ask my PM&R doctor about him and he said he had assisted in surgeries with the young dr. He is good and he does things laproscopically.

I asked the young doctor about results. He said the lumbar fusion has progressed until it is about the same success rate as knee replacements. THAT would be GOOD news. As I read your comments I think..."Hey, they are right, if I don't have it done now, I may damage things worse" - - then I remember Holly. She was married to my buddy and had the same surgery they wanted to do on me. She is in a wheelchair for life and in pain 24/7.

The older doctors said I was inoperable. Too much damage. So, after hearing that, how can you and I believe this young dr. can do miracles? I want him to be right and to do my surgery and then I can play softball with my grandson.

Then I remember Holly and think...Science improves every day. That is what the older doctors said. I should wait until science catches up with me.

No one wants to be on morphine the rest of their life. Unless you are terminal, then it would be a blessing.

I am taking all the steps for surgery. EKGs, a physical, everything the surgeon asked me to do. I am doing it. I will probably go for the surgery, but I am really scared. Not just for me. I can hide behind a pill to a certain degree, but am I doing the right thing for my wife? If I come out in a wheelchair she would have even more to do.

Did you think about your families before the surgery? nuffs3 did for sure.
Queenneeee...I don't have the answers...I hadn't really thought it through. I was just told I am "permanently disabled" 273 days ago. Not that I am counting :) but...it seems I don't like any of my options. Sometimes I back up and have to ask myself...ok, if you won't do this for yourself, how about your wife? If I have a lumbar fusion and it turns out bad? The young surgeon says I will not be any worse off than I am today...I wonder.

Odd, I am not sure I would do it for me. But when I think it might make my wife's life easier, I tend to say yes, I will have the surgery.

What was the worst thing you remember about the lumbar fusion?
Zoey1--"Not sure knowing what i know now would have done things different then I do not feel even with the amount of 2nd and 3rd opinion I did enough research on my situation and believed the docs and what they told me. ..."

What would you have done differently Zoey1?

Different doctor?

Different type of surgeon?

Different type of surgical procedure?

I have talked to two surgeons. One has done surgery on some of my friends, he is from the "old school" and is the one who does the nine inch opening. But all the people he worked on are doing well. THAT sounds good. In fact, I have heard his name for many years. The new surgeon does it laproscopicly.
One of my neighbors works in the ortho surgery ward, so she will have some interesting comments when she gets back.

Hi Shoreline, No one mentioned "stabilizing" my lower back. I had not really thought about it that way. As I recall, the surgeon showed me the disc between L5-S1 and L4-L5 discs will not hold enough pressure to get a valid reading on the discogram. I think the amount of pressure they held was around 35, hence, unreliabe data. BUT the other discs above that appear to be like new. He said they look like an 18 year olds discs. I am 61 now.
THAT is great news..IF he can do the lumbar fusion and make it work ok.

Spondyliotheisis --It appeared to be Grade 1. But what we looked at was stationary, with the disc slightly forward...or was it slightly aft? I don't remember, but it was not "way out" like it might fall over the edge. It was slightly off center...hard to describe. As for my wife giving things up, she already has. Being delicate, my pain centers override other activities 100% of the time. It takes 180mg of morphine and 150mg of demerol to conquer the pain centers. And at that point I am already in bed with pillows under my knees and my sleep apnea machine on. As for her cleaning up after me, no one wants that, but she will if she has too. As I will for her. We have all changed our children's diapers out of love, could I do less for the woman who gave me our children? I am reading your post...we are both retired. And our main dream is to be with each other thru eternity.

You make a real interesting point...Until I do something to stop the degradation of my lower back, it will continue to degrade. My back really got bad in Jan 1987. I had been rear ended a few months before. I was DNIF for my last year or so in the Air Force. So my back HAS been degrading for almost 20 years. I think I have had 2 or 3 years that were essentially pain free since Jan. 1987. So it has been degrading all this time. I think I just put my head in the sand and figured there was nothing I could do except have surgery. Maybe NOW is the time. As I have said before...my pain today is the devil I know...tomorrow, after surgery---who knows???

I appreciate your insightfulness and I am thinking about it. I have done NO research on any theories. I have been researching the best way to relieve pain. Remember...I was told I was inoperable for many years. The concept I can have successful surgery to relieve this is not even a month old. The pain and other stuff is almost 20 years old. THAT is why I am asking this forum about it. The idea they can stabilize the degeneration has not been talked about. Now that you mention it, doesn't that seem odd to you?

Is there a place that lists the success rate of different types of surgery?

By the way Dave, what DID you do? You speak of "knowing I did what I had to do".....was it surgery and was it successful? Remember, nearly every day I think about it, new items come on the market. Also, is there a "name" for this type of surgery? A specific name I can look up?

Right now, after reading the great posts in here, I am leaning towards the surgery...but I do want to research it. One poster said they had a procedure done that was NOT FDA approved!!!!!!!!!!! WOW...and it looks like it failed.
I would not be a happy camper if that were done to me.

Thanks again for your info. This is a great bunch of people, and as for you
Dave, you are a wonderful resource to us. Thanks for spending so much of your time helping others.
It's all too easy to rely on the pump or medications instead of trying to resolve the situation. Sadly too many individuals do this and then as mentioned the window of opportunity is gone and permanent damage sets in.

It is scary to have to decide but you have to weigh the pro's and cons. Generally I make a list after doing research and talking with others wether or not the surgery will to my advantage.

You really have to think of long term as Dave mentioned, untreated, spine disorders can lead to more serious problems. If you have the opportunity to correct it or at a minimum prevent further damage then it definately needs looked into. You could actually be giving up a lot by not having the surgery and opting to live out the remainder of your life with a pump. Because you have already said you have a problem with Morphine due to your asthma surgery may be a better choice as a whole.

One thing to keep in mind, especially when reading boards, is that people are more apt to tell you their bad outcomes as opposed to the good outcomes so it appears that all back surgery turns out bad when in reality it doesn't.

Just be sure that your doctor has a spine fellowship and many surgeries under his belt. Just because it does it laproscopicly doesn't mean he's a better surgeon, he's just more on the cutting edge of things.

Your PM shouldn't be upset because a doctor wants to operate. How do you know that the PM isn't upset not because he thinks you don't need back surgery but because he's going to be out a ton of money if you do not have the proceedure. Has he ever done spine surgery? Does he have a spine fellowship? Probably not. He's not really in a place to tell you what you can or can not do. It is your body, your choice.

Just because other doctors will not operate doesn't mean that it is not viable. My first hip replacement was done when I was 27. I was told by 3 doctors that they wouldn't do it because of my age but a doctor who had previously done did the surgery. It was a wise decision for me because it did give me some level of relief for 13 years. Had I waited the ball of my hip would have eventually broke through my pelvic bone which would have been a more disasterous result.

Good luck in whatever you decide.
I think it is VERY dangerous to ask people on the board whether or not you ought to have surgery. Everyone has had different experiences and "knows" different things which may or may not even be PERTINENT to your case.

-For instance, in some cases spinal surgery relieves pain but actually leaves the SPINE less STABLE. We're not meant to be walking around with fused, decompressed, etc discs.

-In some cases the spine is MORE STABLE but the PAIN is increased!!!

-Sometimes neither are improved or both are worse.

-Sometimes everything is grand and BOTH are greatly improved.

It's THOSE options, based on YOUR films and condition, that lead surgeons to recommend one way or the other. My Dad has had numerous Spinal Surgeries AND he has a Morphine/Baclofen Pump. I'd go with what the majority of the Surgeons told me if I was you--of course ASK them if there's any risk of increased damage from NOT doing the surgery.

Best--
Mya
Avalon,
I can't do anything. Pulmonologist says NO to anything until my breathing is under control.

I appear to have a very rare thing called Vocal Cord Dysfunction (VCD). When you breathe in, your vocal cords open, mine close. But only during attacks. The bad thing is...when you figure out no more air is coming in....
you have already exhaled all your air and you are in a B I N D.

Heliox and oxygen tanks for now.

Sorry to hear about your back being inoperable. As you may have read, only one relatively new surgeon thinks he can fix it. I have found a group of dr. who have the spinal fellowship and will see them if and when my breathing is corrected.

I know pain wears us out, but struggling for every breath weakens you in a little different way. With my lower back I could even move my body sometimes to get "away" from the pain, but not the breathing thing. Luckily I have a machine to help me breathe.

Oh yeah, I can't remember if I mentioned it, but two of my discs are shot.
It would be so nice to be able to walk, talk, breathe again. But hey, lots of people are worse off than I am. LOTS!!

My disc just above L4 is still "ok" and the ones above that are like a 20 yr olds.
So if I could breathe well enough...I don't know. I guess I will wind up with the pump. I have such mixed emotions.

I really thought the pump would be a home run. If I hurt my back, I change the setting from...say...a 5 up to a 6 and my dosage increases a little...ah yes, less pain for the following 4 hours, then automatically it goes back to 5.
That sure sounds simple to me....but I hear it isn't that way.

Did anyone tell you the medtronics morphine pump had a remote control? And that the battery life is NINE years? I am hearing 5, but my dr. told my wife and I the battery is guaranteed to last for 9 years. I just don't know Avalon.

I keep putting one foot in front of the other, after all, compared to some people on here, you and I may be in great shape. I wish you all the best in your quests. There ARE other pumps if you want one. Codman is what Charliecat 31 has. There may be other manufacturers, good luck with it.
I haven't had any pain med actually relieve the pain, which is better sometimes than others but is always "there". I can't take morphine, makes me sick. I'm now on OxyContin (long-acting) twice a day, 20 mg. plus Percocet for break-through pain. I try to limit myself to 2-3 Percs a day (7.5 mg.) I don't know how much I'd have to take to actually make the pain go away -- probably enough to make me a zombie. So since I haven't had much relief with pain meds, I guess I'm doubtful a pain pump would help much either.

In my opinion, the thing in favor of your having surgery is the fact that you have other good discs. The thing against it would be the fact that only one surgeon is recommending it. Think how I felt -- I went to two of the very top spine specialists in a major city -- one said surgery, the other said no. NOW who to believe!!? You're right in pursuing the spine fellowship-trained specialists. Since I've tapped the two top ortho practices in my city, I was actually thinking of going to NYC to a spine specialist to get a FOURTH opinion.

Well, thanks for responding so quickly. Good luck with your breathing and let us know when you receive additional medical opinions on the back surgery.