Discussions that mention morphine

Pain Management board

Hikypt, I've had one for 2.4 years. and it manages about 50% of my pain. The last or 3rd surgery I had was to revise a a failed 3 level fusion that failed and heardware broke and I woke up 11 hours later fused from L1-S1 with twice as much hardware and twice as many vertabrea fused. I was bed wridden the first 10 months and after starting LA meds I have slowly been able to rebuild. It's taken 67 years but I just went back to work part time,. Between the pump and the commitment to excercise 5-6 days a week it's been possible but very difficult. I doubt I will exceeed the limit SD allows you to work part time and retain disabiklity benifits, but if I don't try I won't know.

The pump is really a last resort kind of option. Surgeons don't like to prescribe oral pain meds indefinitely. They were tought opiates were bad and addicting and any doc that went to school or did his internship, ferllowship or resedency prior to the invention of oxycontin and the billions spent to promote proper use of pain meds to treat chronic pain it's much more exceptable.

The pump is really the end of the line although your surgeon would rather put in a pump, refer you to a PM doc to manage it or do basic management himself, but I certainly wouldn't look to the most advanced form orf pain control and a very invasive method if you haven't tried orals. A moderate dose of long acting meds may be more than enough. It's also too soon to call the fusion a failure unless your harware has slipped or broken. It takes years for bone to be reabsorbed so it's unlikely the doc can say the fusion failed to grow or your hardware is the only thing holdng things in place.

I would ask to consult with some PM docs before under going a lifetime commitment. If a hundred mgs oof long acting morphine tywice a day willanage your pain, why go through such an extreme method. What happened if something gets worse, if you get cancer, if you need surgery again when hardware starts snapping. Nothing will compare to the level of meds that are delivered via pump without causing extreme impairment.

usually people consider pumps when they have reached max doses of meds where they can't handle the side efects, and you expected to put up with some side effects if your claiming to bein enough pain to need that level of meds.

It shouldn't be presented as there are dozens of ways to manage pain, but if you want to fly first class, have a pump put in. Even the goal of the pump is 50% pain relief. A trial should be done to be sure it makes a difference and doesn't cause undue side effects.IOther methods should be tried. Other surgical opinos that may suggest that surgery failed and needs corecting. If your spine isn't stable, it will continue to get worse and you will need ever increasing doses to maintain the same relief.

The pump is grerat as far as reducing the impairment and clearing your head from oral opaites, but it's not something you jump into before exhausting other ways to manage residual pain or pain from failed surgery. If the bulk of your pain is nerve pain, like leg pain, more than likely you will still be disapointed with opiates effectiveness on nerve pain.That's when a spinal cord stim may be the beter choice or interventionalprocedures.

It just seems your surgeon is looking at a quick solution on paper that makes him alot of money. When you haven't had the opportunity to try anything else .I don't know how any doc could in good consciuos reccomend something as drastic. If he couldn't fix the problem only the most advanced pain relief methods will work? Come on, they all have ego's and it's just one docs opinion.

If he even manages the pumps himself, I wouldn't expect the same level of care from a surgeon as far as frequent fine tuning untill it's properly set as you would get from a PM clinic that does the management and everything else involved in Pain management. They would be the ones to determine if you need a pump or perahps something simple like one pill twice a day will give you an exceptable level of relief. The goal of a pump isn't complete relief, It's not with oral meds either, so just because something sounds like a better idea or "mousetrap", it's one docs opinion. It's pretty extreme if you haven't run the oral med and more conventional PM circut.

I'm glad I had mine done, but I really didn't have another choice and have beni nvolved in pain management for 13 years. I tried everything else, I had surgery after surgery to correct failed attempts. Allthough a pump is less impairing, you still have a morphine pump in ya, It's not exactly dinner or office converstaion.After 3 attempts and 12 screws, 8 rods, my spine still grinds and rununches and hardware shifts and a pump doesn't mask that pain. %0% tre;ief to oe person may mean they can walk, to another it may mean they can return to work. There is no gaurentee it's going to do what you want and it relly depends on your expectations as to whether you willbe satisfied with it.

It's great the technology is there but not everyone needs the latest greatest gadget when something much more simple may work. Choosing to bypas everything else and simply have a pump put in, over simplifies a very complex issue just because it is available. It's not as simple as choosing to fly first cass across the country instead of driving. If given the choice it's natural to consider, but you have to consider the cons . Do you trust this doc to manage your pump to a reasonable level of satisfaction, have you tried other methods, linterventional procedures, nerve blocks, gotten second surgical opinions to see what's goping on with your fusion. It's not an insult to get another opinion. It's your body and the rest of your life. Why exept one docs opinion that nobody can fix what he can't.

Unles you have tried every cocktail and pain relieving modality, it's like talking about a brain implant to treat depression because the one antidepressant you tried didn't work

.There is probably a lot more a multi facted PM clinic can do for you that this surgeon right now. The pump will always be there if other methods don't work but once it's implanted, other docs will treat you differently. You could break a an arm and the doc will likely assume your pump is handling that pain. It doesn't, that pain is like break through pain and needs something additional for it. I worry about surgery or cancer or how to treat other potentiallly painful problems when I have another 30 years to live out this nightnmare.. Put it on the back burner and let it simmer why you try something less radical would be my advice.

Good luck, Dave