Questions about pain pumps

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mom9mom
Regular Member


Date Joined Sep 2008
Total Posts : 489
   Posted 2/19/2009 8:39 PM (GMT -7)   
A-lot of you talk about pain pumps this might sound stupid but what are thay and what do thay do.I do not go to a pain management Dr. right now.I know that thay are probably the ones that put them in.I go to my reg. Dr. and a bariatric surgeon and a spine surgeon at this time.I have heard so many of you talk about having such a hard time getting the pain medication that you need to control your pain that I worry about going to a pain management Dr.(My Dr. never gives me a hard time about refilling my fentanyl patch just need to see him every two or three months).I know that I need one but what if he would not give me the medication that I need and because for me the patch works well.I do not want to get on something that doest work for me.With out the patch I am not worth anything and can`t do anything.
Lost half of my small intestineJan.2008.Ilieostomy for 5 months then reverst in June 2008,Nerve damage to right leg,part of my right hip bone removed Jan. 2008,Cronic pain,hernia,infection in my back called discites,and depression.Gallbladder removed Nov,2008.Surgery to fuse L3 and L4 vertabra Dec. 31,2008.Mother to 9 kids 7 boys 2 girls and 1 stepson.4 grandsons,9 grandaughters.4 of my grandkids I inherited from my twin sister who passed away 6 1/2 years ago from a blood clot after surgery.God has given me my life back after I almost lost it.Even though its a painful and sometimes hard road to walk I take it one step at a time and give thanks to god for every step I take.


kttn251977
Veteran Member


Date Joined Jul 2007
Total Posts : 554
   Posted 2/20/2009 6:18 AM (GMT -7)   
mom, I swear by my PM Dr, he is fantastic. Mine is close to my age & actually has chronic back pain himself. (30's) so he really gets it, you know? They have a lot of procedures that they can do regular DR.s can't. I'm sure you have heard of some of us talk about spine blocks, nerve blocks, etc. They are painless, just a little sore the day of the surgery itself, the next day you are up running around. They can go in under a fluoroscope (sp) light & hit the areas of your pain with a mixture of cortisone & pain medication to help numb the areas infected. (you are under for this, but I have even been awake before for it- you can have the option) its not bad at all, kind of like a harder acupuncture. Then of course there is physical therapy, a very important part of your regiment. Don't worry that's nothing insane either.... they just teach you how to keep from harming yourself further. Along with exercises to strenghten your abdomine with very little effort, I had mine teach me pool exercises since there is no weight in water- its easier to exercise that way. So PM is more than just medication, its a combination of trying to manage your pain. I was nervous about going too, I didn't want to but my PCP said he couldn't treat me for my CP, and I would never jeopardize his license for my needing pain meds. And they do prescribe the patch; chances are if you have a med that is working they won't change your meds. But you may need something for muscle spasms or a tens unit- they can get you all those things. Mine also treats me for fibromyalgia & depression. I love my pain DR.s, they are fantastic. Hope this gives you some courage to try one..... and you don't need to go back if you don't want to, they are there to help you learn your disease & the best way possible to manage it. And at some point you are going to become tolerant against your meds & need something higher that your PCP may not be able to help you get. Maybe ask around & see if anyone is in your area... they may be able to point you on to a good PM DR. Good Luck!
RX's: Oxycontin 80mg 2x's daily; Oxycodone 30mg 5xs daily; Zanaflex 4mg 3x's daily; Restoril 15mg 1x; Soma 3x's daily; Lyrica 100mg 3x's daily (pain & fibro.); Phenergan 25mg (as needed); Amitriptyline 25mg 1x (chronic pain); Cymbalta 60mg 2x's daily (pain from fibro); Abilify 5mgs at bedtime (depression); Metoclopram (as needed) & Senokot (as needed).
"The most critical choice you'll ever make is the one you make about what you're going to do with this. The past is over. The future hasn't happened yet. The only time is now."
- Dr. Phil


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13477
   Posted 2/20/2009 2:23 PM (GMT -7)   
Hi Mom,
 
I have a Medtronics Intrathecal Pain Pump. The pump is pretty reserved for people that have exhausted all avenues of pain mgt and are unable to get the relief they need. I have done all kinds of different procedures and some worked for awhile and some didn't. I have a real waqcky system that does not tolerate medication well at all. I am not talking just pain meds either, blood pressure, antibiotics you name it, its a real challenge for drs to care for me because of this. With me we had ran out of options on pain medication working for me that is why I have the pump. There are so many different meds that can be used in a pump and the doseage is lower that is needed because of the way the medication is delivered to the pain receptors.
 
The pump itself is round and very small and its inplanted in a pocket like of skin on the side of your stomach. Then an incision is made in your lower back and a very small catheter is fed around to the pump for connection purposes and then the other end of the catheter is placed at the dura space where the pain receptors are located. Once your pump is filled with medication the drs set the rate of your meds and the medication is delivered to these pain receptors stopping the pain signal to the brain. I never saw the incision in my back but my husband did and he said I had about a 5 inch incision and the incision on my stomach was about the same. Its pretty much like any surgery as far as post op pain and ect. These pumps are not inplanted by a pain mgt dr unless he is also a surgeon. My pain mgt dr was in the operating room, along with the representative from Medtronics and the surgeon who did my surgery. My surgery was done as an out patient, which I am opposed to, I think for this a patient should be kept 24 hours just to make sure the patient is ok because that is alot of cutting no matter how you look at it. I had no problems don't get me wrong but I just think for practical purposes it should be an overnight stay.
 
If your Fentanyl patch is handling your pain then you would not be in need of a pump at this time. Like I said they are really the last resort for people with chronic pain. You are very fortunate in having a PCP that is good enough to handle your pain meds. Thats a real rarity as I am sure you know. If you are happy and content with how things are being handled on your part I really don't see a need for a pain mgt dr. Now, if your dr decided to no longer script your meds then yes you would need to see a pain mgt dr. One thing I will tell you is not all pain mgt drs are created equal either. Its like anything else, there are good ones and there are bad ones. I have been very forunate in having good pain mgt drs. None of them ever put me thru what alot of them get put thru in order to get their medications. My former pain mgt dr had all of his patients sign Contracts that set out what we would and wouldn't do and the same with the dr. Quite frankly, I never had a problem signing a Contract, I knew I wasn't just simply shopping for pain meds, I needed help. He also had a sign posted for they did random UA's as well. In four years of being in his care I did two UA's. Both were done right before he quit pain mgt and I feel those were done to make sure I was still that good pain mgt patient that I always had been,  because he would not want to ref his pump patients to a dr if we had dirty UA's. Let me tell you, I think the random UA's are great for the drs so they can weed out the ones they already suspect are there to get drugs only. Most of these drs in pain mgt have a pretty good gut feeling when it comes to knowing a true pain patient or one after the drugs. You always knew the ones that were in there with dirty UA's because they would be bawling and squalling. My pump nurse was real good at having that feeling for a bad pain patient and she was helpful to the dr and getting them weeded out. His Contract also stated that you were to bring your meds in for a pill count, I never did and I never got asked to bring them in either. On my last appt with him he gave me a hug and told me that he had wished all his patients had been as good as me to take care of. Oh, I cried when he told me he was leaving, I trusted this man and he had helped me.
 
My new pump dr is a retired neurosurgeon and she is totally awesome. She only treats pump patients, she does not believe in a Contract, pill counts or UA's. I have a feeling if she thought for a moment someone was abusing their orals meds she would drop them like a hot potato. She is a very intelligent dr. She knows compounding drugs and does all of her own mixing for the meds for the pumps. She does not buy the pump meds pre-packaged. She too believes that people with pumps still need oral medications for BT pain. not all pump drs believe that, and trust me you really do need the orals from time to time if you get in a pickle. She has increased my meds in the pump by 50% which is alot and she increased my BT meds too. Right now, I feel so good, its still scarey to me cause I am afraid its a dream and I will wake up. lol I was having alot of pain but my former dr would not go up on meds. He was just as she said under educated in pumps and under educated in medication. She has been dealing with pumps for over a decade so she knows her business when it comes to these pumps. I will from time to time need increases but thats normal with any medicine used long term. Sorry this got so long...If you have anymore questions on the pump, please ask and I will try to answer them for you...Susie


mom9mom
Regular Member


Date Joined Sep 2008
Total Posts : 489
   Posted 2/24/2009 9:54 PM (GMT -7)   
Susie Thank you on the reply on the pump.I have a cold and that always makes me very very tired and I hurt a lot more so that is why it has taken me so long to get back to you.
Lost half of my small intestineJan.2008.Ilieostomy for 5 months then reverst in June 2008,Nerve damage to right leg,part of my right hip bone removed Jan. 2008,Cronic pain,hernia,infection in my back called discites,and depression.Gallbladder removed Nov,2008.Surgery to fuse L3 and L4 vertabra Dec. 31,2008.Mother to 9 kids 7 boys 2 girls and 1 stepson.4 grandsons,9 grandaughters.4 of my grandkids I inherited from my twin sister who passed away 6 1/2 years ago from a blood clot after surgery.God has given me my life back after I almost lost it.Even though its a painful and sometimes hard road to walk I take it one step at a time and give thanks to god for every step I take.


Pamela Neckpain
Veteran Member


Date Joined May 2008
Total Posts : 1821
   Posted 2/26/2009 2:55 AM (GMT -7)   
Susie,
Thank you a million times over for your post about pain pumps. I still here trembling
in the wings waiting to step up for my own pain pump.

I have so much pain. So much. You know.

But despite the pain, I fear the pump more. You have GOOD doctors. Mine, Susie,
are borderline. However, my pain doctor continues singing and I practice my song
before appointments.

Spiderman Spiderman
Does whatever a spider can
Spins a web
Any size
Can't you see?
Here come the spider man. <--Strangely, I knew all the lyrics. Can u believe it?

He never gives me a UA. I'd faint at the sight of a contract. He just knows.
You know? We "kinda" trust each other.

Last time I said, "I'm in too much pain. Is there anything you can add that will
help me?
Of course he said, "You're already about at the maximum of Methadone. You can
take 3 a day more. I've already written the script so just make your <monthly>
appointment to come in early." I haven't taken any more. I don't like to be here
on the outer limits.

I have problems. I think #1 problem is I'm in so much pain already that I can't take
any more pain - can't.

I have a personal problem about the pump. Could you e-mail me? You may have
rules against that and it's ok but if you can ...

Gotta go.... I'm in pain.

Pamela
MEDICAL CONDITIONS

Osteoarthritis all levels of spine right down to Coccyx,Spondilytis,Myofascial Pain
Fibromyalgia,Bulging Discs,Spinal Stenosis,Scoliosis,Osteopenia,Chronic Constipation
Carpel Tunel Syndrome, Attention Deficit Disorder,
Depression & Anxiety

Methadone for Pain, Xanax for Anxiety, and more, of course.


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13477
   Posted 2/26/2009 6:21 AM (GMT -7)   
Pam, I am real sick with some sort of bug, I came on for a second, I just had to get up from the bed for a few minutes. There is suppose to be a way to email someone here, we will figure that at when I feel better. I feel so bad for you because you think you are at the end of the line with orals meds. I know you think the pump stinks, but it doesn't. But you are so right, you must have a good dr to handle your pump meds and he must be knowledgable in pumps and in medications. I think you and I need to put a list of questions together to ask him about the pump. Get your answers from him then we can talk about them on how he answers your questions. When my pump was put in I was totally stupid about them. Mine was done real fast like in 5 days because my ins was getting ready to change over to a new company. My dr knew the new company was bad about paying for a pump so we did it fast before my ins changed. But, I still do not regert getting the pump at all. Now that I have this new dr managing my pump life is great if I didn't have this stupid bug. FYI drs do not make a fortune off of pumps, your ins only pays the contracted aamt and thats it. They cannot look to the patient for more money if they have a contract with that ins company. Look at your EOB's where they pay your drs, it tells what they pay and don't pay. Susie


denkat05
New Member


Date Joined Dec 2008
Total Posts : 4
   Posted 2/26/2009 8:04 AM (GMT -7)   
I see you are still giving reply's on the pain pump Straydog. That is great to get the advise we all need about this procedure. I posted some time ago about getting the pump and still have not had the pump put in. I went for the pre-test and everything went fine. Then I went for the pre operation test and the EKG showed up abnormal. I was given a stress test this week and will not know the results of that for another week. If all goes well I will have the pump put in around March 6th or 7th.
Thanks again for your information last month.
Dennis

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13477
   Posted 2/26/2009 8:37 AM (GMT -7)   
Hi Dennis oh, I sure hope its just a blip on your EKG. I throw out more abnormal ones than I ever have nromal for some reason. I have leaking heart valves but those don't cause the EKG's to be goofy. Please let us know about your EKG.

Dennis, I have a new dr on my pump and she is just awesome. I just did not know my life would ever be this good again. It just took getting a dr experienced in pumps and not afraid of the DEA breathing down her neck. She welcomes them any time they come in. She is not in the least intimidated by them and that makes a big difference. I did not realize how badly these drs are in fear of the DEA. She says if they are doing everything right they should not be scared. She went on to tell me they can be very helpful to a pain mgt drs office with very good tips. She just blew me away. I am so fortunate-only right now I have picked up a nasty bug. Let us hear from you. Susie


Pamela Neckpain
Veteran Member


Date Joined May 2008
Total Posts : 1821
   Posted 2/26/2009 3:56 PM (GMT -7)   
Susie ...

I have a bug or something too. Back to you later.
You gotta get well quick. Everyone needs your attention.
Pamela
MEDICAL CONDITIONS

Osteoarthritis all levels of spine right down to Coccyx,Spondilytis,Myofascial Pain
Fibromyalgia,Bulging Discs,Spinal Stenosis,Scoliosis,Osteopenia,Chronic Constipation
Carpel Tunel Syndrome, Attention Deficit Disorder,
Depression & Anxiety

Methadone for Pain, Xanax for Anxiety, and more, of course.

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