Dilaudid in pain pump, Doc says cant go higher?

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New Member

Date Joined Apr 2007
Total Posts : 12
   Posted 8/31/2009 10:49 PM (GMT -6)   
HEllo, its been some time since I have been here, I kinda forgot about it and just dealing with daily pain like everyone here.
Anyhow, I have the medtronic pain pump and last year I got my meds switched from morpine like 9mg a day. to Dilaudid now at 4.2mg a day.
Now I have told my Doc its not working as well, because well its been a year plus adn I know my body is use to it. So my pain levels are up high, 8-9 most days Im back to being in bed at least 18hrs of the day, my family again is suffering becaus of it, cant take care of home kids dogs, just cant do anything.
So I claled last week and said I need to come in iom in pain and I want him tio turn it up. They call back and said the Doc wont see me until my appointment, in 42 days, refill time. Last time I was there he also wouldnt turn it up and just gave me a Bolis dose, real quickl like .41mg in 30 sec. Had a good night sleep that night. But told he told me then I was again at high levels of meds adn he really couldnt turn it up much more.
So to all you out there does 4.2mg of Dilaudid in a 24 hour time period seem like alot in a pain pump?
Im so tired of this, I went through this on my morphine prior to changiong to Dilaudid and thought the Dilaudid wouldnt be like that. So am I at a high dose or is he full of it?
Im at the point where my pump is due to be changed out for a new one sometime in the next year, Im wondering if i should jut do away with it all and go back to patches and pills, not my first choice but seems like i had more freedom with them and sure was able to get what I needed for pain.
I just dont know? Is anyone using anything stronger or is there anything stronger? Any other drug that could be used in pump also with my Dilaudid that would help?
Im getting very frustrated and very down again about my life long struggle in pain again! 27 years of hell tends to wear you down!
Well its nice to be back with you all, the support here is great, we are the only ones that truly understand Pain and the hell it can unleash on ones life!
Thank you guys and gals!

Regular Member

Date Joined Feb 2009
Total Posts : 487
   Posted 8/31/2009 11:23 PM (GMT -6)   
Hi Wakeupdead:

I don't know what your concentration is, but I my concentration is 20 mg per ML, and I get 18 mg of dilaudid per day, and 13.5 of bupbivicaine (a local anesthetic). I am currently facing the same exact problem as I have not had any kind of increase in 3 years in my pump or oral meds. My doc keeps telling me that I am maxed out. I have been looking into the possibility of changing pain management doc's, which kills me because at one time this doc was fantastic. Something changed in him a couple of years ago, and he just wants to leave everything "status quo" regardless of the fact that my pain is at a 9/10 every day, and I often get hospitalized because it gets so bad.

It is not easy to change doc's because a lot of them will not take on patients who already have pumps from other doc's, I'm not sure why, but I have been told this several times.

The nurses that come to my home to fill my pump have told me that they have patients on as much as 40 mg per day, and there are a lot of different meds that they can put in the pump along with or instead of the dilaudid.

Hopefully Straydog (Susie) will see your post, she is extremely knowledgeable about pumps and will probably have some good advice for you.

Keep us updated, and I will do the same.


New Member

Date Joined Apr 2007
Total Posts : 12
   Posted 9/1/2009 1:26 AM (GMT -6)   
25MG/ML .175mg/hr 4.2mg/Day

no Oral meds at all, he wont let me have anything like that. he also wont add other meds in the pump and I too have been looking at other docs to see, but only two more near me, and when I say near me I mean with-in 2hr drive.

I have talked with medtronic and they could care less they just say its up to the doctors and they wont say what limits there are. 40mg wow, if i only could have 5-6mg I would be fine! so At least I know you can get higher if your on 18mg. dam i dont even want half that.

I truly believe these docs are scared of the DEA, they are afraid to draw attention and the DEA can be real hard on them if they do come down on them. The DEA should go to medical school first before they tell doctors what they can and cant do. And doctors should be standing up for our rights but they dont.

Anyhow thanks for the relpy, I feel like I have some ammo next visit, just knowing Im at such a low level and he is acting like Im at 40mg is stupid.

I truly want this out of me if this is it, I cant live this way, I got it thinking I would feel better but 5 years ago I felt better than this. I may just tell him turn it up or take it out! I have a family doctor willing to take care of my needs if he truns on me so I dont care! Already talked with him and he has no problems getting me scrips.

Other than that, I could just move to a compassionate state like CA, OR, or CO and get the medicine that 5 doctors have said would help me deal better with my nerve pain and I wouldnt need as much of the heavy drugs like Dilaudid, at least I wouldnt need it turned higher. But my state has no laws for that so Im stuck right now!

Anyhow thank you very much, Ill await more replys, and Straydog too, since you think she would know more!

 8 Back surgeries: 1996 to present!
3 Disks removed, Spinal fusion, Screws, and Rods.
Cronic Pain, Numb feet, Muscle spasms, Leg cramps, Nerve dammage and Major Back Pain.
 Medtronic Pain Pump implanted: Feb.05!
 SSI Disability file dates: Nov.2001 and Dec.2004! SSI disability Judgment Date: 4/11/07 Won! 

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