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Posted By : mallardmark - 3/27/2017 7:38 PM
hello everyone. hope you all are doing as well as can be these days.. i haven't been on
in quite awhile so i thought i would stop by and say hello.
i also have a question and am hopeful i might find an answer.
not sure if anyone recalls but back in 2013ish, i had a medtronic pain pump inplanted
after around 8-9 years of chronic back pain.
since nov. of 2004 i injured my lower back at work and after countless mri's and ct's,
many sessions of physical therapy i had my first of four back surgeries.
aug. and oct 2005 two laminectomies respectively and 2007 and 2010 two fusions.
all of these were L-4/L-5-S1. well things were good for a couple years and then the pain
just kept getting worse and worse until i was recommended to see a pain management
specialist and the fact that i was a good candidate for the pain pump. ok i was game to try
it out so after a series of tests and talking to a psychiatrist about the mental part of having
a foreign object implanted in me. well i passed all the testing and was set for the operation. t
that went well and after about a month or so got the pump set at a great level. no pain and things were going
good for quite awhile. pain started slowly creepying back so i was put back on some oral meds again.
now i have morphine in the pump and i also take 30mg er morphine x's 2 daily plus percocet
10/325 x's 1daily so back to doing good without the pain.

now for the bad news, found out not long ago that my pain docs. will no longer accept my insurance
(medicare/medicaide) and i will have to pay 100% on the pump medicine. well cant afford that and my last appt. is this coming thursday. i called my surgeon today and made an appt. to see about having the
pump removed.
i'm sorry this is so long but i'm wondering if when the pump med runs out will i start having
withdrawals or would the oral meds help prevent that?? i'm alittle scared about not knowing
what lies in my near future and maybe somebody might be able to shed some light.

again sorry so long and look forward to hearing from ya. thank you in advance for any info.

mark.... smhair

Posted By : straydog - 3/28/2017 5:46 AM
Mark, why did your dr not refer you to a dr that accepts Medicare? I am not understanding that. How long ago did he tell you he was going to stop taking Medicare? You can go on Medtronics website as they use to have a list of drs that took care of pumps.

Yes, I would expect you to go through withdrawals, the Morphine in your pump is much stronger than oral. You might ask the dr for a script of Clonodine patches. Has the dr been weaning your dosage down in your pump, if so this may help the withdrawals.

Sorry to read you are in this situation.
Susie
Moderator in Chronic Pain & Psoriasis Forums

Posted By : mallardmark - 3/28/2017 6:23 AM
good morning susie. thank you for responding. my wife also sees the same dr. for some pain issues and she has already had her last appt. about a week ago. my last appt. with oral meds is this thursday and about a week later i go in to have the pump refilled for the last time. we both received a letter from the clinic about what was going on, i just haven't been in since then being that my appts. were already made. every 3 months for the pain meds and around a month and a half or so for the pump. oh and yoou can bet your bottom dollar i will be talking when i go in.
well lets just add a little fuel to the fire. since i've been back here at the forum i've had troubles with my right foot to the point of having a fusion done last oct.2016 (failed) and a second one in febuary. 3 months of non-weight bearing on it so 2 months to go. that,knock on wood hasn't been giving me too much trouble so i'm thankful for that. it's just that it's always one thing or another. i'm sure we all know that story all too well. thanks for the medtronics website, i will look at that today. hope you have a great day and talk to ya soon...smile..mark
mark.

disabled since 2008. (4) back surgeries 2 laminectomies (2) fusions, 1 failed.
neuropathy. and a few other things.
basil cell melanoma, treated with surgery.
pain pump surgery-11-26-2013
pain meds, -morphine 60mgs every 12 hours..oxycodone 30mgs every 6 hrs.
flexeril 15mgs x (3) motrin 800mgs as needed/ nuerontin 2400mgs daily

Posted By : straydog - 3/28/2017 9:33 AM
Mark, your pump dr knows it is very difficult for a patient to find a new pump dr. The only thing that helps you in this situation is him no longer accepting your insurance. I do not understand why he did not refer you to another dr that accepts it, that is not right for him to leave you hanging like this. I have had to switch pain mgt drs before & my drs always had a new one for me to go to that handled pumps.

Did your dr let you use your PTM to give yourself a bolus for break through pain? That device came with your unit. The dr programs it so that you are allowed so many bolus per day.

If you plan to keep your pump & find another dr to handle it, take fair warning, a new dr is likely not to allow you to take oral meds & have the pump at the same time. Mark, not sure if you have kept up with all the changes & recommendations on oral meds or not, but it is really restrictive now.

Do you know what the dosage of Morphine is in your pump? I am talking the concentration dosage & how much do you get in 24 hours?
Susie
Moderator in Chronic Pain & Psoriasis Forums

Posted By : mallardmark - 4/8/2017 10:54 AM
hi susie. thanks for getting back with me. sorry i didn't get back til now. been helping kelly out some(she is really being bothered with her back and shoulder pain also) had my appt. last thursday for a refill on my pain.
was talking to the nurse while i was there. turns out i need to see the pain doc. and not the pa's about wining
off the pump. imade an appt. with my surgeon but cancelled that because at this time there is nothing he could do now so it would have been a waste of both our times really. i have enough meds in the pump to last til june 28th so that should be enough time to weing off the pump (would ya think??) and also to see how my back would do with lower doses. so this could be beneficial. ya know give me the idea if i would still need the pump or if i could have it removed. idea ...

on another note when i was at the docs (pain) cheri is the pa and i talked to her about my pump and how it really worked for me. she mentioned to me about me of a patient who is thinking about getting the pain pump for his back troubles (pretty much the same i had/have) and if i would mind talking to him about the pump.
so i said i would and thought i might mention healingwell to him. would that be ok?

well i guess that's about all for ow. hope all is going good for ya today. talk to ya soon

mark

Posted By : straydog - 4/8/2017 11:05 AM
Mark, if I remember correctly this was to be your final pump refill with your dr. If this is true, then you need to see the PM dr now so he can slow your pump rate down. Weaning a dose on a pump is not a fast process at all. I am confused about your situation. Also, did you ask about them referring you to a PM dr that will accept your Medicare? I suppose my biggest concern is you running out in the pump & then not having a dr to take over the care.

Of course you can give out HW's name to anyone, no problem at all.
Susie
Moderator in Chronic Pain & Psoriasis Forums

Posted By : mallardmark - 4/8/2017 1:50 PM
HI susie. ok i got the low down with my wife. she goes there also. i misunderstood what she said about the clinic. seems that they(clinic) doesn't accept medicaid anymore. kelly only has medicaid so her last appt.
has come and gone.
i have medicaid/medicare so i would still have insurance thru medicare, just not medicaid to back up whatever medicare doesn't cover. for that procedure (refill) would cost me $100.(each) i know it's only $100 but might just as well be $1000.

i'm sorry i didn't have the right info. as far as the weing off the pump medicine(morphine) i can go in on mondays without an appt. and he(the head doc.) can reduce the amount the the current dose is.

if i read the pump info sheet i get at the appt. right, it looks like 16.0 mg/mL then it reads 5.998 mg/mL day.

i wish i understood these numbers on this print out sheet i have.
oh, one other thing, kelly had made an appt. with a new pain doc. it's the meet and greet first appt. type of visit. yes we need to work on our communication...LOL eyes

Posted By : straydog - 4/11/2017 8:11 AM
Mark, here is something I want you throw out to you. I understand your financial situation with you having to pay $100 at each refill every 2-3 months. However, if you switch to oral meds eventually, depending on the medication, the cost factor can end being more monthly than what is would cost to refill your pump. Even with script coverage of some type medications have gone up quite a bit since you were on orals.

The next problem is the new guidelines for treatment of chronic pain. It is very restrictive & Medicare has a limit on what a dr can prescribe per month. The CDC & other entities involved is tightening the noose constantly. Switching to oral medications could end up costing you more a month & you will be restricted with the dosages per month. You have been on narcotics a long time, same with me. People that have been on them as long as us tend to burn through the dosages with oral medication.

This is something you need to consider.
Susie
Moderator in Chronic Pain & Psoriasis Forums

Posted By : mallardmark - 6/16/2017 6:58 PM
Hi Susie, well did See a new pain mang. Doc a week ago. It did say that he would be fine to see me about my pump. I did mention to him about wanting to wean off the disease and see I how I do as far as pain goes. Plus posibily getting off meds altogether. narcotics that is. I kinda feel overwhelmed about this but maybe I'm just more afraid of withdrawal symptoms. I understand their most unpleasant.

Posted By : straydog - 6/17/2017 6:17 AM
Mark, glad that you found another pain mgt dr. The dr will have to do a very slow wean with your pump or at least should. There is a chance of withdrawals taking place that cannot be avoided. The main thing is a slow taper. Once again, you will find being on oral medication even for a short while is very restrictive now it is nothing like what it use to be at all, you need to remember this. I would not have the pump removed until I knew for certain that I was going to be ok. My thoughts would be let the dr wean down the pump & then see how you are doing after that. I am assuming that you are doing much better & no longer feel the need for pain meds. Kudos to you for getting better.

As far as the ankle goes you need to be asking the surgeon questions about it. If he is not listening then get a second opinion.
Susie
Moderator in Chronic Pain & Psoriasis Forums

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