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Pain meds vs stimulator vs pump

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Posted 6/6/2008 1:00 AM (GMT 0)
I need your help.  As I've almost reached the max dosage of the morphine extended, I'm going to need to make a decision in the Fall about where to go from here.

I meet with my Pain doc and his assistant in September to discuss changing my pain relief to: morphine, the spinal cord stimulator or the pain pump. 

Will anyone who has already traveled this road give me their input on his/her experience(s) with the above?

Thanks.

Melanie

Posted 6/6/2008 2:38 AM (GMT 0)
yeah  Hi Melanie,

 

I'm sure to be one of many replies you get so as they say this is one wo-mans opinion. After almost a decade of pain management I too got to that point where I needed to make a decision and I was offered the pump. My brother has one as well and has for years. A lot of people have bad things to say about the pump but to me it is finally paying off. It's taken almost 2 years but yesterday in fact I had an appt. yesterday and for the first time in years I walked out of there with out pain. I am still on my coming down off of my orals but I finally got rid of the patches, Yea!

 

So, for me the pump seems to be working and I actually feel hope for the future. For you it will be different. You will definitly have to learn all you can about all your options and then make an informed decision. Talk to people here, other patients, other drs. as well.

All of the choices have good and bad possibilities and you need to learn alll you can.

 

So good luck Melanie with what ever you choose.         Toritoo

Posted 6/6/2008 7:18 AM (GMT 0)
My pain medicine is no longer working at all well. Every breath is pain.
I worry about getting the pump ... one more ounce of pain in getting used to it? Can I take that?
Pamela Neckpain
Posted 6/7/2008 10:16 AM (GMT 0)
Morning,

my doc has been encouraging me to get the SPS for some time.  I have researched it to no end.  I think in my case (foot and leg pain) it may have less a chance of working than someone with spinal pain as the signal would have to travel further.  I am sure if your doc has spoke to you about the SPS then he/she has spoke to you about the trial.  In my research I have found that it is fairly simple (but not painless) evaluation to see how stimulation works for you.  I think that if I had pain to the extent that you do, I would certainly give it a try.  So many with back and spinal pain has relief thanks to their stimulator.

Good Luck to you.

Su

Posted 6/7/2008 12:22 PM (GMT 0)
If you feel like getting a "first hand" synopsis of a couple of people who have been through the pain, evaluation, a trial stimulator read some of my other threads on this site. By no means make you decision on our experiences but it is at least food for thought.

I wish you much success in whatever you choose. Hope you have a pain free day (or at least tolerable).

lassie
Posted 6/7/2008 12:31 PM (GMT 0)
Indeed, successes we read of on the net are mostly sales driven, however there are many, many, actual people who have received releif from the SCS. Certaintly, if there is a chance that it will work for me, I am more than willing to indure several days of pain from the trial to find out. I, however have only been injured 2 years. I am young and and suffer everyday. I am going to save it, in reserve, for when I get a little older. Just having it hanging there, waiting, a possibility, makes my future look not so dim. That all hope is not lost.

b well

Su
Posted 6/7/2008 4:30 PM (GMT 0)
for me, not yet. but some day.

Good luck to you Mel in whatever you decide.

Su
Posted 6/8/2008 8:26 AM (GMT 0)
I have both an intrathecal pump and a SCS.   The pump was implanted about 3 years ago and the SCS was implanted about 2 years ago.   I trialed both therapies before I underwent surgical implantation.   A   combination of both therapies have given quality back to my life.   I have dramatically reduced my pain level and no longer suffer from the debilitating side effects from oral medications.   I am certainly not pain free, but I am now able to function  and participate in life’s functions without being curled up in debilitating pain.   Even though I still suffer from waves if pain, I would repeat both procedures again in a heat beat.   I am now participating in life.   Something I was unable to do prior to the implantation.
Posted 6/8/2008 7:25 PM (GMT 0)
Stella (or others),
Thanks for posting. I know next to nothing about the implants - pretty much what I've been reading here. It's something that would likely be way down the line for me, if at all, but I don't know the difference between the SCS and an intrathecal pump. Could you explain some details. I wouldn't have thought one could have two different implants, but obviously I'm wrong.

Thanks - and glad you're getting relief!

PaLady
Posted 6/8/2008 8:30 PM (GMT 0)
Thanks, Gramps. I guess I thought the SCS was sort of a combination - like a TENS and also some sort of pump for meds. I don't think I'd ever want to get an SCS implant as my pain is so varied that I can't even accurately target my external electrodes all the time. To have them implanted in one place? Doubt it would work for me. I'll wait for what Toritoo calls "magic beans" (better meds!).

PaLady
Posted 6/8/2008 10:03 PM (GMT 0)
I agree with Gramps 100% about expectations.   I think it is also important to remember that the representatives are paid a large $$ bonus for each device sold.   The SCS (spinal cord stimulator) emits an electrical impulse that basically masks the pain that you are experiencing.   It does not stop pain – it just disrupts the pain feeling.   Some people find the electrical impulse, which I would describe as a tingling sensation, as pleasant.   Others cannot tolerate the feeling.   That is why it is so important to have a trial of the SCS before having the actual device implanted.   The SCS is implanted just under the skin with leads close the the spinal column.   Patients are given a hand held controller that allows adjustment of the impulse.   Mine contains 3 programs that stimulate different areas (feet - lower legs -upper legs, etc.) and I can select impulse intensities from a scale of 1 to 15.   Personally, I cannot tolerate anything higher than 9.   Because I also have an intrathecal pump implanted, I find that the higher impulses from SCS bothers my pump.   It creates an odd feeling that I can not explain, but I find it uncomfortable.  One thing that the sales reps mislead me about  was the frequency that my SCS would have to be recharged.   If I use my stimulator at strong impulses over and extended period of time, I have to recharge every 4 or 5 days.   Recharging involves using an external recharger and placing it directly over the SCS and keeping it in place for a couple of hours. Even though I have the SCS, I still use a great deal of oral pain medications, as well as duragesic patches.   So do not think the SCS will eliminate your use of pain medications.   It is just one more tool you can use to lessen the intensity of certain types of pain.   In no way is an SCS ever going to eliminate all of your pain. Good luck and I will be happy to answer any question your may have about my experience with the SCS.  
Posted 6/9/2008 3:37 AM (GMT 0)

I have the SCS and have been very disappointed in it.  I understand some people do have success with it, however.  If you can control your pain with oral medications, it is my opinion that is a much better option than implanting ANYTHING in your body.  There are numerous pain medications other than morphine that might provide you better relief.  Good luck and God Bless.

Anon

Posted 6/9/2008 6:25 AM (GMT 0)
I reread your initial posting and I am curious why you and your physician feel that you need to choose a pump or an SCS as the next step after morphine is no longer effective.   There is a laundry list of pain medications and combination of medications.   Have you exhausted all of  your oral medication options?   I personally was on Fentanyl patches every 48 hours, Dilaudid, Lyrica and Fentora before I opted to add an SCS to the mix.   Methadone did not work for me.   Plus I already had a pump implanted with Baclofen in it.   I go every 10 days to have my Baclofen dose adjusted so it is not possible for me to mix pain meds with my Baclofen in my pump.   What other meds have you tried other than Morphine and have you considered and second opinion from another Pain Management specialist? Lastly, my life expectancy is another major factor for my choice.  I am not sure I would opt for an SCS if I had a normal life expectancy - but who knows. As I stated before - I am glad I have it.  It does alter pain sensations when all else fails and sometimes that is enough to get you through the night.  Just food for thought! 
Posted 6/9/2008 11:21 PM (GMT 0)
Right now... at this point.... I will take any dang thing they give me....

Posted 6/10/2008 1:12 AM (GMT 0)

Thanks everyone for your input.  I have been on every oral pain med except for oxycontin and methadone.  My doctor no longer prescribes oxy.  I take percocet for breakthrough pain.

I have used the patches but due to my menopausal "tropical moments" I release too much of the medicine into my system every time I have a hot flash.

I am 52 and have had chronic pain for over 10 years now.  I  think I will try the methadone before I go for any implants.  The physician's assistant told me that at my "young age" (52), they don't like to do the pain pump beause it must be reseated every 8-9 years and each time it gets more difficult to do so. 

My tens unit does me no good so I'm not too sold on the spinal cord simulator.

As is everyone else, I'm just demoralized from too much pain and not enough relief.  Out of the past 4 days I spent 3 overdoing it because I felt good.  Now I'm so miserable I could scream,and I can't sleep at night even with the sleeping medicine.  It felt so good to live my life like I used to, but I am really paying for it now.

I'm on a new antidepressant called Pristiq which has given me alot more energy than I used to have.  Having that extra energey allowed me to do more while the breakthrough meds were at work.  WOW am I sorry now.

Thanks again everyone.  I really appreciate your responses!

Melanie

Posted 6/10/2008 3:11 AM (GMT 0)
Gramps,
I have been considering the pain pump. My doctor talks about it alllllll the time. I'm almost afraid to speak of my pain level. I think he's money hungry. He hasn't tried a combination of any medications on me. All I have is Methadone. Yup, I think he's looking for financial reward.
Pamela Neckpain
Chronic Pain for six years
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