The Pain Pump-pros and cons,need advice

Hello Bakerman & welcome to the forum. Glad you found us but sorry you have to be here.

I have a pump implanted. My first pump was put in 2005. The battery finally died January 2013. I literally ran out of pain medication options. I took or tried everything coming down the pike & then ran out. It was either having a pump put in or nothing. Do I regret ever going the pump route, absolutely not. For me it has been my best form of pain mgt.. It gave me the chance to do things that I had not been able to do in a long time.

When my refills are done they are painless. I have been under the care of three different PM drs since having a pump & have not ever been hurt by any of them at refill time. There is only one stick involved. After my first pump was put in my stomach was numb for several months after surgery. I am terrified of needles & shots & this does not bother me in the least. I would rather have my pump refilled versus having an IV put in or blood drawn.

When you first have a pump put in of course you are tender from the actual surgery. You cannot wear tight fitting pants or a belt in the beginning. After having a the pump for a while you will forget its even there. Sleeping is really no different. If you are a side sleeper you will not be able to lay on your side until you are healed from the surgery. It has no effect on sitting. No one can tell by looking at me if I have a pump implanted. Yes you are put out to have a pump implanted, its an out patient surgery.

I am sure there are good reasons these pumps are implanted, mainly to keep a person from messing with it & believe me that is something that would happen too. No the pumps are not left outside the body.

You do have to pass a psych evaluation before doing the trial for a pump. Mainly it is to see if having an implanted device will be a problem for you & to make sure you have reasonable expectations of what the pump can do for you. You are not totally pain free with a pump as once a person becomes a chronic pain patient the days of being pain free are over. Medtronics has a little portable hand held device called a PTM. What this PTM does is if you have a pain spike or break through pain you run this PTM over your pump & it will release a small amount of extra medication from the pump. This is called a bolus. Your dr programs the PTM for how many he thinks you will need per day.

I tell everyone contemplating a pump, your pump will only be as good as the dr managing it. The dr needs to be experienced with pumps & the medications & the dosages that go in them. Don't be afraid to ask your dr how much experience he has with pumps & how many pump patients he has.

Do yourself a favor & go to www.Medtronics.com & read up on pain pumps. They have a very informative web site that is user friendly. You really need to check it out.

I think the reason the pain control is better is because with oral meds you have constant highs & lows & with a continuous drip there is no high or low to a pump.

Ask all the questions you like here & those of us with pumps will try to help you. Take care.

Bakerman, I found both times the recovery from having two pumps implanted to be average. Meaning nothing like the back surgeries you have had done. I was pretty much on my own at home after surgery. My husband has his own health issues. The point being I was able to take care of me. WhiteBeard is another mod here at this forum that had a pump put in a year ago, he lives alone & was able to care for himself too. I think I had a rougher time when I had gallbladder surgery.

They make like a pocket on your stomach to slip the pump in, its small about the size of a hockey puck. The pump is like on your side of your stomach so its out of the way. The incision in your back should be about 2 inches to put the catheter in, very tiny, tiny catheter. The first pump I had put in, the idiot surgeon made a 5 inch incision & every dr that has seen this scar has said, why did he make such a big incision. One dr that saw the scar said "I thought you said you didn't have back surgery". This scar says something different, lol.

I am currently in the process of having this Codman pain pump replaced. Codman's have gone out of business, its a manual pump not computerized & a real pain for the drs to deal with. Either the pump is failing, kinked catheter or a possible mass at the tip of the catheter. If the pump was computerized my PM dr could be able to determine some of the problem. I had my surgery scheduled for 2-10-15, however, 5 days before surgery a cyst on my back reared its head so I have been dealing with getting that thing healed. I did 2 months of daily wound care, its been a very slow process.

I completely understand the grandchildren thing. I have a 10 yr old grandson, only one I have. He was 10 Friday, I spent all of last week planning & running. He is what gets me up & going. I pick him up from school several days a week. I also come over & get him ready for school a couple mornings a week. I could have never done this on oral meds much less drive him around like I do. He is a avid golfer we do golf lessons & tournaments. There is no way I would get in my car & drive if I felt compromised in any way.

You will know when doing the trial for the pump if its working or not. WhiteBeard was on a substantial amount of Oxycontin plus BT meds & like most of us with a pump we need less medication with the pump. Take your time making the decision on doing the trial. Ask questions & ask your dr about his experience with pumps. Like I said, I am terrified of needles & have no problem getting my pump refilled. Take care.

Hi Bakerman and welcome. I also have a pump - though mine is more aimed at controlling my dystonia, so my main pump med is Baclofen, with a moderate dose of morphine.

I'd mostly agree with what Susie has told you. Though her description of the pump as "small" ... I think is definitely a relative term! If you're an average to larger person, the size of the pump is probably no issue - but I find being small (both short and slim) the size is quite an issue for me...the medtronic pumps come in either a 20ml or 40ml reservoir, mine is the 40ml as I'm a "high end user" (mine requires filling every 5 weeks as it is - so with a 20ml pump my fills would be double that frequency) and I have a huge bulge where it sits on my belly that is visible even through loose-ish clothes. The diameter is unfortunately the same whether the pump is 20 or 40ml and this is also a problem for me...I use a wheelchair most of the time and sitting forward means the pump hits me either in the ribs or pelvis - so is important I think to discuss the exact positioning with your dr/surgeon and work out where it will be most comfortable while still allowing easy access.

I do get a small amount of pain with refills - but that is because of the condition I have...usually they shouldn't be painful. My bigger problem is that I always bleed everywhere. My doctor is used to it...but he does sometimes have other doctors sitting in and it tends to freak them out a little ;)

I had a week in hospital with my initial pump surgery - and then 48 hours when I had it replaced - but that was more because of getting the baclofen dose stabilised (and the dangers of overdose or withdrawal with the pump replacement) than the extent of the surgery itself.

Laura

Hi Bakerman and Welcome to Healing Well Chronic Pain Forum. From reading your post I think your life has kind of parallel to my own. I to am divorced after a very long marriage (35 years) and have two daughters and a couple of grandkids. And have had four spinal surgeries, ( three in my neck and one my lumbar spine) Anyway I had been on oral pain meds for well over fifteen years, and a year and a half ago I moved to a state that it is very difficult to find a PM that will prescribe oral pain medications. So I went the Pain Pump route, and for the most part it works very very well! I got mine implanted at the University of Indiana in Indy last June. I go back there every six months to get it refilled. My last refill was last December, and it was a piece of cake, took only about fifteen minutes and I thought it was relatively painless procedure! I will tell you everyone experiences things differently, my pump is noticeable and does bulge out a bit! The one thing I notice most about it, is if I bump into anything (such as the top edge of the back of the couch or recliner) and it bumps in to the pump or the pump area, it will definitely let me know!! To me it hurts like the dickens!! But that is about the only thing bad that I have to say about it. I think allot of it depends on how deeply the surgeon implants the pump and the exact location! As for the catheter leaving the pump and going around into the spine, I have had no problems and don't even know that it is there!

When you get your pump implanted you will need to have a driver with you to drive you home and have somebody close by, to be with you for the rest of that day! It is about the same as any out patient surgery or procedure where they sedate you! One thing to consider, the pain pump will only help relieve the pain that is generated from the local area where the catheter is implanted. I have lots of lower back pain and sciatica pain going down my hip and back of my legs. The pump does a great job at relieving this pain. Pain in my neck and generating from my cervical spine, well the pain pump does nothing for this! So if you have allot of pain coming from multiple areas of your spine, you might want to talk with your doctor about the coverage you will get from having the pain pump. But if your pain is coming from a relatively isolated area of your spine the pump should do fine! The pump will not totally relieve all of your pain all the time, however it can effectively control your pain to a manageable and even a possibly comfortable level!

I am happy that I got mine and wish I would have gotten it years sooner! I also have the PTM that Straydog mentioned, it is a little device about the size of a small cell phone, and it is preprogramed by your doctor. My PTM is set up so I can give myself up to ten bolus's in a twenty four hour period, but they cannot be given any sooner than two hours apart. You just put the device on top of your implanted pain pump and press a couple of buttons on the PTM and it will light up an indicator light and make a beeping sound and show you on the digit screen if it gave you the bolus. ( If it doesn't give you a bolus, it will tell you how long you have to wait before you can try it again!) I know a couple of times, I would try and give my self a bolus, and it would give a low beeping sound and would tell me on the screen that I have two or three minutes yet before I can have another bolus. Also you do not need to put the PTM right on your skin, it can be placed on your clothing, ( shirt, or other clothing as long as it is not to thick, such as a coat or something) and it is place directly on top of the pump.

I think the nice thing about the pump is ( at least for me) since the medication is put directly into the spinal canal, and does not go to any other place, it not only takes allot less medication but I also don't feel any of the side affects of the medication. Some oral pain medications will give your a loopy feeling or make you sleepy or tired? I have not experience any of that with having this pump! It just relieves the pain in the region that it is being generated!

One more thing, I just had a total right knee replacement done this past December, and I had to go back on to oral pain medications to control my knee pain. This pain pump does nothing for the pain of this type of surgery. My PM even wrote a letter to my surgeon letting the surgeon know that this pump I have will not do any thing for pain from this surgery and I would need normal pain treatment for this procedure. ( My PM total me that some doctors mistakenly think that this implanted pain pump will handle just about all types of pain including from surgery, and it will not!) So this is just something to be aware of if you have future surgeries.

Good Luck to YOU and I wish you all the best!

White Beard

Wow Laura, you got down to 60 pounds, good grief. I remember when my first pump was put in I was terrified at my first fill, just a bad thing I have when it comes to needles. My stomach stayed numb for about 6 months after the implant so I never felt a thing. That was something I was real glad of believe me, lol.

Before osteoporosis got the spine I was 5"2". I guess being short has helped keep me from hitting the pump on things, lol.