Chronic Pain

Thanks,Bob I really liked reading on what to expect on the trial pump.My surgery date is the 30th.I'm anxious to get it.But my Dr. told me it was a new Phizer pump.Does anyone have one?I can't find any information.Thanks So Much Debbie

To Mike Harsch,
My story is almost exactly the same as yours.Canyou tell me what you did to get your testosterone level back to normal? The doctors put me on androgel but that killed off all the live sperm. I need to take a nap everyday. A few times I had problems and went through withdrawals that I wish I was dead. My trial went great but never got any relief once the pump was implanted. I am slowly turning the pump down to avoid withdrawals, first they started me off with fentanyl, then they tried morephine and now dilaudid. They had me up to 2.0m/l per day. Iam now down to 1.4 m/l per day. Any help you can give me will be greatly appreciated... Thanks, Tommy

If anyone can help me besides Mike I'd appreciate that, I forgot to mention I also gained 110 lbs since the pump was installed ,all with no relief. But my main problem besides pain is the low testostorone.
Thanks,
Tommy 3737

[QUOTE]Originally posted by Bob Engelbardt:
Hi Tommy,

Sorry that you are not getting any pain relief from your pump but I was interested in your comments about weight gain and low testosterone. Although my pump does provide relief for my lower back pain after being implanted for over a year, I have noticed some recent weight gain. I'm normally a thin person.

Also, I've suddenly developed chronic fatigue and had my testosterone level checked. Surprisingly to me, it was very much below the normal range. I'm now using testosterone patches (at $400 for a 30-day supply unless you have insurance) and am hoping for relief from the fatigue and some mild depression. I've only been using them for about a week and the doctor indicated that it may take some time before I notice any difference in the symptoms.

I was wondering what is causing the fatigue and your post may help indicate one possible reason. My regular doctor is not a pain management specialist so he will not comment on whether the pump and morphine is causing the testosterone problem but he is treating me for the low reading. Next time I visit my pain doctor for a pump refill, I will ask him about this.

Thanks for your post. It is most helpful for me. Keep us informed of how your situation is progressing.

Bob

Thanks for your reply Bob.
My pain management doctor doesn't believe my extreme weight gain, low testosterone, and fatigue are related to the pump. But it's too much of a coincidence that this all occurred
only after the pump was implanted.
And it's interesting to me that others are experiencing similar side effects.

I was using Androgel as I noted before, also very expensive, but discontinued it due to complete loss of all body hair, except for my head, (Thank god for small favors!) and the fact that it killed off all my live sperm.
I'm 40 and trying to start a family so it's pretty important to me and very frustrating.
I wonder if the testosterone patches that you're using might work for me without the crappy side effects. Please let me know the name so I can ask my Endocrinologist.

Thank you all for this site, it's a comfort to know this is not all in my head as some doctors would have me think. Keep in touch.

Hi Tommy3737,

I'm using Androderm which sounds similar to Androgel that you were taking. They are expensive patches that are applied to the skin every 24 hours. At age 76, I don't have the same concerns regarding the side effects as you have experienced. The lab tests showed that my testosterone level was very much below the normal range and he thought that this may be the cause of my chronic fatigue. So far, I notice no difference but it may take several weeks or a month before they become effective. Without my drug plan, they would cost $400/month but I only had to pay $38.00 until the coverage runs out.

I think it's strange that I was on the pump for so long before the testosterone problem started so I'm not convinced it's the pump but I'll ask my pain doctor in the next two weeks when I'm due for a refill.

My trial went very well and I,m now scheduled
for the implant on Sept. 20. My injury is in the C-6 C-7 area. Im wondering if anyone else
here has the tube placed this high. I'm also
wondering how long the pump lasts on the average. Thanks, James

Hi James:

I have not heard of placing the catheter that high but that doesn't mean it won't work for you. Normally, the catheter is routed to the thoracic T10-11 area which is about the middle of the spinal cord area. The medication flows up and down between the brain stem and the lowest part of the spinal cord.

Because of three catheter slippages, mine was raised to the T6-7 level to provide more support. I'm not a physician but I can't see any reason why raising it up further to the cervical area would cause any problems. It may result in the medication being more concentrated in the joint that's causing the chronic pain.

As for the pump's longevity, the battery lasts for about six years and the medication is drained and renewed every three or six months depending on the volume of usage. Replacing the medication is completely painless and takes only a few minutes.

Be prepared for a number of follow-up visits to your pain management physician for adjustments to the pump if the initial setting does not sufficiently control the pain. Remember that you may never be completely pain-free but you should experience considerable chronic pain relief once the pump is optimally adjusted.

Keep us informed of your progress.

Aloha,
Bob

I just stumbled across the forum. I am a 68 year old male with failed back syndrome (since 1975). after 7 major lumbar surgeries/fusions/rods, etc., I have lived a fairly normal life. My last surgery was early 1988. I took the usual mind-numbing pills for many years. I could not do any physical work, so spent 8 years acquiring a PhD and taught for about ten years. In 1994 I was approved for a trial morphine pump.
Since that trial, I have had three installed. The first two were Medtronics battery powered, both failed, that last one coming through the skin while we were in Thailand. Both had battery failure, putting me into withdrawal. If you have not experienced it, I DO NOT recommend it (withdrawal, that is).
Currently I have an Arrow pump, freon powered. The diaphragm separates the medication and the freon. No batteries. Wonderful. I went through a period with severe nerve pain in my left leg. Could not even go to the mail box if it was windy, the pain was like my skin had been burned off. After much research, I found a female doctor in Britain who wrote a paper on pumps.. She explained that too much morphine could cause this. I took it to my pain management specialist, who thought we were both nuts. After I insisted that we try turning it down, he did, in about half. The nerve pain subsided over the next 24 hours...after I had been butchered by surgeons at Shands in Gainesville, Florida. A simple dosage adjustment stopped the nerve pain.
Since then, the arrow was installed and I have been problem free for about 6 years now. I am back at work five or six days a week. Too many years of "bed rest" have taught me one thing, no retirement. I will quit when I die.

Oh, Testosterone? I have the problems that go along with it, but my quality of life is great.

I am experiencing a lot of pain in my left leg, but I had pain in my left leg before. The pain has not subsided in my leg, but my back is better. Did you get this freon pump in Thailand or here in the states? Also can you give me more information on the name of the Doctor in Great Britain? thanks for your help

quote:

Both had battery failure, putting me into withdrawal. If you have not experienced it, I DO NOT recommend it (withdrawal, that is).

Having had several failures (caused by catheter problems, not the pump) I fully agree with you! Withdrawal is most unpleasant. I suggest that anyone on the pump should have a small supply of immediate release oral morphine on hand to take as soon as the withdrawal symptoms appear. My pain doctor agreed with this. 15 mg. should be strong enough and you can always take more if needed. It's also good to have some over-the-counter anti-nausea medicine around.

Can anyone advise me if there is another medication besides morphine that can be used in a Medtronic pump? I am wondering if another med might give me more relief from pain. I still have a great deal of pain, and my pump is now up to 7.980 mg/day at a 12.5 concentration. I will have a refill every 28 days at this rate. Appreciate the input.

Hi Mike,

There are other analgesic medications that can be used in the Medtronic pump. Besides differences in pain control effectiveness for different patients, there's the matter of drug stability. Morphine sulfate and Lioresal intrathecal (also known as Baclofen) remain stable for 180 days. Floxuridine (FUDR) and Methotrexate will last for only 56 days before they must be replaced so the frequency of visiting the physician for draining and refilling must be taken into account.

Ask your pain physician for his or her opinion and experience with these various drugs.

Bob

Bob, is it possible that one of the other medications you listed might react better with my pain, or will all of them probably provide the same results? thanks in advance for your help.

Hi Mike,

Sorry but I'm not qualified to answer your question. Your pain specialist should be able to respond from experience or knowledge.

Bob