Chronic Pain

quote:

Originally posted by Bob Engelbardt:
I'd be interested in knowing if other pain clinics also require clearance from a psychologist before patients are approved for the implant.

Hi Bob,

I did not need to see a psychologist before my implant. In fact it seemed almost too easy compared to what I have been reading here. I was going to a pain management team for about 2 years and when they felt they could no longer help they sent me to my current Dr. My husband and I met with him for about 20 minutes before he agreed to do the surgery.

quote:

Originally posted by CJS:

quote:

Originally posted by Bob Engelbardt:
I'd be interested in knowing if other pain clinics also require clearance from a psychologist before patients are approved for the implant.

Hi Bob,

I did not need to see a psychologist before my implant. In fact it seemed almost too easy compared to what I have been reading here. I was going to a pain management team for about 2 years and when they felt they could no longer help they sent me to my current Dr. My husband and I met with him for about 20 minutes before he agreed to do the surgery.

Hi CJS,

I guess that decision is up to the pain clinic or physician. My pain clinic has a full-time psychologist on the staff. I assume, however, that your physician will perform the trial before doing the actual implant. This is a critical part of the process and should not be skipped.

Bob

Hi Bob,

I had my pump implanted 6/20, but please see my posting prior to the one you responded to. Thanks

I'm not a physician but I'm surprised that your withdrawal symptoms are lasting so long and resulting just from an assumably small change in the pump setting. I've had several withdrawals resulting from catheter failures which completely prevented me from getting any morphine at all but none lasted as long as four days.

Other problems like the flu can mimic withdrawal which often involves nausea and general misery. In any case, I know what you are feeling and it's indeed most unpleasant.

What surprises me is that a small adjustment in the pump programming would result in withdrawal symptoms of any kind. I hope that they didn't accidentally shut down the pump. Have you reported your problem to the pain doctor and what were his or her comments?

If the pump is working OK and you are just sensitive to small changes in the morphine dosage, I suggest that you ask your doctor to prescribe some immediate release morphine tablets, 10 or 15 Mg. in strength which you can take as soon as you notice withdrawal symptoms. I discussed this with my doctor and he agreed.

Also, have some over-the-counter anti-nausea syrup handy to control the nausea. The stuff is very effective. Once the pump is working properly again, you can wean yourself off the oral morphine and let the pump take over again.

I'm still very surprised that a pump reprogramming should cause withdrawal. Generally, pump adjustments are made in accordance with the patient's reported pain level. Reaching the optimum morphine amount may take some time and several adjustments. Also, most pain physicians will prescribe "breakthrough" narcotics such as Vicodin or Norco to handle any major pain flareup episodes.

Please keep us informed of your progress.

Bob

Bob,

As always I enjoy reading your input to others, as it helps me as well. I am experiencing a lot of nausea and wondered if you could let me know the name of over-the-counter syrup that you are using. I use a prescription but it is a little pricey. Thanks again for your input.

Bob,
The top of my pump lines up with my navel, which leaves 3ins. between the pump and my lowest rib. Originally I said the pump over-lapped my hip bone, I meant pelvic bone.
I'm two weeks off of the oxycontin and taking one (if any) percocet, I'm not sure if I'm still having withdrawal, or if something else is wrong, but I feel (pardon me) like shit! I continue to have a lot of nausea, spells of diarrhea, hot flashes, sweats, and occasional feelings of breathing difficulty. It's as if someone is sitting on my chest (I wish![er, rather] I wish I even wished for that sort of thing again). Also, urinating generally makes me wish I were being paid by the hour. My current dose per day is;
DOSE PER DAY
BUPIVACAINE 13.717 mg/day
MORPHINE SO4 0.34293

I still have more pain than I hoped I'd have, however I don't know how my dosage compares to the norm. I'm well informed on the personal variences in pain, and control. I'm looking for input because my "OUCH-QUACK" is useless. He will not listen to anything I ask him, or try to tell him about, (ei. this site for the benefit of his other patients) he blew a gasket as though I was telling him how HE should learn. I'm looking for a Dr. who cares and will take me, but until then......
I've come to realize that I'm also his first implant. I'm so grateful to you Bob, and all sharing on this site.
James in St. Louis

Hi, I'm so sorry I didn't answer your post sooner I didn't know how because I'm so new on this bord. I am even more sorry you hand to have your taken out. I had surgery for the final pump day before yesterday. I hate to sit here and tell you I'm in heaven because it has been 20 years since I have'nt been pain free and because the pump is working sooo good except for the surgery pain. I wish I could wave a majic wand and relieve everyones pain who post here. Let me know how you are going. OK?
TeresaT

quote:

Originally posted by CJS:
Hi Teresa, I had the pump impanted basically to get rid of the low back pain but I also have severe chronic pain in my neck and arms. My doctor added Ketomine (sp) to the morphine in the pump and it seemed to work great but then I developed a reaction to the morphine so they had to remove all the medication and try something new. We have not returned to where he feels confident to add the Ketomine back in yet. Maybe it is just the morphine that does not work on other pains and not the pump. Just a thought.
cjs

Hi Bob,
yes I got the green light to and I am so happy to tell you I had the final surgery on 10/17 07!!! My goodness it is a mircial that it is taken 90% of my pain away! The surgery pain is the only thing that hurts and I'm getting better everyday with that. I never believed there was a treatment out there that could do this for me but I was so wrong. After 20 years of pain and trying everything from Hollistic Medicine to Facet injections to every drug known to man to relive pain I'm finally FREEE! I could kiss my doctors feet I'm so happy! My little girl came up to me and said" Mommy you look diferent and you seem happier did God finally answer our prayers?" I've been through so many different doctors and things they have tried on me my husband and didn't tell her about this implant untill we knew it worksd. My family and myself have a new life to start now, I'm still so suprized that it's working so well I can't believe it. Thank you so much for all your wondeful input you put to this this board and the people who suffer so much.
Sincerely, Teresa

quote:

Originally posted by Bob Engelbardt:
Hi Teresa,

In my other posts, I forgot to mention that I did have to see a psychologist who was resident in the same clinic before I was approved as a candidate for the pump implant. After a few questions, he gave me the green light so I then asked him what what is the criteria he uses to classify a person as ineligible for the pump from a psychological standpoint. He said many patients come to the clinic with serious emotional problems and who believe the pump will cure them of all their ailments. I'm sure some drug addicts are included in that group.

I'd be interested in knowing if other pain clinics also require clearance from a psychologist before patients are approved for the implant.

Hi,
Sorry it took so long to answer your post. I just got my pump put in yesterday and my back pain is 90% pain free! The surgery pain will go away in time. I asked my doctor if the pump would relieve your pain and he said " All the nerves come out of the spine and filter out so I don't see why it wouldn't help the man with the the pancreititis". I also have many serious problems with pain in other parts of my body (broken left tiba & fibula that wouldn't heal for over 20 months) failed rotaror cuff repair, 1 month after that surgery a unknown fungus settled in and ate away most of my shoulder befor they could kill it. The doc said when he re-opened my shoulder a bunch of cottage cheese material came out, yuck!I now have a shoulder that has a huge hole in it. What makes me mad is they didn't name the fungus after me...like Teresa al Fungi. LOL! I coukd go on but I won't bore you with any more of my ailments. The other doctors said they could do nothing to help me except more drugs. Today for the first time in 20 years I can say I'm 90% pain free! Except the surgery pain which will go away in a very short time. They put in the pump 2 days ago!!! A week ago I could not sit at this computer for more than 20 minutes without getting a 8 to 9 pain level. I can't sit here and tell you it will do the same for you as it might do you but I pray it does cause I'm in HOG HEAVEN!
Teresa

quote:

Originally posted by jason:
Hi all,
I suffer from chronic pain due to chronic pancreitis and lower back pain l4-l5 as well as neck pain from bone spurs in neck. I have been treated with 90 60 mg morphine and 240 8mg dilaudid pills for the last several years. I have developed a tolerance to them and have to go into the ER when I get a bad bout of pancreitits as I can't keep my medications down. I have been speaking to my doctor about the pump with the buttons to allow an extra dose as needed, my main question is will this strictly help my back & leg pain(walking with cane) or will this potentially help with my pancreititis pain as well. Obviously I am a bit hesitant to getting something like this implanted but I am at the point where my quality of life has gone down the tubes and this is the next move my physician suggests. I was just wondering how this would work, I have read some posts, it seems a trial is done in the hospital first correct? and then an appropriate medication is decided (I have always gotten IV dilaudid in the hospital). With the control to get an extra dose injected as needed would I still need oral medication to help with breakthrough pain and the adjustment period.
Any help with this would be greatly appreciated, it seems like a fantastic group of people on this board and I hope to hear back from some or all of you soon
thanks
Jason
N. California

quote:

Originally posted by Mike:
Bob,

As always I enjoy reading your input to others, as it helps me as well. I am experiencing a lot of nausea and wondered if you could let me know the name of over-the-counter syrup that you are using. I use a prescription but it is a little pricey. Thanks again for your input.

Hi Mike, the name of the over the counter medication for nausea is Emetrol. It is a 4 oz bottle and costs between $5 and $7. I also found that drinking alot of water or Ginger Ale really helped.

quote:

Originally posted by Bob Engelbardt:
......

I'm still very surprised that a pump reprogramming should cause withdrawal. Generally, pump adjustments are made in accordance with the patient's reported pain level. Reaching the optimum morphine amount may take some time and several adjustments. Also, most pain physicians will prescribe "breakthrough" narcotics such as Vicodin or Norco to handle any major pain flareup episodes.

Please keep us informed of your progress.

Bob

Hi Bob,

Sorry I lead you wrong. I had to have the Morphine removed from my pump due to a reaction. I was brought down to a level that the Dr. did not think would affect me before the removal but it did affect me. The effects started in the evening and continued to get worse. During that time I was so out of it that I forgot to take my oral oxycodone. So I think I was having withdrawal of both. I am pleased to say that the new medication is working wonders and I am up and walking and I feel better than I have in years. For the record, he switched me to Fentenol, bupivicaine and Ketamine. Now lets just keep our fingers crossed that my body won't have a reaction to this.

I'm so glad to hear that you are getting along well now even though you had to withstand the unpleasant withdrawal symptoms to get where you are.

Fortunately, the pump can handle several types of medications for those who don't respond well to morphine which is the most common one used. Sometimes, you have to switch around until the best one is found.

Life should be a lot sweeter for you now.

Aloha,
Bob

While there are probably a number of brand names for anti-nausea medicine, most of the larger drug chains have their own brands, generally at much lower prices. They are generally labeled "Anti-Nausea" liquid or something similar.

The ingredients are cheap and fairly common so there's no need to use an expensive brand. They all contain glucose and fructose (don't use it if you're a diabetic) and phosphoric acid. The stuff is very sweet and can be taken every 15 minutes up to one hour at two tablespoons per dose until the nausea subsides. I have found it to work well almost every time if it's taken early on before you are actively vomiting.

Bob,
I'm a cancer patient with bone mets in my spine and sacral area which are starting to cause significant pain.
I'm considering having an intrathecal implant. Is Medtronic the only outfit which produces such a device, or are there others (which are less expensive!)?

Hello everyone,

I'm new to this site but I was wondering if someone could tell me how long your recovery time was after the implant surger?

I've had several failed surgeries on my L3-L4, L4-L5 and L5-S1 disc. No surgeons wanted to do a fusiion because it would have to be a double spinal fusion. And because I had 2 different surgeons in the same office do my surgery, no one really give me the time of day. I'm a liitle worried about doing the final implant surgery (scheduled for this Friday, Nov. 9th) because I'm still young. I'm 32 yrs. old with 3 little kids and I can't keep living my life the way it is now because it's not a life.

I currently take 180 mg. of MS Contin daily and 4-5 Percocets a day. So I guess I'm a litte afraid of how strong my meds will be with the implant and how high they can go on the meds. Will I wake up one day with the highest possible and have to feel the pain again because they can't go any higher on the meds. I just did the trial and it was so different waking up without the pain.

I have just been diagnosed with Rheumatoid Arthritis so do you think the implant will take care of my knee, wrist and feet pain. Does anyone else have any of the burning feet pain on the bottom no matter what you do? I could take what ever advice anyone has for me. I want to get my life back so I can be a parent again. Thank you.