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Chronic Pain
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Paige, I second CJS's comment. I have a pump in now, and drive, and you will NOT lose your license! As far as I know, I was never 'reported' to DMV (secretary of state, or whatever they call it wherever you are!). As CJS said, you get a very, very small fraction of pain med - from 1/100 to 1/300th of the dose orally, and it's intrathecal, so it doesn't go into the brain as easily as the systemic (oral) pain med. I LOVE my pump. Yes, the swelling made me look pregnant (of course, I don't have any parts left, anymore <G>  but at least I'm now equal - I'm gaining weight from prednisone use <G>, and had to go out and buy bigger waisted pants anyways LOL! Now, if I could stay out of the hospital long enough (pneumonia 4 times since September, twice in both lungs, plus colitis), I could get my pump tweaked on a weekly basis :/ I'm up to 4.5 mg morphine right now, and the pain control isn't still to my complete liking, but it's MUCH better than it was pre-pump implant! I can now go an few hours instead of a few minutes standing and walking before pain goes down my legs and makes it impossible to walk. |
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Hi Paige, I fully agree with the comments posted regarding losing your drivers license after the pump is installed. As you know, the pump releases a tiny fraction of narcotic into the system compared to the equivalent of oral medications required to achieve the same pain control. There are many people who take pain oral narcotic medications continuously and still drive safely. Here's an interesting article that comments on this: "Driving Abilities Not Impaired By Moderate, Long-Term Pain Medication Use" which can be found at: http://www.newswise.com/p/articles/view/535591Best wishes. Bob p.s. I also just had knee joint replacement surgery. |
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| Posts: 258 | Location: Hawaii | Registered: 01-25-2007 | |
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Hi All!
My doc is advising a stimulator trial or a pump. Has anyone done both the stimulator trial and the pump? Any ideas as to which was better?
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One more...
Does anyone know if you can have a safe pregnancy with the pump?
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quote: Originally posted by Bob Engelbardt:
Hi Tina,
I've never had problems with the pump itself - just with the catheter slipping out of the spinal cord on three occasions following implant of the pump. This resulted in most unpleasant drug withdrawal symptoms and a dramatic increase in pain level which required me to return to oral morphine and breakthrough medication with all of the bad side effects like constipation, etc.
I finally had the catheter revised by a neurosurgeon who placed it higher up (T6-7 vs. the usual T10-11) and who used a stiffer material along with surgical glue to hold the thing in place. So far, it's held up and I'm doing fine.
Like you, I have the later version that's a larger pump which holds more medication and reduces the frequency of refilling. When you first had your unit implanted, Medtronic only sold a smaller unit but have since replaced it with the larger one as a standard.
My morphine dosage appears to be much less than yours and I don't generally require more than one or two Vicodin a day if I do a lot of physical activity which increases the pain level.
Although I now sleep very well, I do have a lot of pain early in the morning despite the fact that the pump is programmed to put out additional medication between 4 and 6 AM. I take a Vicodin as soon as I awaken and after I get up and eat breakfast, the pain level goes down for the rest of the day most of the time.
The pain management clinic I go to said I would never be totally pain free but, like you, the pump has made a major change in my life and, despite the setbacks, I'm glad I had it implanted.
I'm happy to hear that you, too, are satisfied with the pump. As for the placement problems you're having, a lot depends on where they implanted it and how much body fat surrounds it. Although I'm quite thin, I did develop some fat around the middle of my abdomen so the pump is fairly well insulated from external damage. I can put my fingers around it but it's still pretty well protected by the fat layer. I try to be very careful not to cause any great movement of the pump itself even though its sturdy construction makes it quite impervious to physical damage.
The biggest potential problem from pump movement involves possible breakage or disconnect of the feeder line that runs from the pump to the spinal cord area where it's connected to the intrathecal catheter that's placed in the sub-achronoid space of spinal cord. The instructions accompanying the pump stress avoidance of manual manipulation.
As a man who occasionally wears a belt, I do have to decide whether the belt is above or below the pump. Women may have less of a problem with this.
If you are very thin with minimal abdominal fat, protecting the pump may pose a problem but so long as it doesn't move around a lot, it should be OK. Otherwise, minor out-patient surgery may be necessary to re-anchor the pump deeper and more securely.
Sorry to be so verbose but I'll be happy to answer any other questions from you and others.
Aloha,
Bob
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| Posts: 2 | Location: Plant City, Fl | Registered: 04-20-2008 | |
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