Chronic Pain

Hi Catcher,

Glad to hear that you are on your way to better pain control via the pump. You mentioned being nervous about the trial. I don't recall that as being a very traumatic experience. They simply use a standard hospital pump that's normally used to infuse pain medication into a patient's IV line. For the trial, they insert the tube into your spine and adjust the medication (usually morphine) to simulate the pump. They use a local anesthetic and I don't recall having any pain when they inserted the catheter.

In my case, they had me up and walking around the hallway dragging the pump behind me similar to what post-operative patients often do. The next day, they asked for my pain level which was much lower. This indicated that the pump would probably work for pain control. They released me and I scheduled the pump implant procedure. This was done on an out-patient basis but it does require anesthesia. Again, I don't recall any great post-surgical pain and I think they gave me oral meds. to control this until everything healed.

Following the implant, your doctor may want to make small adjustments in the pump's output for optimum pain control.

Keep us informed of your progress.

Best wishes,
Bob

dtillinghas: Just read the Wikapedia info you listed: "One never knows when something can go wrong with the pump's function. This is a major reason why intrathecal pumps are not recommended when other solutions such as rhizotomy or stable oral doses of the medication can be used instead". That paragraph and the next paragraph are a little exaggerated I believe, but did shock me a little as I plan on the trial in January. I have a question that has never been discussed at this site: Sex! I'm 59, 9 vertebrae fused, lots of pain, but can be reasonably comfortable from noon to about 6pm when I have the most opiods in me at full strength. I'm taking less than most here (15 mg methadone & 30 mg Oxycodone daily)but am fairly uncomfortable after 6pm until sleeping pills put me to sleep at 1am and again at 4am.Then in morning I'm uncomfortable until I start taking my pills at 11am. I wait as long in the morning as possible, even using ice packs to wait until 11am. In bed almost all the time as standing/sitting more painful. Now my question: I've been on this dose for 18 months and now find myself much much less interested in sex, but still have sex. Wife is 10 years younger. find myself cutting back on pills and putting up with more pain in an attempt to reverse this. Does the pain pump, if implanted give you back your old sexual desire as it helps relieve constipation and other side effects of oral meds. Hope I didn't offend anyone, but very important part of life to many.

PS - Just looked up rhizotomy which was mentioned in the Wikapedia info on the pump. Its a medical procedure in which they cut nerve fibers which they identify as producing a person's pain, thus relieving pain. Says it is used for spastic diplegia and severe back pain. Never heard of this before. Who is a candidate? Or is this very very dangerous.

Hi Chet,

Assuming that your lower libido is the result of fairly high doses of oral medications, the answer to your question about the pump giving you back your sexual desires is probably yes.

The purpose of the pump is to place a low dose of medication directly into the spinal cord where the nerves that are involved with your pain are located. The dose of medication is not only lower than your oral meds. but oral meds. are metabolized by the body resulting in side effects such as constipation and possibly lower libido although I don't recall anyone previously posting anything about libido.

From my own experience, I didn't notice any particular libido problems when I was on oral meds. but I wasn't taking as high a dosage as you nor was I using several medications in combination. If so, I might have experienced similar problems as yours.

Now, except for occasional break-through pain, I don't take oral meds. and rely entirely on the pump. Libido is normal for a person my age (78) so I can assume that the pump is not causing any problems in that area.

It's well known that sexual activities can temporarily reduce chronic pain. Do you notice this when you do have sex?

I'm sure your question will not offend anyone and it should help others with similar problems.

Bob

Hi Bob and everyone else out there, I have been reading the messages for a whilr now and really appreciate them. Thank you Bob for your dedication to this site. I guess I will just start off by saying that I too have been through "it all" with the chronic pain thing, especially due to back pain. I was advised to try the pump about 8 years ago, but had a fear of it. I believe I am ready for it now. Your site has helped me make that big step of faith. I have been taking Fentanyl 100mcg/h patch (every 72 hrs) 80 MG TER Oxycontin, one three times a day and for break-thru Roxicodone 30 MG. If I ever leave the house or do anything very strenuous, I also use Lidoderm patches also. I have,earlier this year had two stimulators put in. I did not find them to be a good source for continuous pain relief. One is used to stimulate the leg area and the other for my back. I feel that the leg stim. helps as a therapy source, like a tens unit under the skin but it would cover a much larger area. It feels great for that. I am troubled though because my Dr is inserting the smaller pump and I want the larger one. He also will not entertain the thought of the PTM (Personal therapy manager) He just does not believe in them! Thats it no more discussions. I live in an area that has few good pain mgt Dr's and I really do trust him and I am glad that I have him as a Dr. He says that a larger pump will be "uncomfortable for me" I am 5'2" but pretty hefty and have a good amount of "me" around my abdomin. I just REALLY want the larger pump! Don't know what to do.I'm tired of Dr visits, if you know what I mean. Those of you that have the smaller one, do you find it to be adequate? Can anyone tell by the meds that I am taking if I will have to go to Dr once a month or every two months? I go in Aug 6th for the trial. I have been on a small weaning process so that the trial will be more "telling" I hope I will be able to tell as I am counting on it By the time I take my test, I will be on 25 mcg/h patch and down one 80mg Oxycontin and have been trying to not take any break thru meds. It has been hard, but I really want to know I guess if all goes well the pump will probably be se a week or so later. Please Bob, Shiela and all other christians out there please pray for me. I have in the past been attacked by infections and have gone thru debridements that it tends to put a little fear in you. But I do believe God will watch over me and all will be okay. Again I thank you all so very much for this site and your dedication. GOD BLESS

Hi Dena,

I believe the only difference in the pump sizes is that the smaller one holds less medication and needs to be refilled more frequently. The refill is a quick and painless procedure so it shouldn't be a problem.

I had the larger one implanted and lost some belly fat over the past year so now it protrudes and is somewhat of an annoyance. I would accept your doctor's recommendation on this matter.

It sounds like you've really been through the mill with all of your problems and the various medications to relieve the chronic pain. You are taking more than I've ever used but you also have more complications than I do so it's necessary. You will have to continue weaning off of the current dosages as the pump begins to take over. Hopefully, you can cut out all oral meds. and patches after the pump is adjusted for optimum pain control.

We all wish you the best.

Bob

Dena - After reading your post I feel I must be doing pretty good as I'm on much less meds than you, so your post helped me (didn't help you though), A thought on prayer, believe its been actually proven to be beneficial, so all should get on board with you. I have just the opposite resevoir problem---I'm 6'4"+ and weigh barely 170, (lost 35 pounds after 1st of 5 surgeries) docs not sure where they will place the pump due to bones here, bones there, but large one out of the question, so I to worry how much more often it will have to be refilled. Look forward to trial in January. Anyone seen the Medtronics VHS video about the pump. The guy who had the pump surgery is like a zombie. Seems all drugged out. Weird that they would have a guy like that star in a Medtronics video to sell the roduct.

Hi Chet,
It's Sheila and I read in your post that you are worried about sexual complications and such.
I am going to swallow my pride on this one and try to help you out with this.
Somewhat embarassed I will tell you that with the pump and without all of the pain meds, sexual desire thrives once again. It's true. I also have found myself in the same rut sexually with my husband, which he doesn't deserve, although I am the 11 year old YOUNGER spouse, I have experienced no sexual desire whatsoever due to pain and I must admit pain meds do not help with this. BUT while having the pump, life was restored back to me although there was some need for some oral meds.
While having the pump, the sex life is much better and more thriving I must admit.
I am blushing, but understand your situation. We all have our "crosses" to bear with this pain thing. But sex was better with the pump.
Good luck Chet,
Sheila

Hi Dena,
It's Sheila....and sweety I have prayed for you. I do have good news about the smaller pumps Dena, they can actually double, even triple the concentration in the medication that they put into the pump. They gave me the small pump but they literally doubled and were going to triple my concentration on my Dilaudid in my pump. They do like to start with the smaller ones, because of risks of rejections and such
Dena, know someone is praying for you, and know that we understand. I have been there.
I am praying Dena,
Sheila

CHET, thanks for your reply. Sorry about the quote, I'm just learning my way around. I did want to comment on your sex question. I'm no authority but I don't think it is wise to cut down on your pain meds in an attempt to keep up with your wife. It will just keep your system all out of wack & unstable as far as pain control. Your wife will understand! As soon as you get your pain more in control (with up & coming pump) I think the sex drive will get back to normal. It takes a lot to deal with PAIN (as we all know) your body is just on "pain mode" for now!
I am excited about going in for my "trial" tommorrow. I'm not scared or anything, just don't know why I waited so long to do it. Dealing with the monthly trips to the doctor, the constipation, the anxiety caused by the way the world looks at you when you fill your Prescription, the judgements....all of it....I'm just tired of it! I don't know if the pain pump changes the publics opinion or not but I guess I am about to find out. It's odd how some folks think. Some actually have sympathy for those in pain if you have a pump but think of you as a "drug seeking drain on society" if you are on opiates in pill form.
Anyway, I'm ready! Will let you know how it all goes. ps I'm 64 married to a wonderful, patient man who is probably wanting to see if the pump helps our sex life out too!! tee hee!

Hi Dena,
Here I go again on this post...being vulnerable. Sweety, God will take care of you. I did have to have the Intrathecal Narcotic Pump taken out due to infection BUT God answered prayer and I am having the pump reinserted the 20th of this month. Trust me, I haven't done this whole pain thing and pain med thing perfectly....have any of us? BUT God is faithful to watch over us when we can't even hang on.
Dena, after they have taken my pump out, my blood pressure has been EXTREMELY high and all of the doctors say that I must be a fighter. The reason that my pain is so high is because of pain, BUT I AM still living am my God has kept me....the same way that He will keep you. I am praying for you Dena and please know that I understand and many of us do.
God Bless
Sheila

Sheila, Thank you so much. It is good to know that others are thinking of you. We may not know why things in our life happen the way they do. We just need to trust that God is ultimately in control and knows all the answers. To my mind, I must have went down the wrong road, made the wrong decision,etc for everything to be going so wrong. BUT...Only God know the WHYs of things. I need only to TRUST in HIM. When we do join Him, He will let us know what it was all about! His ways are not our ways. His thoughts are not our thoughts. Just needed to share that and thank you sheila.

Hi Dena and Chet,
It's Sheila again. Sorry I messed up on my spelling before, I was crying for the both of you...just understand about it all.
What I was trying to tell you is that my blood pressure can not be controlled with high blood pressure medicine. My pain controls my blood pressure and I guess that I am a walking, talking miracle.
I can only tell you both to trust something much stronger than the both of you...and whatever that is...well God bless you.
Pain is disabling. I am only 40 years old and am disabled from pain. My whole lumber spine has collapsed...so they tell me. It's a very good thing that they placed the cage in my whole lumbar spine nearly 3 years ago or I would have to use that wheelchair that sits in the corner of my living room.
I have faith, it's true, but God believes in the both of you more than you believe in Him
Blessings to you both,
Sheila

Dena,
You have me crying again.
I have questioned my goood God why....so many times...more times than I have even sought after Him. But there is that scripture in the Bible that states, "All things work to the good of those who love Him and call upon His Name". Dena, you and I both may be someone to help somebody else with all of the struggles that come along with this pain thing.
Blessings to you and you will be fine, please keep us up to date.
Sheila