Chronic Pain

Sheila and Nan, Thank You for your input.

My bad for not providing a little more backround.... I have been on opiates for chronic pain and RLS for 10 plus years, currently now on subutex primarily for RLS, but it does give modest relief for backpain.

My biggest fear is the long term (20 year)problems that would be associated with using a pain pump.

MJ, provides me with much needed sleep and modest pain relief, but I do understand the medical community being paranoid with this issue. Was unsure what standard policy is for those qualifing for and being maintained on the pump.... Is this the same protocal used in states that recognise medical MJ...?

Thank You for your help and info.....
F.

Hi Fran,

Welcome to the forum! As others have already indicated in response to your questions, I fully agree that the pump should be considered the last resort after oral medications and patches fail to provide sufficient pain relief or cause side effects that are too severe to withstand.

Almost all of us with the pump have gone though psychological screening following initial treatment with various oral opiates and other drugs, sometimes for years, before the pump is implanted. While no one can or should minimize your chronic pain level or determine how seriously it's affecting your life, those of us with no MJ experience cannot rationally judge its effectiveness. However, if it's illegal in your state, contacting a pain management doctor could pose a problem if you get tested or you reveal your use of this drug. Most pain doctors and clinics perform judicious screening to weed out drug-seeking patients and if you are placed in this category, it could prevent further treatment in the future when MJ no longer provides you with adequate pain relief.

The fact that you are still relatively young and have been diagnosed with failed back surgery could indicate that your pain will only worsen as you age and at some point, you may need to have the pump. If so, I wouldn't worry about how long you may need it because it's really a long-term solution as compared to oral medications and patches which often eventually lose their ability to provide satisfactory pain relief without severe side effects.

If I were in your position, I would stop using MJ for several weeks (I'm not sure how long it takes for it to no longer be detectable in your system) and then consult a pain doctor or clinic. If you decide not to start the pain management process, you can always go back to using MJ until such time you decide it's losing its effectiveness.

In any case, please keep us informed of your situation by posting. We all wish you the best.

Bob

Hi Dena,

My clinic also will not increase the pump levels by more than 10% at a time so it could take some time for some people to achieve optimum pain control depending on how often they can visit the doctor for the increases.

I think this is the correct approach because the purpose of the whole exercise is to infuse into the spinal cord the smallest about of opioid possible for optimum chronic pain management. Initially, except for the trial before the pump was implanted, they have no idea of how much medication is necessary. They could start with a high dose and then drop down but too much medication could result in various problems so it's better to start small and work up.

I know this results in more time when we must use breakthrough oral medications or suffer from increased pain levels before the pump takes over entirely but this is usually the process used by most pain management people.

Aloha,
Bob

Fran wrote:
My biggest fear is the long term (20 year)problems that would be associated with using a pain pump.

MJ, provides me with much needed sleep and modest pain relief, but I do understand the medical community being paranoid with this issue. Was unsure what standard policy is for those qualifing for and being maintained on the pump.... Is this the same protocal used in states that recognise medical MJ...?

Thank You for your help and info.....
F.[/QUOTE
Hi FRAN- My current Pain management clinic did a Urine Drug Test on me- my very first visit- I signed a contract with my MD,(this is standard procedure)-the contract informs me of the "terms of agreement" I must comply with-or my doctor can dismiss me. If you would like a copy of it, I can email you the contract. My doc can do another drug test anytime he feels it is necessary. I have tried your method and my results are mixed- sometimes I do get pain relief and lately no pain relief. I am not going to partake anymore.
I am not judging you- but if it works for you don't fix it. I have been through so many changes in my pain management and often go through a horrible period of pain-
Right now I am having the worst time in my life with this adjustment off a higher strength fentanyl patch-
Honestly believe that these powerful drugs are alot more dangerous than MJ- even if you are still using opiates, why add another medication such as AMBIAN or Trazadone for sleep?
If you do decide to go the pain management route- stop smoking and wait at least 2 months before visiting a pain management MD- I am a retired Medical Technologist and as I recall the MJ accumulates in the fatty tissues- and can be present for at least 2 months.
For sleep I found a great multi-purpose medication- will looking up some info on TRAZADONE I accidently found that it has a pain relief quality- and it always reduces my pain level. I take 100mg just before bedtime.
I am glad you joined the forum! and please keep us posted

Bob & Claire, Thank You for your input, I am very carefully considering this option. As of today, I am functioning at a limited level and and pretty happy about not having to chase my pain with oxycotins and such. But this comes at a price, I havn't worked in 6 months and do only very light yard/house work. I realize the only way I could go back to my previous career would have to be with the assistance of a very strong opiate program. So if I can manage not to return to work via disability I gladly would not entertain a pump until later down the bad back road.
I just find the mj histeria in todays world ludicris at best. Its OK for these pain quacks to be the sheeples for big pharma and pass out the candy as long as you dont test positve of something less harmful than alchol or cigaretts.

Thank You all for your advice and concern...

Hi Fran,
I hope that I didn't offend you in any way. I have often wondered about MJ use myself for muscle pain and also for sleep. Recently, I was awake for over 4 days due to the worst pain level that I have ever experienced and this caused me a large amount of mental problems and someone had mentioned MJ to me, but I signed a contract with my Dr. and I am pretty worried about getting caught with it in my system.
I didn't mean to minimize your pain level at all. I had a friend who suffered with a high level of chronic pain in his neck area along with muscle spasms and he found that MJ helped with his pain more than Oxycodone did.
I myself am a Christian and I have always believed that God placed the plant on this earth for a reason.
Good luck to you Fran
Sheila

Bob,
I had a seroma after my 2nd pump last year. I never had any ill effects and I too have a lump at my insertion site. I haven't really checked it's size. A couple times it has been sore if I pressed on it but went away as quickly as it had hurt.
My doc told me not to worry about it so I don't. Hope this helps.

Dena,
I have had a pump since 2002 and another in 2008. I fell in 1998 and hurt my back. I tried everything imaginable and nothing worked, had surgery still did not take care of pain.
anyway before pump I was on Oxycotin and then Fentanyl pain patch plus breakthrough meds.
My family told me how wierd I was on the pain meds and how much my personality changed. I was also on antidepressants. I had just been promoted to Director of Pediatric Nursing but I could not function. I still had pain, I could not think straight. I was on Morphine for years. After Katrina I found a new doctor and he added Bupivacaine whick allowed me to get better coverage with less Morphine. The pump has been a God send. It changed my life from a depressed confused mother of 3 to a happy functioning active mom and wife. I did not return to work cause I do not think I could do both cause I do lay down before the kids come home from school. I also exercise at least 3 days a weeek which has made a big difference. I take Loratab for breakthrough and have Zanaflex for muscle spasms. Life is not perfect and I have my worries especially when I read bad things about pumps but I think it saved my life.
I hope this helps. Most people do not even know I have a problem.Any other questions please ask


Sheila, Praying for you. Great news things are going well.
jsd59

Thanks jsd59. I'm no longer concerned about my seroma thanks to your post. It really hasn't bothered me and has never been sore. So long as there are no other symptoms, it's just one of those unexplained things that happen, I guess.

Bob

Hi everyone,

Intresting. I have just read the posts n drug testing.
I have been in Pain Manegement for 6 years now and I have never had to have a drug test! It has never even been suggested.
Perhaps because they know I'm allergic to all narcotics? and almost all othermeds too. Of course I get no pain relief either so...!
Mag1

I believe they do drug testing for 2 reasons...
1.) To make sure the patient is taking the medication and not selling it.

2.) Also, to ensure the patient is not over medicating or abusing other substnaces while on medication.

Pain patients have a bad stigma. I work in healthcare and have an intrathecal pump.

Does anyone know what the long term side effects are? I have not been able to find any information on long term side effects from either the pump or the medication. Thank you!!

Hi Heather,

I don't recall any posts from people who experienced problems from using the pump long-term. As I've indicated previously, most of those who post to this forum do so because they have questions or problems. Those who are completely satisfied will generally not post because they have no reason to do so.

That being said, we do know that some people have experienced diminishing pain control after using the pump for a long period, because, over time, the body may become tolerant to the particular medication being used. Changing to a different medication could resolve this.

The pump itself is designed to last for about 5-6 years after which the battery wears out. This requires total replacement of the pump that will probably be a newer and improved version.

I hope this answers your question. Perhaps someone else will respond with more information.

Sincerely,
Bob

Hi Fran,

I just turned 50 as well. I have had a pump since 2002. Had it changed out in 2008 not cause of battery but cause my tubing was getting a bit clogged up. They now have new tubing so should not be an issue anymore. I have always used Morphine and they added Bupivacaine in 2005. It potentiates the Morphine so i can use a smaller dose with same effect.
I also have failed back syndrome. It think it just means when u have had surgery and it did not "fix" you! I have worries and concerns too since I was in my early 40's when put in. I have an amazing doctor in New Orleans. He assues me he has many patients that are older without difficulty. Some are on the same dose as where they began. He says there are so many drugs on the market there is always something to change to. I am very close to the dose I was on after they got me to the right dose. I have gone a lttle up or down depending where and what I am doing. Stress really makes my pain leel go up because they say the nerves start firing more when your stress goes up.
When I tell you this thing has changed my life. My apin is very manageble. I am rarely wthout any pain but most time it is just aggrivating and if I aly down and take something from Advil or pain med it will go away.
I have never been drug tested. My doc monitors the pharmacy I think once a month so they can see you are not getting drugs from anyone else.
Good luck
jsd59

Fran - I've been pretty much bed-ridden for 4 years, have 5 vertebrae fused in lumbar, 4 in neck and take Oxy and Methadone to stay reasonably comfortable in bed,(am out of bed an hour a day) age 60 now, tried MJ twice a couple years ago and it doubled my pain. The MJ made me constantly think about my pain and thus feel it. Was horrible. PS - having trial for pump in January and probably implant shortly after that. My 1st choice for having all this done (in N.Dak) won't implant pump unless you are at least 65 or have cancer. No one on here had ever heard of that before.

Hi Chet!

Unbelievable! That doctor or clinic must think that only people over 65 or those with cancer can really suffer from chronic pain. The rest are just imagining it.

What about failed back surgeries and all of the other conditions that so many people deal with which results in chronic pain?

There's no reason why you would have to wait for 5 years in order to control your pain. Too bad you can't go to the doctor that may be more convenient to your location but with that attitude, I would be suspicious of him anyway.

Bob