Intrathecal Pain Pump

I had 7 joint replacements or surgeries of neck posterior, neck anterior, 5 disks lumbar spine, left hip, left knee, and left shoulder and right hip and right knee. I have degenerative, disk disease. It is an arthritis that is very crippling. My mother had the same thing but only had her hips done. In my mother's family 4 siblings were affected with these horrible Irish bones; only one was not. I always thought the arthritis would take me out and not be able to work, but it was sepsis that took me out. Aftermath, brain damage. +

I had my pump implanted just over two years ago after a very successful trial by injection with Dilaudid. They started the pump at the lowest setting. I had numerous increases over the next year with no help. I decided to have the settings decreased so I could have the pump removed. However, I decided to reverse course on the advice of my pain doc. He said that where i had stopped wasn't all that high, so I am in the process of having the output increased again in hopes of getting the relief that I had gotten with the trial(8 down to a 2).

How much pain relief do you get from your pump> And, what drug is in your pump. Hope it continues to help you.

I have a Medtronic pump with Morphine. The pain clinic I go to you have to refill every 3 months. So, the first thing they do is drain the morphine left in the pump which is 50% of the total and then refill it with 20 whatevers and we start again. I know you fear addiction and don't want to increase it, but it's better than pain killers by mouth, where all you do is sleep. They don't give out targeted drug delivery to just anyone, so I suspect your pain is pretty bad. I've had about 4 or 5 bump ups since 2012 and I'm still in the low dose amount. I hope things get better for you.

Thanks for your response. I am not fearful of becoming addicted. I am going back up on my pump’s output. I have had it increased at least seven or eight times over the past two years.
Morphine trial didn’t touch my pain. Hydromorphone dropped the pain way down.
How did the pump affect your pain?

I have only had morphine, for me it works very well, occasionally I take Percocet for break through pain. Everybody responds differently, my doctor stressed that it may make you feel better, the DDD continues to do damage. I hope that answered your question.

Thanks. I am in the process of increasing my daily pump output. The nurse who refilled my pump yesterday told that I was still on a fairly low dosage. I guess that a monthly increase of ten percent, it's going to take me a while to get to a therapeutic level...for me at least.Do you know that your output is? He told me I was at about 0.9mg.

I may have missed this answer, but are you using dilaudid in your pump? 0.9mg is a very low dose. I have maxed out at 5mg per day with an additional 6 blouses per day, I also use 4mg oral dilaudid 4 times a day, if ur not getting adequate pain control at ur current dose, there is room for a reasonable increase. Wish you the best!

So interesting to read all your comments regarding your experiences with a pain pump. As I have mentioned several times previously, my pump was implanted after a successful trial by injection with Dilaudid. They started my permanent pump at about the lowest dose possible. After several increases, I had no relief. After moving to new state, I had several more increases with same result...no relief. I started reducing output with thought of having pump removed. After doing some research, I discovered that I may have still been at a low level of drug output. So, I am in the process of going back up on my dosage.

So, here's my new question, fellow pumpers. Last Thursday I had my pump output increased by 15% to about 2.1 mg. I have no idea how that compares to my previous high dosage. Anyway, The next day after taking my afternoon pills and a bolus, I suddenly felt better. Yes, noticeably better! The bottom of my feet didn't hurt when I walked. The backs of my legs didn't hurt so much. I could work out in my shop. I was so excited. I told my wife how I felt. First time in two years that I felt better, not worse. I woke up the next morning after a particularly good night's sleep. Getting out of bed, the pain in my feet had returned. The boluses did not help. Pills did not help, Here I am on Monday with pain all back. I'm trying to figure out what happened. Was the extra 15% boost helping for just a little until my body readjusted and then the pain just overcame the drug. Will I need extra output increases to reach a lasting effect on the pain. To say I am disappointed would be an understatement! I would like to know if any of you have experienced something similar. Or, any helpful suggestions?
Thank you all who share my pain. Only we really know how it feels.

All I can say regarding your post is that 2.1mg of dilaudid is still a modest dose. I think the 15% increase provided helped for the short term, but still is not an adequate dose to relieve the level of pain you are feeling. I titrated up to 5mg of dilaudid and I also use 6 blouses per day, it helped quite a bit, but my Dr. also prescribed 4 4mg of oral dilaudid to control my pain. I can say that for the 1st time in my life, I don’t mind waking up each day. I’m not groggy or tired from that dose, but my pain is adequately managed. My point is, to work with your Dr. and see if he’ll continue to work with you and continue to adjust your dose in a slow and controlled manner until you feel better, and am happy. The maximum daily dose is 5mg. But you have a long way to go to reach that level, you probably won’t need that level, but a bit of an increase I think will improve the quality of your life! I hope this helps, be your best advocate.

I am not on a pump, but I have had this experience multiple times with procedures. One very good day, then back to hell! Frustrating!