Change of medicine in Intrathecal pump for Chronic back pain

Does anyone out there with an implanted pain pump know what their daily dose is? I am at 0.9 mg daily. Apparently, this is a very low dosage, so I am having it increased. I discovered that my trial with an injection of hydromorphone was about 4 mg. I know that's high, but I was told that some pump users are at a level of 5.0 and 6.0 mg daily. I am anxious to find out how much many of you are at, especially for a therapeutic dose.

Does anyone out there with an implanted pain pump know what their daily dose is? I am at 0.9 mg daily. Apparently, this is a very low dosage, so I am having it increased. I discovered that my trial with an injection of hydromorphone was about 4 mg. I know that's high, but I was told that some pump users are at a level of 5.0 and 6.0 mg daily. I am anxious to find out how much many of you are at, especially for a therapeutic dose.

Hello,
Can I ask is this your first implanted pain pump? How long have you had it in? What they don't tell us is that after years/decades of having one implanted, you're basically setting up your body for life so my recommendation is to never get off it especially after its been in you for more than 5 years. Even though the docs take you down very slow should you want to try something else, like for me, 20 years and I had Marcane/Morphine, then Prialt, then Morphine, and then Hydromorphone these past 6 years. The makers of these pumps-Medtronic and Abbott don't tell you this, but your body gets to where it can't do without it as I found out recently when I shut the pump down (Feb 4) and tried medical marijuana (month of March). That did't help at all, just made me high so I told the doc lets replace the dead pump this past April. But I need to tell you what happened: Last Dec 6 I was rushed to the ER for severe withdrawals (reason is we went down too much on pump earlier that day: I felt freezing cold on my skin, burning hot on my back, ears hot, my feet felt like they were in a bucket of ice water 24/7 and I was violently shaking over my whole body), they gave me a shot of Dilauded (hydromorphone) and the symptoms went down to about 25% which slowly decreased over the next 5 months until the new pump was emplaced april 18 and hydromorphone put in couple weeks later May 5. May 6th, the withdrawal symptoms totally disappeard-finally. Now I'm slowly going back up. I was contemplating Fentanyl but from what horror stories I've already be advised of through this forum, I plan to not try it- as I've already experienced that hell. I really hope that if this is your 1st pump, I hope it works for you, just remember please, after 5 years your body gets depended on it. I"m currently at 0.1399mg daily and will probably go up to around 5-6, but the constipation will be worse than what it is now. I'll pray for both of us,
sincerely,
Arkynut

Hello,
Can I ask is this your first implanted pain pump? How long have you had it in? What they don't tell us is that after years/decades of having one implanted, you're basically setting up your body for life so my recommendation is to never get off it especially after its been in you for more than 5 years. Even though the docs take you down very slow should you want to try something else, like for me, 20 years and I had Marcane/Morphine, then Prialt, then Morphine, and then Hydromorphone these past 6 years. The makers of these pumps-Medtronic and Abbott don't tell you this, but your body gets to where it can't do without it as I found out recently when I shut the pump down (Feb 4) and tried medical marijuana (month of March). That did't help at all, just made me high so I told the doc lets replace the dead pump this past April. But I need to tell you what happened: Last Dec 6 I was rushed to the ER for severe withdrawals (reason is we went down too much on pump earlier that day: I felt freezing cold on my skin, burning hot on my back, ears hot, my feet felt like they were in a bucket of ice water 24/7 and I was violently shaking over my whole body), they gave me a shot of Dilauded (hydromorphone) and the symptoms went down to about 25% which slowly decreased over the next 5 months until the new pump was emplaced april 18 and hydromorphone put in couple weeks later May 5. May 6th, the withdrawal symptoms totally disappeard-finally. Now I'm slowly going back up. I was contemplating Fentanyl but from what horror stories I've already be advised of through this forum, I plan to not try it- as I've already experienced that hell. I really hope that if this is your 1st pump, I hope it works for you, just remember please, after 5 years your body gets depended on it. I"m currently at 0.1399mg daily and will probably go up to around 5-6, but the constipation will be worse than what it is now. I'll pray for both of us,
sincerely,
Arkynut

I broke my back in a parachute accident in the early 80’s. Reinjured it in 2004. By 2017 I had 16 surgeries and was fused at C3-C6, T2-S1, had an implanted spine stim and intrathecal pump. I was running out of morphine space. On a Thursday morning the pump meds were switched to Fentynal. Takes about 14 hours for the full transition. By Friday night I was a dissociative space cadet. It was horrible. It was worse than horrible. I was sick and out of my mind. I was really glad I was married that weekend. Wife drove me to docs Monday morning without an appointment. My wife sounded like Charlie Browns teacher and apparently I just stood there on a walker and drooled, ready to hurl at any minute. Doc, not staff, fetched me from the waiting room. God blessed me and they had a refill kit for another patient. Don’t remember much till Tuesday when I was getting morphine flowing through the pump again while simultaneously getting drug sick from fentynal withdrawal. It was 7 days in hell. I looped Lennon’s “Cold Turkey” and screamed in unison wishing I was dead. Ultimately we upped the morphine concentration to 20 and my daily bolus schedule was working again. Stuck it out a year and was able to switch my 20 for the 40 pump. Obviously I’d vote against it. But we all act different on these dangerous meds. Good luck to you my fellow pain sufferer.

Hello,
Thanks for your input, sorry but I don't know if I already responded to you. I think I've made my mind up, to not try fentanyl. From Dec to May 2025, 5 months of hellish withdrawals from shutting down the pump to try medical marijuana which didn't help at all. I fell down a wet ladder in 1982 on the USS Proteus and injured the Lumbar area of my spine. Re-injured it in 1988 & 1997 at work. I've had 11 surgeries so far, the 1st one in 1998 fused my L1-L% & S1, wish I'd seen a neurologist instead of that orthopedic doctor. I had a 40 pump implanted in 05 and a stimulator implanted in 06. I've had Marcane/Morphine, Prialt, Morphine and currently Hydromorphone in the pump. Only thing I haven't tried is fentanyl and from what horror stories that have been brought to me, no way will I try it. I'll just go on in pain. Now that I got another 40 pump back in me, guess I'll go back way up on it and fight with the chronic constipation. I guess I can't have pain refief without that. Its just that when I was at 8 on the pump, I'd be screaming trying to have a dang bowel movement even with the constipation meds they give me. After my experience shutting down the pump I'll be happy to life whats left of my life with the pump. That's so true, we all act so different on these dangerous meds. Hope you find some relief with your pain, good luck.