@heisenberg34 I’ve had the pump for 8 years and just had it replaced with the 40ml unit. The Medtronic rep at my first implant didn’t have any 40’s, so I got a 20. And monthly refill trips. My trial was with morphine. After the 6 week dry out. She injected 250 mcg. (A 1/4 of a milligram!) within minutes, I was dancing in the hallway with my cane like Gene Kelly singing in the rain. The trial dropped my pain from a 9 to a 1 ! When I went for my first refill it was 275 mcg. And that wore off pretty fast. 8 years later, I’m on 12.1 mg./day. Four 2.5 bolus’s and 1.97 continuous. I went from 8 to 6. How I long for a level 4. My first doc was very conservative and it took over 18 months to be titrated properly. I have a high tolerance for morphine and pain. But my 6 turns to a 7+ at night and a strong 8 on rainy days with a low pressure barometer. At the time I got it, hydromorphone was not acceptable in a pump. But at 40x the strength of morphine I’m going to ask my doctor to plan on switching meds. The best part for me is now I have a full 2 months between refills! And I’m in PT which has to hurt before it helps. If he won’t change to the Dilaudid then it’s another 15% increase in 6 months. Unfortunately I live in the MS/TN border and all health care is in Memphis and it’s awful.