Intrathecal Pain Pump

How does it make your head feel? How large is incision to implant pump? If you don't mind, of course.

@dasunbehagen The medication is delivered into the intrathecal space around the spinal cord. Literature states that the med does not pass the blood/brain barrier (it doesn't go into the general body systems), so no real side effects. I have not experienced any weight gain. Most pumps are implanted inside the abdomen just under the skin. This is so the port can be easily accessed for refilling(about every two to three months). The pump is about the size of a hockey puck, so a small incision 1-2" is made on your front, side abdomen. Tubing is fished around to your back where a small incision is made in order to place a catheter(needle) into the spinal canal and then attached to the tubing. Hope that answers your questions.

@archie2 I have a spinal cord stimulator since 2021. It worked for about a year and then stopped. I think the problem was that my stimulator moved. It is now sticking out of my back instead of being flat against my back. I am now looking at a pain pump. The first trial was unsuccessful. It took many hours for the medication to work, but I still had to take OxyContin that night. I will be having another pain pump trial in the near future and I’m hoping it will work better. In other words I would give the stimulator a chance.

@ukdebcat Sounds a lot like my experiences. My SCS lasted about two and a half years before it also just stopped one day. No warning. Tried another, different battery. No luck. Two years later I had my pain pump trials. Both were done by injection. First one used morphine. No help. Two weeks later they injected hydromorphone(Dilaudid). Within ten minutes it dropped my pain from an eight down to about a two. It was great. Two and a half years later I am still in the process of having it adjusted. Initially I had it increased, but after about a year I stopped and considered having it removed. But, after some research and with help from the great commenters here on Mayo Clinic Connect, I discovered that I was still at a relatively low amount. So, I began having it increased again. Except for ONE DAY(!) I have not gotten any pain relief, so "Up< Up, and Away" for now. I will certainly keep everyone in the loop. My daily total output is 1.75 mg. Good day and God's blessings to you all!

@morkat I just came across your post regarding your pain pump. Looks like you are pretty happy with it. I've been trying to get relief from mine for over two years. Can you tell me what your total, daily output is? Also, do you have any boluses? Do you use them? Thanks for sharing. I apologize if I have reached out before and just forgot.

Don't apologize I get sidetracked so easily I understand. I have to find my folder and I can answer your questions then, okay?

@heisenberg34 I can answer that about my pump. My doctor was very conservative about dosing. In theory it’s supposed to be micro dosing. Took well over 2 years before I got to some relief which is to get my pain to a 4. And it got there for several years. Now I’m on flex dosing. I get 1.97ml. Continuous, with 4 daily 2.5ml. Per bolus. Right now, after 8 years I’m at 12.1ml. Per day. And it’s keeping me at a 6. When I was on 24 continuous, I had 2 bolus per 24 hour period. I’d use them both. But wasn’t enough. I think my body has acclimated to the morphine and it’s time for a new drug. Maybe hydromorphone or Dilaudid.

@bilt4pain Thanks for getting back to me. I really appreciate it. Wow! Over two years! Now that's what I call being really conservative...or really cruel. Seems like you should not have had to suffer with that pain for so long. I'm at about the 2.5 year mark since my surgery, so it appears that my docs were being conservative as well. There was a point about 16 months ago when I was so discouraged that I began to have that pump output decreased, with the thought of having it removed. I'll just say that after several months and some research I decided to keep it and start going up again. That was a little over a year ago. I have hydromorphone which is 4-5x as strong as morphine. I am at about 1.74 mg per day with 4 boluses. I managed to get all this info from my own searches and from my fellow commenters like you. How was your trial? Injection or temporary pump?
I think hydromorphone might be a good choice for you. If not, you can always go back to morphine. Pain level of 6 doesn't sound like much pain relief. What was the worse that your pain was? I hope you can back to a 4 or better! Have a blessed day!

@heisenberg34 After my 6 week dry out brain reset I got a 275mcg. Injection. The whole point of the pump is to micro dose. Pain level 6 is if I do nothing all day. I can’t do that. I would love to get hydromorphone. It wasn’t an approved drug in 2018. The biggest issue I face is my location. In TX I had the best healthcare ever. Now I live in Northern MS near the TN border. Most(mine) docs are TN. They won’t allow facet ablations here ??? Had them every 10-12 months. I’m definitely going to call and ask. My next refill is 11/20. They tried switching me to fentanyl. Absolute nightmare. Had it changed on a Thursday afternoon, can take 10-15 hours to make the internal transition. By Friday evening I was completely lost in space. And had a general feeling of malaise throughout my body. I felt zero pain, but with zero cognitive function. It was hell till Monday morning. Thanks for your advice. It was very helpful.

@heisenberg34
my pump is 20ml; rate per day 0.910mg I think my rate is still on the low side. If I have breakthrough pain I take an Oxycodone tablet. I hope this helps.