Intrathecal Pain Pump

@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.

@morkat if you’re on hydromorphone, I would say you are on the low side. I am on about 1.74mg of it per day. Thanks for your reply.

@heisenberg34

The pump is morphine.

@morkat Who prescribes the oxy? Seems as if most Docs shy away from it.

@heisenberg34 I've been at this for over 20 years. When I began my family doc wrote for me, but pre-pump I had gotten to almost 6 oxycodone's a day that made my family doc nervous so I talked to my neurosurgeon and he agreed to write. Once when he checked the records he said it took you 2 months to refill the last Rx. Certainly not drug seeking behavior. When I had my whole lumbar spine done the hospitalist came in to release me to home. At that time I asked him to cut in half my Rx for oxycontin. He said I want to but you on a billboard the only person in America who wants less Oxycotin. My son who passed from an overdose keep telling me how addictive it was and for some there is no coming back. does that explain it? Hope so.

@morkat Thank for your reply. I am truly saddened to hear of your son's passing. I don't know if any doc here in Dover, DE would write scrips for oxy, and I'm not sure I would ever want to get on that train...unless my pain becomes unbearable. For now I will put my hopes on my pain pump being able to reproduce that one day of good pain relief. And, perhaps I will look in THC gummies. I just need to find a doc locally who knows about the various strengths needed to combat neuropathic pain.

I don’t know about that. I’ve tried two different brands of CBD gummies but had no effect.