Intrathecal Pain Pump

Have an appointment with pain management in a few days. Plan on asking about the implant. After a failed TKR my pain is off the charts. Hoping for some relief. Were your results immediate?

@bilt4pain I have been searching for information regarding my pain pump. Many out there have been a great help. More recently I have been increasing my pump by 15% every three weeks. I had one good day of pain relief back in September, but nothing since. After my most recent visit, the doc put it up to about 2.3 mg/day of Dilaudid with six boluses. No help. I am getting a bit discouraged. I know that some of you have reported getting to 4,5, or 6 mg/day. Can you please share how you felt, trying to get to a helpful dosing from your pump? Were you discouraged along the way? Thank you.

@heisenberg34 I was constantly discouraged for most of my first year and a half. My Doc was very conservative. And started me with true micro dosing after my trial. Keep in mind I’ve been on morphine. It was very frustrating. So, I kept complaining of no real relief. I was at 1.3 mg of morphine when she sent me to an associate for a surgical procedure to check if the catheter was clogged. It wasn’t. So he boosted me to 3.0 milligrams. Finally some relief. I guess he crossed a boundary she was to cautious of. After that I might get two, 15% increases a year. I was limited in that I had the 20ml pump. So concentration had to be adjusted too. I just got my pump replaced in September 2025. Now I have a 40ml and I’m at 12.47mg of morphine per day. Four 2.3 mg. Bolus flex dosing and 1.99 mg for 24 hour continuous. It keeps me at steady 6 level pain. I too enjoy a 3 month stint of level 4 pain. I’ve never been able to get there again. I have a lot of back issues that require interventional pain management, injections and ablations. When they are done on a regular basis I’m good unless it rains. Had fentanyl in the pump for 1 weekend, thought I was losing my mind. I’ve never been given dilaudid. But I’m getting ready to ask. I’ve attached some photos of what’s inside me. I’ve had 14 back surgeries, and a hip replacement. I also have a 16 lead SCS that I use on Tingle every night to help with the pain. My pump philosophy is that having it can be real frustrating nuisance. But without it, I’m a deadman walking. So I’ve learned to live with my discouragements, as they are temporary. It’s a forever thing inside us. And docs are afraid of going to far to help. At 67, disabled since 2005, I’m not afraid of going to high. What good is retirement if I can’t enjoy it. Hang tight, maybe interview a different doc if yours doesn’t listen. I should have answered this earlier in the day when my pain is lower. If I didn’t give you the message you needed, ask again, I have it. Wrong time for my response. Good luck 👍

@bilt4pain Man! You are about as close to the bionic man as anyone I’ve seen. I truly appreciate your getting back to me. I have Dilaudid in my 20 ml Medtronics SCS. Currently on 2.3 mg continuous with six small blouses available daily.
I’ve had this thing in me for over two and a half years. So, you can see why I am discouraged. Plus, my neuropathic pain seems to be getting worse. Walking is problematic along with balance issues. You say tat you are at a pain level 6?!That sounds like still quite a bit of pain.
I had a spinal cord stimulator that worked well for a couple of years until it just stopped. I have seen others here saying that the had to go up to 4 mg daily to get relief. I’m praying that getting to a higher dosage will help me. Again, thanks for responding. I hope you can find a way to bring tat pain level down.

@archie2 Thanks for getting back to me. When you say that you are getting 6.8 mg/day, does that include the boluses? Also, how long did it take you to get to that 6.8? I am only at 2.3 mg/day after two and a half years. I don't know why it has taken them so long to get to this point. Going up at 10% or 15% every three weeks or so seems so slow. I have seen other members who are at 4 mg or more. Just an FYI for any who are not aware: you can check your pump's info by clicking on the three horizontal bars in the upper left hand corner of your remote's display when giving your self a bolus.
Have a wonderful and blessed New Year, Archie!

@bilt4pain Another question for you. You were at 1.3 mg/day and a doc ramped you up to 3.0. Was that all in one shot. That's a 230% increase. I felt woozy once when I had a 20% increase. Of course I am on Dilaudid so maybe that's the difference. Thanks.

Yes it was in one shot. But I was way below where I should have been and I have a very high tolerance to morphine. When I got the pump in 2018, morphine for pain and baclofen for spascitity were the only drugs permitted. Never felt woozy, only a bit more pain relief. Yes, I’m the real $6million dollar man. And I also have an internal rod on my right calf bone( the skinny bone) from a spiral fracture I got in Boat sales showroom. I did get a great price on the boat! I hope to eventually change to dilaudid.

@archie2 hey, Archie. I really appreciate your getting back to me with this information. I don’t even know where to start. I had to Pain Pump and planted about 2 1/2 years ago. It must’ve been really really low probably less than .1 mg for 24 hours I had it increased. I don’t know how many times while I was living in Pennsylvania. Then we moved to Delaware. I have a new Pain Pump doctor who’s so much sullen , and non-communicative. I have had it also increase many times as I mentioned to you. I’m now at about 2.3 mg for 24 hours. From what I’ve seen from you and others this is still fairly low. So I will soldier on, and try to get this thing up to 4 or 5 mg/24 hrs. Yes, I am on Tramadol, diclofenac potassium, and Pregablin. Who know if they do anything. I would love to get off some of them… I can only pray.
Thanks again!
Chris from Dover, DELAWARE

@bilt4pain You got de boat, man! That's great. You may find that dilaudid will work better than morphine since it is about five times as strong as morphine. I would love to tell the Doc to push my pump from its current 2.3 mg/day up to 4. That's what they shot into me for the trial. Dropped my pain down to about a two. Chugging along, getting 15% increases every two to three weeks is so very slow. The wait in between is so very painful.
Have a blessed Christmas!

@archie2 I wish I had a pain doc who was willing to be more flexible. When I felt a bit shaky after amping my pump output up by 20% he has gotten very cautious. Probably afraid I'll sue him. The other pain doc in the office has been more willing to try things. She gave me six boluses and is going to try increasing the concentration of Dilaudid in my pump. Assuming the Big Dog doesn't nix it. I wish we had more pain docs who manage pain pumps here in Dover.
Yes, getting rid of some of these crazy meds would be great. We'll see if I can get that done.
Have a blessed Christmas, Archie!