@lynnsaunders Not sure is this is relevant to your mom's pain, but I had a pain pump implanted almost three years ago. So far I have not gotten any pain relief, except for one day about three months ago. I must have been started on a very low dosage of dilaudid because I was having the pump output increased for almost a year and a half. Since I was not getting any relief, I started having the output decreased with the thought of having it removed. Then I checked in with the doctor who did my trial. Apparently, He gave me quite a high dose in the trial by injection. It wasn't until I discovered how to check my pump stats using the pump remote that I saw that I was still at a relatively low output. So, I have been having the dosage increased for the last year. At just a ten percent increase every three or four weeks, it takes quite a while to get to a therapeutic dosage. See if you can find out your mom's current dosage. My trial shot 4 mg of dilaudid into the intrathecal space. I am currently sitting at about 2.8 mg/24 hours. BTW, My pump is a Medtronic unit. Good luck.