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Severe chronic pain and Intrathecal pain pump

Chronic Pain | Last Active: Mar 24 9:25am | Replies (60)

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Profile picture for alexandercrps @alexandercrps

Reading these posts. I am so sorry so many have such awful experiences with this pump.
I have had CRPS foe 6 years and I suffer through the most extreme neuropathy you can imagine. Therefore I’ve have had the pain pump from Medronics implanted since 2022. Last year I got an SCS implanted for my pain as well. So I know what ya’ll have gone through. One red thread on here that I see is that some unfortunately get this pump implanted and later managed by inexperienced surgeons and doctors. The scarring and complications I read about here are all mostly due to crappy surgeons who don’t know what they are doing. I am
lucky to have had both my implants operated into me by one of the most experienced neurosurgeons in my state, maybe even the country.
This is why I say the same thing over and over again to anyone who asks me for any type of advice on intrathecal pumps: I always say the same thing: you need to find the most experienced neurosurgeon you can muster, and you must also make sure to have access to the absolute best possible pain management doctor team to manage your pump after it’s implanted. You need an expert doctor to decide which meds that might fit your condition best, and then you have to go through the titration of the chosen med. It can take a long time to find the right medicine and the appropriate dosage. All this takes a long time to get right. It took me 1 1/2 years of trial and error before finding my «sweet spot». and which meds fit
me. And luckily so far I have not had very many complications, apart from one major one; after about 1 1/2 year of having the pump the catheter fell out of my spine and consequently sent the medication right into my flesh in my lower back instead of into my spine. It took 6 months before my doc caught this error. It was far from ideal but I got the placement of the catheter redone properly and due to the fact that my neuro surgeon is amongst the very best in my state, things have been working well since that redo. But as some here say, when not managed well this pump may very kill you. Which is why I never recommend this pump to those living far from experienced neurosurgeons and professional pain management docs. It is important to stress that when done right these pumps can be life savers. Honestly I would not be able to function the way I do today without my pump w/dilaudid and clonedine. I just needed to let people know that these pumps can be highly effective..but again,
you really need to do a lot of research and importantly, you need an experienced care team around you to make this pump work properly. I would never allow a «newbie» surgeon attach this pump to anybody’s spine. The risk of permanent irreversible damage is always a factor when deciding whether to get this pump or not..and very rarely will the pump replace your other oral meds. I still need oral opioids in addition to the SCS stim and the pain pump; but together they work as layers to help the pain. In an ideal world all the different therapies I am on work in symphony with each other, and it’s all designed to keep my extreme and constant nerve pain at bay. If
you have questions or need advice I am happy to answer.

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Replies to "Reading these posts. I am so sorry so many have such awful experiences with this pump...."

@alexandercrps Sounds like you've been through a lot and have gained a lot of insights. I, like many here, have been on a ten year pain journey. Pain was well managed up to 2021 when my SCS paddle shorted out. All my pain came flooding back, even with the meds I was on. So, in 2023 I had my trials of the pain pump. Both were done by injection. The first was done with morphine...no help, just a lot of vomiting about eight hours later. Two weeks later the second trial was done...hydromorphone dropped my pain from a seven down to about a two.
I have read of trials being done with externally mounted, temporary pumps which are worn for several days. I wish I could have had this type of trial. Instead this massive amount (4 mg) was shot into my spinal fluid. Unfortunately, when I received the permanent implant, they started very low(I haven't been able to find out how much). Here I am, three years later with exactly one day of relief. I just had my output raised to about 3.5 mg/24 hrs. with six boluses. I gave myself everything yesterday... no pain relief. Now, I had noticed that several days ago, the full dosage plus all boluses dropped my pain down to about a four.
Very odd and discouraging. I know that there are some here with pain pumps with a daily output of 6+ and 7+ mg/24 hours and get pain relief. I am afraid that my PM doc won't boost my output anymore. He said that higher concentrations can lead to granulomas on the catheter tip. All I know is that I am willing to go higher if I can get some pain relief and reclaim some quality of life. I will welcome any advice from my fellow pump users.

@alexandercrps
Alex- May I ask what your daily dose of morphine was at the time it dislodged from the CSF in the intrathecal space. My doctor has always been honest with me and expressed her concern of a “pocket fill” when the pump port is missed and they warn that it could be fatal! So please let me know you survived.