@kaki068 I am not sure if I sent my reply to you or just the general post so I am sending it again.

Ask if he will only do microdosing, which limits Dilaudid in the pump to 1.0mg/day. Other opiates have different max amounts, but the bottom line is that it may not be enough. Ask him about other drugs that can be mixed in like Baclofen, a muscle relaxer which I have found does not help. Also, they can add Bupivacaine, a local anesthetic similar to Lidocaine. Also, be sure to read up on Prialt, a nerve agent kind of like Gabapentin that is made from snail venom. Docs like to use it but it can have very serious side effects like delirium. I cannot take the nerve agents (Gabapentin, Lyrica and Cymbalta) due to their side effects on me so I refused Prialt when my doc wanted to use it. My trial was just and injection into the CSF. It helped, so I was a pain pump candidate within a day. I have the 40ml pump reservoir vs the 20ml. The 40 is nice since I am at 0.9mg Dilaudid/day and my doc is a fan of microdosing. I only have to refill every 4-5 months. If I was on higher doses, it would go faster. The drawback is that I feel it and it sticks out of my stomach some. I am thin, 5'11" 175lbs. Also, there are two ways to set the pump: (1) you can set it so that it automatically ups your dose at certain times of day when your pain usually is at it worst, and drops lower when pain is lower, like when you sleep. The drawback is that you cannot give yourself an extra dose (bolus) when you need it. (2) You get a remote control that allows you to give yourself a bolus when you need it, usually set at 10% of your daily dose. This is the one I have and recommend. At first, my doc only gave me two bolues in a 24 hr period. That was not enough, so they upped it to three. I would push for three boluses. You have to wait at least three hours between boluses. The drawback to this way is that you have to carry the remote around with you, which is a cellphone plus a device you place over the pump that talks to the pump and Bluetooths to the remote, so that is a bit bulky.

I am happy to answer any questions.