I have a Pain pump with Morphine, I'm still in so much Pain

@donaldrobert

prayers have power
PRAYING FOR YOU NOW

@cgrove9 Thanks for your kind words and prayer. I am at the point now where it seems that I am feeling a bit like the apostle Paul. He was not lifted out of prison and was content to be in whatever state he found himself in. Prayers for you as well.

@alexandercrps I know this might sound like a silly question but I thought you would be the person to ask. When getting a pain pump implanted, how does the doctor deal with someone like me who has multiple areas of severe pain in my spine. I’m so worried about this and having to deal with my severe pain. I’m terrified! How do they address this?! Thank you!

@kaki068 Hey I’m not quite sure how to answer that question but I’ll try my best to provide you with a somewhat sensible response:
Firstly, everyone is different and every case has its own unique set of challenges. As I said earlier, this pump is not for everyone. What I do know for sure is that these pain pumps tend to be a last resort treatment. Moreover this pump is mostly offered to people who have responded poorly to all other treatments, so basically it is only offered to those who really need it. And there is a an important psychological aspect to this implant procedure too that you must consider. Initially you have to talk to a psychiatrist and pass a psychological assessment before they even consider giving you this implant. Furthermore, you will likely be asked to do a number of MRIs in order to make sure that your spine is in good enough shape
i.e. that your spine is healthy enough and in good enough shape to even entertain the idea of this implant. So if you already have issues with your spine and/or pain in several different areas of your spine, then this pump likely is not for you. Pain pumps work best for targeted chronic pain. This pump is not made to treat multiple areas of your body at the same time. Instead as I said earlier these pumps target a very specific area of your body.
In my case the pump drips tiny amounts of medicine right ontop of the nerves that causes my pain in my left foot. My catheter is placed low in my spine as it targets the nerves around my L4-L5-S1 area. However before you get to that point you will be assessed both physically and mentally to make sure you are a good candidate for this pump. I hope this may help clarify things and if I was not able to understand and answer your question sufficiently then please accept my apologies. When I give advice it is only based on my own learned experience and I cannot stress often enough how many variables and differences there are in each case. At the end of the day my advice is to always advocate hard for yourself in order to get the best possible medical treatment you deserve and need. These pumps are quite finicky and definitely not for everyone, but it can also be an amazing asset for you and of great help when it works as designed. One must however have a healthy spine and one must pass the psychological exam before they move forward with the actual implant. I hope this information is helpful and I wish you the best of luck with your illness. I hope you find the help you need.

@kaki068 I think the person to ask is a neurosurgeon or pain management specialist. My pain was in my lower back and buttocks. All I can tell you is that after they injected the hydromorphone into my intrathecal space, I felt great relief in about five minutes. Interesting thing... even though the pain in my buttocks was reduced to about a 2, I was still aware of feeling like there was a stone in each butt cheek. It just didn't hurt very much.

@kaki068 Sir- I hope you read all these replies carefully. I realize that folks convey what their doctor told them or they think they told them.
First- You don’t automatically get offered a pump trial under most circumstances. I knew I was toast, and when I showed for my first appointment the doctor knew what I was there to ask for. I was on copious amounts of pain pills & patches. That she could easily read from my intake papers. The one thing I didn’t have was a healthy back. I was already fused or had stabilizing hardware from C3-C-6, (C7-T1 is the only thing not fused) and T2-S1, bone spurs, arthritis, scar tissue, FBSS of both Thoracic and Lumbar spine, DDD, RSD/CRPS. They place as low as possible and not interfering with your anatomy or other equipment (like a SCS at level T8). Morphine is water soluble and your CSF is over 90% water. So as soon as it enters the intrathecal space it instantly dissolves and circulates. It can’t be targeted to a specific nerve at a specific level. It treats the entire spinal cord. And therefore the entire back. Since it doesn’t cross the blood/brain barrier, you don’t get any relief for other systemic pain. Hurt knee, hip, broken ribs, no relief at all. Strictly the back, the entire Cervical, thoracic, lumbar & sacral spine is covered.
The complexity of your spine, will ultimately determine where the catheter will be placed

I do not necessarily agree about needing to have a healthy spine to get a pain pump. I have a congenital defect in my spine, my vertebrae are misshapen and more concave then normal, which makes the disks wider than normal. The extra width makes my disks unstable, which puts more stress and them and the facets and causes them to deteriorate faster than normal. A pain doctor at the world renowned Steadman Clinic in Vail, CO told me I was one of the ten most complicated backs he had ever seen because of all I had going on with it. Before I received my pump, I had two fusions, fused L3-S1, two artificial disks at L4/5 and L5/S1 that had been fused over, twelve electrodes and three batteries implanted subcutaneous, arthritis in every facet, significant stenosis forming in L2/3 and was on massive doses of opiates. I spent at least three hours a day in bed and did not leave the house much. Given all that, they implanted a pump in me with Dilaudid (0.88mg/day), Baclofen and Bupivacaine. I am off the oral opiates and live a better life than I did before the pump. I still have a lot of pain, but having been in so much more for 12 years, I can deal with it.

I agree with what @bilt4pain said about the pump medication moving through the spine and giving more than localized relief in the spine, though it is my understanding that the further away the pain is from the catheter tip in your spine, the less effective the medication, which makes sense as it has more time to be diluted in the cerebral spinal fluid.

As other people have said, you have to advocate for yourself and if faced with a doctor who thinks he knows more about your pain than you do, set him straight. If that does not work, dump that doc and find another.

Thanks for the shout out!
However, I respectfully disagree with your opinion of more relief being closer to the catheter. Your CSF is mostly water, morphine is water soluble and instantly dissolves after exiting the catheter. The CSF does not remain stationary. It circulates and bathes the entire spine.