Hi and thanks for your question. First of all what happened to me is not considered a pocket fill. A
pocket fill is when the entire amount of medicine (2 ml or 4 ml depending on the size of pump) get injected right into your tissue and not into the tiny hole of the pump. I know I keep yapping about the same thing over and over again on here, which is you need a higly specialised and extremely experienced doctor to deal with these pumps. If not this pump can kill you. A pocket fill, which can be deadly, is probably the most know problem with these pumps. but it is not common at all. Moreover my incidence is not considered a pocket fill since I only got tiny amounts of medicine slowly pumped into my flesh, as opposed to getting the entire 20 ml injection all at once. This is not a common occurrence and it only happens when the physician misses the port and injects all the medication straight into your soft tissue. A pocket fill can be deadly, so always make sure that you have the most experienced docs filling, emptying, and programming your pump. What happened to me was that the pump sent my small 24 hour dose right into my flesh in my lower back. What I experience was the most extreme itch you can imagine in my lower back. And it was driving me crazy. I know now that both hydromorphone and morphine have side effects that can make you extremely itchy. And it is an itch coming from inside deep of your tissue and bone, it is not the skin that itches but rather the bone and the surrounding muscles was itching like crazy. I had this itch for 6 months and I kept complaining about it. But nobody made that
connection and I can tell you it was awful! And we finally identified the
issue when I was under the
fluoroscope for a lumbar steroid shot. He couldn’t see the catheter tip which meant that the catheter had fallen out. What my doc was more worried about in my case was how I didn’t go into withdrawals. But I also use oral opioids which prevented such withdrawals. I cannot remember what my dose
was at that time, it wasn’t very high but definitely high enough to be a deadly dose had there been a pocket fill. Again my case was not considered that since it was a catheter issue, I simply didn’t get the tiny amounts of meds into the right spot inside my spine. It wasn’t fun during those 6 months, I remember not feeling great but I am so used to always feeling crappy so I just went on with my life. The incessant itching though is a sure sign that something is wrong. I actually sometimes get the same extreme itch in my ankle and foot sometimes, and I believe this is a side effect of the dilaudid. The itching is a known side effect of intrathecally injected narcotics such as morphine and dilaudid.
My physician never uses morphine on his patients exactly because of
the extreme itching most people experience. So to sum up, a pocket fill is when all the meds are injected into your flesh because they miss the pump port. An experienced pump would never inject anything unless they are 100% sure that the syringe tube with your meds is safely connected to the pump’s tiny port. If you have an experienced doctor dealing with your pump you shouldn’t have to worry about pocket fills. Your main concern should be an optimal catheter placement, and that the said catheter is properly connected to the part of your spine where your pain stems from. Lastly there so many various aspects to these pumps. I wish we could start a zoom support group for people like us who wear implants such as pain pumps and spinal cord stims. I hope I managed to answer your question. Wishing you all the best.