Sorry to hear this. I was given a spinal injection with dilaudid before I got the pimp to make sure that was the right drug for me. 1.39 mg. is too low. I began at 3.6 and now I'm closer to 4 mg. Plus .9 mgs. that I can give myself in 10 doses over 24 hours, .09 per dose. Find another doctor. I'm not sure if the starting dose is determined by the oral or patch dose we were recieving before the pump. I do know that raising the dose too much can make the pump worse than useless leaving you in more pain than ever. Best wishes.