Overdose from pain pump refill

@mmalone1804 Like you say, when inquiring about pain pumps the tendency is that you’ll hear all the horror stories first. The success stories on the other hand are a lot harder to find but that doesn’t mean they don’t exist. There are tens of thousands of chronic pain patients like us who now have much better quality of life because of these pumps. The absolute most imperative piece of advice I always give anyone contemplating getting a pump is to find the absolute best neurosurgeon you can find with a proven track record of successfully implanting and placing pain pumps. If it is not placed correctly and if the catheter isn’t placed right on the exact nerve which causes you pain, it simply won’t work. Secondly you need to find an equally proficient pain management doctor to program and service your pump. This is a millimeter sport which requires an extreme amount of “fingerspitzengefühl”; one millimeter of wrong placement of the catheter and you will experience zero relief. I cannot stress enough how imperative it is to try and find the absolute best specialist in this field before you decide to get the implant.
Also when you get this implant you get an implant card to put in your wallet. On that implant card they list your designated pain management doctor’s cell phone number. So in a way you are stuck with this doctor as your pain pump specialist so you’d better off actually liking and respecting this doctor. Because this tech requires close cooperation and sound communication in order to make it work. In the beginning after the actual implant operation is done, you will likely have to see this doctor once a week to titrate the medication. Given this frequent contact with your doctor it is imperative to both like and trust this person. So please make sure to do your due diligence BEFORE you get this implant. A pain pump can be a blessing and a life saver when done and operated right, but it can also very easily become a complete nightmare, especially when you don’t like or respect the doctor managing it. Wishing you all the best and I hope you get this pump and get the relief you need. Just be patient, it can take some time to get to that point, but as long as you trust and like your doctor and trust the process I think you’ll be fine.

This is excellent advice, and things I hadn’t considered. My current pain management doctor is not someone I would trust to do the surgery or anesthesia. I knew that.
So, I did find the expert physician I was looking for. However, he is unable to do the ongoing maintenance, and the PM doctor will then take over.
But now, I see your response, and was unaware of those particular issues regarding the ongoing maintenance. Maybe my surgeon can recommend a different PM doctor. He is the head of the Pain Department at a large university hospital, but they do not do pain management and prescribing. I would trust his recommendation though.
It sounds like you found exactly what works for you. Any chance you live in Northern CA?

@mmalone1804 Yes these are all very important aspects to consider. However most of us are typically so bogged down in pain dwe fail to consider the aftermath of how to live with and use this pump day to day. I know a lot about this issue because I went through quite the nightmare myself before I found my current setup of pain management.
For the first two years it was a complete disaster. I had to see this doc weekly for titrations, but he didn’t understand how to bolus and essentially he didn’t understand this tech at all, so I got zero relief and I mostly got tons of anxiety and even grief for how it didn’t work throughout that entire period, all because my pain management doc at that time was utterly useless. It was a very scary time because I could see how uncomfortable and anxious this doc was when dealing with the pump. And this in turn made me scared. Eventually it all came to a head when this doc gave me an overdose of ketamine (600 mg) causing me to puke for three days straight. During this godawful process I was so exhausted from my crps pain not being controlled that I became suicidal. Consequently I was referred to an emergency pain psychologist for help, and it was through this group of psychologists that I found my current pain management doctor. They put me in contact with a woman who also had a pain pump and she was very happy with her doc and I finally made the switch. But it didn’t stop there: when I consulted with Dr Diaz for the first time he simply said he didn’t like anything about my pump setup so he booked me in for surgery where he redid the whole thing; he placed the catheter much further down on my spine and he made a new pocked for the actual pump too since it had sunk down and rested on my hip bone. Moreover he changed my meds too, I had a bupivacaine hydromorphone mix at first but he traded that for a clonedine hydromorphone mix. He also preprogrammed 6
boluses which flushes the nerve with more medication at specific times during the day/night when my pain typically spikes. In other words, it took me over 2 years to figure this pump out. Had I seen Dr Diaz from the get go I would have saved myself from a lot of fear, pain and discomfort and I woud have gotten some relief after just a few months of titration. So please do your due diligence before you get this pump. Your ability to cooperate closely with and communicate well with your pm doc is imperative.
And lastly I live in Texas but if you live in California you should be able to find some sound pump doctors over there. I hope you figure this out, best of luck to you

Do your due diligence before get a pain pump. My quick story:
> 4 back surgeries over my life, multiple injections in the L3,4,5 area.
> Now at my age it is spinal stenosis, pinching nerves and now peripheral neuropathy, more right leg than left.
> Difficult and very painful to stand for an extended period.
> Walking (cane) intensive, exertional dyspnea. Balance big issue.
> Sitting can do all day mostly pain free.
> Spinal cord stimulator consider, but went with Medtronics Pain Pump.
> Neurosurgeon implanted Medtronics, pain management Dr. maintains.
> Main ingredient is Morphine.
> 6th month since implant, NOT good.
> Doctor's never informed me of edema problem.
> Feet and legs swollen, painful, inability to walk is worse than before.
> Bad decision on my part, but bad advice by Physicians. Now less movement, less strength, depression.
> Anyone experienced this scenario, did you find remedy?
John

Patients need to be realistic in that pain pumps are machines and machines fail everyday. When people are involved mistakes can happen after all nursing staff and doctors who refill pumps are human and people make mistakes. Thankfully you were OK after treatment in the ED. You might consider carrying Narcan with you in the event this occurs again!

@alexandercrps what is the brand name of your pump?

@rashida the pumps is called Medtronics Syncromed II.

@rashida The most common pump on the market is Medronics Syncromed II platform. Additionally in the US there is another brand of pump available called Fluvonix Prometra II. The biggest difference between the two is battery life and mri compatibility; Medtronics pumps last up 5-7 years whilst Fluvonix pumps last for 10 years. The Medronics system is the easiest system of the two when it comes to mri compatibility: Medtronic pumps turn itself off when your start the mri and then it automatically turns itself on after. The Fluvonix pumps, on the other hand, needs to be completely emptied before you can safely do an mri. These pumps are also MR Conditional up to 1.5T only (whereas the Medtronics pump is MR Conditional for 1.5T and 3.0T scans). Crucially, the Fluvonix pump must be completely emptied of medication and refilled with sterile saline (0.9% NaCl), with the flow rate set to 0.0 mg/day before entering the MRI environment. This is because the magnetic field can open the valve-gated mechanism and cause a dangerous, immediate drug overdose if medication is left inside. I guess this is a main reason why Medtronics pumps have the biggest market share of the two.

Flovonix also has some limitations to how much