Anyone had Spinal stimulator removed? Replaced?

The anesthesiologist who implanted my 1st one in 2021 was a quack. He threaded the top of the catheter to my C2 level inside skull. He also shallowly implanted pump in my left buttock. He decided to use Bupivicaine instead of Morphine. FDA does not approve Bupivicaine for intrathecal pain pumps, but I didn't learn this until i began researching drug toxicity. Also needed Baclofen for severe muscle spasms. Said would start with low dose (~300mcg/day). He OD'd me & wound up in hospital for 5 days. Medtronic had to come into hospital and zero out the dosing. Restarted medication thru pump a month later, with Baclofen at 70 mcg/day. He started dosing me higher on the Bupivicaine to the point I began experiencing toxicity on that med and kept denying that was possible. After 14 months of Bupivicaine toxicity and exposure to unhealthy levels of Benzene in my apartment, my PCP & insurance provider contracted with a different pain practice & specialist that willing to assume care of dosing for my pain pump. Only condition was the pump spinal catheter needed to be retracted back to the more standard C5/6 vertebral level. This was Jan 2023. The new pain doctor referred me to a neurosurgeon willing to do correction. Upon review of my problem, he informed me that it would be too risky to surgically remove the original catheter since it was implanted nearly 2 years prior & located to major veins/arteries entering my skull. In March of last year, new Neurosurgeon replaced original pain pump and implanted in lower left abdominal area. Original catheter was cut back and surgically tied off while leaving leading tip in place. Morphine & Baclofen were dosed in my new pump. Everything was going fine and controlling pain, even post-shoulder replacement pain. However, in June, I developed a fluid seroma within the cavity where new pump implanted. I had 350cc of fluid aspirated from pocket in late June. In August, I started to notice a lump at the base of my thoracic spine. An ultrasound confirmed it to be a rather sizable cyst. My Neurosurgeon drained it on Oct 2, in his office. That afternoon, I got a severe spinal headache and the cyst sack had filled back up by the next morning. I went into emergency surgery on Friday where my surgeon found the tie-off to original catheter had eroded and the fluid collecting was cerebral fluid leaking from my brain. The old catheter was securely resealed (tied off) with additional clips as a security measure. This was not the end of my problems and had another surgery on Nov 8 to securely attach the pump to my abdominal wall. All the fluid from the seroma had created a large cavity one fluid absorbed and pump was doing sommersalts & flips that were pinching &/or wrapping the catheter around the pump and pulled the tip down to T1 level. This may all sound scary and horrific, but I fought nearly 10 years to get that pump and, despite all the problems have had better pain control (with the Morphine) than I ever got with my stimulator, oral opiates or medical Marijuana. My problems have been largely due to the fact I'm 69 y.o. and have autism on top of complex medical issues never addressed before learning of my autism at age 60. I encourage you to pursue getting the pain pump if your pain is chronic & multi-systemic (caused my multiple health problems). Just be sure you find a good doctor/surgeon who is experienced and lacking a big ego. Be sure to ask what type of infusion meds (s)he'd use. I know this is a lengthy reply and must apologize for any grammar or spelling errors since I'm typing on my phone.

I appreciate the thorough response. Having dealt with a lot of pain doctors and surgeons (I am 70 years old), I can understand how you engaged with all of these doctors in good faith and gave them all an opportunity to do a good job.

You have confirmed my gut instincts about the pain pump. To date, pain doctors have encouraged me to try a spinal cord stimulator, but I don’t understand the science behind SCS. I understand how the pain pumps work, so it seems more obvious to me they would provide relief. I have had good relief with oral and IV opioids, but it’s not practical or safe for me to take the doses necessary to sustain relief. The pain pumps make sense to me because they are more efficient at lower doses.

A lot of the pain doctors prefer SCS or pain pumps, but I would prefer to try a pain pump before trying SCS. I appreciate that you are so candid that you feel pain pumps are fundamentally a better option.

Then it comes down to finding a good doctor with good surgery skills. That’s also true for SCS. I’m also thinking about relocating across country before I get too old, so I can be closer to family. So, I will look for a doctor who does pain pumps near my new location. I was surprised when I first started researching pain pumps, to find that doctors don’t want to support patients who didn’t get the implant from them. Basic maintenance like getting the pump refilled in the new state would be hard.

And I appreciate that you encouraged me to ask in advance about what medicine the doctor intends to use. If the doctor suggests something besides the main 3-4 medications that are typically used (morphine, hydromorphone, baclofen and ziconotide and a couple others), I will run out the door and keep looking for another doctor;-)