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Medtronic Morphine Pain Pump Problems


I have had pain pump for 7 months and received no relief from back pain, dr. & sales rep. says, "it should be working". It is at maximam dosage and they have tried both morphine and dilaudid.

I am 78 year old female, with osteoporosis, multiple compression fractures in T & L spine, and L - spinal stenosis.

Am I alone?
Hi Molly, I'm just curious as to what they consider maximum dosages, How many mgs a day of either med did they call max relief. I know of docs that would call 2 mgs of morphine the max dosage which is rediculous when It took 12 mgs a day of morphine to get relief. But some docs have their limits just as they do with oral meds.

Also if you did get relief during the triall, it seems it's time to look for a problem like a the cath having disklopdged and moved or the pump leaking and not delivering meds, This is easy to check using the side port and a rdio opaque dye..

No relief doesn't make sense, not being satisfied or having high expectations that aren't met is something else.

Good luck, Dave
I dont have a pump but I have a close friend who has a Medtronic pump and she had the same problem. It took almost 9 months of hounding the doctor and company to do more investigating. When they finally did they found the problem. There was something wrong with the catheter that delivers the medicine. It was cracked, broken, or something causing the medicine to not be delivered into the spinal area it was supposed to be. The way they found this out was that they put her in the hospital and disconnected the pump and gave the same dosage through a different catheter. Her pain was immediately under control again. (she had good success when they did this as a trial before the permanent implant)

Good news - they found the problem, Bad news - they had to repeat the surgery and reroute a new catheter. The old one is still in her body and they cant remove it for some reason???

She is much better these days and has not had problems since the repair. I dont know if I am being of much help but it might be worth investigating.

Good Luck,
Liz
Hi Molly, Like liz pointed out , Your doc and specially the rep are slow to consider the possibility that there is a failure of the pump or cath. I don't know which model pump you have but the synchromed pumps by medtronics have a side port designed to run radio opaque dye through the cath so they can see with flouoscopy exactly where the meds are delivered. Caths pulling out of the spinal cord and simply deliverying the tiny amount used for intrathecal use into some part of the muscle basically becomes no different than an IM shot of the med and nowhere near as effective as intrathecal delivery. I would insist they check the cath placement and run dye through the pump rather than continue to make you suffer when they don't lnow for sure where the med is being delivered untill they due this test. Cath disloging is probably the number 1 potential defect of alpumps. They are supposed to be anchored but if you have osteo perosis, and even if you dond't, the anchors can easily be pulled out and the cath will simply slip out of the spine.

I am still interested what this unknown max limit is. I've met folks recieving as much as 18 mgs of morphine a day and my pump delivers 7.2 mgs of Dilaudid a day and I have yet to be told I'm aproaching any sort of limit. If you have the non battery operated unit the limit may be on the concentration they can use as contration of medication is what controls the amount of meds delivered rather than the what the pump is actualy capable of. Non batery pumps deliver a steady flow of drugs and the dose delivered is based soley on concentration of meds. I can see a limit as far as preventing granulomas from forming at the cath tip once you reach 30 mgs per ml of morphine or above, But if you have a programable pump, I have never heard of any sort of limit other than a docs comfort zone. The only limit I'm aware of, is side effects and what you can tolerate.

Take care, Dave
[QUOTE=MollyGirlUSA;2926122]Medtronic Morphine Pain Pump Problems
Dear MollyGirlUSA,

I BadbackJack have had fusions from L4 to S1 and have had a nuerostemulator implanted and also had a medtronic pain pump installed. I still suffer from svere back pain and I gto have gone from morphine to dauladid and still no relief. I have been on just about every oral pain medication that is out there and I still have pain. I have to go on long tem disability because i could not work anymore. Im only 37 to 40. My pain doctor wants to take my pump and stem out and send me to a pain management clinic ( he is pain intervention.). I wish you luck let me know what happens. Oh yeah I have been going through this for 10years.

I have had pain pump for 7 months and received no relief from back pain, dr. & sales rep. says, "it should be working". It is at maximam dosage and they have tried both morphine and dilaudid.

I am 78 year old female, with osteoporosis, multiple compression fractures in T & L spine, and L - spinal stenosis.

Am I alone?[/QUOTE]
[QUOTE=MollyGirlUSA;2926122]Medtronic Morphine Pain Pump Problems


I have had pain pump for 7 months and received no relief from back pain, dr. & sales rep. says, "it should be working". It is at maximam dosage and they have tried both morphine and dilaudid.

I am 78 year old female, with osteoporosis, multiple compression fractures in T & L spine, and L - spinal stenosis.

Am I alone?[/QUOTE]

I had a Medtronic. pain pump some time ago.I had the same problems you seem to be having.
Shoreline hit the nail on the head.
After complaining to my Dr. for some time, he finally got around to injecting dye into the pump and and under flouroscapy, saw it come out the other end of the catheter. Unfortunately,the catheter had become dislodged from my spinal column so the medicine was simply spilling out into the surrounding tissue and muscle.
That was surgery #1.
After another 6-7 months,I told the Dr. I was still having too much pain and was requiring oral meds.
This time,when they injected dye into the pump, it simply leaked out of the pump itself into my belly area, as the catheter had come loose from the pump.
That was the last straw and the next operation was to remove the pump and go back on oral meds.
Though it's not as 'easy' as the pump is 'supposed' to be, at least I knew what I was taking was going into my body as intended.

Good luck!!
I totaly understand where you are coming from. I had L5-S1 fusion in 2004 with 2 discetomies before that. I have had L2, L3 & L4 disectomy last year. I had the stimulator in, but had it removed because it was causing more pain that it was helping. Don't get me wrong, it did help for a while, but went downhill after only a few months of some relief. I've had the intrathecal pain pump since April 2008 and I'm still waiting for relief. I did get some relief during the trial; that's why I went ahead and had it put in. I was getting some relief, but not much and I'm still taking all of my oral meds, plus additional ones that i wasn't taking previously. I am getting extremely fustrated, but am still trying to be optimistic. They say that there are lots of medication and combinations of medications to use. So hopefully I will get some relief soon. Like you, I can no longer work and am on permanent disability and am under the age of 40. I try my best to get by each day because I have an 11 year old son that needs me. Hopefully they can find the magic medications for us who aren't getting relief!
All the best, Donna
I know the original post was awhile ago, but I will add what I know. My mom got the Medtronic pump put in April of 05. The plan was to keep her on the patch and oxy for breakthrough(which was her original meds at time of pump placement)until the meds in the pump(morphine) got to the right level. She had great success with the trial. The doc slowly raised the dose in the pump for about 6 months and everything was fine. Then her pain went through the roof. So in addition to the pump, patch and oxy, he added actiq thinking she would get relief sooner or later with the pump. Starting around this time, she began to get a tumor like bump around the cath site. None of her docs thought anything of it. She kept pointing it out over the next year. In addition she was now maxed out on the pump, new meds had been added to the pump and nothing was working and she was on more meds now than when she started. They finally did the dye and of course the cath had slipped and the tumor was the meds building up in that area.

She thought about having it taken out, but decided to keep it and she went in to surgery hoping only the cath needed replaced and not having to have the whole thing redone on her other side. They were able to just replace the cath and she was sent home. They said because she had not been getting the meds through the cath, they needed to start out low again. She went through some bad withdrawls, but the doc gave her other meds to help. From the moment she got home after this surgery she said something was different, but because of the withdrawls and the surgery, everyone thought it was just that. Next she began to complain of numbness in her legs and not feeling when she had to go to the bathroom. The surgeon said these would go away. On the day she was to go to her follow-up with the surgeon about 2 weeks after surgery, she was putting her pants on and collapsed being paralyzed from the waist down.

From here to make a very long story short, she ended up getting meningitus from the new cath. After they took the WHOLE pump out this time, cath and all, she went to a rehab hospital and it will be a year next month. She now can walk, but still can't really feel her feet. She did finally get control of her bathroom issues, but at first she had none.

I know the pump has helped many, but you will never get one near me. Now she uses the patch and oxy and is doing OK, but she is still not the same. I think it did something to her mind as she has trouble with her memory, at times slurs a little in her speech and she just repeats what you say a lot of the time. She had none of these before all this happened.

Melissa





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