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Recent Unsuccessful Bolus Pain Pump Trial

Hi to all of my fellow Spineys :) It has been awhile since I started a thread here. The last time I did was before and after a failed Thoracic SCS trial in 2010.
After that I worked extensively with my Pain Psychologist to learn to live in my body the way it is. I am very fortunate to be a patient at an Interdisciplinary Pain Clinic. Once we got my medications dialed in I was living day to day with pain levels between 3 and 6 which is fantastic and more than I could have hoped for.
Over the last 6 months side effects of Gabapentin and daily pain levels from 5-7 led to a 3 month discussion about the pain pump. The change in my pain happened when I moved to a beautiful cottage in the redwoods in March of 2013. There are no flat roads where I live to walk my dog. Walking Sammy on hills, and using my freestanding wood stove to heat my home has been very difficult. I have found sources for fire wood that provide lightweight small madrone and almond. I have tried every possible loading method to reduce strain to my thoracic spine.
My trial was on 01/09/2014 and was going very well. Doctors orders were to walk a LOT post injection. My pain level increased to a 5 and my Physician deemed the trial unsuccessful only 6 hours after the injection. While on the telephone with my doc I found myself saying ridiculous things. I said that I did not have my walking shoes and that I just needed to rest up then walk more like I do in my daily life. The truth is I was very sad, more sad than I have been in a very long time, to hear that the trial was not a success. The pain relief that I experienced before I walked was fantastic. I did not want to let go of the idea that I could have this relief permanently.
I have been on a roller coaster of emotions and thoughts since then. It is just a lot to go through and I feel very sad, then I think that it just was not meant to be.
So here I am again on spine-health, where I know it is safe to put it all out there.


  • that the trial didn't offer you the relief that you hoped it would. It might be possible somewhere down the line to try again, with a different medication used during the trial.
  • Time is a gift for me right now. I am coming to terms with the outcome of this trial. My emotional state is better and I am thinking more clearly. I had not thought of another trial with different medications. Perhaps this will be a possibility. For now I am being present, staying with my daily routine and am getting tremendous comfort from friends and family which for me include all of my four legged kiddos.
    Take care all :)
  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,732
    I don't understand??? There are a lot of different ways The P.P. Drs. do these trials. Usually a Dr. that does a single injection. Has you stay at the Place that He's using. (hosp. or surgery cent.) For a few hours.
    So they can watch your vitals. And if you got at least 50% reduction in pain, Then it's deemed a success. I would try another P.P. Dr.
    Good luck, Jim
    Click my name to see my Medical history
    You get what you get, not what you deserve......I stole that from Susan (rip)
    Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!
  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,732
    edited 02/22/2014 - 3:07 PM
    The description you gave, the trial WAS a success. The injection only lasts a short while and wears off.
    No way would it last for 6 hrs. You have a miscommunication with your Dr. How long were you in 50% or more less pain for?
    Click my name to see my Medical history
    You get what you get, not what you deserve......I stole that from Susan (rip)
    Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!
  • Thank you! I agree.
    I am talking with my Specialist about both the results, and possibly doing another trial. Maybe the medications are not the right ones for me, or maybe a Bolus Trial is not for me. No one fits perfectly in a tidy little box with this type of treatment.
    The Interdisciplinary Clinic is so busy these days that I am am beginning to have a lost in the shuffle feeling. If we do not come up with a plan that I am comfortable with there is another Specialist in my area now who I will consult with.
    I am in a great deal more pain now than I was this time last year. I am not going to let this fact make me rush into treatments as I have int the past.
  • I was learning about the protocol of my trial the day I had it. This alone caused me so much distress and is not acceptable to me.
  • What do you mean hon? If you indeed had a reduction of 50%, then I am not sure why they considered that a failed trial, especially given the type of trial they apparently did. A single bolus injection is different than the use of the temporary cathether, and is more like an epidural when giving birth.
  • Jackie,
    I had the pain pump trial as well. I had the bolus dose, and I remained at the clinic for about 3 to 4 hours afterwords. I was very sleepy from the medication and do not remember much of what occurred after the trial, except that it has helped my pain. I knew it helped my pain because I was able to sit upright in a chair for those 3 to 4 hours which was something that I had not been able to do any year and a half. There are many different medications that they can try in your pain pump and they can also mix the medications together. I know what it is like to feel like there are no options left, and that extreme disappointment you have when something your counting on didn't work out. After I had the pump installed and had the Rare side effect of spinal fluid leakage, and what was supposed to be a simple surgery resulted in three more procedures and surgeries, along with weeks of bed rest. I am getting relief from the pain pump now but I have also lost my job because of the time I had to take off. Me losing my job was like losing part of myself. It adds to the pain I feel and the worry I have of being a burden. I feel I am not who I was before the surgery, and looking back I don't know if I would do it again. I also believe that there has been nerve damage done from multiple surgeries and procedures, which has resulted in pain in my leg below the pain pump entrance. If you do have another trial I hope it goes better. I am only telling you my story because I wish I had known about the side effects that could occur, although the spinal fluid leakage is a rare side effect. Good luck
    2000- spinal fusion, complete spine due to scoliosis
    2012- pain began, started treatment for chronic pain
    2013- install of pain pump, procedures to address complications
    2014-blood patch, spinal fluid leak
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