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life after intrathecal pump questions

A brief summary first. I've had a failed back surgery an have been put on many many diff pain meds, none of which touched the pain. I've been told twice by two diff surgeons I need revision surgery, then told no it won't help with the pain. Both levels fused somewhat, neither are fused more than half. Now the surgeon wants to do a discogram to see if it is a diff disc/level causing the pain. If that isn't the problem, I've been told pretty much all that's left is the pump.

Here are my main questions as far as the pump goes. I worked as a maintenance mechanic in a factory when i was injured, does anyone know if I will be able to return to that type of work after the pump is installed?? Second question. Does the meds make you feel out of it like oral meds or does it work just strictly on the pain an leaves your mind clear. Third, if not being able to return to that line of work. Will i be able to get hired at any job, being i will fail a drug test because of the meds in the pump. Any help with this would be greatly appreciated.



  • Those questions are best answered by the pump physician who will do the implant. Once you are healed from the catheter insertion and the pump placement, I am not sure if the mechanic position would be okay.......it may very well be , as I said, once you are healed the catheter is scarred into the thecal sac...
    The pump delivers medications in much, much smaller doses, micrograms, versus milligrams, and is very concentrated, and delivers the medications directly into the spinal canal, where the pain signals are transmitted.......therefore, it doesn't circulate through your body like oral medications do.....so the foggy brain and lethargy shouldn't be an issue.
  • I know I should have asked him. I typically bring a notebook with the questions I want/need to ask, but I had forgot it at home. Plus was mainly looking for answers from people that has the implant as opposed to a dr's veiw or what he's read in a book. That is great, about not having a foggy head!! I will make sure I bring the notenotebook on my next visit. Thank you Sandi

    One other thing, I've seen posts an such that muscle relaxants are sometimes use along with pain meds. What muscles does this work for?? Mainly just wondering if they would relax the gluteal muscles, that run up along the sides of the lumbar spine. I will also ask the dr but once again just wondering from people that have the implant
  • My friend is just about to have Baclofen (muscle relaxant) put into hers. She's done an oral trial. It works great for her muscle spasms but makes her feel way too foggy to work while taking it. Her doc has assured her that won't be a problem once it's in the pump.
    I don't have a pump but I've taken muscle relaxants for many years. For me they help with spasms but don't 'relax' tight muscles...that takes heat & stretching, massage etc. For me all the side effects & sleepiness went away once I'd been taking muscle relaxants 3x a day for a couple of weeks.

    I'd consider a second surgical opinion. My friend recently had her 3rd fusion. Her doc doesn't believe in discograms (it seems like docs are very divided on them) but she had a whole host of tests to identify her pain generator. If your surgeon isn't sure what's causing your pain, he can't be sure what surgery is needed & he can't guess what could happen to your pain. Know what I mean?
    I believe in doing my homework. It's great that you're investigating the pumps but they are just another way to mask the pain. It would be better if a surgical solution could be found. Like everything pumps can bring their own problems.
    Osteoarthritis & DDD.
  • I agree with a lot of your reply. The original surgeon was against discograms an gave me a list of why he refused to do them. I also agree that the pump can cause problems as you said anything could. I would much rather be fixed as opposed to just given a band aid (pain pump). Mainly because I very much want to get back to the job I've had for going on 10 yrs. Being that my case is a work comp case, I'm at the mercy of the doctors an where they send me. I've used up my two options of doctors, so now I can only go to the doctors the insurance company send me to an the ones which Im sent to by the drs I'm presently seeing.as for the muscles I'm not sure if they are just extremely tight or if they are in spasm, just not a full out spasm. I've been through p.t. that I was taught many diff stretches none of which helped. Along with deep tissue massage, heat, tens unit yhen H-wave. None of them helped, my pain management dr tried two trigger injections an they didn't help. About the only real relief I've had is when I was in aquatic therapy, when I was in the heated pool an was in the deep end an would just hang from the wall I was virtually pain free for the moment. With in a minute of getting out of the pool all the pain came back the spine pain along with the muscle pain/spasm. Thank you again for your reply englishgirl
  • Ugh! I know nothing about those kinds of cases but I hear people complaining all the time about them. I'm so sorry. Will they not allow you to have revision surgery? I know there's no guarantee it will help your pain but it might! What will happen if you don't have surgery? Did they tell you that? Ugh! I'm so sorry.

    To answer your concerns... The people I know with pumps have returned to work. Let me be honest, I don't know the very happy, no problems, patients. Despite issues with the pump they are both working. It took one nearly a year to get back though. I think they are both worst case scenarios (short of having it removed). One works part time in an office setting & one runs her own small business & pulls stock (crafting supplies) & packs orders, goes to the post office everyday. They both complain of pain but are so much more functional than before. Both have had extensive fusion. Both can socialize etc.

    I'm on the fence about it. I'm currently researching how well it's supported in England...I might have to go back home. I'm considering having an implant if it is despite knowing friends who haven't had great results. I don't think it's desperation talking! For me, in my head, I don't think I have a lot to loose by trying. I'm sorry. I'm still undecided.

    I've accepted that I will always be in some pain but obviously I want it to be as little as possible...don't we all? Have you had RFAs (nerve burning procedures)? Like a lot of people I go around this merry-go-round chipping away at the pain, trying different therapies, different therapists, different products. Always trying to stay functioning as well as possible. Sorry, bad days have become a bad week & I'm not very perky & positive at the moment...
    Osteoarthritis & DDD.
  • Sorry to hear you had bad news an i hope things turn around for you. The surgeon never said anything as far as what he thinks will happen if revision isn't done. He just pretty much said that he doesn't think the lack of complete fusion is the cause of the pain. Not sure why he changed his mind when the images looked identical an were a long time between the mri an c t. I did have the rf ablation done on the left an right sides. I did get relief from them as far as the nerve pain. I have been telling my pain management dr the left side seems to have came back to life. I've been trying to get him to do it again before it comes completely back like it was. Hopefully he does, cause that on top of the other pain had me sleeping only a cpl hours a night. That's great to hear, that people with the pump have regained their life back after the pump. I hope that isn't the route either of us have to go, but if it is I hope it's a cure with no other problems added
  • Have you had your SI joint checked out? I had the procedure a few weeks ago. I was surprised how much of my hip & back pain was coming from there. It took a LONG time to get the needle in past all of my bone spurs but as soon as he injected the numbing agent I could feel some of my pain melt away. Sadly the steroids haven't helped much but at least I know what & how much pain is coming from there. If its the same for you I know a lot of people are getting some relief from one of the SI belts...you can get them from your doc or just buy 1 from amazon. My arthritis makes my spine feel constantly bruised so the belt hurt more than it helped me but anythings worth a try isn't it?
    Osteoarthritis & DDD.
  • Did you try the Botox trigger point shots or just the lidocaine & steroids? For me the Botox lasted longer. When I first had them done it didn't seem to help much but I got into a routine of having them done, applying ice on the way home & for a few days after, airomatherapy massage (gentle, at home), stretches & muscle relaxant meds. Doing all of it, at the same time seems to work where all the individual 'bits' don't.

    I've recently switched my muscle relaxants from Baclofen (3x a day) back to Tizanidine. I'd been taking Tizanidine for years but became tolerant so I switched to Baclofen for a few months. I've now realized that it was a very painful mistake! The Baclofen was obviously working so much better than I thought it was. The Tizanidine isn't touching my spasms by comparison. It's worth trying different ones. What works for some doesn't work for others.

    Sometimes things I've tried without success in the past help much more when I've tried them again. That's true of meds, procedures, therapies etc. I'm always better when I have a plan. I'm constantly tweaking my 'blend' of pain management options trying to find the mix that helps the most. Sometimes it feels like one step forward, 2 steps back but I can remind myself that I'm doing much better now than I was a few years ago.
    Osteoarthritis & DDD.
  • john1971jjohn1971 Posts: 21
    edited 10/21/2014 - 5:04 AM
    Faseet (typo?) Injections, but said he couldn't get a clear picture an do it correctly. That's when he decided to do the rf ablation. As for the injections I think it was just the steroids and another additive. Not sure if it was a numbing agaent cause I was in a good, well bad amount of pain after that for a few days. They did say that was normal, but it didn't provide any relef, so he never tried any other trigger injections.
  • Usually they inject your facet joints first with a numbing agent to see if it helps before they go ahead with the RFA. Did they have trouble getting in there because of bone spurs? I have a lot of 'weird! Bone growth all over the place & it often causes problems for me with procedures & stuff.

    I'm going to the docs this afternoon to swap back to Baclofen. Fingers crossed that will help a bit. What's next for you? It must be a nightmare dealing with workers comp. I've heard it's frustratingly, exhaustingly slow. I'm so sorry.
    Osteoarthritis & DDD.
  • Nerves when testing for an rfa. I think the only joint he couldn't see visually was the si. It was nice during the diagnostic an the actual rfa cause it provided some relief. from what he said an kinda showed me is the hardware since it was anterior cast a shawdow on the screen an he couldn't inject the si. Next will be the discogram but not to sure that's the pain generator, but who knows. I do hope the baclofen help you get some relief!! Yes dealing with work comp is very frustrating, an the waiting stinks. But going on 3 1/2 yrs its became a norm.
  • Nerve to determine one if an rfa would help. I know he had said since the fusions were done anteriorly that there was a shawdow on the si joint so he couldn't do the facet inj there which is why he went on to do a diagnostic rfa thing. I do hope the baclofen is helping you. Thats one thing they never tried with me. Well there's a lot of things they haven't tried but that is one...lol. Yes dealing with the work comp is slow an with no meds helping with the pain it seems to drag even slower. Eince its been going on since early 2011 its become a norm.

    Maybe this time it will send...lol I tried twice yesterday/last night an seen today it never posted
  • EnglishGirlEEnglishGirl Posts: 1,825
    edited 10/22/2014 - 1:30 PM
    I've found that taking a muscle relaxant (Baclofen) 3 times a day WITH a narcotic helps so very much more than taking either alone for me. When I start a new one or change the dose muscle relaxants make me feel really sleepy & spaced-out for a while but within a week or 2 things settle down & it just feels like taking a Tylenol...except it helps with the pain. You know what I mean? I always start taking new meds at the weekend when I've got support & I don't have to drive or anything.

    The nerve meds (Lyrica, Gabapentin etc.) & the antidepressant things like Cymbalta help a lot of people but I either have horrible side effects or they don't work for me so I have a prescription compounded topical cream (Lidocaine, Ketamine...to numb. & muscle, nerve meds) which works for me when I use it very regularly. I really like it. No side-effects & it doesn't go through my liver..bonus!! I wish they could just stick all my meds in the cream for me!!!

    It took me a while to realize that all these things were available. My old PM wasn't into compounded meds. My pain is structural, nerve, spasms & inflamation from arthritis. Tackling it from every angle with meds works so much better than just narcotics (I've heard they're best for structural) until I had the muscle, nerve & inflammation meds WITH the narcotics I wasn't getting enough relief even on very high doses of narcotics.

    I was taking Tizanidine (muscle relaxant) for years on & off. It's really surprised me how much better the Baclofen works for me! I'm lucky, I've got a PM who will let me try different things & switch back very easily if they don't work. Ugh! I used to get so frustrated & depressed when I had a doc who wasn't as compassionate & supportive of me. I'm sorry. I can't imagine battling workers comp year in, year out for my care!! Living with chronic pain sucks at the best of times. A great PM can make all the difference. I used to drive home in tears after every appointment!
    Osteoarthritis & DDD.
  • It sounds like you have some great drs. I've went through the leaving the drs office shaking my head and overall shaking from the frustration. Kind of like this past monday. It does tend to drag a person down. It seems to many doctors either just don't care or aren't to concerned about anything except getting paid. Regardless if they help with the problems or not. I hope that your getting relief being back on baclofen
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