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Intrathecal Pump Surgery --A Success

NursesrangelsNNursesrangels Posts: 29
edited 10/17/2015 - 7:50 AM in Pain Management
I had an intrathecal pump implant on May 28, 2015---18 days ago. I have a non-opiate in my pump called Prialt. I have experienced excellent pain relief in the last 18 days of my thoracic spine pain that I have lived with for over 25 years. I am a nurse and have been unable to work for the past few years due to the severity of my back pain.
As I recover, I wanted to offer my time to answer any questions anyone may have about the pump. I have been researching the pump for the past 5 years since I was first referred for it. I've been involved in webinars with physicians, talked to Ambassadors who have the pump, and done many hours of personal research.
I've had a long history of spine surgeries & procedures including a spinal cord stimulator trial. Unfortunately, the SCS trial failed. The pain pump was my last hope, so I could possibly return to my beloved profession, specifically Hospice. I realize that placing such high hopes in anything is dangerous, that if it was not successful I would be extremely let down. But after decades of severe pain, when I could no longer help other people, I truly felt as if my life was over. I've had to live with the intolerable side effects of opiate pain medications for much too long. I considered myself a perfect candidate for the pump. Insurance and I went a few rounds and I finally got the approval for the trial, which was followed very quickly by a surgery approval. I've fought for this and this means the world to me to be blessed to have gotten the pump surgery, and above that, to have a positive and safe outcome. I am aware this surgery has risks as any surgical procedure does, that having an implant carries risks, and for me, the benefits outweigh possible risks. I am a medical professional but I am not a physician, this is simply MY personal experience.
I've read the wonderful thread by Pat W. and was so moved to read her words written after her pump surgery that sounded similar to how I feel about my pump.
The amount of pain reduction in the last 18 days has been significant and the pump surgery has been a success. I am on the initial settings set at surgery. At my 11day post op appointment the staples on the pump pocket were removed. There was no change in the dosage of Prialt as I reported acceptable pain relief.
I am feeling great for 18 days post op. There is some pain around the pump area, and if I do too much my muscles in that area become very sore. I tend to push myself in most things and living with pain for so long, I've adapted by 'pushing through the pain'-- sometimes to my detriment. I need to remember this will soon pass, and to take it easy as scar tissue forms around the pump and catheter sites. This is important for the life of this device and to start out with a properly anchored pump and catheter is extremely important.
My physican is an Anesthesiologist who has a Pain management practice. He happens to be the same doctor my old PM doc referred me to for the pump back in 2009! I trust him and made sure he was experienced in placing pumps before the trial. I think it's every patients responsibility to thoroughly understand any medications, procedures, surgeries, etc before agreeing. Sometimes when we live in great pain everyday, desperation creeps in and the thought of any type of relief can take over our better judgement. It's human nature to do what it takes to stop pain.
Thanks for letting me post my story!
God bless and I wish you a day of tolerable pain.
Gentle hugs


  • SavageSavage United StatesPosts: 5,427
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  • chicagoandycchicagoandy Posts: 1
    edited 07/10/2015 - 11:09 PM
    I had my pump implanted the 27th of May. Everything has been going well so far. I have had my titration increased after my 2nd follow up visit. I have used the bolus dosage about 10 since I have started walking. Just did a 30 minute walk with minimal pain. Normally, I would have dropped 2 Norco's after a walk.
    The best part about the implant is that I have not taken any pain meds in 44 days. No more constipation too, am I am a vegan so my diet was not the problem. Best of luck to you.

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  • barecat685bbarecat685 Posts: 1
    edited 07/17/2015 - 10:35 AM
    do you need to stop all oral meds before pump trial?
    what about after pump installed is there withdrawal problems?

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  • NursesrangelsNNursesrangels Posts: 29
    edited 07/17/2015 - 12:46 PM
    barecat685 said:
    "do you need to stop all oral meds before pump trial?
    what about after pump installed is there withdrawal problems?"

    Depends on each individual case, doctor, and what medications are used in the pump. For instance, my pump has a non-opiate called Prialt in it. If I had opiates in the pump, my doctor said we would have titrated my oral medications down, but I am on a very low dosage of opiates. The pump uses 1/300 of what you take orally. This goes for all types of medications used in the pump.

    (1st time doing the quote feature looks like it kept me in the quote field too) oops :/
  • I am really glad to read that your pump has been so beneficial to you and you have been able to walk with minimal pain. It is encouraging for me to hear that others have had good results. We are both on the same post op time frame---I haven't taken 'that' walk yet, for me that goes way back and is something that I have been trying to get to for many, many years. I think I am more afraid than anything to strike out and take that first walk. My pain relief has been amazing, but I am now tending to overdo it (something I've had a huge problem with during my years of chronic pain). Just being able to go out and do so much more for many hours at a time has been such a change in my life, I sometimes have to stop and realize just how much freedom this has given me!! I do need recovery time however, after a marathon day.
    Glad to see other pump patients write here. :)
  • I'm glad to hear of your success with the pump. I have a Medtronic SynchroMed II for 6 years with Dilaudid and Bupivicaine, and never had any issues with it. It saved me from being bedridden and I see it as an improvement even though I have chronic pain. I am more functional because of it today. Is Prialt the only medication you've tried? How well does it work for you? Thanks..
    Ol' Spiney...Microdiscectomy L4-L5, TLIF L4-S1 -post op central disc herniation L4-S1, sciatic nerve damage, retrolisthesis, epidural fibrosis, facet arthropathy, severe DDD & OA.FBSS- Medtronic SynchroMed II pump.
  • And the Prialt was increased by 10%. Prialt loses its efficacy in 30 days and must be withdrawn out of the pump, then replaced with a fresh batch. Because I had experienced a sudden increase in pain last week, I discussed an increase---last month it was a 4% and we felt we could go up to a 10%. Since I've only had the pump for 2 months we are still finding good settings and I understand that is just part of having a pump. No different than oral meds, we must assess how our dosages are working.

    Meydey it's great to hear you've had a good outcome with your pump over a six year period! That encourages me greatly. Yes I only have Prialt in pump at this time. I wrote about my lofty expectations of having a pump in another thread, it was after the sudden pain spike I had as of last week. I discussed that with my doctor yesterday, was I being too impatient and expecting too much of myself at this point? Yes!! Was the resounding answer. She knows my desire to return to work and my passion for my job, but she also knows I am pushing myself. It takes 3 months just for the pocket to heal---I have pain/uncomfortable sensations in the pocket and tenderness where the catheters were run. This is all normal and after such an honest talk yesterday, I feel much more comfortable in going with my gut feeling---I was pushing myself.

    There is always time to persue goals...but I must be healed correctly to do so!! :)
  • NursesrangelsNNursesrangels Posts: 29
    edited 08/09/2015 - 4:27 PM
    Been wondering when this would happen. My pump hasn't set off an alarm at any retail or grocery store, nor the library; it was walking through one at a courthouse that did it. They asked me 'what I had' I told them an intrathecal pump and that I had an ID card for it. The officer running the front looked at me and asked "is that all you have?" I responded Yes and he said okay go ahead!

    I found the whole thing a bit humerous for some reason.
  • NursesrangelsNNursesrangels Posts: 29
    edited 10/17/2015 - 7:57 AM
    ,I've been experiencing symptoms such as my head feeling 'full', a spacey sensation and overall confusion. Like being drugged!! This is very strange since the pump has been in since May 28th. My doc said I'd feel any negative side effects effects from the start so chances are this is not from the pump medication. However, I had pain spikes that were distressing as pain relief since surgery had been good. My doctor said Prialt is either a home run or--- it's not. Not much wiggle room. Now Morphine is in, it takes 96 hours to reach catheter tips and give a bolus dose, meanwhile the Prialt is working its way out of what remains in the catheter. We're fine tuning this so I'll go back in 2 weeks for next adjustment.

    Still extremely thankful to have the pump. This is something I've wanted for years. Feeling blessed!!
  • It's been 4 1/2 months since my pump implant. The morphine has been extremely effective and I stopped oral MS 3 months ago. Because of starting with Prialt the doc kept me on oral MS. After the Morphine was put in the pump I just didn't need the pain control of oral MS anymore. I titrated myself down over 3 weeks. So thankful and feeling blessed.

    I can take walks again!! That alone is huge to me as walking was one of the biggest challenges for me with my pain. I feel stronger and the endorphins are awesome. I'm no longer afraid I won't be able to get back from a walk.

    I still experience pain in my spine and muscle spasms. These will be with me always. I still have to watch my activity level and not push myself too much. Some days are very hard still....my pathology is still the same and actually the is more damage as the years pass--herniations get worse, osteophytes grow larger. But to have such a reduction in pain levels that will allow me to return to nursing (even if part time) is what I've been fighting for and working towards for the past 6 years.

    This pump has given me hope. :)
  • Forgot to add that my PM doc gave me a patient programmer to give myself Bolus doses when needed. They program the information into the pump, which is the frequency of allowed bolus, which is the time in between doses. Also how much medication is given in each dose. This has been an excellent tool in my pain control. This is logged into the pump and at each appointment the doctor can see the time of day I request a dose. Medtronic should make one of these available to each pump patient, if one is needed for bolus along with the continuous infusion rate.
  • That's great to hear! I had mine for a few years and it saved me from being bedridden. Yes I still have pain, and it also comes from other problems that crept up but I'm glad I have a pump. I have Dilaudid and Bupivicaine and I've done well without any side effects. I know one thing doesn't work for all, and outcomes depend on the person and the problems they have. I hope you continue to have a better quality of life.
    Ol' Spiney...Microdiscectomy L4-L5, TLIF L4-S1 -post op central disc herniation L4-S1, sciatic nerve damage, retrolisthesis, epidural fibrosis, facet arthropathy, severe DDD & OA.FBSS- Medtronic SynchroMed II pump.
  • Your encouragement means a lot!! Knowing you've had such success with your pump is so great to hear. I'm glad to know your quality of life has improved so much. I look back on the Pre-pump years and can see so clearly why I was often depressed and felt at times there was no hope. Life was unbearable many days despite oral medications. I always had an attitude of I can do this yet would end up in tears with unrelenting pain, after trying so hard to be a part of life. I've had spinal pain and more since I was 16---40 years---with the last 10 being the worst. I feel incredibly blessed to have this new lease on life!! Really helps to hear from others who can relate. Thank you for your input!!
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