Intrathecal Morphine Pain Pump!

Pain levels are rated on a scale of 1 to 10.

Most chronic patients report pain levels between 6 and 10.
Typically, patients go through a specialized pain clinic... they undergo all the tests and screenings, including
a trial involving four different medications or narcotics, one of which is just a placebo.
It varies by individual, but some rely on CNS tablets or capsules used for
depression... though they work for pain too. Gabapentin and Tricycle antidepressants are common; there are others, but those are the most effective.

A TENS unit using electrical impulses is also an option, or alternatively, a neurostimulator can be implanted during surgery.

Many people react to narcotic morphine, but over time they require much higher doses and often end up combining it with other drugs.
The clinic runs a three-month program, offering lectures and rehabilitation 6 days a week,
for 8 hours a day.

About 30% of patients don't see any results or get any relief... those poor souls are stuck dealing with pain for the rest of their lives.

An Intrathecal Morphine pump is only an option for certain people who respond well to morphine... but they need large amounts, and they often end up in the hospital facing complications from excessive narcotic use.

=============
An intrathecal catheter delivers morphine from a programmable implanted pump into the intrathecal space (see image 1)—the area containing the fluid surrounding the spinal cord. Because the sensors are right at the spinal cord, you only need a tiny amount of medication.

The catheter is usually inserted through the abdomen toward the back. This means there is one opening for the pump and another on the back, where a small 10 cm incision is made to clear a bit of bone and slide in about
12 cm of catheter (see image 2) into the intrathecal space.

Candidates are carefully selected. They undergo testing to ensure the pump and this method will actually reduce their pain by 50%, to confirm they aren't allergic to morphine, and to make sure there are no other options left.
The patient has a programmable pump implanted in the abdomen, just below the waistline (see image 3). The dosage and timing can always be reprogrammed or adjusted. The latest pump models hold 40ml, which lasts about 2-3 weeks before it needs a refill.

The pump sits just under the skin and is easily refilled via an injection through the skin.
Once everything heals, you wouldn't even know the patient has a pump.
The titanium pump battery lasts about 5 to 7 years, meaning the pump itself eventually has to be replaced.

The cost is roughly $40,000 for the pump and catheter, plus about $30,000
for the remaining surgical costs, anesthesia, and a 3-week hospital stay to transition from oral morphine to the pump. So, we're looking at $70,000... a lot of money.

Position of the pump and the intrathecal space (image 1).

Pump and catheter (image 2).

Intrathecal pump (image 3).

A neurostimulator is essentially like a Mobile TENS unit used externally,
relying on electrical pulses to function.
When a neurostimulator is surgically implanted, the electronic connector sends signals directly to the target area via electrical impulses, which interrupt pain signals before they can reach the brain where you actually feel them.

Since it doesn't rely on medication like Intrathecal Morphine, it won't produce the same effects as drugs.
That said, it isn't a universal fix for every type of injury, surgery, or pain.

Neurostimulator implanted device.

Neurostimulant.

Patient programmer

Electronic connector.

Mobile TENS units!

Where should I put the electrodes?

TENS UNIT

ELECTRODES!

So? Are we all supposed to start using a pump or Mobile TENS instead of just taking an Aspirin?😕

stormylynx14 said:Yeah, and? Are we all supposed to be carrying around a pump or a TENS unit instead of just taking an Aspirin?😕

Someone who needs Aspirin doesn't have chronic issues; they don't fall into the group I'm talking about. Their pain isacute, not chronic. 🙂

Out of everyone dealing with acute pain, only about 5% deal with recurring issues.
Statistically, only 5% of those people end up needing surgery after at least six months.
Pain that persists every single day for more than three months falls into this category.
The cause could be anything from non-specific lower back pain to cancer or other serious injuries.
In the USA, Canada, Australia, and Europe, about 10% of the population lives with chronic
pain, and some individuals are completely incapacitated or immobile.
Those are the people this discussion is actually about.

Patient history.

Back in 1999, a Verizon technician was inspecting solar panels
that support mobile communications across the US, located about 1,000 miles
out in the desert, when he had an accident....
The entire battery rack gave way, and heavy batteries fell right on him.
Each one weighed about 130 lbs; we're talking a total of 1,300 lbs.
Some missed him, but a few hit his legs, back, and neck.

The technician was alone; the nearest group was 311 miles distance away from where the
accident happened. Somehow, he managed to pull through... he connected the batteries on the ground just to get the system running and
drove his Land Rover back, stopping every hour.

Honestly, when he finally made it back to camp, he didn't complain much. As a supervisor,
he used the satellite phone to notify the San Diego headquarters that they were heading back a week early due to his accident.

He was completely bruised and swollen, and everything hurt. It was right around the Yule log season, and things weren't running smoothly at the hospital. He went through an exam and was given a month off work, with instructions to see a neurosurgeon specialist.

In January 1996, he lost consciousness... ambulance, new CT scan... three cervical vertebrae and one lumbar vertebra were injured.
Soon after, he had neck surgery involving a fusion using donor bone. The patient actually felt worse, not better... another MRI showed it wasn't working... he needed a new surgery, this time using bone harvested from his own leg.

A year later, at his father's urging, he traveled north and switched neurologists.
A new MRI revealed the vertebrae weren't supported by the fusion at all; there was almost no hope they would fuse.

Then came a third surgery. They took bone from his other leg for the fusion, and this time they used titanium plates and screws to hold everything together... he was just thankful he wasn't paralyzed.

He spent five years going through rehabilitation and a pain clinic, where they taught him how to manage the pain. His narcotic doses were massive, and he was taking several different types... his father eventually reported both the doctor and his son to a medical board.
/After speaking with the doctor/ they admitted him to the hospital for three weeks to stabilize his
narcotic use.
But it didn't work; his pain levels stayed consistently between 8 and 10 on a 10-point scale.

The pain clinic decided the only way out was to implant an Intrathecal Morphine pump.

To be continued.

Update!

Dario is in the hospital!

The patient’s medical expenses have already climbed past a million dollars.
He was declared unfit for work, though he isn't technically disabled—by law, they have to keep paying him until he turns 65... but he’s only getting 60% of his original $120,000 salary.
Right now, he’s pulling just $30,000 gross.

Insurance refused to cover the $70,000 cost for the Intrathecal Morphine pump. His doctor moved him to a pain clinic, which costs about $50,000 a month... luckily, he got quick approval for the surgery.

Implanting the pump in the abdomen, just 13 days old!

On 11/23/04, he had abdominal surgery for the pump port /attaching photo/ taken 13 days post-op... he also had back surgery to place the pump catheter.
At the same time, they performed a discectomy at L4 due to a workplace injury.

Dario's back operation

As I write this, the patient is heavily medicated on narcotics but still in intense pain. They are currently adjusting the pump dosage; he's receiving Morphine injections every four hours.

He’ll likely be in the hospital for about 3 to 4 weeks total.

Morphine ruins your teeth. He has to wear a special fluoride tray every night and visit the dentist every two months; he's dealing with skin changes too.

It's hard to wrap my head around it. At the time of the accident, he was 36. Now, at 41, he's living with a disability and hundreds of complications.

What kind of life is that? His kids are 16, 12, and 11, and he can't see them nearly enough because
he’s divorced and remarried, paying child support, and every time he tries to visit them, something happens or he's stuck in the hospital.

Son, please come home from the hospital for the Yule log... we want to spend it all together!🙂

Mom and Dad love you and just want a better future with less pain.😘

William

8/12/04

My younger son and my grandson are visiting today; they live 249 miles nearby.
We all went to visit Dario together. I was a bit concerned when I saw the IV drip, so I asked him what was going on. He told me they removed his staples yesterday after 14 days /see photo/.... he has an incision on his abdomen. Following the surgery, he was on an antibiotic drip just to be safe while the pump was being implanted in his abdomen, but they took that off after a few days.

For now, they have him on a strong antibiotic until the test results come back. We're really hoping it isn't Staph, but it takes about 24 to 36 hours to get those results.

It’s looking less likely that he'll be home in time for Christmas.😢

12/22/04

It’s been quite a while... they’re still switching out antibiotics on the IV drip. His abdominal wound still needs daily dressing changes; it's still inflamed and isn't healing the best way. This is week five post-op.

Weaning off narcotics is a long process. They increase the dosage on the pump... then very slowly taper down the injections, moving from 4 hours to 6 hours, and so on. He’s still taking medication orally, too. Everything is being managed by a pain management specialist.

There’s nothing happening at home right now... the ambulance will bring him back for the Yule log and then return him to the hospital the next day just so he can be home for Christmas.
Psychologically, he's lost... just like anyone else struggling with a prescription or street drugs. He’s in a state where he doesn't even want to see us... and he won't even be able to see his kids, which is the hardest part of all.

I’m grateful that I managed 34 years of chronic pain without becoming addicted to narcotics, but that’s incredibly difficult... everyone knows their own limits. I had to work for 24 years through it,
but that's just my situation.

It is heartbreaking to see my son (41 years old) suffering this much,
and even more tragic seeing how much it affects us as a family... especially his children, who can't quite wrap their heads around it, even at 16, 17, 12, and 11 years old.

My heart aches when I think about it... I just hope things improve. This is the lowest point I've ever seen him. Sometimes I think he was better off just on morphine, but the pump had to be used for the rest of his life.

12/30/04

I saw my son today. A home health nurse is coming by the house to check on his surgical wound and manage his pump implant.

The hardest part was definitely him getting off the narcotics. Now the pump is working, delivering tiny doses of intrathecal morphine directly into the spinal canal at regular intervals.

He told me, "Dad, I can't even describe the difference. My head feels clear, like I'm not even on anything... and the pain is gone."
It’s hard to wrap my head around the fact that you worked for 34 years dealing with constant chronic pain, and there was nothing I could do to help.

I'm just so relieved to see him finally free from those heavy doses of drugs... he's like a completely different person now.

But, of course, he's looking at neck surgery in about five years... and then another pump replacement in 5 to 7 years once the battery runs out.

Even though he can't do much physical labor, he works in IT, so he'll have a much better quality of life than I ever did.

Thank God things ended on such a positive note, even if it's a lifelong commitment. We'll be refilling the pump every 4 to 6 weeks and just hoping we don't run into any complications
with the pump or the catheter.

🙂 😉 😎

It’s been about six or seven months now since my 42-year-old son, Dario, passed away.
I had an implanted intrathecal morphine pump for pain management.

It’s like I’m a completely different person now. The pain is gone. I still get some occasional discomfort in my legs from the bone removal during surgery, and I can feel the pump site on my back and abdomen, but honestly? Compared to how I felt over the last five years versus where I am today, it’s nothing.

My wife and I are finally going to bed, completely at peace. We aren't lying awake worrying about whether someone might overdose or if things will take a turn for the worse.

He’s all set up with the pump. It’s programmed to trigger an Intrathecal Morphine refill every eight weeks, and it even gives him a heads-up when the supply is running low or when it's time for a top-off.
If you happen to be somewhere outside of Australia, you might be able to get the same results if there's a center with fluid available, but honestly, it’s much easier to just handle it on a computer.

If he needs Intrathecal Morphine for an emergency, it’s available. He’s traveled to places like Bali and Singapore before without any issues. The only real headache was when the alarm went off at the airport, but he carries all his medical documentation and a medical alert bracelet that's recognized worldwide.

Thank God my son is at least managing okay now; I know exactly what he’s been through.

The mere thought of going back under the knife for my cervical spine—having to swap out that titanium support and then deal with another pump replacement—is honestly pretty heavy.

That's just life.

🙂 😉 😎

Jamie Clark74 said:...
He’s psychologically checked out... just like anyone else hooked on a prescription or hitting the streets. He’s reached a point where he doesn't even want to see us, and worst of all, he can't even face his own kids.

I’m glad I managed to deal with chronic pain for 34 years and am still standing without being an addict... but man, it’s a grind. Everyone’s fight is different. Personally, I had to pull 24 years on the job,
but that’s just my situation.

Drugs aren't the answer. They look like a silver bullet, but they end up destroying a person in the long run.
Living with pain is brutal, but there are ways to adapt and manage it. At the end of the day, addiction is addiction.

placidfox55 said:Narcotics aren't the answer. They might seem like a perfect fix at first, but they end up destroying a person in the long run.
Living with constant pain is incredibly tough, but there are ways to adapt and find relief. Addiction is addiction, plain and simple.

I’m actually writing a book about my experience—basically "when help seems out of reach and how to live with chronic pain"—in collaboration with a pain management center. I suspect an American health clinic would be quite interested?
We're talking about realistic, neurological pain here.

For me, it doesn't matter; I've been living with a 5 or 6 out of 10 for thirty-five years.😁

🙂 😉 😎

@placidfox55 said:Narcotics aren't the answer. They might seem like a perfect fix, but they end up destroying a person in the long run.
Living with pain is incredibly hard, but there are ways to adapt and find relief. Addiction to narcotics is still addiction. [/B]

I misspoke. What I meant was that American
health institutions—specifically pain management clinics—would be very
interested in what placidfox55 is suggesting. If we knew "which way" this method was, it would reduce
costs and help so many people... currently, about 30% of patients
don't experience any pain relief at all.

We’ve all gone through those 3-6 month rehab programs and
classes on "how to live with family while managing chronic pain."
I’m actually part of the group that gets screened based on their medical history from childhood... because
little kids and doctors often can't tell when a child is actually in pain.

It’s the same for someone who worked full-time while in constant pain,
whereas most don't work anymore... In my rehab sessions, I talked
about how I lived day-to-day, what I used just to
keep working, and how much it impacted my family life.

Regardless, placidfox55, you mentioned having "unsuccessful surgeries"... Laminectomy,
so do you truly know from your own experience what this pain is like and how to handle it?

Do you know what it's like when you can't even lean over the sink to
brush your teeth without pain? Or after using the bathroom, when you can't even
wipe yourself without sharp pain and spasms?
And you can barely walk more than 50 to 250 feet before you have to sit down, just to get going again?

😉 😎

I received an email earlier tonight

Jamie Clark74
My name is Frank. I’m originally from Chicago, though I spent 36 years living in Johannesburg, South Africa. I read your post about the struggle you've been through—please know you aren't alone. I've walked a similar path myself, but let's focus on you. I have a request based on your situation with your son, Darryl. My own son fell from an eight-foot height and broke his spine. After reading about what Darryl has been going through with his intense pain, my son, Robert, is also looking into getting a pump implanted here in the States since he lives here. Please, just be honest with me—how is Darryl feeling today? If Darryl wants to connect with Robert, he can reach him via email at Robert.Breganski@tmeic or at roberbr@world.net.

Drop me a line and I’ll give you the full story regarding my son's nine years of suffering.

Frank
===================
Dear Frank, I'm responding right away since it looks like you missed this thread.

Since getting the pump, my son Darryl has been incredibly happy; he's a completely different person.

He hasn't had any issues... though he does mention how much he wishes I could help him, but I just can't because I don't tolerate any kind of narcotics.
I actually just got back from seeing my neurosurgeon... another degenerative level at S1. It's pinching the nerve, and there isn't much that can be done. Right now, my pain level is sitting between an 8 and 10 on a scale of 0 to 10.

I’d highly recommend getting a second opinion for your son, and maybe doing a trial run if that's an option. Also, keep in mind the pump needs to be replaced every 5 to 7 years, depending on the battery life.

There's also the possibility of complications with the pump itself or the catheter lines.

You can find images in the links within the articles!

Best of luck!

Jamie Clark74
🙂