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    Is a Pump Reasonable For Me
    revbd7 posted:
    Greetings, 18+ yrs ago I had an accident and almost completely broke my neck, blew a disc, did damage to my lower back, broke my ankle. And Fibomialgia ,Arthritis. After 6 surgeries 18+ yrs of pain. I have barretts esouphegus and it has become hard to swallow. More surgery to come soon too to replace knee. Is it reasonable to look into a med pump in order to avoid furthers throat and stomach probs? If it is resonable...where can I find doctor, I live in Maine. And my present Dr. seems to get upset if I ask to many questions like this one? I just want to get away from the pills and have my pain under controll. I was told my barrets, may become cancerous. ? Thanks for any ones help...

    Rev.Brian Dunbar
    Kelly_30 responded:
    Hi Brian,

    I do think a spinal pump is a reasonable option for you. Have you thought about the option of having a spinal cord stimulator installed? My friend Bet that posts here has one and it helps with her pain a lot.

    Another option are pain patches. You can get the fentanyl patches or butrans patches, and I think there are others. The benefit of these is that they can be worn for 3 to 7 days before having to apply another one for pain. You shouldn't add any heat around where the patch is applied as it causes the system to release too much medicine at one time.

    Living one day at a time.
    revbd7 replied to Kelly_30's response:
    I tried the neuro stimulator and it did not help at all. I am also in the beginning stages of a diabetic. And the doctor want to replace my knee. And they are watching my barretts esophugus for cancer. When it rains, it pours.

    As you say - One day at a time
    annette030 responded:
    I am not clear on what throat and stomach problems you wish to avoid by not taking oral pain meds??? They don't cause Barrett's Esophagitis, and the nausea that they can cause is usually transitory and goes away after a few weeks at most.

    As long as you are eating or using a gastric tube for your food and meds, I think your oral pain meds can still be taken. Check with your pharmacist to be sure.

    Usually med pumps and SCS devices do not absolutely remove the need for oral meds, they just decrease the amount necessary.

    I would personally avoid any invasive procedures unless the doctor tells you that you are not able to use oral or topical meds anymore due to either side effects of because they no longer work. I am somewhat conservative and try to avoid any surgical procedures as long as possible. Do your own research and see what you can find.

    Take care, Annette
    annette030 replied to revbd7's response:
    Diabetes is another reason to avoid surgery unless it is absolutely necessary. It is an increased risk for anyone having surgery.

    Take care, Annette
    periwinkle52 responded:
    Good morning, I just read your letter about a pain pump. I have severe stomach issues, (Zollingers Ellison Syndrome), and my Dr. proposed a pump, to help avoid my stomach. After having one for 7yrs., I can say yes, & NO WAY! It worked well, for a while, you must be on top of EVERYTHING they are doing. Like, I had to have another Dr. in the firm, refill it for me, as my Dr. was on vaca., anyway, he put the wrong med. in it, which is next to impossible, as the refill vials have YOUR name on them. Next thing I knew, I was tripping! That med., as it turned out, I was allergic to! When I called the office, getting sicker & higher every minute, they called me in nausea meds.! Then there was the time my Dr. decided to try a more concentrated morphine, than what was already in the pump. Before I even got home, I was in withdrawls. My body would not absorb this new concentration. I ended up in the hospital for 5 days. I could go on & on. There is good, like when they find the right amts. & mixtures, but when it messes up, you can't just reach inside your body & shut it down!! There is a lot of thought to go into this. Ask a GOOD pain control Dr. his advice & what the pros & cons are! Good luck to you, periwinkle p.s. I had mine removed...
    cweinbl responded:

    You should consider Fentanyl Transdermal before having surgery to implant a device that has at best a 60% success rate (see;12;699-802.pdf ). All surgery entails morbidity, including implantation of a mechanical device for pain. While the risk may seem low, infection (including MRSA) is not unusual. The pain pump is for patients who cannot benefit from all other forms of pain treatment.

    Meanwhile, with Fentanyl Transdermal, the mouth, esophagus and stomach are all bypassed, as the medication is absorbed through the skin. This process is completely non-invasive. Each patch can last up to 72 hours. Dosages range from 12.5 mcg to 100 mcg. Yes it is measured in micrograms - that's how powerful it is. Fentanyl added 9 years to my career. Initially, it reduced my pain by 80%.

    Have you also tried TENS, biofeedback, acupuncture, hypnosis, PT, kinesiotherapy, trigger point injections, epidural and all other treatments found at a comprehensive pain management program? I can reduce my chronic pain by at least 20% with biofeedback alone.

    Good luck, whatever you decide - and especially if you decide to have a machine with a 60% success rate implanted. The intrathecal infusion pump, like the spinal cord stimulator, should be considered last resort options, after all else has been tried.

    revbd7 replied to annette030's response:
    The Oral Meds get me sick because of gastroreflux and the meds make it worse. Sometimes I can't even swollow them. And the doctor is tring to keep the reflux away from my barrets.

    Fentynal Patches are possible but the adhesive leaves welches over my body. where ever the patch was. I thank you all for your replies. Keep them coming. I am looking for a good doctor in Maine. Any body know where I might find one?

    Thank You All
    revbd7 replied to cweinbl's response:
    After 18 yrs I have tried every medicine out there. Including alll the above. And I tried the spinal cord stimulator twice on two different places on my spine. With Know real help. I was hoping it would give me some help.

    CTBeth replied to revbd7's response:
    Hello Brian,

    It sounds as if you've tried just-about everything over eighteen years.

    I'm assuming, by what you've said, that you have used Fentanyl patches.

    Have you been with the same MD a long time? Even if you have not, certainly your current MD has access and knowledge about your complex case.

    It would seem reasonable that you'd be at a point to discuss an implanted "pain pump". You can start by doing lots of internet research.

    If this is really what you want, it is, in my opinion, too bad if your MD "gets upset" when you ask questions. You have the right to ask and MD has an obligation to answer.

    Just for my curiosity, what do you mean when you wrote, "... almost completely broke my neck" ? Is your neck fused? Do you have spinal cord damage, or were the fractures ortho only? I would imagine that you have had your cervical spine fused, yes?

    Where, in your body, is the most pain? I just read that you also have fibromyalgia. I guess that means that you hurt all over.

    Have you been seeing a rheumatologist for that? Perhaps, if your pain management MD isn't easy with whom to talk, your rheummy will answer some of your concerns.

    If you are a good candidate for the intrathecal system (pump) and you have tried so many other treatment modalities, why is your MD reluctant to discuss this with you?

    Good luck with this decision,

    annette030 replied to revbd7's response:
    I assume you have taken meds for gastric reflux without relief. I had not heard of opiates causing this problem before.

    How are you eating if you can't swallow sometimes? It is really important to maintain your nutritional status with your other health issues.

    Some folks have posted here that they have used a nasal steroid spray like Nasonex on clean skin, then let it dry and apply the fentanyl patch. This prevents the topical reaction to the adhesive. Of course, you need a RX for the spray, so discuss it with your doctor if you think it is worth trying.

    Best of luck whatever you decide.

    Take care, Annette
    missycats35 responded:
    that is a good idea another good idea when my esophagus got eroded from being on vioxx for 2 yrs after my accident and took on empty stomach which they said was ok at the time we know thats not true still on antireflux meds to prevent the healed esophagus to be damaged again in addition to my heartburn I also limit my intake of nsaids or antinflammatory meds. when I started having stomach problems besides the esophagus(gastoparesis) was hospitilized frankly my gut stopped workin from the pain meds it slows the nerves in the stomach and almost creates a blockage awfull.I was put on a duragesic patch after the gastoparesis ( which is a strong narcotic that is delivered hourly thru your skin,but got to be carefull and follow instrucion fully. I still take breakthru pain meds and muscle relaxers and a 24 hr musc relax. among massages and procedures,botox,etc. I would try the patch 1st before doing this but it's your choice. I advise getting a pain management doc they know best good luck

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