Opioids Medtronic Synchromed II Drug Pump

[PrivateIdaho]

Just had this drug pump installed a few weeks ago. It's running Fentanyl and Bupivacaine and directly into my spinal fluid at the T10 level. They say most people don't get an opiate high from these devices. I disagree. My pump is running a basal dose rate of 32 micrograms an hour 24/7 and I have a small device that allows me to get a bolus dose of 68 micrograms every 4 hours. The best thing about it is that when I take my oral meds 8mg hydromorphone Q6h I get f'd up like you wouldn't believe. if anyone has the option to have one of these pumps installed I high-ly recommend it. Just make sure your pain is real and chronic because it is a painful and long process to have it installed. You have to come off all pain meds for a trial to make sure it will work for you. Then you to stay on low doses of pain meds for about a month while they are getting insurance approval to have the machinery installed. The device is about the size of a hockey puck. It holds 40ml of very concentrated pain med. My fentanyl is 3,000mcg per 1ml so when its full it has 120mg of Fentanyl. If anyone has questions about this device and the process of having it installed, I would be happy to answer.

 

[nikkotopp]

I have one, it's been a nightmare. I have been getting it adjusted for over a year now and I still have terrible pain. I have to lie down after just being on my feet for half a day. I don't know what the problem is. Mine has morphine in it, I did really well with the trial. I had great pain releif. Since it has been installed I have had the worse pain I have ever had. I'm on my 3rd doctor to no avail. Not sure what to do or where to turn.

 

[MDPV_Psychosis]

Im sorry to hear that Nikko. Is it like it's not working properly or just not delivering enough morphine fast enough to help your pain? I know very little about this device so I cannot offer any advice but it might be helpful for others to be able to help you if you could elaborate a bit.

For example, How much morphine does it give you per dose and how often does it dose you? Or does it provide a constant release?

Is your doctor willing to try different medications, say like first poster who's pump had fentanyl? I'm assuming they've tried adjusting the amount of morphine but no matter what it sounds like it isn't working like it did through the trial period. Again, I'm sorry. I hope you and your doctor can find an adequate solution.

If you don't mind me asking, why do you need this device instead of just taking morphine orally?

 

[sekio]

administering drugs intrathecally (into spinal fluid) is not only incredibly risky (any external path to the CSF = pathway to get infection) but it is literally the end of the road in terms of pain treatment, you are literally bypassing the blood-brain barrier and dumping opioids directly into the brain, tolerance would be a major concern

this is something that would be appropriate in an end stage cancer patient but I just don't see the risks/benefits being there when a fentanyl transdermal patch literally is safer ..

 

[nikkotopp]

Im sorry to hear that Nikko. Is it like it's not working properly or just not delivering enough morphine fast enough to help your pain? I know very little about this device so I cannot offer any advice but it might be helpful for others to be able to help you if you could elaborate a bit.

For example, How much morphine does it give you per dose and how often does it dose you? Or does it provide a constant release?

Is your doctor willing to try different medications, say like first poster who's pump had fentanyl? I'm assuming they've tried adjusting the amount of morphine but no matter what it sounds like it isn't working like it did through the trial period. Again, I'm sorry. I hope you and your doctor can find an adequate solution.

If you don't mind me asking, why do you need this device instead of just taking morphine orally?

I sustained a shotgun wound point blank to my chest, leaving 28 #4 BB size pellets in me. Plus an accident with an 18 wheeler left me with lumbar and thorasic problems. I have taken oral medication for so long it became ineffective. Not to mention the hassle of trying to keep myself in pills. It was suggested that this would be a viable option for me. My dose of morphine is continuous, and is currently set at 6.720 my bolus that is available 4 times a day is 0.200mg. It doesn't make any difference, if I choose to use it or not. If you told me there was water in my pump instead of Morphine, I would believe you. Everyone says " you need a pump adjustment " I have been getting adjusted for over a year with no relief. My tolerance is very high, in that I had a doctor in Canada that kept me in oral Hydromorphone solution. For years I had a two liter a month supply. Let's just say I never ran out. I see the latest Dr. here in Florida tommorow. He keeps saying your on a low dose, and turns the pump up. To no avail, I'm not sure what to ask for and am just worn out with pain and depression. Thanks for your reply to my original post.

 

[sekio]

That's opioid tolerance for you... probably why the other poster has bupivicaine added. IMHO Opioids alone are not worth the risk, they should always be used in concert with e.g. NSAID, local anesthetic, etc.

 

[MDPV_Psychosis]

Yea I'm sorry to here you are going through this. I think your tolerance is just too high like sekio is saying. Hopefully the doctor tomorrow can do something. Good luck.

 

[nikkotopp]

Yea I'm sorry to here you are going through this. I think your tolerance is just too high like sekio is saying. Hopefully the doctor tomorrow can do something. Good luck.

Thanks man,
Went to Dr., Going to put Hydromorphone in pump next month. Also was given 10 mg Hydrocodone tabs. Makes things a little easier, as opposed to having nothing. I will touch base after the drug swap.

 

[nikkotopp]

Thanks man,
Went to Dr., Going to put Hydromorphone in pump next month. Also was given 10 mg Hydrocodone tabs. Makes things a little easier, as opposed to having nothing. I will touch base after the drug swap.

Update: I have taken the Hydrocodone and 60mg oral morphine (MScontin) To no avail, I'm surprised myself. I have been out in the yard, light duty. Actually just joing some wires with a hand tool. Pain is unbearable. Totally out of control. My day ends early, anytime I'm ambulatory.

 

[sekio]

Do you also take any sort of NSAID? I am a big advocate for adding e.g. naproxen, diclofenac, or high dose ibuprofen into the medication regimen of ANYONE suffering from pain that stems from physical injury or inflammation. Even plain old ibuprofen can make a humongous difference in how effective your opioids are at controlling pain - even if it does nothing on its own, two drugs with different mechanisms of action can be much more effective than a huge dose of just one.

It sounds dumb that an OTC medication could help with severe pain but it's certainly been helpful in my case (healing from3rd degree burns).

 

[Nagelfar]

Basal dose of 32 micrograms intrathecally, is that equivalent to IV? I was under the impression the multiplication from IV to actual dose IT or ICV was in the thousands if not tens of thousands. Enlighten me from one who is on it and not some abstract statistics.

 

[nikkotopp]

Thanks man,
Went to Dr., Going to put Hydromorphone in pump next month. Also was given 10 mg Hydrocodone tabs. Makes things a little easier, as opposed to having nothing. I will touch base after the drug swap.

Well it's been a couple of weeks, I see the doctor soon and need some advice. I found that Norco is almost worthless for me in that when my pain is at it's worst and I take it. #3 10/325 at once doesn't really help much, this is my limit as far as acetaminophen goes. My liver has had a tough life, trying to be nice to it. Plus it upsets my stomach. I have had MScontin 15 and 30mg and Oxymorphone 30mg. ( No the doctor didn't prescribe them ) I wish someone would tell me how or where to look for IV instructions. I tried to prep both tablets for injection. I immediately recognized the gel forming. Ruined 1 of each finding out. I have not tried the Oxymorphone but the morphine made me feel like a 5 pound weight was in my belly. Terrible, and not really effective at any dose oral. The Oxymorphone I tried to prep I took like a spoon of cough syrup. Once I realized it wouldn't break down. i don't know if trying these other drugs while having hydrocodone in my system is causing my stomach discomfort. But I'm having it again after eating the spoon of Oxymorphone. Here is my question, if I had it my way I would have IV Hydromorphone in a vial, ( sterile ) or oral solution (like before) and use it accordingly. I don't think that's going to happen here in Florida. I am going to need some serious medication, what kind I don't know. Asking for it or how to ask for it is uncomfortable for me. I don't want any chance of ( drug seeker ) happening. This Doctor any myself are new to each other. And the Hydrocodone is the first oral medication he has prescribed.( Probably the last if he knew the meds I tried this month) I'm very tired of suffering daily, pain so severe, it's a 20 in my mind at it's worse. it will bring tears to my eyes. I would give 5 million dollars for the ability to put my pain in the doctors body for a minute. That way we could get right down to business. That's not going to happen either. Please if you can tell me maybe what med might help me and how to discuss it with the doctor. That's what I need ..Thanks very much..Nikko

 

[nikkotopp]

Do you also take any sort of NSAID? I am a big advocate for adding e.g. naproxen, diclofenac, or high dose ibuprofen into the medication regimen of ANYONE suffering from pain that stems from physical injury or inflammation. Even plain old ibuprofen can make a humongous difference in how effective your opioids are at controlling pain - even if it does nothing on its own, two drugs with different mechanisms of action can be much more effective than a huge dose of just one.

It sounds dumb that an OTC medication could help with severe pain but it's certainly been helpful in my case (healing from3rd degree burns).

I tell you, what works short term and quickly for me is a shot of Toradol In the butt. It works but I don't want to ruin my liver. Never had much luck with any NSAIDs I have tried many different kinds.

 

[nikkotopp]

Im sorry to hear that Nikko. Is it like it's not working properly or just not delivering enough morphine fast enough to help your pain? I know very little about this device so I cannot offer any advice but it might be helpful for others to be able to help you if you could elaborate a bit.

For example, How much morphine does it give you per dose and how often does it dose you? Or does it provide a constant release?

Is your doctor willing to try different medications, say like first poster who's pump had fentanyl? I'm assuming they've tried adjusting the amount of morphine but no matter what it sounds like it isn't working like it did through the trial period. Again, I'm sorry. I hope you and your doctor can find an adequate solution.

If you don't mind me asking, why do you need this device instead of just taking morphine orally?

I took at 12 gauge blast point blank in the chest. It was loaded with a #4 Magnum shell. Barely survived, I still have 27 pieces of buckshot deep inside my body. Add an accident with an 18 wheeler and life...and you or I am in a world of hurt my friend.. The 24 hour constant Dose isof morphine is 8.35 in a 24 hour period. Bolus is at 0.200 I can have 4 a day...at this dose it doesn't do shit..(Bolus). pardon my French. Yes sir.. the pump is not titrated probably. With my tolerance it's going to take a healthy dose.

 

[nikkotopp]

Im sorry to hear that Nikko. Is it like it's not working properly or just not delivering enough morphine fast enough to help your pain? I know very little about this device so I cannot offer any advice but it might be helpful for others to be able to help you if you could elaborate a bit.

For example, How much morphine does it give you per dose and how often does it dose you? Or does it provide a constant release?

Is your doctor willing to try different medications, say like first poster who's pump had fentanyl? I'm assuming they've tried adjusting the amount of morphine but no matter what it sounds like it isn't working like it did through the trial period. Again, I'm sorry. I hope you and your doctor can find an adequate solution.

If you don't mind me asking, why do you need this device instead of just taking morphine orally?

Because I have an incredible tolerance due to having for 10 years in Canada..1mg per Ml Hydromorphone oral 2 leiters a month # 60 80mg oxycontin #240 10/325 Percocets. This is what I did for 10 years. It's necessary now...I don't know about if it was needed then. I wish it wouldn't have happened. I took a 12 gauge shotgun blast to the chest. I still have 28 #4 buckshot deep inside my body. Add an accident with an 18 wheeler and life. It has created a huge problem. Morphine does to spinal fluid is 8.50mg over 24 hours...Bolus dose is 0.200 available 4 times a day. It doesn't do shit at this dose.

 

[nikkotopp]

I took at 12 gauge blast point blank in the chest. It was loaded with a #4 Magnum shell. Barely survived, I still have 27 pieces of buckshot deep inside my body. Add an accident with an 18 wheeler and life...and you or I am in a world of hurt my friend.. The 24 hour constant Dose isof morphine is 8.35 in a 24 hour period. Bolus is at 0.200 I can have 4 a day...at this dose it doesn't do shit..(Bolus). pardon my French. Yes sir.. the pump is not titrated probably. With my tolerance it's going to take a healthy dose.
[/QUOTE
I'm sorry to.post the same thing more than once... next time I will use my laptop. It's difficult for me using my phone...on top of not knowing how to use the website. Please delete the repetitive posts. Thanks for your help.

 

[nikkotopp]

Update: I have taken the Hydrocodone and 60mg oral morphine (MScontin) To no avail, I'm surprised myself. I have been out in the yard, light duty. Actually just joing some wires with a hand tool. Pain is unbearable. Totally out of control. My day ends early, anytime I'm ambulatory.

You and me both...it sucks to only be ambulatory for only a few hours a day. I'm my own worst enemy because I push it until I can't go anymore. Then I pay the next day... Like hardly being able to get out of the bed.

 

[sekio]

Maybe look into ziconotide or something like that if you are on intrathecal drugs, it's a non-opioid peptide related to cone snail toxin that acts as a really damn potent painkiller...