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| | From:  bhamm (Original Message) | Sent: 10/18/2006 4:20 PM |
I was on 150 fentanel patch everyother day and 8 15mg oxycoutin a day. I have had 4 lumbar and 2 cervical opperations, most in the last 3 years. My doc has recomended a pump to replace all pain meds. I have had a temporary pump implanted. The temp. one has a bag with the meds and a pump that you carry and a line that goes into the spine. The permanet pump and med. will be inplanted under the skin on my belly and they refill it with a syrenge monthly and can adjust the rate via radio freq. Does anyone have any knowledge of this... Pors or cons.. The Temp. does seem to control the pain better with less effects on my thinking ( with the fentenal and oxycoutin I was very forgetfull and had very little ambition). Please send any info you have, I need to give them an answer within a week as to how to proceed. Thanks Bhamm4254 |
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Look at www.medtronics.com that make about 95% of the implanted pumps. The current model of their pump Synchromed II can hold up to 40 mls of medication... when using Infumorph (morphine) that is a 1000mg. Medtronics has determined that this medication is stable in their pumps for 6 months. Typically, the amount of opiate that is needed is 1% of what was needed when taken orally... thus most of the side effects are eliminated or better managed especially constipation and "mental fog". The battery in the pump will last 5-7 years. FDA approved last fall what Medtronics refer to as PTM ( Patient Therapy Manager) which is like the "morphine button" that is used in the hospital after surgery to manage pain. My wife had this system implanted in June and the results have been good.. with the PTM .. when she activiates a push .. initial relief is within 5-15 minutes. 60% of her max allowable dose is done via a constant drip and she uses the PTM for breakthru. The downside to the pump is that as your pain is managed better you will fell like becoming more active .. which will induce pain.. this is where the PTM comes in handy ... since you can help manage activity induced pain .. without having to take that much medication every day .. when you are less active. Many docs use compounding pharmacies to produce the meds that they put in these pumps.. sometimes it is necessary many times it is not .. but the docs MAKE MORE MONEY doing this... here is a link to see what experts think of this issue Personally, I made my wife leave one pain clinic.. that would not discuss anything but using meds compounded by a pharmacy rather than the commercially available products.. While not everyone will have the same outcomes ... my experience with my wife is TWO THUMBS UP! Pharmacist Steve |
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| | | From: Dan | Sent: 10/20/2006 12:22 AM |
Wow, thanks Steve. That's a great explanation of the pump, how it works, and what to expect. That's terrific. And you know, I didn't know about the compounding, or that there was commercially available stuff out there. Are there commercially avaiable concentrations of dilaudid too? That's what's in my pump right now. Your wife has a pump? And she likes it? I love mine. I had some problems with it when I lost some weight and the line from the pump to my back kinked up. But after the revision it's been working flawlessly. Bahm, I think you're another one that I've not said hello to. So hello. I'm Dan, one of the managers here. You've got a gender neutral name. So no hugs for you. LOL Not until I find out you're a girl anyway. <Grin> If you're a guy, that's OK too. We need more guys here. The girls have us guys hopelessly outnumbered. Dan |
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Dan .. As far as I know only Morphine is commercially available (Infumorph Elkin/Sinns) for the pump.. to put something in the spinal fluid is has to be both sterile & perservative free. As a rule of thumb.. I have been told that the docs pay as little as 25% of the cost of the commercially available products to have the drugs compounded. I have been told that some docs will put some lidocaine type products in the pump ... to "justify" having the product compounded... even though ... when pushed the docs will admit that the lidocaine type products seldom provides any additional benefits. It is all about the money. Just imagine if one or more patients get mennigitis from a contaminated product.. do you think that the doc is going to tell the patient that he was not using commercially available products and that is the reason they were hospitalized or tell their family that is why they died? Who are they going to sue to make them whole? the doc? .. how deep is the pockets of the compounding pharmacy? I just put an addition on my blog today about how the FDA is failing to protect our drug supply. They found three compounding pharmacies producing commercially available products in Aug 2005 .. it took them ONE YEAR to send a cease/decease letter... no shut down of production, no drug recall... they were not only producing products illegally.. the FDA tested their products and they were both 22% sub-potent and adulterated... all the meds involved were dealing with respiratory meds.. Few if any of the docs that prescribed the meds nor the patients that got the meds were informed that they were getting compounded drugs in place of the commercially available drugs that were prescribed. According to the FDA published information.. there was million of doses involved and tens of thousands of patients and they were "dispensed" to patients nationwide. There are other issues with the FDA and our drug supply beside this... Pharmacist Steve www.chronicpainresourcecenter.com |
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| | | From: Dan | Sent: 10/20/2006 11:46 PM |
Well, we should probably move this discussion to the political forum at this point, but I do want to respond quickly. And then we'll move it. LOL As you and I both know, the FDA, as with most all of the agencies charged with protecting the public has had it's budget slashed drastically during the past 6 years. They've had to lay off scores of compliance officers, cut back on inspections of meat, poultry, and produce production facilities. Where they were all being inspected regularly, now only a "sample" is being inspected during any one year period. So while it's easy to blame the FDA for falling down on the job, one must look a bit further. The real blame lies at the feet of politicians who have failed to fund the agency. That's been better under the current secretary of Health and Human resources, (where the FDA resides), Micheal Leavitt, who was appointed in 2005 after his predecessor resigned. Leavitt, (a former insurance guy and three time governor of Utah) seems to have a better grasp of his department and the multiple agencies that make it up. It's nice to see a competent guy in charge of such an important cabinet instead of one of Dubya's cronys. However, he's still severly underfunded. Dan |
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I have advanced degenerative disk disease plus many other sources of spinal pain associated with osteoarthritis. My pain doctor was generous with his prescriptions for opiates(oxycontin) supplemented with other drugs pending installation of an electric pain-interfering stimulator. this would have him install two wires up my spinal column, along side my chord, and wear a tiny pacemaker-like device under the skin of my abdomen which has a rechargeable battery. with the stimulator, whenver pain reaches a certain threshold, i touch a remote control and the stgimulator prevents my brain from recognizing the pain signals. i understand success is about at the 50% level, certainly better than the enormous volume of actually ineffectiv e drugs i was on. this doctor told my that the LAST rresort would be for the installation, in my belly, of a morphine pump. In desperation, i sent searching further, after hearing all my local orthopaedists tell me: Sorry, there is nothing further that can be done for your spine" i contacted the orthopaedic department at mt sinai in miami beach and was referred to a surgical practive that specialized in patients that others have given up on and offers some brand new surgical technology for my disease. about 9i0 days ago i had this 9-hour procedure followed by 6 days in the hospital (mostly to detox me from opiates) and 16 days in the hospital's post-surgical rehab center. Now, 3 months later, i walk on my own two legs/feet (i had been wheel-chair bound for many months);, i sleep in my own bed (after spending 6 months sleeping in a chair), and i off virtually all heavy drugs-just one percocet plus 2 ultrams per day, and, although my surgeon has warned me i will always be in some pain, it has little effect in my life now. the key: DO NOT GIVE UP! Technology is improving medicine and surgery all the time. lthe procedures done to me did not exist in the US 15 mon ths ago (called XLIF and AXIALIF). my surgeon is now travelling all over the world teaching surgeons these new techniques. In fact, i understand the FDA just approved these techniques for use in diseases of the cerebral spine, too. Good Luck! |
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