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Pain pumps?
I have been on about every med they can prescribe. Right now the hydrocodone takes care of my lower bach issues a little where there are 2 rods and a plate after 3 surgeries. 1 plate in my neck from c3 to C6. I have had these migraines for almost 2 years and had to leave my job of 24 years because of losing the use of my left arm and right eye because of it. RF burn didn't do anything but make my skin numb. today is the 14th and this year I have had a migraine 10 days, some worse than others. So should I follow my pain Dr recommendation and go with a pump and will it affect my chance of getting disability? I am at my wits end with the pain and being broke all the time because I cannot work/drive doesn't help.
Yes, and while neurosurgeons do all kinds of surgical procedures, including brain surgery, a board certified specialist in interventional pain medicine (DABPM) it trained specifically in the insertion of spinal cord stimulators, and spinal pain pumps.
I'd choose a DABPM over a surgeon.
Still the 700 hour rule applies.
I'd choose a DABPM over a surgeon.
Still the 700 hour rule applies.
Good point! The '700 hours' is often overlooked.
Not too long ago, I had a plastic screen protector put on my fancy phone. I interviewed each "Screen Protector Applyer" and those that hadn't done at least a 1000 didn't make the cut. (I went with one who had done 3000, in 3 years, and was happy.)
If we are going to apply that much care in searching for someone to stick a silly piece of plastic onto a phone, we should *at least* apply the same amount of care in choosing a neurosurgeon!
Those in search of one should never be shy, "How many years have you been doing this? How many surgeries have you done? What is your success (and mortality) rate? How many have been a partial success?"
If they pass the muster, well, THEN, and only then, will I let them touch my phone LOL
Not too long ago, I had a plastic screen protector put on my fancy phone. I interviewed each "Screen Protector Applyer" and those that hadn't done at least a 1000 didn't make the cut. (I went with one who had done 3000, in 3 years, and was happy.)
If we are going to apply that much care in searching for someone to stick a silly piece of plastic onto a phone, we should *at least* apply the same amount of care in choosing a neurosurgeon!
Those in search of one should never be shy, "How many years have you been doing this? How many surgeries have you done? What is your success (and mortality) rate? How many have been a partial success?"
If they pass the muster, well, THEN, and only then, will I let them touch my phone LOL
No, my friend. Pain psychologists don't prescribe, but they usually have good relationships with physicians. When they make a recommendation for medication, physicians usually listen.
I'm not sure how effective a psychiatrist can be. They did not prescribe for pain outside of TCAs that turn most into a zombie.
I'd use an interventional pain specialist who does hundreds of these procedures a year to implant a stim and not a neurosurgeon who's main job is surgery.
The statistics show that the best outcome with procedures, including surgical procedures occur when the specialist has over 700 hours of experience doing that particular procedure.
I'm not sure how effective a psychiatrist can be. They did not prescribe for pain outside of TCAs that turn most into a zombie.
I'd use an interventional pain specialist who does hundreds of these procedures a year to implant a stim and not a neurosurgeon who's main job is surgery.
The statistics show that the best outcome with procedures, including surgical procedures occur when the specialist has over 700 hours of experience doing that particular procedure.
Philnoir was responding to the original poster. The original poster is "Migrainehater," so I'm guessing you meant to direct your response to Migrainehater, and not Philnoir.
Anyway, you make some good suggestions. I had suggested a "pain psychologist," and you suggested a "pain psychiatrist." Perhaps your suggestion is better, as I understand a psychiatrist usually has the credentials to prescribe. Maybe psychologists do, too, but I think for the most part, not.
Anyway, you make some good suggestions. I had suggested a "pain psychologist," and you suggested a "pain psychiatrist." Perhaps your suggestion is better, as I understand a psychiatrist usually has the credentials to prescribe. Maybe psychologists do, too, but I think for the most part, not.
As one who had a hard time accepting chronic pain and daily headaches w/ migraines I would give you this advice, go to a psychiatrist first. They can ( find a good one, ask around for a referral), prescribe to correct antidepressant which moderates the pain....really, it can. Next, ask for topamax or lamotragin for the migraines. Learn meditation, it helps. Learn and practice mindfulness, it helps. Exercise, even a little. Find the warmest pool or even a cool hot tub and start or keep moving. Stay in touch with friends and family, it's hard to go out when you hurt but it will help, find a way.
The reason for the psychiatrist? You will be sent there anyway before the Neurosurgeon will do the pain pump or spinal stimulator.
The rational for all the suggestions? In all probability, you will never get rid of the pain 100%. You stand a good chance of reducing the pain to tolerable levels, levels that allow you to work and play. Your definition of work and/ or play may well have to change but you can have a good life.
If you go with the pain pump, be very choosy about your surgeon....use a neurosurgeon!
Good luck.
The reason for the psychiatrist? You will be sent there anyway before the Neurosurgeon will do the pain pump or spinal stimulator.
The rational for all the suggestions? In all probability, you will never get rid of the pain 100%. You stand a good chance of reducing the pain to tolerable levels, levels that allow you to work and play. Your definition of work and/ or play may well have to change but you can have a good life.
If you go with the pain pump, be very choosy about your surgeon....use a neurosurgeon!
Good luck.
This will sound "out of left field" and you may very well say "nope that doesn't apply to me," but I still want to give you my two cents worth.
Getting a pain pump may be a blessing for you, may be the perfect thing! Conversely, it might *not* be such a good thing.
Right now, you have "so much on the table," that you want all the pain to end, and you want it to end so bad you might just well say "yes" to just about anything! I remember the last time I had a migraine, I was willing to do anything to make it stop ("Yes Doctor, I'll wear a purple kilt and sing karaoke every night").
But, getting a pain pump is quite a big decision, one that needs to be made conscientiously, and lucidly.... not during a several-week migraine streak.
Do you know what I mean?
You have all the "fixins" of many of the chronic pain patients on this forum, with the addition of one more really excruciating and awful thing: migraines.
Therefore, if there is any way you can afford it, I have something for you to consider: a pain psychologist. I know, i know, you're like *what!?" no no newwwww," but, at least google it. Here's one of those 'simplistic' web pages that that addresses pain, headaches, and, yep, a pain psychologist:
http://neurology.stanford.edu/headache/ourteam.html
Where I'm going with this is that you would have a trained 3rd party to not only help cope with the exacerbating pain you are going through, but also to afford you some clarity for the big decisions that need to be made.
And, most importantly, *nothing* needs to be done in a knee-jerk fashion... for example, a physician may prescribe one of the many migraine drugs, may prescribe an alternate opiate for your pain that has may have less propensity to cause you headaches, or one that works in tandem with a headache medication, and at the very least, temporarily reduce the "overwhelmingness" of all that you are going through so that you can make these big decisions.
Whatchya think?
Getting a pain pump may be a blessing for you, may be the perfect thing! Conversely, it might *not* be such a good thing.
Right now, you have "so much on the table," that you want all the pain to end, and you want it to end so bad you might just well say "yes" to just about anything! I remember the last time I had a migraine, I was willing to do anything to make it stop ("Yes Doctor, I'll wear a purple kilt and sing karaoke every night").
But, getting a pain pump is quite a big decision, one that needs to be made conscientiously, and lucidly.... not during a several-week migraine streak.
Do you know what I mean?
You have all the "fixins" of many of the chronic pain patients on this forum, with the addition of one more really excruciating and awful thing: migraines.
Therefore, if there is any way you can afford it, I have something for you to consider: a pain psychologist. I know, i know, you're like *what!?" no no newwwww," but, at least google it. Here's one of those 'simplistic' web pages that that addresses pain, headaches, and, yep, a pain psychologist:
http://neurology.stanford.edu/headache/ourteam.html
Where I'm going with this is that you would have a trained 3rd party to not only help cope with the exacerbating pain you are going through, but also to afford you some clarity for the big decisions that need to be made.
And, most importantly, *nothing* needs to be done in a knee-jerk fashion... for example, a physician may prescribe one of the many migraine drugs, may prescribe an alternate opiate for your pain that has may have less propensity to cause you headaches, or one that works in tandem with a headache medication, and at the very least, temporarily reduce the "overwhelmingness" of all that you are going through so that you can make these big decisions.
Whatchya think?
As my friend Pharmacist Steve wrote: "Pain patients are exhausted physically, emotionally, and financially." He is absolutely correct.
I don't understand why you're using hydrocodone, which is more appropriate for use with the acute pain of root canal and sprains. If your pain is severe I'd expect to hear that you''re on morphine, hydromorphone, methadone, or fentanyl patch,
If your pain is managed with hydrocodone, then the pump may be premature.
However, if you've been on all the stronger opioids and are indeed severely opioid tolerant, then consider it. If your pain doctor recommends the pump and their is no contraindication, go for it.
Do you understand how the pump works? A small catheter is inserted into the intrathecal space and placed wherever medication works the best and is comfortable for you. You'll begin with a trial catheter as your doctor attempts to optimize its placement. With the trial catheter, the pump is taped on the skin of your hip. The pump delivers a regular but small flow of medication all day and night. If all goes well with the trial catheter, you'll be ready for the implantation procedure.
It may take a few weeks to titrate you to the correct dose. Since no opioid is wasted via metabolism, you'll need only 1/20 to 1/100 of your oral dose and you will experience enhanced analgesia from the pump, because a majority of the opioid receptors are in the spine and brain.
BTW, hydrocodone is not used in a pain pump. Drugs of choice are morphine or hydromorphone. Sometimes methadone is added to the mix, and sometimes more exotic medications, like ketamine, is also added.
During the implantation procedure, a permanent catheter is placed in the spine, which runs to a pump that will be installed under the skin, somewhere in the pelvic cage. This can cause a little discomfort at first but you'll soon get used to it.
You will have to visit your pain doctor every few months for a refill, depending on the flow rate of the pump. New medication is injected through the skin into a self closing membrane on the surface of the pump.
There are risks with the pump, as with any procedure. Your doctor will explain them thoroughly.
Most pumps are made by Medtronic (http://www.medtronic.com/). See the website for more information.
I would have this treatment if I could. (I have a bleeding disorder that contraindicates use of the pump.) The thought of receiving better analgesia with a fraction of my opioid dose sounds like heaven to me.
Best wishes
I don't understand why you're using hydrocodone, which is more appropriate for use with the acute pain of root canal and sprains. If your pain is severe I'd expect to hear that you''re on morphine, hydromorphone, methadone, or fentanyl patch,
If your pain is managed with hydrocodone, then the pump may be premature.
However, if you've been on all the stronger opioids and are indeed severely opioid tolerant, then consider it. If your pain doctor recommends the pump and their is no contraindication, go for it.
Do you understand how the pump works? A small catheter is inserted into the intrathecal space and placed wherever medication works the best and is comfortable for you. You'll begin with a trial catheter as your doctor attempts to optimize its placement. With the trial catheter, the pump is taped on the skin of your hip. The pump delivers a regular but small flow of medication all day and night. If all goes well with the trial catheter, you'll be ready for the implantation procedure.
It may take a few weeks to titrate you to the correct dose. Since no opioid is wasted via metabolism, you'll need only 1/20 to 1/100 of your oral dose and you will experience enhanced analgesia from the pump, because a majority of the opioid receptors are in the spine and brain.
BTW, hydrocodone is not used in a pain pump. Drugs of choice are morphine or hydromorphone. Sometimes methadone is added to the mix, and sometimes more exotic medications, like ketamine, is also added.
During the implantation procedure, a permanent catheter is placed in the spine, which runs to a pump that will be installed under the skin, somewhere in the pelvic cage. This can cause a little discomfort at first but you'll soon get used to it.
You will have to visit your pain doctor every few months for a refill, depending on the flow rate of the pump. New medication is injected through the skin into a self closing membrane on the surface of the pump.
There are risks with the pump, as with any procedure. Your doctor will explain them thoroughly.
Most pumps are made by Medtronic (http://www.medtronic.com/). See the website for more information.
I would have this treatment if I could. (I have a bleeding disorder that contraindicates use of the pump.) The thought of receiving better analgesia with a fraction of my opioid dose sounds like heaven to me.
Best wishes
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