Questions and Answers – Getting a Drug Pump

How will my doctor know if I am a candidate for a drug pump?

Talk to your doctor about what you would like to achieve with your treatment. Your doctor will do a screening test to determine whether a drug pump will provide adequate pain relief or help you meet your goals.

Why do I need to take a screening test?

A screening test is a way for you and your doctor to evaluate your response to the medication delivered into your spinal region, to see if you are a candidate for a drug pump.

How long does the screening test take? Do I have to stay in the hospital?

This will vary depending on the type of screening test your doctor feels would be best for you. The tests could take as little as a half day up to 4 days. Depending on the type of screening test, you may undergo a procedure that takes approximately 1 to 2 hours and then need to stay in the hospital to be monitored after the procedure. Consult your doctor to understand the details for the type of screening test that your doctor thinks would be best for you.

Will it hurt?

Before you are given the screening test injection or the catheter is placed, your doctor may numb a small region of your lower back with a local anesthetic.

Can I have other pain medication during the screening test?

This will depend on your doctor and your pain level. Your doctor may reduce or withdraw your oral medication 1 to 2 weeks prior to the test.

Will I receive the same relief that I get during the screening test when I receive my permanent drug pump?

If the screening test has been successful and you go on to receive the implanted system, your pain relief may differ slightly. Be sure to tell your clinician about the way you feel so that changes can be made that will give you the best pain relief possible.

How long after the screening test is the drug pump implanted?

If you decide to proceed with drug delivery therapy, there will be a waiting period after the screening test and before your implant procedure. This will give the incision in your back time to heal and allow time for your insurance provider to be notified, and for the surgery to be scheduled.

What type of anesthesia is used during the implant?

Typically, the implant is performed under general anesthesia. However, you may wish to talk with your doctor about other options.

What is the average length of the hospital stay?

Depending on your doctor's preference and hospital policy, a 1- to 2-night hospital stay may be recommended.

On average, how long does the surgery take?

On average, the procedure takes about 1 to 3 hours from start to finish. Talk with your doctor about the specifics and duration of your procedure.

How big are the incisions?

There are two incisions. One is for the pump and is usually located in your abdomen. The size of the incision depends on the size of the device and could be up to 6 inches long. The other incision, made on your back, is 2 to 3 inches long.

Is spinal cord damage a possible complication?

Spinal cord injury may occur from surgical placement of the catheter.

Can a previous abdominal incision be used?

No, because the incision needs to be made where the pump will be implanted to help properly anchor the device.

Between which vertebrae is the catheter placed?

This depends on your specific condition and the results you received from the screening test. Your doctor will advise you of the recommended location.

How long will it take before I start receiving benefit from my pump?

You will begin receiving treatment as soon as your pump is filled with medication and the medication is delivered through the catheter to the specific site. However, depending on your medication, it may take several days to weeks before you experience benefits from your medication. During this transition period, your doctor may reduce or eliminate your other medication.

How often will the pump need to be refilled?

The medication in your pump needs to be refilled every 6 weeks to 6 months, depending on your dosage. A higher dosage requires more frequent filling. It is refilled by a needle injection in your doctor’s office. During these appointments your doctor can adjust your dose of medication to address your pain relief needs.

Will people be able to see that I have a pump?

Because your pump is placed near the surface of your skin for refill access, on occasion someone might notice a slight bump if you are wearing fitted clothes. However, depending on your size and shape, where the pump is implanted, and the size of your pump, it may not show under your clothes at all.

What if my pain changes? Can my doctor increase or decrease my dosage?

Yes. After implantation, your doctor can make changes in dosage requirements.

Can the pump be removed?

Yes. The screening test is designed to determaine whether the pump will help manage your pain. However, if you no longer need the pump or change your mind about the treatment, your doctor can turn it off or surgically remove the system.

Will my insurance company pay for a drug pump?

Many insurance carriers will pay for drug pumps. However, as with many pain treatments, your doctor will have to get approval from your insurance company before you can receive treatment. Consult your doctor or insurance carrier for more specific information. For more information about insurance coverage, you can send an e-mail to rs.therapyaccess@medtronic.com or call (800) 292-2903.

Is the procedure covered by Medicare?

Drug pumps are approved for coverage by Medicare. Medicare will pay 80% of the cost as long as the procedure is determined to be medically necessary. Talk to your doctor about the Medicare Conditions of Coverage.

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Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.

Last updated: 18 Feb 2013