These statements reflect the experience of one individual who is receiving a Medtronic Pain Therapy for the treatment of chronic pain. Medtronic invited this person to share his story candidly. As you read it, please bear in mind that the experiences are specific to this particular individual. Not everyone who receives drug delivery therapy will receive the same results as this individual. Talk with your doctor to determine if drug delivery therapy is right for you.
Ask Hank
Hank has been receiving drug delivery therapy since 1993. Do you have a question you would like to ask Hank about living with a drug pump for chronic pain? Send an email to askhank@medtronic.com.
Before traveling, do you take any special precautions with your drug pump?
Hank says: I love traveling. In the days and weeks before I leave, I determine how long I'm going to be away and whether or not I'll need a refill during that time. If my vacation conflicts with my next refill appointment—or if I return within just a day or two of the appointment—I ask my doctor to refill my pump early so that I don't have to worry about it when I'm gone.
Before going to another state or country, I use the Medtronic Physician Finder to locate a doctor in the area where I'll be staying, just in case I should need help with my pump.
It's a good idea to take along a printout of the most recent refill session. This printout has the name of the medication and the dosage in the drug pump. I bring this printout with me so that if another doctor needs to care for me, he or she will know exactly what's in my pump.
Finally, I never enter an airport without my Medtronic ID card. The beauty of this card is that anywhere I go, it tells people in a variety of languages that I have this pump. I present the card to the attendant at the metal detector.
Safe travels!
How long did it take until you reached your optimal dosage where you felt the pump controlled your pain? How do you handle breakthrough pain?
Hank says: I received my pump back in 1993. I started on an extremely low dose which definitely lengthened the process for arriving at the right dose. About three months after my implant I changed doctors.
My new doctor got me to a comfortable dose by month five. He played around with different combinations in the pump and we hit on a combination that worked well. By month seven I was at about 95% of what I needed. By month eight I was feeling pretty good and taking very little oral pain medication.
For me, breakthrough pain is usually caused by overexertion or an issue unrelated to why I have the pump – such as arthritis. It may be that I'm exerting my body beyond where the pump is programmed to relieved my pain.
I have a prescription for 4 mg of Dilaudid® four times a day to address any breakthrough pain. I end up taking about one pill every three days.
My advice is to be patient while you and your doctor work together to find the dosage that is right for you. It's a team effort!
Now that you have a drug delivery therapy, what exercise activities keep you healthy?
Hank says: When I got hurt, not only did my social and spiritual life dwindle, so did my health. Just walking was hard to do. After my accident I was lucky if I could sit for 5 minutes without pain, but it was also uncomfortable to stand. Being in the car was hard because I couldn't sit still. It was hard to be physically active—even physical therapy was excruciatingly painful for me. I had to give up skiing, scuba diving and walking.
After I got my drug pump I took activities up again, one by one. I didn't want to overexert myself, so I gave myself time. I consulted with my doctors and got an exercise plan. I purchased an elliptical machine and now it's the first thing I do in the morning. I have a pool and I can dive in and swim from one end to the other and do some laps.
I really try to concentrate on low impact activities. I have gone skiing a couple of times and had a lot of fun. If it's cold out, I might hear my pump alarm beep because it's temperature sensitive. I love to go into the hot tub. But again, I need to be aware of the temperature and make sure it's no warmer than 102 degrees. That applies to a steam room and a sauna, too.
I just got back from a vacation. I hiked five miles outside Lake Tahoe, and at Yosemite I hiked to the top of a waterfall and to a frozen lake. This was something I've wanted to do for a long time. It took me longer than the others on the trip, but that's okay. I didn't rush.
Before my drug pump, I'd be looking at people's photographs of these outings. Now, I'm doing them myself!
Do you ever experience an overdose or underdose of medication with your pump?
Hank says: I'm so used to the pump now, I forget it's there. But if I overexert, I feel enough pain to take a bolus dose from the Personal Therapy Manager (myPTM™) remote device. Early on, this caused me to experience a very sudden hot flash, breaking into a sweat severe enough for a shirt change. If this happens to you, talk to your pain management doctor about decreasing the dose or lengthening the interval over which the bolus is given. If you don't have a remote, note any symptoms that recur consistently in your daily pump schedule.
If you take oral opioids for breakthrough pain along with the pump, be cautious as well. Even though you took higher narcotic doses before having the pump, these prior levels may give you an unsafe opioid response stronger than expected. Always follow your current prescription for your medication dose. My symptoms of too much opioid included a headache that felt like a tight ring around the top of my head, foggy thinking, fatigue, constipation, sweaty palms, and overall itchiness. When those old symptoms come back, you remember all the reasons why you wisely chose a pump!
As for an underdose, I remember waking up one morning in pain. When that happens, I ask myself "What activity did I do yesterday?" This particular time there was nothing unusual. The next day I experienced another 25% loss of pain relief and I realized something must be wrong. It turned out there was a small obstruction in my catheter.
My doctor dislodged the block and within 24 to 36 hours my pain relief returned with no problems. If it seems like your pain is ramping up quickly without reason, it could be a partial or complete obstruction.
Don't ignore unusual or abrupt changes in pain or symptoms. Always check with your doctor.
While Hank had no complications, there are risks associated with the procedure. The most frequently reported problems following drug infusion system implant surgery include infection, spinal fluid leak, pump inversion, skin erosion, drug side effects, loss of therapy effect, and therapy that did not meet the patient's expectations. For a complete list of adverse events that have been associated with the therapy, please refer to the Important Safety Information
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.
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