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Questions and Answers – Getting a Drug Pump

Cancer Pain

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

Your doctor can do a screening test to help predict whether a drug pump will control your cancer pain.

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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 pain medication delivered into the intrathecal space to see if you are a candidate for a drug pump. If the pain caused by your cancer is measurably reduced, it means that the drug pump may work effectively for you.

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How long does the screening test take?

This will vary depending on the type of screening test your doctor believes will be best for you. The test could take as little as a day, and up to 4 days. Depending on the type of screening test, you may undergo a procedure that takes approximately 1 to 2 hours plus additional time to be monitored in the hospital or surgery center after the procedure. Talk with your doctor to understand the details of the type of screening test that your doctor thinks would be best for you.

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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 or pain patches 1 to 2 weeks prior to the test.

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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. Be sure to tell your doctor about the way you feel so that adjustments can be made to give you the best pain control possible.

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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 allow time for your insurance provider to be notified, and for the surgery to be scheduled.

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What type of anesthesia is used during implant?

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

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On average, how long does the surgery take?

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

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How big are the incisions?

There are two incisions. One is for the pump, which is implanted in your abdomen. The size of the incision depends on the size of the device you and your doctor have selected. The other incision is for the catheter. This incision is made in your back and is 2 to 3 inches long.

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Where is the catheter placed?

The catheter is typically inserted into the lumbar region of your spine and then advanced to the correct vertebral level as determined by your surgeon.

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

You will begin receiving pain treatment as soon as your pump is filled with medication and programmed by your doctor, and the medication is delivered through the catheter to the specific site. However, depending on your medication, it may take several days before you experience benefits. During this transition period, your doctor may adjust the amount of pain medicine from your drug pump so that you receive the best pain control possible. At the same time, your doctor may adjust your other medications..

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How often will the pump need to be refilled?

The medication in your pump needs to be refilled every 5 to 24 weeks, depending on the type of medication and your dosage. It is refilled in your doctor's office by inserting a needle through the skin into the pump. During these appointments your doctor can adjust your dose of medication as needed for satisfactory pain relief. It is extremely important to keep your scheduled refill appointments so that you don't run out of medication.

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

Because your pump is placed near the surface of your skin for easy refill access, you may be able to see the pump when you are wearing fitted clothes. However, depending on where the pump is implanted and its size, as well as your body type, it may not show at all under your clothes.

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

The SynchroMed II pump is programmable, so your doctor can reprogram your dose. If your pump is not programmable, your doctor can change the concentration of drug in your pump, which then changes your dose.

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Can the pump be removed?

Yes. The screening test is designed to determine 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 off or remove the system.

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Will my insurance company pay for a drug pump?

The drug pump is a proven treatment for cancer pain management and is covered by most health insurance companies. However, as with some 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.

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Is the procedure covered by Medicare?

Intrathecal drug delivery systems 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.

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.