Local pain block type?

It's called an intrathecal medication pump and I wouldn't let them do it. There's all kinds of hushed up problems with medication pumps. Lines come lose dosing gets messed up and even worse there's a problem with growths called granulomas. They're biological material that tends to clump up on the end of the catheter (white blood cells antibodies and what not) which they see as a foreign material in your body. So your immune system attacks it, They gather on the tip of the catheter and harden. And get very sharp. Sharp materials and important nerves close together can have bad results. There's studies dating back to the mid 70's that nobody is drawing attention to, where it seems that a common result of these granuloma/nerve interactions is lower body paralysis. If you go to Google and do a search in the group alt.support.chronic-pain for intrathecal medication pumps you should find some well documented information.on this problem.

I am hesitant to advise you outside of my own area of "patient earned doctorate" (chronic pain from 20+ years of my own back injury and the experiences of many others in chronic pain from any number of other diseases and conditions, so I am going to be as cautious as possible as I enter your arena of patient earned expertise, please be aware that I am just trying to help. I am particularly wary when it seems that even the experts don't seem to exactly have a lock on Aspergers what it is and how it works, but it does not seem that this zero opiate effect is constant throughout the diseases population.and not all local anesthetics have the same effects through the pain drug "resistant" populations. It may be this way throughout the opiate family as well. There's morphine derived, codeine derived, thebaine derived, semi synthetics, full on synthetics, agonists, antagonists (some that do both) and about a half a gazillion different analogues, legal, illegal and under study...I am just wondering if your doctor, given the current hostile environment over prescription opiates, has given you enough of a tour of this family of analgesics. We are, back in pain, my "home court", and I really don't want you trying a pump, they are such bad news. Additionally I don't know how forthcoming doctors are these days (I do know and they are not very) regarding these drugs, but as long as the side effects (essentially constipation) are controlled, there is no oral ceiling on most opiate drugs. Note I did not say most, there are a few oddballs, due to additives in the formula they do have dose ceilings.

It just makes no sense to expose you to at least one surgical procedure, likely several more than that to get things straight at the beginning and throughout the life of the unit (I certainly hope they keep making strides to improve one of many tools for fighting chronic pain) and leave you open to the unnecessary dangers granulomas can cause, just because someone is afraid to write a certain medication and dose on a piece of paper.

I don't know if your 72 hour comment about having the sugical pin/appliance was there when I originally wrote this or not, but the high dose of tramadol is very interesting. A completely synthetic that most of the net spends time arguing if it is truely considered an opiate or an "other" type of drug in a class of it's own. Those who consider it an opiate consider it bottom shelf. Additionally there's a significantly stronger analog of tramadol with the brand name Nucynta, known generically as tapentadol for moderate to severe pain.The only reason to push a narcotic through a pump, infuser, or IV line is that it can make the drug anywhere from 3 to 6 stronger. It bypasses the guts and goes straight to the brain and its opiate receptors. Bluntly if there is no additive that restricts the dose ceiling on an opiate, it's the doctor being afraid of making waves prescribing high dose opiates. That is not justification to perform a surgical procedure to implant a medical device (even if they had good reputations, which pumps do not) and leaving open the prospect of numerous procedures, incisions and scar tissue formation to come. you don't give your age but I am willing to bet the farm you will outlive at least one battery in the implanted device. Until they can steal a Star Trek transporter and "beam in" a replacement battery, they'll have to be more invasive than calling the auto club for a jump start.

If you can be kept out of pain with a blast of lidocaine/lignocaine/Xylocaine every couple hours through an iv line or medication infuser, outstanding.

But a permanent implanted pump with lines run inside your body without doing the due diligence of investigating all of the opiate options at their various doses, high low and in-between (there's been lot of success with all kinds of difficult conditions with a drug called naltrexone in very tiny doses Google LDN for low dose naltrexone. Better yet U-tube it) is akin to deciding to remove a lung because an aspirin didn't improve the patients condition.

May you have nothing but success and be as pain free as a life can be. All the best...

Hi, There. If you are under the care of a specialist, I don' believe you need to do his / her job for him / her if it is known that the current situation with the opiates is not helping you. In addition they are habit forming as well.

I believe you have to ask your specialist the question as to the next thing to be done in your case because you are not getting relief from the opiates. It is then that he will have to come up with an alternative if he / she is abreast with the situation you are talking about. The doctor - patient relationship is guarded by political correctness & you have to follow the rules. Good luck.