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Suggest procedure for removal of intrathecal pump

Nov 2013
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Answered by

Practicing since : 1994
Answered : 5574 Questions
What is the standard steps taken when having an intrathecal pump removed at the patients request? (How long is the process? How are medications discontinued? Are medications used along the way in exchange for the pump meds? Is the process different if one is considering exchanging the pump for a stimulator? How?) BRIEF HISTORY: I had a back injury 12 years ago. I have had an intrathecal pain pump since 2004 which was implanted and cared for by the same PM MD who had managed my pain since 2002 and who implanted the second replacement pump in 2011. Shortly thereafter I relocated to XXXXXXX and have a new PM DO that has followed me since. Initially it took time to find the right medications for the pump because of sensitivities trying Morphine and Fentanyl, but found the right drug combinations and have had what I would call pretty good results with pain management. But I am tired, very tired of the effects of these drugs on my cognitive realities. Throughout the past nearly 9 1/2 years there have been a number of times I have considered dcing the pump because of this, but opted to continue - trusting that it was indeed better to manage and LIVE with pain than DYING FROM PAIN ;) But with a geographical move two years ago I have found I have new inner strength and able to physically push myself to do more and need less meds. I am on no ORAL narcotic Class 2 drugs. I take 1200mgs of Neurontin and 450 Wellbutrin and an occasional Baclofen orally for pain. In my pump are Dilaudid, Baclofen, and Bupivacaine. Along with the cognitive frustrations the Bupivacaine has caused my leg, groin, even labia to be numb, an issue the Dr. I have currently is finding more humorous than concerning. (?? this bugs me.) I have decided to try dc'ing my pump - thinking about (just considering) the possibility of replacing with stimulator.
Posted Tue, 25 Feb 2014 in Brain and Spine
Answered by Dr. Sudhir Kumar 15 hours later
Brief Answer: My reply is below. Detailed Answer: Hi, Thank you for posting your query. I have noted your details, and I agree with your decision to discontinue the pump and replace it with stimulator. With your current oral medications, it should be easy for you to switch. The medications in the pump should be gradually tapered and discontinued. This would improve your quality of life. I hope my reply has helped you. I would be pleased to answer, if you have any follow up queries or if you require any further information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist Apollo Hospitals, Hyderabad, For DIRECT QUERY to me: My blog:
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