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How do I know if the drug pump will be safe for me?

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Updated August 12, 2008

Question: How do I know if the drug pump will be safe for me?
Drug pumps as a treatment for chronic back pain are generally a last resort. You may be a candidate for this type of procedure if you have been through physical therapy, oral narcotics and even back surgery, yet nothing abates the pain.
Answer:

One reason doctors do a trial procedure for implantable drug pump patients is to determine if and how well the patient will respond to this particular treatment. Before the trial, however, it is wise to go through the following list of conditions that could indicate danger ahead and be a reason for you not to have the procedure done.

  • You’ve not tried the less-invasive pain management treatments before considering the drug pump.
  • Your medical condition is not stable. In other words, you would not tolerate surgery very well at this point in your life.
  • Your oral meds didn’t relieve pain very well when you tried them.
  • Side effects from oral meds were intolerable.
  • You pain is not constant.
  • You need a lot of narcotics as it is.
  • You have a tumor in your spine.
  • You have less than 3 months to live.
  • You are obese.
  • You are not able to tolerate the medications that will be used in the trial.
  • You have an infection either right where the surgery will be done or in your blood stream.
  • You have a blood clotting problem. (Note: This is especially important in cases of chronic back pain if you do not have a terminal disease.)
  • You have psychological problems, such as mood disorders, dementia, severe anxiety, addiction or major psychotic episodes.
  • You have family problems that may interrupt you from making it to all of the appointments.
  • You are unable to pay for the medications that will go in the drug pump.

Sources:
Dr. Sudhir Diwan, Director Pain Medicine Fellowship Program and Director of the Division of Pain Medicine at Weil-Cornell Medical College of Cornell University. Telephone Interview. May 2008.

Lipov, E., MD. Ch. 34. Intrathecal Drug Therapy in Chronic Low Back Pain. Low Back Pain: Diagnosis and Treatament. ASIPP Publishing. Physicians. Paducah, KY. 2002

Markman, J., MD., Philip, A., MD. Interventional Approaches to Pain Management. Anesthesiology Clinics. Dec 2007. Volume 25, Issue 4. Saunders, An Imprint of Elsevier

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