Life with a Pain Pump - Part 3
Pain Pump Disadvantages
In the last Chronic Pain Report in this series about Pain Pumps, we took a look at their many advantages over oral and other opioid delivery methods. But, of course, for every “Pro,” there’s a “Con,” so today we’ll explore the Disadvantages of Pain Pumps.
Pain Pump Disadvantages
While there are many upsides to a pain pump, there are also a few downsides. Among the more serious risks are the possibilities of a severe injury from a car wreck or a bad fall. Either could potentially detach the pump catheter’s connection from the intrathecal space or, in a worst-case scenario, rupture the pump in your body, thereby releasing a potentially fatal dose of medication directly into your body cavity and while I would think this would be extraordinarily rare, it can happen. Other more common risks include:
Spinal Puncture Headache (Migraine): My surgeon warned me before my implant surgery that a spinal puncture headache, SP for short, was a possibility. SP happens when the dural space surrounding the spine is punctured, as it is when your surgeon inserts the tip of the catheter in it. As a migraine sufferer, I knew this might be a problem for me, and it was. You can read more about my experiences post-surgery in upcoming reports.
Infection: Since implantation requires surgery, there is the risk shared by all open surgeries for potential infections, such as MRSA. You should take this risk seriously by checking on the infection rates for the hospital or surgical facility where you plan to have your surgery. You may have some control over where your surgery is done if you are uncomfortable with your surgeon’s choice of facility. You must begin doing your homework as soon as you decide to move forward with your surgery. You can find links to hospital rating sites in the Resources section of my medical memoir, “War on Chronic Pain.”
Pump Failure: While this is a reasonably low risk, it can and does happen for several reasons, including battery failure or a problem with the pump itself. While battery technology is advancing quickly, batteries will not last much longer than five (5) to ten (10) years, with seven (7) to ten (10) years being more realistic. The length of battery life you experience greatly depends on which pump you choose. Your choices will likely be the Flowonix Prometra II or Medtronic SynchroMed II if you are in the United States. (more information on these pumps follows this Report.)
Be sure to read the pump manufacturer’s warnings in their fine print to discover other potential points of failure and failure rates for their devices. Also, do a comprehensive web search, adding the search terms “failures” or “recalls” after the name of the pump manufacturer you are researching. The FDA also maintains these records for the public to access on its website.
Catheter Failure: There are two potential types of failures for the catheter:
Catheter Tube Failure: The tiny tube that runs from the pump to your spine can leak, become kinked, disconnected from the pump, or be damaged, preventing the medication from being delivered into the intrathecal space.
Inflammatory Mass: Crystallization of medication at the tip of the catheter can cause infections and block pain meds from being delivered.
Physical Problems: A pump may wear through the skin for a few people, requiring a second operation to relocate and reimplant it. There are also cases where the pump moves or becomes detached in the body cavity, requiring an additional operation to reposition and secure it.
MRI Scans: Depending on the pump you and your medical team decide on, getting an MRI once implanted is a potential issue. The Flowonix Prometra II pump (my pump) requires the pump reservoir to be emptied before having an MRI and then refilled afterward. This is due to the positive pressure design of the pump and the fact that an MRI, with its strong magnetic field, could cause the pump to release all its medications at once, which might potentially prove fatal. This is not a problem with proper planning, requiring a trained nurse or doctor on-site to empty and refill the pump. This issue is a trade-off, as the Prometra II pump offers greater drug delivery accuracy (also due to the positive pressure design) and longer battery life than other pumps that don’t share this MRI restriction. Obviously, despite the extra steps required, I decided it was worth the trade-off.
Battery Problems: Obviously, any device with a battery has the potential problem of the battery failing or just running out of juice. When this happens, the pump must be surgically removed and a new battery installed in the pump. As previously reported, battery life can run from five to ten years or so.
The potential problems listed above can have severe and even life-threatening consequences, although they’re rare. Pump, catheter, and battery failures will require additional surgeries, and, in some cases, the pump must be repaired, removed, or relocated. You should read about various other problems that are specified in each pump manufacturer’s literature. Don’t fail to do your homework! The devil really is in the details. Read the fine print!
I’ve had my pump for a couple of years now, and knock-wood, so far, I haven’t had any problems with the pump or the catheter. Thank You, Lord!
Next week, we’ll do a deep dive into the whole process as you follow along with me as I describe my experiences with my implant surgery. While the first three Reports have been free, to go into surgery and rehabilitation with me during the three or four upcoming reports, you’ll need to upgrade to a paid subscription to read the entire Report.
This is a reader-supported newsletter, and I badly need your support to keep investing the many hours it takes to research and write each Report. Won’t you invest the cost of one coffee per month to help me reach more people in pain with information that just might help them discover the treatment that will help control or eliminate their pain? Thanks in advance for your consideration and support, and a Super-Thanks to my paid “Supporter-level” subscribers! I couldn’t do it without you!
All the Best!
Franklin
EXTRA! EXTRA!
As I previously mentioned, here is some information on the two top-ranked intrathecal pump manufacturers in the good ol’ US of A. You’ll read more about each in later Reports in this series.
Pain Pump Device Manufacturers
Flowonix®: This device maker is headquartered in New Jersey, USA, with other locations worldwide. I selected their Prometra II pump after careful and extensive research. My decision was based primarily on the following factors:
More Accurate Drug Delivery: The Prometra II delivers drugs more accurately than other pumps on the market. This advantage is due to the pump's positive pressure design, which is also why the MRI restriction was noted earlier.
Longer Battery Life: I was told that the Prometra II pump’s battery would last from seven (7) to ten (10) years. This long life is advantageous because, like all medication pumps, they must eventually be removed via surgery to replace the battery.
Medtronic®: The largest and perhaps most well-known medical device manufacturer is Medtronic. They make the SynchroMed II drug pump, which my surgeon recommended to me. Unfortunately, he wasn’t aware of the Flowonix pump that I ultimately chose, and the hospital where the surgery was to take place authorized only the Medtronic pump. The result was that it took a few extra weeks to get the pump approved before my surgery could take place. My surgeon was fine with this choice.
Your pain doctor or surgeon will likely prefer or be familiar with one pump or the other, but you should make up your own mind about which one best suits your needs. Since Medtronic is a much larger corporation and has been around the longest, not all pain doctors or neurosurgeons will be familiar with Flowonix, but it’s your body, your pain, and your choice. So far, I’m glad I chose Flowonix.
More information about these two pumps will come in future reports.