Anesthetic Pain Pump for PN?

[blightcp]

Does anyone have experience with a pain pump delivering local into the pudendal canal?

As you can read over in my other thread on Nurostimulation I have been working with the implanted Medtronic nurostimultor for 6 months now.

It helps with pain but not nearly enough, I am still taking 90mg of oxycodone a day and 90mg of time release morphine a day to barley mange the pain. I tried 50Mcg Fentanyll patches with no success as they made me to drowsy to do anything.

I went back to my pain physician Dr. Ross, I highly recommend him for PN issues, he has been very supportive and understanding just how much pain I am in.

I am about to start a trial of having a catheter put into the pudendal canal to deliver a local anesthetic onto the pudendal nerve to put it to sleep.

Does anyone have this therapy? I would love to get some feedback and any questions to ask?

[blightcp]

FYI I am going in for the trial tomorrow 3/17/15 I will start a thread an keep you posted.

[LottaNerve]

I am very interested in this! I read your story on a different thread and will continue watching for your posts. As a pudendal pain patient with a "standard" intrathecal pump with catheter going to the spinal canal, I am excited about this new procedure.
Have you found anyone who has had the catheter placed in the pudendal canal?

My very best wishes on your surgery in May!!!

[blightcp]

I have the pre-op for the surgery tomorrow, the pump is going to be placed in at S2. pointing down into the lower IC space whereas the typical pumps point up. I am going to try to get some more specifics when I see Dr. Ross.

I am still not %100 sure where the pump is being placed exactly, it is definatley not in any of the "normal" spots for a IC pain pump.

[LottaNerve]

Thanks, and best wishes on your pre-op and surgery! It sounds like it was moved up from May, right?
Once you know where they are placing the catheter I would be very interested in hearing more about it.

My understanding from your previous posts was that it was going to be placed in the pudendal canal. ?
FYI - I have a Medtronic SynchroMed II pump, 40 ml, (the larger size) implanted in my lower left abdomen. The catheter was "tunneled" through the soft tissues around to my spine during surgery (I was awake - but numb from the waist down - so I remember that part. It didn't hurt but it sure felt odd. The catheter "extends into the thecal sac at the L3-L4 level."

I am very happy with my pump, as I feel like it, along with the combination of medications - morphine, bupivacaine and clonidine - have been very effective. I still have some pain, but I don't feel it if I am focusing on other things.

All my best on your pre-op tomorrow!!

[blightcp]

Yes I thought it was going to be in the pudendal canal but it looks like it will be at S2. That is where the trial was, if it works like the trial, then I will be ecstatic.
This should keep the meds contained in the sacral area and not as much into the lumbar area.

I am getting the same pump, above the kidney on the opposite side of my back from my stimulator. I believe it will be the 40cc also.

What type of drugs do they put in your pump?
How often do you need a refill?
Do you have the remote for more medication?
How long does the extra meds take to work?

Thanks

[LottaNerve]

Hi
I have a blog with lots of this information about the pump, including links to the NIH information on pain pumps and off-label medications like bupivacaine and clonidine at:
www.icandpne.wordpress.com

I sent you a PM with answers to your questions.

I think it is wonderful that we can exchange information! I hear from PN sufferers on the east coast all the time and never had a resource for them. It would be great to refer them to Dr. Ross and his team in Boston.
Best to you today!

[river133]

Should be hearing this coming week about my pre trial pump. So I should be asking dr,Schultz if he will be placing the cathator in S2? He is so stoic. I sent him info about where to put the leads for the stimulator trial. He called me to let me know he has been doing this for 20 years, I really have other issues. I will be having a injection this week in the transforaminal nerves. saw a PA.this week . about my mri. Impinged L5, T12 fracture she said it was fractured but has healed. Well,I am hoping Dr. Schultz
will take care of the leg and this nasty pudendal pain. This steroud injection I will be having on tues is diagnostic, said I could have back surgery ,I choose not to. Blightcp and Sharon,. Will be watching for your progres . I will post on my slowly upcoming events..

[blightcp]

River,

I know its been a battle for you, and I can only imagine the frustration of being a pin cushion with no relief. I am glad to hear that you now at least know the condition of your spine, now you at least know what is wrong. I doubt L5 would cause the pudendal pain. the image below shows where the different nerves run to in the body.



L5 has nothing to do with pelvic area unless it is compressing the "path" that the sacral nerves runs along the surface of the spine.

I hope everything goes well and that they find the right spot to help with your pain.

Carl