Updated April 28, 2015.
Question: Follow Up Care After Drug Pump Implantation
Implanted drug delivery systems for chronic back pain involve more than just one procedure. In fact, by agreeing to this therapy you are committing yourself to ongoing appointments as well as the limitation of certain activities.
Answer:
The first time you will return to your doctor is between the trial and the actual implantation. The trial is done to answer some basic questions about how well you respond to the therapy, and to get a ballpark idea about how much medication you will need.
Some pain management specialists wait a few days after the trial is fully complete before they implant, to make sure there are no signs of infection present.
After that, you will periodically need to go to the doctor for drug refills and prescription adjustments, monitoring, retooling of the catheter, pump replacement and more. These visits are vitally important to the success of the procedure as a whole. That’s why you should think carefully before you decide on an implanted drug pump in the first place. Things to consider include how you will pay for not only the procedure, but the trial run, and the follow up visits, and if your schedule and family situation allow you to make all of your appointments. Can you handle it?
Generally with a drug pump, your medication will be continuously delivered. You don’t need to think about the dosage amount or other things – they determined by the surgeon and calibrated by telemetry. All you need to do is note and communicate to your doctor any side effects you may experience.
Each time you have a procedure such as those listed above to revise your implant, you risk infection. Should there be any type of complication, infection or otherwise, you will need medical attention, and it could be a life threatening situation.
Complications with the equipment or other health emergency can happen anywhere, at any time. To be prepared, carry information, about the brand and model of your pump, the medication, including type and most recent dosage, and how to contact your doctor, with you at all times.
Because a machine of sorts (the device) is now implanted in your body, certain activities you previously enjoyed may need to be limited. Check with your doctor about any lifestyle changes necessary after implantation, including what to avoid. If you are not sure if an activity you wish to resume will be safe, run it by your doctor or other member of your pain team first.
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.
Gould, H., III, MD, PhD, Understanding Pain: What it is, Why it Happens and How It's Managed. American Academy of Neurology. 2007. New York.
British Pain Society. Intrathecal drug delivery for the management of pain and spasticity in adults; recommendations for best clinical practice.December 2006.