FAQs
How do I know if intrathecal drug delivery (IDD) will work for me?
Your doctor will perform a test allowing you to see if IDD works before you decide whether to have the operation. The test can be done as an outpatient or you may be admitted for a short hospital stay. Testing can be done in two ways. You can either have one injection or several injections of a small amount of pain relieving medicine into the intrathecal space. Or, you can have a continuous injection of pain relieving medicine through a temporary tube placed in the intrathecal space and attached to an external pump. You may stay in the hospital or you may return home with the external pump for several days or weeks. Your doctor will also carry out a psychological assessment. As chronic pain involves both your mind and body, it is very important to see if there are any psychological aspects of the pain that need to be treated.
How does intrathecal medicine differ from oral medicine?
IDD delivers medicine directly to the spinal cord, where pain signals are transmitted. In contrast, medicines taken by mouth affect the whole body. This often causes side effects such as sleepiness and confusion, which may stop your doctor from giving you greater amounts of pain relieving medicine this way.
Can I stop taking other pain medicines with my pump?
Your doctor will assess whether you still need to take other medicines. Many patients find that IDD leads to a reduction in the need for pain relieving medicines. To prevent any negative side effects, do not make any changes unless your doctor has told you to do so.
What risks are associated with IDD?
Complications are rare, and are only seen in a very small number of patients. As the pump is put in place during an operation, problems such as infections are possible. The catheter could move or become blocked. In rare cases the pump could stop working. This would cause a reduction in, or loss of, pain relief and may require another operation to correct, but is extremely rare. Talk to your doctor about the possible side effects of IDD.
Should I worry about drug dependence?
Drug addiction is extremely rare and unlikely due to the way the drug is delivered and to the low levels of pain relieving medicine used. People in pain rarely get addicted because their pain relieving medicine is used to control pain, not for emotional gratification.
Is the pump comfortable and will people notice it?
Most people report that the pump is not uncomfortable or restrictive, and does not interfere with their movements. The pump is unlikely to be visible through your clothes.
What happens if my pump runs out of medicine?
If your pump runs dry your pain will return and you may experience withdrawal symptoms. Your doctor can tell when the pump will run out by checking it with the programmer during your regular check ups. He or she will make a refill appointment for you before the pump runs out of medicine. If you forget your refill appointment, the pump has an alarm to let you know when it is time for a refill. It will emit a soft high-pitched beeping sound repeated several times per minute. It is important to try and have your pump refilled before the alarm sounds. If you hear the alarm sound, call your doctor for an immediate refill appointment.
How will I know when my pump or battery needs to be replaced?
Your doctor will be able to tell the state of the battery when he or she checks the pump with the programmer during your regular refill appointments. In addition, the battery in the pump has a built-in alarm to let you know when it needs replacing. It will emit a soft, high-pitched beeping sound repeated several times per minute. If you hear the alarm sound, call your doctor at once.
What happens when the pump needs to be replaced?
Your doctor will arrange for the pump to be replaced at the end of its battery life.
Will the pump prevent me from travelling?
It will not prevent you from travelling, but be sure to keep your regular appointments with your doctor to obtain more pain relieving medicine. If you plan to travel far from home for long periods of time, notify your clinic. Your doctor will tell you about any change in dose needed, and work with you to coordinate any care or refills needed during your trip.
Will flying affect my pump?
Flying in commercial airlines will not generally affect the pump. Talk to your doctor before long flights or flights in non-pressurised aircraft.
Will I be able to take hot baths or showers?
Most of the time, a hot bath, shower or sauna will not interfere with the pump's operation. You should talk to your doctor about other activities that may greatly affect the temperature or pressure of the pump, such as deep heat therapy or scuba diving.
What safety precautions should I follow with the pump?
You can safely use most common household appliances including microwave ovens, televisions, radios, remote controls and video games. But the pump can be affected by
magnets. For this reason you should try and avoid magnets. These, depending on strength, could affect the pump. In addition, various medical activities and equipment may affect the pump. These include magnetic resonance imaging (MRI), X rays, radiation treatment and diathermy. Always consult your doctor before having any additional treatments or tests.
Are there any special instructions for patients receiving the pump?
Avoid physical activities that might damage the pump site. It is essential that you keep all follow-up appointments as scheduled.
Will the pump cure my pain?
No. This therapy provides pain relief but does cure the reasons why you have the pain.
