Doctor placed an intrathecal pain pump implant for dilaudid & baclofen, is it justified?

Hi. I am a 34 year old female w/an extensive medical history. Mostly due to botched bariatric surgery & about 13 surgeries since the initial surgery in 2/2011. I ended up getting into a car accident on 5/2016 & my malabsorption (bariatric surgery that left me w/short gut, horrible absorbing of food/meds/liquid/vitamins/etc that requires numerous blood/fluid/TPN/platelets/potassium/etc transfusions & infusions) has caused me to be on VERY high doses of opiate medications + TPN mostly. My Pain Mgmnt doctor placed an intrathecal pain pump implant for dilaudid & baclofen (spelling?) to be inserted into the pump on 12/2/2016. Well, after it was placed, 2 was post-op he stated that I have to be off all opiate medicine for “3 weeks” before he’ll place the medications in my pump. How is this possible!? If I’m ok w/o pain control for 3 wks, then, why do I need a pump implanted? Does this sound like common practice to anyone else that’s a physician? My sister is an internal medicine doctor, not a pain specialist but will be going w/me to my appointment to pose these questions in January, doesn’t understand this “plan” either. Furthermore, the detox place that he had me call just as a “back up if I need inpatient care” & they said they’re not “in the business of ‘drying out someone so they can go back to the same medications & don’t really know anyone that would do that. If my plan is to stay w/him, I need to know that going into his plan, no detox place will be on that plan w/him. However, I might want to seek a 2nd & 3rd opinion.” Thank you-bye. So, my question is: Does this seem normal practice or should I find another Neuroscience/Pain Managment doctor? Thank you!

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Ahmed Fawzy
6:37 pm

In my opinion your doctor wants detox from your drugs because he fears from drug interaction from dilaudid with your current medication which can be sever drowsiness or ever shallow breathing (inability to breath )
Practically staying of pain medications for 3 weeks is kinda impossible

I suggest an alternative which you should run by your sister , why not take the missing vitamins and minirals intravenous , (treat the cause not the symptoms)

Good Luck

6:24 am

your doubts are absolutely justified and even i feel that its a complete mismanagement as far as the treatment protocol is considered.These things are not done in common practice (except in rarest of rare cases)
Best option is change the neuroscience / pain management doctor.

Ayman Darrag
8:03 am

I am sorry to say this is weird .. You make sense by saying if you stay 3weeks without pain then why will you get pump implanted.. Extended use of opiates changes the structure of nerve cells in your brain. These cells will begin to need the drug just to function properly. When you stop using opiates abruptly, your body will react, leading to symptoms of withdrawal. So you need to go through a gradual withdrawal or you will fall into abrupt withdrawal symptoms which has severe complications .. I agree with dr. Ahmed Fawzy that you should treat the… Read more »

Masr Fawzy
6:51 pm

I do believe that your doctor has a wrong belief that surgery for a patient not on opioids is a must or better,

According to the american pain society new guidelines , its okay to be on such drugs without a need to stop it…

But i prefer not to assume anything untill you meet your doctor and discuss your concerns with him.. may be he is having another justified explanation