Implantable Pain Pump

Care After

Pain can be treated many different ways. Sometimes, though, pain can be so severe that nothing makes it go away. Then, an implantable pain pump might be suggested. Implantable means it is put inside your body. It delivers pain medication directly into a blood vessel or the area around the spinal cord. Delivering it right to these areas is like giving the medication extra power. As a result, less medication is often needed. That also should mean fewer side effects.

If you just had a pain pump implanted, this is how it will work:

  • During surgery, the pump was put under your skin. It is usually round and about the size of a hockey puck. It may have been placed under the skin of your belly or perhaps below your collarbone.

  • The pump is attached to a small plastic tube (catheter) that was inserted into a blood vessel or into the area around the spinal cord.

  • The pump has a space (reservoir) where the medication is stored. When it is needed, the pump pushes the medicine through the catheter and into your body. Your healthcare provider can set the pump to give you a steady flow of medication. Or, it can be set to deliver different amounts of pain medicine at different times.

  • Your healthcare provider can refill the reservoir. That is done by inserting a needle through your skin into the pump.

AFTER SURGERY

  • You will stay in a recovery area until the anesthesia has worn off. Your blood pressure and pulse will be checked every so often. If the implantation was an outpatient procedure, you will go home once your body functions are back to normal. Sometimes, but rarely, an overnight stay is needed.

  • Before you are sent home, your healthcare team will make sure the pump is working well. They will also make sure you do not have a reaction to the pain medicine or to the anesthesia.

  • Tell your healthcare providers how much pain you are having. Be honest. They need this information to make sure you get the right amount of pain medicine.

  • You will have a cut (incision), 4 to 6 inches long, on your skin. This will be near where the pump has been implanted. You might also have a small incision on your back. Stitches or staples will be keeping all incisions closed. Also, there will probably be a bandage (dressing) over the incisions.

  • Be sure to ask your healthcare provider for a list of things you should not do for the first few days after your surgery.

  • Before leaving, make an appointment for your first check-up. At this visit, your healthcare provider will check the pump to make sure it is still working properly. And, the pump can be refilled with pain medicine.

HOME CARE INSTRUCTIONS

  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

  • You should be feeling less pain than before the pump was implanted. Continue to let your healthcare provider know about your pain. Also explain any side effects you might have. The goal is for the pump to give you enough medicine to control the pain but not so much that you have side effects.

  • Sometimes fluid leaks from the spinal cord area. This can cause a severe headache (called a spinal headache). The headache can also make you feel dizzy or sick to your stomach. If you have a headache after surgery, let your healthcare provider know. Treatment for a spinal headache is usually to lie flat on your back. You also should drink fluids and caffeine has been shown to be helpful. Try coffee or tea.

  • The pain medication used in a pump is sometimes a strong pain reliever (narcotic) that can have side effects. Tell your healthcare provider if you have any of these reactions:

  • You feel sick to your stomach.

  • You are having trouble breathing or feel short of breath.

  • You feel more sleepy than usual.

  • Your skin itches.

  • You have trouble passing urine.

  • Do not get the incisions wet for several days (or until your healthcare provider says that it is OK). You might be asked to avoid soaking baths for several weeks and to shower only.

  • Follow your healthcare provider's directions for changing the dressing on the incisions.

  • Wear loose clothing until your incisions are healed. This will keep the skin around them from becoming irritated.

  • At first, limit your movement and activities.

  • Do not sleep on your stomach.

  • Avoid significant bending and stretching.

  • Do not raise your arms over your head.

  • Do not lift anything that weighs more than 5 pounds.

  • Do not drive for at least two weeks (or until your healthcare provider says it is OK).

  • Do not do work around the house (inside or outside) until your healthcare provider gives you the go-ahead. For example, do not load the dishwasher. Do not vacuum. Do not mow the yard.

  • Return to your regular activities gradually. Ask your healthcare provider whether physical therapy would help.

SEEK MEDICAL CARE IF:

  • An incision becomes red, swollen or painful.

  • An incision leaks fluid or blood.

  • You feel sick to your stomach, feel more sleepy than usual or have itchy skin.

  • You have trouble urinating or having a bowel movement.

  • You have a bad headache or back pain.

  • Your pain is not being relieved by the pump.

  • You develop a fever of more than 100.5° F (38.1° C).

SEEK IMMEDDIATE MEDICAL CARE IF:

  • You have trouble breathing or feel short of breath.

  • You have a headache that lasts for more than two days.

  • You hear the pump beeping.

  • You have sudden symptoms (back pain, weakness in you legs).

  • You suddenly lose control over urination or bowel movements.

  • You develop a fever of more than 102.0° F (38.9° C).