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i went for an IME to have a morphine pump trial implanted

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  • i went for an IME to have a morphine pump trial implanted

    the IME told me to not rush into it, however my pain management doctor refuses to treat my pain as it is now,
    I am trying to find another PM doctor , but it seems so many are scared of the current opiate craziness that the media has IMO made a click bait type hit generator.
    if the opioid epidemic was as strong as they say it is across the country , 90% of the SCI injured people that have used opiates for pain Management would be dead, and i have lived for 15 years now without an overdose or a problem.
    Since my PM doctor now refuses to treat me pain, i am concerned that if he installs the morphine pump, that he may also not treat my pain. When i do physical activity , any gym work, prolonged walking , gog help if i have sex again, my pain will go up insanely. sincehe refuses to treat my pain now, he may refuse to program the pump correctly
    cauda equina

  • #2
    When you say IME, are you referring to a second opinion doctor that you chose yourself or were you sent to the doctor by your insurance carrier? An IME doctor that saw you at the request of an insurance carrier does not, by definition, have a patient-physician relationship with you.

    Before the pain pump is placed, you usually go through a trial infusion to determine if the intrathecal pain pump is going to be effective.
    Here's a link to what happens during a pre-pump trial from one of the major manufacturers of these devices:

    You would never want someone installing a pump in you if you don't have a doctor who is going to refill the pump with morphine. Is your current PM doctor certified to perform pump refills in their office?
    ​Not all Pain Management doctors are certified to install pumps. Neurosurgeons and Pain Management doctors who have completed an accredited Anesthesiology Pain Management or PM&R Pain Management fellowship implant them in my city.

    From your post, it doesn't sound like you and your current PM doctor are working well together.

    Why not get a copy of your medical records and set up an appointment with an Interventional Pain Management doctor at one of the NYC teaching hospitals
    ( Presby/Cornell, Mt. Sinai, NYU, etc. ). When the Appointments clerk asks you the purpose of your initial visit, tell them its to discuss a pain pump trial and possible implant.

    I hope you find some way to relieve your pain.

    Last edited by 2drwhofans; 04-14-2017, 10:38 PM.


    • #3
      yes the IME, was for the insurance carrier, The IME was a neurosurgeon who also implant them , and said they have seen people lives turned around due to the success of the pumps. Since the IME warned me 3 times and about rushing into it,i realized it was time to look at the negative side of the pumps and slow down .
      My oral meds are 30 methadone a day, 3600 neurontin ,and currently trying 600mgs of lyrica, my BT med is tramadol, which doesnt control the pain. MY doctor refuses to raise my methadone or prescribe and opiates for BT .
      l have problems with serotonin syndrome with methadone, and when i take a lot of tramadol , it increases the serotonin syndrome.,sweating out ,overheating
      mount sinai is where i am receiving treatment now, i am looking though.
      I have been looking but it is hard to look when i am in pain,large doses of tramadol make me sleephy.
      My doctor also abandoned me for over 3 weeks, and i may follow up with the state , yes the relationship is fucked.
      i find it insane that the doctor only option at this point is a morphine pump
      Last edited by metronycguy; 04-16-2017, 08:53 AM. Reason: add.correct medication name
      cauda equina


      • #4
        Gabapentin = Neurontin. Perhaps you are also trying pregabalin (Lyrica)??

        The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.


        • #5
          good catch KLD, yes the med i am trying on top of the 3600 neurontin(daw), is 600mg of Lyrica .
          I had originally wrote a reply before 5pm , at a library i had a good solid wifi connection, and i thought the reply posted , but when i logged in last night i saw it had failed.I see a auto saved flash
          I have an appointment with the VA SCI department where i am going to pursue the treatment of the pain, I will still look for a pain management department outside the VA since i have WC insurance which pays much higher than most insurances including medicare in NY. The best surgeons in this area will take workers comp,but will not take medicare.
          I am concerned that the VA has gone on the opioids only for end of life and short term pain bandwagon
          Last edited by metronycguy; 04-16-2017, 09:45 AM. Reason: fix
          cauda equina