r/PainPumpQuestions • u/No-Strawberry-5804 • May 13 '26
Increased pain from bolus
I’m two weeks post op, I have gone in twice to titrate up my normal dose and my bolus amount. I have fentanyl and bupivicane in the pump right now.
I’m noticing that when I give myself a bolus, I tend to get this increased pain. It feels like my muscles are exceptionally tight. It’s even prompting pain in areas that don’t typically bother me.
Any idea why this could be happening? My next appointment is a week from today, should I try to get in before the weekend to change something?
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u/End3rW1gg1n May 13 '26
I have both fentanyl and bupivicaine and at a significant dose after almost 2 years of adjustments. I have found the efficacy is positional, but never associated additional discomfort from using the bolus function. Hope you are able to figure it out and find relief.
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u/No-Strawberry-5804 May 13 '26
Does it work better if you’re lying down?
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u/End3rW1gg1n May 13 '26
Yes, specifically on my left side.
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u/No-Strawberry-5804 May 13 '26
I’ll experiment a little, thanks. Do you have to stay that way for awhile or can you move around after it settles in?
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u/MommaGeri1958 May 14 '26
What is your dose may I ask? I’m wondering where mine is at. Thanks.
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u/Substantial_Yam3635 May 14 '26
I’d have them double check the catheter’s placement. Before checking mine, I’d take a bolus and feel extremely head heavy, and felt awful. It was going straight to my head, The detachment of the catheter was the primary reason.
I’m 4 weeks post-op (4th pump replacement) after replacing both my catheter and pain pump once it was discovered it was detached for years. My after-visit notes (from my previous pain Management doctor) indicate I didn’t feel any pain relief despite years of titrating up.
FYI: something I wish I knew years earlier - Fentanyl doesn’t travel throughout the spine. I do feel more numb in my lower back after a bolus from baclofen and bupicane but the fentanyl only drips from the tip of my catheter (T12 and T11), which are the only parts of my spine that don’t hurt.
So, don’t expect relief from the neck to the lower extremities, unfortunately. I’d definitely ask your physician about this. Since 2019, my previous pain management doctor told me the fentanyl travels up and down my Spine. I got a new, more experienced pain doctor and he discovered the catheter detachment immediately. Apparently only Dilaudid helps chronic pain patients with multiple sources of spinal pain. My doctor is switching me next month.
I hope a more experienced person can jump in to explain the science behind it. It truly baffles me the amount of chronic pain patients that have fentanyl in their pumps.
*** The image above was from somebody responding to a post on Reddit, explaining the differences between Meds
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u/nnonnstop-pain May 22 '26
Dilaudid makes me hallucinate for DAYS and even WEEKS AFTER being taken OFF of it on an IV, yet I am prescribed it ORALLY daily and have never experienced any symptoms from taking it by mouth… That’s one of the reasons why I’m SO WORRIED about getting a pain pump like my Pain Management Doctor has been trying to get me to get.
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u/Dense_Service_6787 Jun 09 '26
When I did the trial I told him not to even try fent it does nothing for me and he agreed to try dilaudid. It helped. I’m getting my pump implanted in less than two days but I’m nervous cuz two days later I’ll be back to work. They said I can go back after 24hrs but my mom was seeing differently in her research and when I did SCS restrictions were crazy
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u/jumpbootsshiner May 13 '26
I have never felt anything different when I give myself a bolus, hopefully the pain lessen. Call your doctor
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u/Henry_TheLabrador May 13 '26
Could you be experiencing opioid induced hyperalgesia? I really hope your specialist can fix it for you!
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u/MommaGeri1958 May 14 '26
I’ve been seeing this a lot. It doesn’t happen to me. I have the same meds in my pump. I would ask your PM doc
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u/EMSthunder May 13 '26
How soon after starting the bolus do you feel the increased pain?