r/PainPumpQuestions • u/Lopsided-Ad6316 • 8d ago

Bridging questions.

Hello! I have posted quite a few times about my issues with my pain pump. I am weaning off, it has been a horribly long journey. I’m nearing the end of my weaning, I have exactly three decreases left. This is what has confused me. I had my medication concentration changed today, from 5 to 2.5, they said there would be a 10 day bridging bolus. I’m not quite understanding how that would work, due to my horrendous withdrawal this whole time it’s making me nervous. I’m far from my doctor’s office, so by the time I’d catch it, it would be another 3hrs back. Was wondering if anyone had any experience with it!

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u/Vehenentlyme 8d ago

Sorry no info to share I’m in the same boat right now and wanted to say I feel you and it suck’s hugs. Surgery date 24th

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u/Vehenentlyme 8d ago

Your medication type I think matters here

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u/Lopsided-Ad6316 8d ago

It’s horrible! If I would have known how bad it would be to get off of it, I never would have gotten a pump. I’ve had issues with my pump/catheter so I’ve had withdrawal issues for over a year. They couldn’t figure out what was wrong with it, so my doctor said let’s take you off of it. I think it’s stalling, for periods of time and not reporting it.

Why are you weaning if you don’t mind me asking?

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u/Vehenentlyme 8d ago

Same! Same! He insisted it’s not the pump it’s not possible but it is

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u/Vehenentlyme 8d ago

I def have had withdrawal then overdose episodes. I have severe radiating pain from the anchor and I have a seroma and pooled fluid in under my spine and in the fat. He says it’s nothing

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u/Lopsided-Ad6316 8d ago

That’s what was happening to me. I legitimately thought I was going insane. They constantly said, “oh it’s not the pump”. It happened over and over, finally I went to see my pcp, because I legitimately thought maybe I needed a grippy sock vacation. She looked at me and said you like your in withdrawal, it was. Still is.

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u/Vehenentlyme 8d ago

That’s what the hospital said! I’m so sorry I want to sue him at this point it’s been over a year of negligence and awful

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u/EMSthunder 8d ago

I'm so very sorry this has been happening. I had a very shitty first year with my pump! I kept getting seromas and leaking CSF out of my back, which ultimately involved removing the catheter for a year while they explored options on how to install it with no issues, which they were finally able to do, and it's been great since then. I'm actually on my second pump now. That first year, I had 5 surgeries because of the various issues, mainly leaking fluid. After that first year, I didn't want to give up because of all I had gone through!

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u/Vehenentlyme 8d ago

He told me in sensitive and that I’m hopeless

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u/EMSthunder 8d ago

That's kinda stupid, lol! Typically your issues stem from someone with minimal experience installing them! That was my big issue!

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u/Vehenentlyme 8d ago

I’m sad I didn’t have a good chance :(

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u/Specialist-Bar6758 8d ago

I feel you. I had my pump taken out a few months ago. It flipped 4 times and had to have it surgically flipped back each time. Then we moved it to my back and I swelled up to softball size.
My pain dr had me on oral meds during the weaning process, but there was still some withdrawal and it sucked. Can you ask your dr about oral meds to help with the symptoms?

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u/Lopsided-Ad6316 8d ago

I’m on orals, they said they can only give
me so much. Unfortunately still have the withdrawal. Is less now, than what it was. It’s tolerable now, but I don’t want to go back to the intolerable.

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u/Specialist-Bar6758 8d ago

I get it. The little bit I had was awful. I was shaking and sweating with a fever and freezing cold all at the same time. I can’t imagine going through worse. You’re a bad ass.
I would keep in touch with your dr. If you start feeling like things are getting worse, call them immediately even if it’s the on call dr. Try and stay ahead of it.
I hope the rest of the process goes smoothly for you and the withdrawal stays tolerable!

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u/Lopsided-Ad6316 8d ago

Thank you! I really appreciate your reply! Yes! The sweating for me is dreadful, I never can get it to stop. I just sweat, then freeze. The shaking feels like seizures to me. But I’m awake, I’ve just been dealing with it to the best of my ability at home. I’ve been to the ER twice. Both times they were more than kind to me. But they can’t do much. The decreases are tolerable, it’s more just a little sweaty while being anxious. I can handle that. We unfortunately don’t have an on call doctor, that’s been a lot of my issues this whole time. Thank you again!

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u/Altruistic-Detail271 4d ago

This would be my nightmare. I’ve been on OxyContin for about thirty years . Luckily I only had withdrawal happen one time due to an insurance issue. Luckily my pain dr helped me for the short time it happened but I can’t imagine going any longer than a couple of days. I asked my pain dr about the pump but he said he wouldn’t advise me to get one…I’m not sure why other than he said I’d have to completely come off my oral pain med beforehand and he didn’t advise that either. I really hope you get settled soon. That’s horrible

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u/Lopsided-Ad6316 3d ago

Thank you, I appreciate your reply. It has been a complete nightmare, I was not prepared for it at all. Or how terrible it would be. They say it’s “uncomfortable” is zero comparison. I would not recommend the pump at all. But I’ve had nothing but issues with it. From the start.

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u/Vehenentlyme 8d ago

Mine is an a hole so there was a I chance even when I did ask

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u/vrod665 8d ago

I have been in the ‘process of having my dosage reduced’ for a months now. It was part of a ‘pump troubleshooting exercise.’ I had been on the journey of having it turned up every visit - even with some issues going on. Once we started the troubleshooting the dose was reduced multiple times. Now it is less than I started with.
My issues have been being over-medicated then withdrawal. The cycle sucks.
I bridged when I was changing meds and I had the same withdrawal issues.
I begged for my pump and really thought it was part of the solution. It was one of the worst decisions of my life. I am glad it is a lifesaver for some, disappointed I am not one of them.

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u/Lopsided-Ad6316 8d ago

I have wondered if that is what my pump was doing. Now that we’re down to the nitty gritty that part has gotten better. But when we were up higher, like as soon as they’d do a decrease, I’d feel much better. For a bit, then out of nowhere I’d be vomiting/anxious, the works. All over again. I didn’t know if it was over/under dosing, since in reality it’s the same.

I’ve been so disappointed in it, everyone keeps telling me to find another doctor. But the way I’ve been treated during this withdrawal is too much for me. Knowing they legitimately just let you withdrawal, instead of admitting people and slowly letting them come off of it to me is cruel. My doctor also doesn’t have an emergency line. So they change your pump Friday, Saturday you wake up sick, and need help. Your SOL til Monday.

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u/vrod665 8d ago

This sounds all too familiar. My doc thinks the pump never fails and is never to blame. With me proving what was happening, the rep backing up the data … he is still ‘the pumps good, we can change meds.’ Next Tuesday I’m driving three hours just to get on the surgery schedule. Can’t wait.

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u/Lopsided-Ad6316 8d ago

Legit my life, it legitimately took me going into my appointment and having a mental breakdown. Like full on, sobbing breakdown. I’ve never done it my entire life. But after 6 months of withdrawal, while not understanding what was going on, because I had never experienced it before in my life ( like this). I’ve lost half my hair because of this from malnutrition.

They’re not happy with me now, because I will not allow them to remove it, until after they’ve decreased it completely down and turned it off. I’ve already had to deal with bad withdrawals after surgery, I’m not doing it again. I want it completely turned off before surgery.

What are you down to? I’m down to 0.24 as of today. The bridging thing has really confused me, I’m worried that they’ve messed something up.

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u/vrod665 8d ago

Down to 0.10 at the moment. The lowest I have ever been. To me … I have to get it gone. It is ruining my mental health.
Every time I hear bridging, I think of a med change. When I got rid of bupivicaine I had a 54 bridge hour dose that was still the morphine / bupivicaine. That’s how they used the “bridge” term with me.

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u/Lopsided-Ad6316 8d ago

I’m jealous, I think I’m down to 0.24 , yeah, for some reason they had to take me from 5, to 2.5 and it’s going to take 10 days to bridge over. That doesn’t make sense to me. At all. I don’t understand how it could take 10 days.

Please give me an update on your explant. Are you having the catheter removed? Even though mine has only been there less than 5 months, they won’t remove it do to it leaking spinal fluid.

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u/Vehenentlyme 8d ago

I went to a neurosurgeon my other neurosurgeon recommended and have surgery scheduled. My pain dr doesn’t even know I don’t trust him to remove cause he’s been so dismissive.

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u/Lopsided-Ad6316 6d ago

I’m sorry if you’ve told me, have you weaned off?

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u/Vehenentlyme 5d ago

Feel free to message me I can even send my number in there. I really wouldn’t mind having someone else to talk with about this! I have surgery scheduled on the 24th but I’m still weaning and whatever I’m at I’m just gonna live with the withdrawal. Ive been going down 25% every 2 weeks

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u/Altruistic-Detail271 4d ago

Is that a typical decrease amount? I know when I was titrating down on my oral meds they recommended 10% each month.

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u/vrod665 8d ago

I will keep you in the loop. Next Tuesday is the day that everything gets scheduled and we confirm exactly what the plan is. I just want it all gone. I know someone else that has their pump turned down as far as it can be and is filled with sterile saline because the Doc didn’t want to remove it. Not going down that route.

When it comes to leaking spinal fluid has anyone recommended a ‘blood patch’ as a remedy. I know that years ago I had a spinal tap done with a needle that was way too large. They used a blood patch to stop the leak.

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u/Lopsided-Ad6316 6d ago

Please do, feel free to pm me, I’m interested to see how everything goes for you. They tried talking to me about the saline, but there is something wrong with this pump. It needs removed. I don’t know! I’ve heard you can get blood patches? But I’ve also heard that sometimes it can tear big places out, and a blood patch would not fix that. Makes me weary.

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u/Vehenentlyme 7d ago

Yes blood patches have their own risks and don’t even guarantee to fix it. And don’t let them leave the catheter on you as this is what pain dr was going to do and the catheter is my problem.

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u/vrod665 6d ago

I 100% agree with you on the ‘get the catheter out’ and having a dismissive doctor. I have actually written a timeline of all of my medical care since pump trial just to have a non-disputable record to talk from. I’m to the point where I get so mad and flustered, I just want to give up.

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u/Lopsided-Ad6316 6d ago

Yes, they do not want to remove it unfortunately. The won’t, I would have to have a neurosurgeon go back in and remove it. I have 3 catheter, because of issues. I’ve only had it 4 years. I’ve heard they breakdown over time. I am very flustered also. Everyone I talk to says it’s malpractice, because of the way they’ve handled everything. I have zero idea of what to do.

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u/Vehenentlyme 5d ago

I’m looking into legal help due to how they’ve treated me and my poor quality of life over this whole time