Hi,
this is a question for any pain pump patients in our group.
Were you given advice by your pain mgmt doc- regarding laxatives to take to combat possible side effects ?
Tho the pump doesn't constipate like oral meds, it apparently still does a bit.. so I've taken over the counter meds for 2 years with unpredictable and often painful results.
I have one opiate in my pump at a decent but fairly low level, plus a low level of Bupivicaine.
I also use valium/baclofen supps, but Ive been told by medical folks that the pump meds are responsible for any digestive or constipation issues.
Please if you are a pump patient can you tell me--- do you take a laxative nightly to prevent backup...impaction etc. I do because of a doctor/s advice given a fews years back.I was on oral opiate then,and she warned me about avoiding impaction, thus Ive been afraid to skip the nightly laxative. But finally, with pump Im realizing it may not be necessary and often causes me to be sick --- with stomach issues.
Pump patients, if you don't mind saying--- What do you take and how often? What helps you to have a normal "elimination"? My pain mgmt
Doc has given me no advice other than to take colace.
So sorry to go on and about this disgusting subject, but this issue has really been driving me crazy and making me quite sick.
My PT tells me to meditate,stretch, do self PT and water walking.. but cannot advise me as to any meds to prevent constipation or the sensation of it. (this 'feeling' I think is also a part of my disease.... my anal and pelvic floor spasm spasm gives me the sensation. But when taking laxatives I really do have to go..eventually.
My laxatives seem to wait a couple days to take effect and then I am very sick and attached to the toilet for a day.
I am away on a trip and had to return to our hotel room for that reason today. So sorry to keep writing but at my wits end
Pls pump patients.. tho we are all different, I would really appreciate your advice on what you take to prevent this problem. Pls PM me if you prefer.
Thx and forgive me moderators for harping on this ..I just want to figure out what can help me.
I have not tried some of the natural methods suggested yet, but will soon, as I have thankfully become able to drive short distances occasionally and may be able to pick up the items myself.
Thanks again for any help here!
Sorryt o all if Im repeating myself.
Pain pump patients?
Re: Pain pump patients?
Hi kathyd,
I have a pain pump with prialt and fentanyl, both low dose I am told. I don't remember the exact quantities.
I also take oral opiates at night. The pump is not helping all that much with my PN pain, but I continue on it as I can walk again; something which was not the case before the pump, and it does help with PN pain, I was hoping for more.
I recently increased the opiate dose and started having more serious constipation.
I was on 5/325 and moved up to 7.5/325.
On the 5mg I was able to keep constipation at bay most of the time with lots of vegies, water and psyllium if need be.
When I moved to the 7.5 my regimen stopped working.
My PN doc had me try movantik.
So far, I am happy with it. Very regular BMs and kind of like they used to be so, so long ago...
I hate to take one more med on top of all I am already taking, but the new situation demanded it.
I also believe that most of my constipation is due to the oral opiates.
I think psyllium powder is the most natural way to deal with constipation that is not serious.
You might want to try natural first. I think the pain pump causes just a small amount of constipation.
All the best to you and good luck!
Skip
I have a pain pump with prialt and fentanyl, both low dose I am told. I don't remember the exact quantities.
I also take oral opiates at night. The pump is not helping all that much with my PN pain, but I continue on it as I can walk again; something which was not the case before the pump, and it does help with PN pain, I was hoping for more.
I recently increased the opiate dose and started having more serious constipation.
I was on 5/325 and moved up to 7.5/325.
On the 5mg I was able to keep constipation at bay most of the time with lots of vegies, water and psyllium if need be.
When I moved to the 7.5 my regimen stopped working.
My PN doc had me try movantik.
So far, I am happy with it. Very regular BMs and kind of like they used to be so, so long ago...
I hate to take one more med on top of all I am already taking, but the new situation demanded it.
I also believe that most of my constipation is due to the oral opiates.
I think psyllium powder is the most natural way to deal with constipation that is not serious.
You might want to try natural first. I think the pain pump causes just a small amount of constipation.
All the best to you and good luck!
Skip
Right testicle pain started ~2005
Stanford Pain clinic (~2007).
Dr Weiss diagnosed PNE; said I needed to go to Hibner for surgery (2010'ish). Sorry, no surgery for me.
Neuro-stim (~2012) caused horrible back pain - removed; pain pump 13 or early 14.
Pump brings pain level down by ~ 50%; Prialt and fentanyly in pain pump
Since going on disability much easier to control pain levels with bedrest - Carmichael throne helps too.
Since fusion at L2/L3 pain meds decreased by 50% ! Yesss!
Stanford Pain clinic (~2007).
Dr Weiss diagnosed PNE; said I needed to go to Hibner for surgery (2010'ish). Sorry, no surgery for me.
Neuro-stim (~2012) caused horrible back pain - removed; pain pump 13 or early 14.
Pump brings pain level down by ~ 50%; Prialt and fentanyly in pain pump
Since going on disability much easier to control pain levels with bedrest - Carmichael throne helps too.
Since fusion at L2/L3 pain meds decreased by 50% ! Yesss!
Re: Pain pump patients?
Thx so much Skip for your reply. I have been offline for a few days and just saw it.
I am happy for you that the Movantik is working. It is well worth it to be "regular" again.
I'm sorry your pump meds don't help enough .. It seems like it is not an exact science to manage a pump, and docs seem new at it.
Mine do not either.
I am more active this year than I was a year ago, tho, I've had the pain pump for over 2 years.
I attribute that to the work of my PT, who knows pelvic floor issues better than anyone I've seen in the past.
After months of working with her I became able to drive locally, and sit/kneel on cushions at restaurants on occasion, which was impossible for before I met her, tho Id seen several other PTs in the past.
She feels my issues are mainly muscular --in that my anus and pelvic floor are in spasm, so its hard to tell if the meds are causing me the feeling of 'not being empty in anal canal ---or the spasm.
I suspect the pump helps a bit , as when we tried to lower the meds at one point, my pain spiked up. Not sure tho.
It's far from ideal yet ...still have bad anal pain, But am grateful for any positive change.
I'm hoping if we could work out the constant bowel issue, the pelvic floor would have a chance to get out of spasm..
Thx for the info regarding Movantik. My pain doc started me on it as well,a few months ago.
For me it has mixed results. I think it may prevent actual opiate constipation, which is good) but it also seems to increase the urge to "go" even if nothing is there, which can drive me crazy.
Pump nurse says to just ignore it as I'm really not Constipated but it's pretty hard to to do so !
Since I take Movantik and a laxative, I suspect the spasm as causal. I wish I could just be "regular" daily, but the latter is prbly the cause of this feeling.
Milk of Magnesia works best for me-- but it causes constant small bms that could go on for days! It's a powerful med.. and my PT says its too harsh to keep doing this to my system. I also try Amitza, ..but its not too effective, in the normal result I need.
With the Movantik -- in your case-- you don't need laxatives anymore? That's wonderful and what Im hoping for As well.
Im glad the drug is doing its job for you. I guess it takes awhile to know for sure if the med is right for us. They tell me I can break it in half and or skip a day if I want to.
I worry that my system became too used laxatives over the past couple years, and that may be part of my problem.But I was following advice of my original pelvic doc ( a great gyn with good Intentions. Who knows!
My PT says the main thing is to calm the central nervous system -which is so related to the digestive system.
She says that this along with meditation /Relaxation etc. should cause this sensation to settle down, until time passes and all the trigger pts are gone, etc.
I have tried supplements.. you name it. Just tried Magnesium citrate , which sometimes can aggravate my bladder. It varies so I never know what to expect!
(bladder urgency was my original complaint) It waxes and wanes these days.. but Pt is working on it as well.
Meditation is hard for me... distraction , doing something I enjoy works better. But I try!
One quick thing Ive heard tho, that I wanted to pass on in case you are considering it.
If one is on opiate meds ..I was told that physllium husk (Sp?)(and other bulking -type agents etc.) can make your stool like cement, and hard to pass, and should be avoided.
Its fine tho, in helping those who are not on opiates.
Good luck with the Movantik. Hope all goes well.!
Kathy
I am happy for you that the Movantik is working. It is well worth it to be "regular" again.
I'm sorry your pump meds don't help enough .. It seems like it is not an exact science to manage a pump, and docs seem new at it.
Mine do not either.
I am more active this year than I was a year ago, tho, I've had the pain pump for over 2 years.
I attribute that to the work of my PT, who knows pelvic floor issues better than anyone I've seen in the past.
After months of working with her I became able to drive locally, and sit/kneel on cushions at restaurants on occasion, which was impossible for before I met her, tho Id seen several other PTs in the past.
She feels my issues are mainly muscular --in that my anus and pelvic floor are in spasm, so its hard to tell if the meds are causing me the feeling of 'not being empty in anal canal ---or the spasm.
I suspect the pump helps a bit , as when we tried to lower the meds at one point, my pain spiked up. Not sure tho.
It's far from ideal yet ...still have bad anal pain, But am grateful for any positive change.
I'm hoping if we could work out the constant bowel issue, the pelvic floor would have a chance to get out of spasm..
Thx for the info regarding Movantik. My pain doc started me on it as well,a few months ago.
For me it has mixed results. I think it may prevent actual opiate constipation, which is good) but it also seems to increase the urge to "go" even if nothing is there, which can drive me crazy.
Pump nurse says to just ignore it as I'm really not Constipated but it's pretty hard to to do so !
Since I take Movantik and a laxative, I suspect the spasm as causal. I wish I could just be "regular" daily, but the latter is prbly the cause of this feeling.
Milk of Magnesia works best for me-- but it causes constant small bms that could go on for days! It's a powerful med.. and my PT says its too harsh to keep doing this to my system. I also try Amitza, ..but its not too effective, in the normal result I need.
With the Movantik -- in your case-- you don't need laxatives anymore? That's wonderful and what Im hoping for As well.
Im glad the drug is doing its job for you. I guess it takes awhile to know for sure if the med is right for us. They tell me I can break it in half and or skip a day if I want to.
I worry that my system became too used laxatives over the past couple years, and that may be part of my problem.But I was following advice of my original pelvic doc ( a great gyn with good Intentions. Who knows!
My PT says the main thing is to calm the central nervous system -which is so related to the digestive system.
She says that this along with meditation /Relaxation etc. should cause this sensation to settle down, until time passes and all the trigger pts are gone, etc.
I have tried supplements.. you name it. Just tried Magnesium citrate , which sometimes can aggravate my bladder. It varies so I never know what to expect!
(bladder urgency was my original complaint) It waxes and wanes these days.. but Pt is working on it as well.
Meditation is hard for me... distraction , doing something I enjoy works better. But I try!
One quick thing Ive heard tho, that I wanted to pass on in case you are considering it.
If one is on opiate meds ..I was told that physllium husk (Sp?)(and other bulking -type agents etc.) can make your stool like cement, and hard to pass, and should be avoided.
Its fine tho, in helping those who are not on opiates.
Good luck with the Movantik. Hope all goes well.!
Kathy
Re: Pain pump patients?
Hi Everyone,
Ive been offline for awhile but am back with a similar question for those of you who have pain pumps as their medication.
( with opiates in the pain pump ). I have Dilaudid and Bupivicane. Im told by my nurse its an average dose.
I also use baclofen/valium supps for my anal pain caused by tight pelvic floor muscles.. They give instant but not long lasting relief.
These supps usually help with pooping,, which makes sense, as they loosen the muslces hopefully!
Just wondered if you other pump users use a bedtime laxative to combat the constipation the pump can cause?
I know constipation is less with pump meds than oral opiates etc, but still happens due to the opiates or other meds in our pumps.
What laxative do u use and how effective is it? I know one group member replied he didn't even use a laxative.. But all our systems are different.
I use approx 1 Phillips M.O.M. tablet (sorry if I'm repeating my story)
I try to titrate down a bit on the tablet (cut a bit off ) as I 'go' some days after each meal and after use of my pain supp.
Regardless of whether I have any stool there, I get the urge and then try to go. My PT and learned that this is because the tight muscles of the anal sphincter make me feel like I have to go..Arggh!
Also I find when I press the Bolus button to send more medicine into my system, I sometimes feel a bit of urinary hesitancy (my original pain issue) Everything feels tighter...This doesn't happen each time tho. Sometimes it's harder to poop as well. I have to push, when I usually don't
Muscle tightness- originally urinary and now anal as well - has been my problem since day one of my pain issue.
I apparently clench my pelvic floor without realizing it. I want to stop this but it is kind of a subconscious thing.
The only advice Ive been given by every practitioner is to listen to muscle relaxation tapes. I've been hoping for something different!
I find these tapes so repetitive - and boring ("try to relax every muscle head to toe" etc... With my nervous personality it is very hard for me to concentrate on relaxing each muscle. Does anyone else find this effective?
I feel like I either spend my day in the bathroom pooping (which causes more anal pain) or feeling painful urge and pressure if there's nothing there.. I just want to feel normal again...less pain and less need for the bathroom.
BTW I do feel much better when out shopping (which I enjoy) and can stay on my feet for a couple hours .. as my mind is occupied and distracted in a good way.
At home tho, its a different story. This has been going on for about nine months to a year.
Anyway just wanted to inquire about pump use, bolus use, its side effects and how to control them. Thx very much to any pump users!
Ive been offline for awhile but am back with a similar question for those of you who have pain pumps as their medication.
( with opiates in the pain pump ). I have Dilaudid and Bupivicane. Im told by my nurse its an average dose.
I also use baclofen/valium supps for my anal pain caused by tight pelvic floor muscles.. They give instant but not long lasting relief.
These supps usually help with pooping,, which makes sense, as they loosen the muslces hopefully!
Just wondered if you other pump users use a bedtime laxative to combat the constipation the pump can cause?
I know constipation is less with pump meds than oral opiates etc, but still happens due to the opiates or other meds in our pumps.
What laxative do u use and how effective is it? I know one group member replied he didn't even use a laxative.. But all our systems are different.
I use approx 1 Phillips M.O.M. tablet (sorry if I'm repeating my story)
I try to titrate down a bit on the tablet (cut a bit off ) as I 'go' some days after each meal and after use of my pain supp.
Regardless of whether I have any stool there, I get the urge and then try to go. My PT and learned that this is because the tight muscles of the anal sphincter make me feel like I have to go..Arggh!
Also I find when I press the Bolus button to send more medicine into my system, I sometimes feel a bit of urinary hesitancy (my original pain issue) Everything feels tighter...This doesn't happen each time tho. Sometimes it's harder to poop as well. I have to push, when I usually don't
Muscle tightness- originally urinary and now anal as well - has been my problem since day one of my pain issue.
I apparently clench my pelvic floor without realizing it. I want to stop this but it is kind of a subconscious thing.
The only advice Ive been given by every practitioner is to listen to muscle relaxation tapes. I've been hoping for something different!
I find these tapes so repetitive - and boring ("try to relax every muscle head to toe" etc... With my nervous personality it is very hard for me to concentrate on relaxing each muscle. Does anyone else find this effective?
I feel like I either spend my day in the bathroom pooping (which causes more anal pain) or feeling painful urge and pressure if there's nothing there.. I just want to feel normal again...less pain and less need for the bathroom.
BTW I do feel much better when out shopping (which I enjoy) and can stay on my feet for a couple hours .. as my mind is occupied and distracted in a good way.
At home tho, its a different story. This has been going on for about nine months to a year.
Anyway just wanted to inquire about pump use, bolus use, its side effects and how to control them. Thx very much to any pump users!