What To Expect While You Have an Intrathecal Pump

In this video, we’ll explain what to expect while you have an intrathecal pump.

You’ll get an ID card in the mail after your surgery. The ID card says you have an implanted device and has information about your pump.

It’s important to keep the ID card with you all the time.

Show it if you need emergency care, are getting an MRI or other imaging scan, or if a healthcare provider needs to adjust your pump.

Your pump will probably set off metal detectors, so you will also need to show the ID card to the security officer.

While you have an intrathecal pump, don't expose your body and pump to extreme hot or cold temperatures, such as warm or cold compresses, saunas, hot tubs, or ice baths. Extreme temperatures can keep the pump from working like it should.

You’ll get a personal therapy manager, or PTM, before you leave the hospital after getting your pump. Keep your PTM with you all the time.

Keep track of your PTM’s battery charge and recharge it as soon as the home screen shows it has used a little over half the charge.

Your PTM lets you give yourself an extra dose of pain medicine when you need it. This extra dose is called a bolus.

Your pain clinician will set the amount of medicine in each bolus, the amount of time you need to wait between boluses, and the number of boluses you can give yourself each day.

If you have pain, give yourself a bolus of intrathecal pain medicine before you take oral pain medicine. Even with the intrathecal pump and bolus, you may still need to take oral pain medicine to control your pain.

After you give the bolus, your PTM will show the amount of time until you can give yourself the next one. It also shows the number of boluses left for the day.

Your pain clinician will need to refill the medicine in your pump at least every 90 days. They may need to refill it more often, depending on how often you use boluses.

It’s important keep track of when the pump is due for a refill. The refill date may change depending on how many boluses you use. It will update each time you use a bolus.

Call your pain clinician's office 1 week before the refill date to schedule an appointment and ask them to order the medicine.

At your refill appointment, your pain clinician will give you a shot of local anesthetic near the pump. This medicine will numb the area so you’re more comfortable.

Then, they will put a needle through your skin and into the pump. The needle will be connected to a catheter with a syringe at the end.

Your pain clinician will take out any medicine left in your pump and put new medicine into it.

They will place a small bandage over the area. You can take off the bandage after 1 day.

Between refills, your pain clinician may need to adjust the amount of medicine you get through your pump if your pain increases or if you have side effects.

They can use a portable electronic tablet to adjust the settings on your pump and PTM during one of your regularly scheduled appointments.

Each time your pump is refilled or its settings are changed, your PTM will update to show the kind of pain medicine in your pump, the amount of medicine the pump gives you, and the date your pump will need to be refilled with new medicine.

It's very important to keep track of this information so your pump doesn't run out of medicine.

It’s safe to have MRIs and other imaging scans while you have an intrathecal pump.

If you have an MRI, tell the technologist you have an intrathecal pump before they start your scan. Your pump will stop working for a short time, and it may sound an alarm while it's stopped. It should go back to working normally soon after the MRI.

The battery in the intrathecal pump usually lasts for 4 to 7 years. If the battery wears down, it will alert your clinicians when they program it.

They will have enough time to replace the pump, which will require another surgery.

While you have an intrathecal pump, call your pain clinician if:

• Your pain gets worse.
• Your side effects get worse.
• Your legs feel numb or weak.
• You have trouble peeing.
• You have pain or redness where the pump was placed.
• You hear a beep from the pump.
• You have any questions or concerns.

For more information about intrathecal pumps, visit msk.org/pe and search “intrathecal pump.”

You can also visit msk.org/pe/intrathecal-part-1 and msk.org/pe/intrathecal-part-2 to watch parts one and two of this video.

If you have any questions, contact your healthcare provider.