Pump for pain? MRI vs. C.T. Scan?

[kpjpmom]

Hi everyone,
I am exploring the option for a pump to be placed in my abdomen with catheters that would carry the med's to an area in my spine. I have cc in my bone that is in the sacrum. My pain Doctor believes this will help my pain which has ramped up in the last two weeks. I had a C.T. Done that came back negative for growth. I am holding steady. My CEA was really high, was 839 three weeks ago and now1207
. Has anyone had one of these devices implanted and how did it work for pain management? Also, a question about MRI vs. C.T. Which is better for following mets?
Once the pump is placed, I will not be able to get MRI.
Thanks for your help!
Kpjpmom

[midlifemom]

Bump

[Nik Colon]

I would ask your doctor about your concerns. The only time I had my 2 MRIs done were to get a better look at my liver.

[dianetavegia]

I don't remember John's username. He and his partner both posted and it's been a number of years since his passing, but John had a pain pump put in when the pain in his sacral / pelvic area became unbearable. It gave them many more months to enjoy friends, cook outs, etc.

MRI's are good for watching for mets in the liver/ abdominal area and CT is good for watching for lung mets. You cannot have metal implants and have an MRI.

CEA readings are more indicative of liver than lung concerns. I honestly don't know about the bone mets and CEA.

[CRguy]

Diane a couple of your comments are a bit misleading / incomplete :

MRI : you cannot have FERROMAGNETIC metals in your body ( iron containing, steel etc. ) which can be magnetized by the fields and get ripped ouuta' you !
You CAN have NON-ferromagnetic metals like surgical titanium, which I have in my resection staples and had in the frame/hub of my power port when I had 2 MRIs without any issues. The MRI techs should ask you and your Docs should know what IS and what is not allowed so patients need to be proactive and check things out for themselves with their own doctors.

Which is better MRI or CT ? depends upon who is looking for what, where. There is no one best imaging modality but most Onc and Rads like CTs with IV contrast for general followups of CAP, and then go to other things as needed
( PET, MRI, U/Sounds, X-rays etc. )
I have had all of these depending upon what we were looking for and where.

CEA : always an enigma !
CEA needs to be a marker for you so if it is not it won't matter where a problem is … it won't be indicative.
CEA is generally MORE responsive to any inflammation in the body and is especially so in the lungs !!!! which is why folks with a chest cold or smokers will have HIGHER CEAs than normal and it may not mean anything in terms of CRC follow up.
Alkaline phosphatase would likely be monitored with concerns of bone mets.

kpjpmom
I have only had experience with external automatic and PCA pain pumps which work kind of the same as internal. Depending upon which meds are used, they should in fact get you to a better level of comfort for sure. I know opiates, neuromodulators and local anesthetics can be used alone and in combination for great effect. Think of it as a continuous IV of pain meds delivered to a specific site in higher levels locally than you would get from general IV or oral medication. The option here is to act at the level of where the pain is generated and on the nerves which transmit the pain impulses, so you can also still add systemic medication if that is needed to control pain at the level of the brain receptors. It is called multimodal analgesia and attacks the problem form a number of areas.

Sending you MEGA POSI ++++++ Vibes you get more comfortable ASAP.

Cheers and Harmony
CRguy

[midlifemom]

Alkaline phosphatase would likely be monitored with concerns of bone mets

CRguy

CRguy,
Can you explain, what is relationship between alkaline phosphatase and bone mets?

[CRguy]

Alk Phos has a couple of isozymes ( versions of the molecule) which are produced in different areas. Liver and bone are 2 major areas they are used for. When bone is actively being destroyed and / produced by normal or abnormal means, the enzyme levels go up accordingly. The docs need to figure out with other evidence if they are dealing with bone mets and then use the AlkP as one tool.

Normal lab values will indicate average adult "resting" metabolism of bone and liver. If either / both areas are affected the AlkP may be up so they'll check isozyme, if it is bone they'll do different scans which we have not talked about here but any of CT, MRI, bone scan, PET could be used.

growing children/teens, post surgery bone fracture patients, post liver resection patients etc. may also have elevated AlkP as that enzyme will be active during repair and maintanence of the healing state as well as during ongoing "damage" from any of a number of causes

( seems to me I recall the placenta also produces higher levels of one AlkP isozyme … sorry just going from memory here )

HTH
Cheers
CR

[midlifemom]

Thanks CRguy, very helpful.

[kpjpmom]

Thank you for your responses and help. I have decided that I will get the pump. I cannot have the surgery until the Avastin has cleared my body. I am in so much pain. I hope the medication/pump works.

Kpjpmom

[eleven11]

I am very familiar with pain pumps especially if it isolated to one area of your body (good friend of mine is a pain physician). Certain pain pump companies (Medronic) are MRI/CT compatible, you may just have to have your pain doctor see you after your MRI. The data is very good with the pain pump for cancer related pain. One of the big benefits you have is that there is usually a trial to make sure you benefit well without any side-effects.

[kpjpmom]

I have done my pain trial and had no side effects. I have to wait to see if my insurance will cover placement. I hope so since I have been in constant pain since rhe trial on Feb. 11th.Thanks for all thu excellent information.
Kpjpmom