Metronics Morphine Pump

[Jcp2]

Where do you do most of your diving? I've only been to Florida and Hawaii, and in both places, there are boats that do two shallow reef dives rather than a deep wreck followed by a shallow reef. But I agree, most boats not in a high traffic tourist area like to do a deep followed by a shallow dive.

 

[EWC]

Where do you do most of your diving? I've only been to Florida and Hawaii, and in both places, there are boats that do two shallow reef dives rather than a deep wreck followed by a shallow reef. But I agree, most boats not in a high traffic tourist area like to do a deep followed by a shallow dive.

Boats the do only shallow dives are hard to come by. So I do the majority of my diving in Florida’s fresh water springs. I’m planning on diving in the Intercoastal along Saint Augustine as well. And I’m hoping to dive the quay walls along the harbor entrance channel. Those aren’t the clearest destinations, but at least on the last, there may be some interesting stuff to see tucked within the rocks. I don’t require crystal clear water to have fun. I would love to go diving in the keys, but those boats tend to do 1 deep/1 shallow dive vice 2 shallow dives. Most reefs in the Keys are well within my reach. I would love to go diving in the Keys if anyone has a boat. I’m careful to stay well within my limits as prescribed by my Doctor. To stay proficient, I do practice dives in my local dive shop’s swimming pool. Diving skills should be conducted by using muscle memory. That requires getting wet a lot more often than just once a year. I’m also getting myself set up so I can do underwater photography. Additionally, I plan on being able to go diving off my jet ski as well. Ultimately I would like to find another diver with the ability of having underwater communications for a regular dive buddy. And I’m hoping at some point that the pump is designed to handling much deeper depths, as I miss wreck diving. I had plans on getting into Technical and Rebreather diving, as well as possibly becoming a diving instructor before I was hit.

So before you go jabbering or texting on your cellphone while driving, think about how you would feel is someone else, doing the same, destroyed your future because of their inability to make clear rational decisions. Instead they only thought about answering that phone while they’re driving.

 

[GJC]

Are there any divers in here with a Medtronics Morphine Pump installed under the skin? What effects has this had on your ability to go diving, and what limitations has it caused for you?

You need to pose your question to the engineers at Medtronics.

I can see 2 scenarios that could cause problems for you to ask the engineers about.

Are there any air pockets sealed in the pump (like around the battery)? If so, there is the possibility of the pump being crushed and deformed at depth. Worst case scenario is that all of the morphine contained within the pump leaks out into your body. Best case is that the pump just stops working.

Is there any body fluid inside the pump? If so, there would be the possibility of bubbles forming inside the pump on decompression. The pump could then deform internal parts or crack the pump from expansion.

 

[GJC]

I may or may not be sticking my opinion where it is not needed. Sorry. (Just started diving.) I have been on a Medtronic Minmed pump since 7 August 1998. I just found out in May that I could get a signature from my MD ( We have had a relationship for 31 years.) and get PADI certified. Here I go!
I researched a half a dozen available products that could perform the task of sealing the pump and tubing and finally came up with this: Amazon.com: Aquapac Waterproof Insulin Pump / Radio Mic Case 158: Electronics
Keep in mind, this is what worked for me. I do not work for them, do not advocate it I only am reporting to you what worked really well and in this case, it worked flawlessly for my situation.
I placed a (back up) pump in the pac and was able to keep the system attached during my confined diving and all my open water training in July/August. The pack comes with a hook to align the pump tubing and the plastic flaps have a thin foam layer that seals around the tubing when you engage the pac latches. The pump remained fully functional with access to the buttons through the plastic, albeit next to impossible to get to underneath my wetsuit. The basal rate was left unchanged and no bolusing occurred, although I could have if really needed too.
I was only at 57 feet at my deepest, for about 22 minutes and then at 38 feet for 27 minutes. The pump remained as dry as before it was placed in the pac and did not appear to suffer any ill effects. (I left it in place and running for another 24 hours before switching back to my primary.) Considering that the greatest changes on me are in that 1st atmosphere, I am planning to go from 80-100 feet on 18 August off the coast of FL. I will write a follow up then.
Interestingly enough, a service rep and two engineers at MiniMed would not confirm/deny ANY numbers for depth and pressure. Their last report to me before I gave up was "We cannot recommend recreational diving at ANY depth." I have made a (informed) decision to continue to try it. If it fails, then what that will mean is no pump for diving and surfacing every hour to hour and a half to bolus.
But then I'm brand new at this. I burn through a tank faster than I burned through my checking account to get dive equipment and get to this point.

I see that the bag says "guaranteed submersible to 1m for 5 secs." Makes for a really short, shallow dive.

If you are bound and determined to use it to deeper depths, realize that as the air compresses in the bag, the buttons are going to be pressed and the pump case may be crushed squeezing insulin into you. Therefore, it may be helpful to fill the bag with as much air as you can before the dive. (Do not construe this as me recommending that this is OK to dive with this configuration).

 

[EWC]

You need to pose your question to the engineers at Medtronics.

I can see 2 scenarios that could cause problems for you to ask the engineers about.

Are there any air pockets sealed in the pump (like around the battery)? If so, there is the possibility of the pump being crushed and deformed at depth. Worst case scenario is that all of the morphine contained within the pump leaks out into your body. Best case is that the pump just stops working.

Is there any body fluid inside the pump? If so, there would be the possibility of bubbles forming inside the pump on decompression. The pump could then deform internal parts or crack the pump from expansion.

1. Medtronics engineers are the people have set the restrictions associated with the pump. The pump is specifically designed to slow the rate the patient gets morphine with depth. Not that it has a lot to slow from, as I remain on a very low dose already.
2. As for air pockets within the pump...I certainly imagine there are. After all, the pump and it’s reservoir are located inside a stainless steel (or titanium) casing. The best case scenario is exactly what the pump is designed to do as it gets deeper and deeper. I don’t know what depth it is that shuts it off and I’m not looking to find out. I stay within my Doctor’s approved limits. The pump is detectable by one of those security scanners you go through at an airport, so I was given an identification card that allows me to pass through those scanners. Therefore, I think it’s stainless steel. I have plenty of titanium throughout the lower half of my back and that’s NOT detectable.
3. No, there’s no body fluids inside the pump. If there was, I would have a problem. The pump is completely sealed. The only way any fluid can get in it is through it’s self sealing refill port. Once it’s filled, I’m good for another 3 months.

 

[EWC]

I see that the bag says "guaranteed submersible to 1m for 5 secs." Makes for a really short, shallow dive.

If you are bound and determined to use it to deeper depths, realize that as the air compresses in the bag, the buttons are going to be pressed and the pump case may be crushed squeezing insulin into you. Therefore, it may be helpful to fill the bag with as much air as you can before the dive. (Do not construe this as me recommending that this is OK to dive with this configuration).

Your pump is completely different from mine. You’re using an external pump. My pump is internal. It sits under a layer of muscle in my abdomen. I have a device that I can hold over the pump that can talk to it. It’s refilled through a long, large bore syringe that’s pushed through my abdomen and into the pump’s refill port. I usually cover the area a couple of hours prior to getting it refilled with Lidocaine cream to numb up the area. Otherwise it hurts like hell. But when its numbed up, it just feels like a lot of pressure. The human body has a remarkable ability to get used to just about anything. I’ve had a pump so long I’ve almost forgotten what life was like without it. Other than I liked beer. I gave all that up as soon as I was approved for getting a pump. Sure, I could go diving deeper without it. If and when I was lucid. That’s because back then I was on fentanyl patches and oral narcotics. I certainly wasn’t going diving on all that crap. Life sucked. Getting a pump really changed everything...FOR THE BETTER. The improvement was drastic. I became totally lucid. That alone made the pump worth its weight in gold. But additionally, it finally was able to control my pain to the point of eliminating it all together. Pills and patches didn’t even come close. If you ever suffer from chronic pain, just hope that you’re eligible to get a pump. My life improved 1000 fold once the pump was turned on.

Incidentally, why aren’t you wearing a drysuit when you go diving? It seems like that would be a better option for you. That would be a much safer means of protecting an external pump. It would also prevent buttons from being pressed due to the water pressure, because with a drysuit you can add air into the suit to offset that, which also causes suit squeeze. I use a drysuit myself. Getting into a wetsuit can be a bit frustrating with a fused back, and if I somehow twist in the wrong direction it could be the end of the day’s diving. A drysuit relieves much of that frustration.

A 1 minute 5 second dive certainly isn’t worth the effort of getting dressed out in scuba gear. It had better be one truly remarkable dive!!!

 

[beachedsiren]

Sorry. bad post. Newbie.

 

[beachedsiren]

I am considering the pain pump too. Maybe this isn't the right forum to discuss all the questions I have for you but hoped to open communications. Especially since it sounded like you had also tried the Spinal Cord Stimulators (SCS). I was hoping to know why you not longer use/like the SCS. I have heard that they become ineffective at about 5 years.

Regarding the depths manufacturers use my research found they vary wildly - at least with Spinal Cord Stimulators. As yet I haven't done much research on pain pumps past Medtronic's 33 foot limitation. I am working with a Rep from another pain pump company named Flowonix which may or may not have the same depth limitation. I have concluded from talking with a number of reps for the SCS that they just don't pay for the extra costs of testing past 33 feet in general. They consider divers a minority group. However, one of the of the newer SCS high frequency companies actually tested their to 90 feet which impressed me. This was true at least 5 years ago when the newer style of SCS came on the market. While another one that produces a ganglion nerve root stimulator was only tested to 15 feet! Even the surgeon was unaware of such a depth limitation. One couldn't even swim with one of those.

For those that think the pain pump will dose out more drug at depth that is just not true. The reserve is true. One would get less drug if one dove past the depth that the manufacturer's set. In fact NIH found only one incidence of a malfunction of a pain pump in a diver who was unaware of the diving limitation. This diver continued for years diving past the limits until eventually the pump reservoir couldn't be filled adequately. The diver finally told his surgeon that he had dove past the stated limits MANY times. Of course not suggesting this just bring up this research to show the pumps are strong devices that, at least in this divers situation, was abused for years and he remaind unaware the pump was being damaged. Upon eventual removal of the pump they found the pump had deformed due to his diving past the set limits. So the pump isn't going to blow up and pump more drug into the patient. Again the reverse is true. If damaged due to diving past set limits the drug is reduced not increased. Pain pumps can also have a high altitude limitation of 8000 feet which of course will not be an issue for you in Florida. The link below is to the NIH study I found discussing this diver and his pain pump malfunction due to his diving habits.

"Scuba diving with an intrathecal baclofen pump is encouraged for people with spinal cord injury who are suffering from spasticity. However, the diving depth is limited to 10 metres in this context. Proper physician and patient education in this respect is mandatory since non-compliance can lead to an irreversible loss of drug reservoir capacity due to collapse of the bottom shield. We report such an incident in a paraplegic diver diving to depths down to 30 metres' water."

Problems with an intrathecal pump in a paraplegic scuba diver

Anyway, if you are willing to chat about your experiences with the SCS and pain pump in more detail I would be grateful as it might help in my surgical decision making process. Not sure if I am allowed to give you a private email or not but here goes: beachedsiren@gmail.com. I don't want to bore the folks that are not interested beyond the depth limitations which was your original question.

Judy

 

[beachedsiren]

EWC

I have been talking with the sales rep for another pump manufacturer who claims there is no set limits to diving depths as their device is "immune" to depth and elevation changes. Of course the pump discontinues delivering medication at 15 feet of depth but resumes upon ascent. Flowonix is the company's name. I am currently chatting with one of the engineers to ensure I have correct information. But if you ever return to this chat, you may wish to consider changing from Medtroic to Floxonix device instead. It may get your around that 33 foot limit you are currently having to maintain. IF the engineer confirms then this is the device I plan to have installed.

Judy

 

[pauldw]

Could one of those pumps be modified to pump benzodiazepines? I'd find that really helpful sometimes. Especially if it ramped up automatically in low vis, deep, cold, surge, etc.