Screening Test for Medtronic Drug Delivery Therapy

If you have been in pain for more than 6 months and your current treatment has not provided adequate relief, don’t lose hope. A Medtronic pain pump may be an option for you.

One of the benefits of Medtronic drug delivery therapy is that you can test it to see if it will help manage your chronic pain before making a long-term commitment.

If you are considering a drug pump to control your pain, think about having a screening test. With a screening test, you will have a reasonable idea of what your results might be before you have the device implanted.

The screening test is important for a variety of reasons. During the screening test you can:

• Assess how well a drug pump relieves your pain
• Feel what it is like to receive pain medications intrathecally
• Determine with the help of your doctor which size drug pump would be most effective for you if you decide to proceed with the therapy
• Decide if you want to go on to have the drug delivery system implanted

What Happens During the Drug Delivery Therapy Screening Test?

During the screening test, medication is delivered into the area surrounding your spinal cord to simulate the drug delivery therapy. A much smaller dose of medication – compared with the dose you take orally – is required because the medication goes straight to the source of pain.

There are two screening test methods for drug delivery therapy: a bolus injection and continuous infusion. Your doctor will recommend the method that makes the most sense for your situation and discuss the risks of the screening procedure with you.

Before the Screening Test

Before the screening test begins, your doctor will answer any questions you have and make sure you are familiar with the risks.

It’s helpful to set realistic goals for the type of activities that you would like to do again with the help of Medtronic drug delivery therapy. It is important to understand that this therapy will not eliminate the primary source of your pain and will not cure any underlying disease. Talk with your doctor about the types of activities that may be easier for you with drug delivery therapy.

During the Procedure

The screening test will take place in either the hospital or a surgery center. After the screening test, you and your doctor will discuss your experience and decide if an implantable drug delivery therapy system is right for you.

There are two screening test methods. Your doctor will decide which screening test method is performed.

• Injection Method
  This procedure consists of a single injection or multiple injections of a small amount of medication into the intrathecal space.
  
  Generally, these are the steps your doctor may take during the injection method:
  • You will be placed on a surgical table
  • You may be given medication to help you relax
  • Your back will be cleaned with a solution
  • Your heart rate will be monitored
  • Like an epidural injection, a special needle filled with pain medication will be used. It will be placed in the intrathecal space of your spinal cord. A single or multiple injections of the medication will be given
  • After the injection, you will be monitored in the hospital
• Continuous Infusion Method
  This type of screening test takes place over a few days and closely resembles the therapy delivered by the implanted drug pump.
  
  Generally, these are the steps your doctor may take during the continuous infusion method:
  • You will be placed on your stomach on a surgical table
  • You may be given medication to help you relax
  • Your back will be cleaned with a solution
  • Your heart rate will be monitored
  • A small incision will be made in your back for the catheter
  • The temporary catheter will be placed in your back and attached to an external pump
  • A continuous flow of medication will then be delivered to the intrathecal or epidural space of your spine
  • After receiving the medication, your response will be monitored
  • You may be in the procedure room for up to two hours and then monitored for up to 24 hours. The rest of the test period may take place at home or in the hospital, depending on your doctor’s preference

Complications can occur with the screening test, including bleeding, infection, and drug side effects. The catheter also may need to be replaced. You should not undergo a screening test if you have an active infection at the time of the test, have a body size too small to accommodate an implanted pump, or if you are allergic to the screening medication.

After the Procedure

After the procedure, you will be taken to a recovery room. You may experience some discomfort in the area of your back where the incision(s) was made. This is temporary and will resolve in the hours and days following the procedure.

If your screening test involved the injection method, you will:

• Discuss your response to the screening test with your doctor before going home. Your doctor will want to know:
  • Did your pain decrease?
  • Did you experience any discomfort?

If your screening test involved the continuous infusion method, your doctor will discuss the following regarding your temporary system:

• How to use the external drug pump
• How to care for the area around the catheter while you’re at home
• What activities and movements to avoid during the screening test period

If you are uncomfortable during the continuous infusion screening test, you can have the temporary catheter removed.

After the Screening Test

At the end of your screening test period, your doctor will:

• Remove the temporary catheter
• Discuss your experience during the screening test
• Ask you if you were satisfied with your experience with the drug pump
• Help you determine if you should proceed with the implant procedure

One way to think about your experience with a pain pump is to compare your ability to do things before and during the screening test.

If you decide to proceed with drug delivery therapy, there will be a waiting period after the screening test and before your implant procedure. This will give the incision in your back time to heal and allow time for your insurance provider to be notified, and for the surgery to be scheduled.

How to Get a Screening Test

If you think a Medtronic Pain Therapy might help you relieve your chronic pain and get back to a fuller life, the first step is to talk with your doctor or a pain management specialist. Need help finding a pain management specialist who offers a full range of treatment options? Use our Find a Doctor tool to locate a specialist near you.

Your pain management specialist can help you schedule a test for the therapy that is most appropriate for your needs. Be sure to discuss with your pain specialist the risks and benefits of the screening test and long-term therapy.

Talk with Someone Who Is Receiving Drug Delivery Therapy

Before or during your screening test, it can be helpful to talk with someone who has been living with drug delivery therapy. The Medtronic Ambassador Program for prospective patients puts you in touch with a volunteer who is interested in sharing their experience with a pain pump with you. Learn more.

Next: Long-term Therapy