EWC
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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?
Metronics Morphine Pump
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Doubler
Contributor
I am not a doctor but I would think that diving while on Morphine would be a real bad idea. I would think that Morphine is a much more powerful drug than Budweiser and they say don't dive when drinking. I would also think that no dive boat in their right mind would let you dive from their boat while on this drug and it is also very unfair to put your buddy in this position.
OP
EWC
Registered
well, you jumped, but you didn't look before you leaped!!! Actually, the use of a morphine pump is far and away the best way to kill cronic pain. The pump runs at a ridiculously low dose, but because the pump uses a line attached to it to deliver the morphine EXACTLY where its needed, the amount of morphine I use in three months equates to two pills. So not only am I responsible, I'm very responsible. Before I got a pump, it took 150 ugrams of fetenal to get less pain resolution than I have now. You don't get high off a morphine pump. They exsist for the sole purpose of keeping the patient lucid. There are driving restrictions for pump patients. Next time, do a Google search on Morphin pumps. I would have to take a lot of pills to get the same results that the mere 2mg of morphine that I get out of this pump every 24 hours.
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Hi EWC,
You’re off to a bit of a shaky start here, Jeffrey, so let’s try to sort matters out.
True, that is a small dose, but not a "ridiculously low dose." 2mg IV is generally considered a normal starting dose, with more being given if pain relief is inadequate.
Moreover, it is important to keep in mind that just because a diver is on a small dose of morphine doesn't mean that s/he cannot experience adverse reactions worrisome to scuba, especially when it's possible that the drug's effects on mentation could be additive with those of depth, e.g., nitrogen narcosis. As such, the diver taking any type of narcotic should give the drug an adequate topside trial before diving to see how they respond, and if scuba is undertaken, to dive conservatively, at least initially.
I suspect that you actually took "fentanyl," no?
This is simply untrue. You most certainly can get "high" if the metered dosage is sufficiently large. More importantly, such pumps do not exist for "sole purpose of keeping the patient lucid...." Their primary purpose is to maximize pain alleviation while minimizing dosage, and therefore mitigating a range of unwanted adverse effects of morphine, such as nausea & vomiting, sweating, headaches, anxiety, constipation, falling/unsteadiness, lightheadedness, dizziness, and the development of tolerance. While indeed this also very likely reduces euphoria & impairments in levels of alertness, this is not the pump's “sole purpose."
A final point in closing. Since pumps of this type will be subject to increased atmospheric pressures during scuba, the diver will want to contact Medtronic’s Customer Service center (Medtronic Customer Service | Location | Phone Numbers | Contact Us) and determine if the specific device has been pressure tested, and, if so, to what limits. I know that they have done so with some of their SynchroMedII programmable pumps. You might want to consult their webpage entitled "System Components; Hyperbaric Conditions " pp 16-17 at http://professional.medtronic.com/w...uro/documents/documents/synchii-ref-guide.pdf.
Here is Medtronic’s short answer: “’Can I go scuba diving or use hyperbaric chambers?’” Do not dive below 10 meters (33 feet) of water or enter hyperbaric chambers above 2.0 atmospheres absolute (ATA). Pressures below 10 meters (33 feet) of water (or above 2.0 ATA) could damage the pump, requiring surgery to replace the pump. To minimize damage to the pump when hyperbaric treatment is required, your doctor should fill the pump to capacity using the appropriate refill kit and maintain the current infusion prescription prior to exposure to hyperbaric conditions. Before diving or using a hyperbaric chamber, discuss the effects of high pressure with your doctor. As pressure increases, pump flow decreases. Continuing to increase the pressure will eventually lead to serious injury or death.”
Regards,
DocVikingo
This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.
You’re off to a bit of a shaky start here, Jeffrey, so let’s try to sort matters out.
True, that is a small dose, but not a "ridiculously low dose." 2mg IV is generally considered a normal starting dose, with more being given if pain relief is inadequate.
Moreover, it is important to keep in mind that just because a diver is on a small dose of morphine doesn't mean that s/he cannot experience adverse reactions worrisome to scuba, especially when it's possible that the drug's effects on mentation could be additive with those of depth, e.g., nitrogen narcosis. As such, the diver taking any type of narcotic should give the drug an adequate topside trial before diving to see how they respond, and if scuba is undertaken, to dive conservatively, at least initially.
I suspect that you actually took "fentanyl," no?
This is simply untrue. You most certainly can get "high" if the metered dosage is sufficiently large. More importantly, such pumps do not exist for "sole purpose of keeping the patient lucid...." Their primary purpose is to maximize pain alleviation while minimizing dosage, and therefore mitigating a range of unwanted adverse effects of morphine, such as nausea & vomiting, sweating, headaches, anxiety, constipation, falling/unsteadiness, lightheadedness, dizziness, and the development of tolerance. While indeed this also very likely reduces euphoria & impairments in levels of alertness, this is not the pump's “sole purpose."
A final point in closing. Since pumps of this type will be subject to increased atmospheric pressures during scuba, the diver will want to contact Medtronic’s Customer Service center (Medtronic Customer Service | Location | Phone Numbers | Contact Us) and determine if the specific device has been pressure tested, and, if so, to what limits. I know that they have done so with some of their SynchroMedII programmable pumps. You might want to consult their webpage entitled "System Components; Hyperbaric Conditions " pp 16-17 at http://professional.medtronic.com/w...uro/documents/documents/synchii-ref-guide.pdf.
Here is Medtronic’s short answer: “’Can I go scuba diving or use hyperbaric chambers?’” Do not dive below 10 meters (33 feet) of water or enter hyperbaric chambers above 2.0 atmospheres absolute (ATA). Pressures below 10 meters (33 feet) of water (or above 2.0 ATA) could damage the pump, requiring surgery to replace the pump. To minimize damage to the pump when hyperbaric treatment is required, your doctor should fill the pump to capacity using the appropriate refill kit and maintain the current infusion prescription prior to exposure to hyperbaric conditions. Before diving or using a hyperbaric chamber, discuss the effects of high pressure with your doctor. As pressure increases, pump flow decreases. Continuing to increase the pressure will eventually lead to serious injury or death.”
Regards,
DocVikingo
This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.
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OP
EWC
Registered
Thank you for your answer. I have no ill side effects from the morphine. And I fully understand the benefits of the pump, which has been very effective for me. The individual I was responding to made it out as if I was being irresponsible, which is hardly the case. My concern is for the pump itself. Your answer mirrors others that I've heard. Medtronics also has an implantable electronic nerve stimulator that's also beneficial for patients with serious back injuries such as myself. Both the pump and the electrohic stimulator are listed as having same depth rating which brings the question as to why. Being that the pump has a resevare, I get their point on that, but why the same for the implanted nerve stimulator? I don't take chances with diving (or driving for that matter). Incidentely, the back injury is a direct result of being rear ended on my motorcycle while stopped at a red light by an SUV doing 60 mph (she was more interested in her cell phone than watching where she was going). There are lots of places to go diving here in Florida without going below 10 meters, but my ultimate goal is to get rid of the pump completely, but not if that means those darn patches or popping pills (incidentally, I never dove while taking oral or patch pain killers). My accident was back in 2003 (less than one month before retirement at that). I had to stop diving and have just recently gotten to the point of starting again, but not at the level I was before. I've had a pump for the last seven years, so I'm very familiar with them. Thanks for your input.
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KMDD
New
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 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.
OP
EWC
Registered
Your input is appreciated. I've had this pump for around eight years. Before I comment on your post, I just want to say that any doctor who meters a patient's pump to the point that the patient gets high off it is incredibly irresponsible and should have his license to practice medicine pulled. I certainly wouldn't use such a doctor. The pump is used to stop chronic pain in my back caused by a severe auto accident. Frankly, I'm lucky to be walking, as my spinal cord became crushed. Somebody's looking out for me. And yes, I was on Fentanyl first, which I truly hated. I like living a sober life and don't find a need for chemicals to make life better. I'm trying to get back as much as possible of what was taken away because of that accident.
Your pump sounds like it's external to your body and you hook it up as needed. Mine in internal and lays under the skin and muscle in my abdomen. While I can turn it up for a bolus a few times a day if needed, I have no control over the pump itself. It's all programmed at the doctor's office. I've got a device I can hold against the skin and tell it to give me a bolus, but that's my only control. I can't turn it off or make any adjustments. My question stems from the information that Medtronics puts out, because they put the same info out for different types of embedded pain relief devices, including that which block pain through electrical stimulation alone, or internal tens unit (I've got an external one of those too). I'm hoping to get to the point of no longer needing the pump, as I'd really like to manage without it. But going through life with constant pain throbbed down both legs day in and out isn't a solution. I've had my pump turned down twice this year, but it's summer, and summer's always much easier to get through than when the cold weather moves in.
In the end, I'm following the rules posted by Medtronics, as they know more on this than I do. And I don't take chances with the pump, as bad things could happen to both myself and the pump. And for those of you out there who think texting and driving or holding your cell phone to your ear and driving is perfectly safe, I'm still alive to tell you it's not. That's how I was rear ended while on my motorcycle stopped at a red light to begin with. The lady who hit me was jabbering away at 60 mph through me and the traffic light. It's been 10 long years now since this happened. My only luck was that I still had about 20 days left to go before I was officially retired from the Navy when she hit me. I had an entire second career lined up that I lost due to that one phone call that somebody else made. So please, when you get behind the wheel, put that damn cell phone down and leave it down no matter how much it rings!!!
Your pump sounds like it's external to your body and you hook it up as needed. Mine in internal and lays under the skin and muscle in my abdomen. While I can turn it up for a bolus a few times a day if needed, I have no control over the pump itself. It's all programmed at the doctor's office. I've got a device I can hold against the skin and tell it to give me a bolus, but that's my only control. I can't turn it off or make any adjustments. My question stems from the information that Medtronics puts out, because they put the same info out for different types of embedded pain relief devices, including that which block pain through electrical stimulation alone, or internal tens unit (I've got an external one of those too). I'm hoping to get to the point of no longer needing the pump, as I'd really like to manage without it. But going through life with constant pain throbbed down both legs day in and out isn't a solution. I've had my pump turned down twice this year, but it's summer, and summer's always much easier to get through than when the cold weather moves in.
In the end, I'm following the rules posted by Medtronics, as they know more on this than I do. And I don't take chances with the pump, as bad things could happen to both myself and the pump. And for those of you out there who think texting and driving or holding your cell phone to your ear and driving is perfectly safe, I'm still alive to tell you it's not. That's how I was rear ended while on my motorcycle stopped at a red light to begin with. The lady who hit me was jabbering away at 60 mph through me and the traffic light. It's been 10 long years now since this happened. My only luck was that I still had about 20 days left to go before I was officially retired from the Navy when she hit me. I had an entire second career lined up that I lost due to that one phone call that somebody else made. So please, when you get behind the wheel, put that damn cell phone down and leave it down no matter how much it rings!!!
I don't have direct knowledge ... just an engineer. But one reason for the same limitations is that they both may have been tested successfully in hyperbaric trials to 2ATA and not higher (or actually higher but 2 ATA is the conservative result of the testing.) I suspect they tested to this level as what I understand to be a standard hyperbaric O2 therapy pressure (2 ATA.)
Carl
I'm wondering if you ever dove on a commercial dive boat that knew about your pump. Things like that are kinda unknown, so the ops I know would err on the side of caution and liability protection, and decline to participate.
Maybe it's perfectly ok. That "discovering new side effects under pressure" is not fun to deal with at all.
Maybe it's perfectly ok. That "discovering new side effects under pressure" is not fun to deal with at all.
OP
EWC
Registered
I’m not allowed to make deep dives. That’s a restriction of having a pump. It’s amazing how many people hear the word “morphine” with diving and automatically think that person is irresponsible BEFORE they even bothered to do any research. The entire point about having a pump to begin with is so the patient can obtain pain relief WITHOUT having to deal with the addiction and/or getting high. If that’s what you want, you won’t get it from having a pump. Just stick to the pills and smile every time you take one. As for myself, I’m on my 4th pump and have NEVER gotten a buzz or anything else from it. Both the company that makes the pump (Medtronics) and the medical community have certified that the pump is perfectly safe for scuba diving. There are depth restrictions though, so you don’t damage the pump due to pressure. No matter how deep you go, you’ll never go deep enough to squeeze more morphine from the pump than the doctor programmed in. In fact, the deeper you go, the LESS morphine you get, as the pump was designed to slowly decrease it’s flow with depth. The dose I had mentioned before is the same one I’m still on, and to make sure this is clear...that’s per day. The Doc above that butted in said, in my response that he purpose of the pump was to keep the patient lucid, “This is simply untrue. You most certainly can get "high" if the metered dosage is sufficiently large. More importantly, such pumps do not exist for "sole purpose of keeping the patient lucid...." Their primary purpose is to maximize pain alleviation while minimizing dosage, and therefore mitigating a range of unwanted adverse effects of morphine, such as nausea & vomiting, sweating, headaches, anxiety, constipation, falling/unsteadiness, lightheadedness, dizziness, and the development of tolerance.” Sorry Doc. It’s been awhile since I’ve been in here, but what you described is called “GETTING HIGH and it’s AFTER EFFECTS.” All you did is tell me that my comment wasn’t true and than went on to describe EXACTLY what getting high is. If you EVER get high from your metered dosage, your doctor should either loose his license or you as the patient clearly LIED to your doctor. I’ve had a pump running in me for more than 15 years now, and on absolutely ZERO occasions have I ever gotten even the slightest high off my pump...EVER. And I don’t drink. Drinking with a pump is a really bad idea. But some people do it all the same. Not only have I been cleared to scuba dive by my doctor, but from Medtronics as well. And they built the pump. They also showed up to help install it. I don’t keep secrets from my doctor. My high in life is scuba diving. And living life to the absolute fullest that I still can. And I never say “I can’t do something“ until I at least try. Those that give up gave up on life. I’ve been using a personal trainer 3x per week for the past 5 years to keep my back from tightening up so I can continue to do those things I love doing. I don’t take on anything without talking to my pain physician first. My local dive shop is fully up to speed on my condition, fully agrees that I’m capable of diving, re-certified me, and then built me a fully customized scuba system to make diving both safer and considerably easier on my back.
Unfortunately, finding a commercial boat that makes both dives within my limits has been nearly impossible to find. They don’t cater to the needs of disabled divers unless there’s enough of us at one time to fill the boat. That’s because they’re a money making operation, not a charity. And I for one, don’t want handouts.
Sorry for breaching this topic again, but it pisses me off that you would make such unfounded comments. As a disabled Veteran, I’ve come across a lot of doctors who act as if they know everything, but when pushed, know practically nothing at all. Some even worked at the VA. Others worked in the Navy’s medical field. Such doctors often don’t like their patients to ask questions and they’ll roll their eyes if you dared to look up a comment they said on the Internet only to find it to be completely false. That’s why we, the patients, have the right to choose our own doctors. I refuse to have any doctor that avoids answering my questions.
Unfortunately, finding a commercial boat that makes both dives within my limits has been nearly impossible to find. They don’t cater to the needs of disabled divers unless there’s enough of us at one time to fill the boat. That’s because they’re a money making operation, not a charity. And I for one, don’t want handouts.
Sorry for breaching this topic again, but it pisses me off that you would make such unfounded comments. As a disabled Veteran, I’ve come across a lot of doctors who act as if they know everything, but when pushed, know practically nothing at all. Some even worked at the VA. Others worked in the Navy’s medical field. Such doctors often don’t like their patients to ask questions and they’ll roll their eyes if you dared to look up a comment they said on the Internet only to find it to be completely false. That’s why we, the patients, have the right to choose our own doctors. I refuse to have any doctor that avoids answering my questions.
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