Cautions on activities
When you have Targeted drug delivery therapy, certain activities may damage the pump system or be dangerous for you. Always follow your doctor's instructions on what to avoid. Below is a list of common instructions.
Bending, twisting, bouncing, stretching
Avoid sudden, excessive, repeated movements like bending, twisting, bouncing, or stretching. These movements can damage your pump system, requiring repairs or replacement. They may also dislodge, kink, or block the catheter, stopping drug delivery and causing serious prescribed medication withdrawal.
Other medications and alcohol
Prescribed medication makes some people feel drowsy. This may add to the effect of alcohol or other depressants. You should be careful driving, operating dangerous machinery, or taking part in activities that may be dangerous if you are not alert.
Hot tubs, steam rooms, saunas, tanning beds
You should not use facilities with temperatures higher than 102°F (39°C). The flow rate of the pump increases as your body temperature rises, and a significant increase can cause the pump to deliver too much medication (overdose), which may cause side effects.
Scuba diving
Do not dive below 33 feet (10 meters). Diving lower can damage the pump, requiring replacement surgery. Before diving, discuss the effects of high pressure with your doctor. Pump flow decreases as pressure increases. Continuing to increase the pressure may eventually lead to serious injury or death.
Security devices and metal detectors
Security devices and metal detectors won’t damage your pump, but the metal in the pump may set them off. Reduce chances of setting off a security device alarm by not lingering around or leaning on security screening devices in stores or the airport. If you do set off a device, show your Medtronic Device ID card to security personnel.
Everyday items
Most household appliances and equipment will not interfere with your pump.
If directed by your clinician, turn off your cellphone before a pump programming session.
Cautions on medical procedures
Always call your doctor’s office before you have a medical test, medical procedure, or dental work. There may be precautions or special steps. Here are some common procedures with special instructions.
MRI
Before having an MRI, contact your doctor for special precautions. If you encounter a doctor or MRI technologist who seems unclear about MRI safety related to your Medtronic drug delivery system, show him or her your Medtronic Patient ID Card. The front of your card lists the model number of your drug delivery system. Your doctor can enter that model number on our MRI Resource Library, listed on the back of your ID card. The website will provide FDA-approved information for safely conducting an MRI scan with your Medtronic drug delivery device.
Under certain conditions, an MRI can be conducted with the pump. Always inform your doctor that you have an implanted infusion system before any medical or diagnostic procedure such as MRI or diathermy.
Please ask your doctor to determine if the MRI scan can be used with the pump. The MRI will cause your pump to temporarily stop, which will suspend drug delivery during the MRI. The pump should resume normal operation and drug delivery after the MRI is complete. Your pump may also temporarily sound an alarm during the scan; the alarm should stop at the conclusion of the scan. Following your MRI, your doctor should check your pump to confirm that it is working properly.
Diagnostic ultrasound
Electromagnetic interference from diagnostic ultrasound (for example, a carotid scan or Doppler study) is not likely to affect your TDD pump. To minimize potential image distortion, the transducer must be kept 6 inches away from the pump.
Hyperbaric oxygen therapy
Before treatment with a hyperbaric chamber, discuss the effects of high pressure with your doctor. A hyperbaric chamber is used to treat wounds that are not healing, bone infections, and tissue damaged by radiation. Do not have hyperbaric oxygen therapy at a pressure above 2.0 atmospheres. As pressure increases, pump flow decreases. Continuing to increase the pressure will eventually result in a loss of or change in therapy, which may lead to a return of underlying symptoms, drug withdrawal symptoms, or a clinically significant or fatal drug withdrawal.
To minimize damage to the pump when hyperbaric treatment is required, your doctor should fill the pump to capacity and maintain the current infusion prescription prior to exposure to hyperbaric conditions.
For more information about medical procedures with a pump, consult your patient manual.
Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.
Patient important safety information
When receiving TDD Therapy make sure you follow your clinician’s instructions closely. A sudden stop in therapy can result in serious medication withdrawal symptoms, such as high fever, changed mental status, muscle stiffness, and in rare cases, may result in the loss of function of many vital organs and death.
It is critical that your clinician be called right away if you experience any of these symptoms. Make sure you keep your scheduled refill visits so you don’t run out of medication. You should also know the early symptoms of prescribed medication withdrawal. Some people are at more risk than others for medicine withdrawal; speak with your clinician about this.
Q: What is severe spasticity?
A: Severe spasticity is a condition that results from an injury to or disease of the brain or spinal cord. Spasticity may make your muscles feel tight, stiff and difficult to move. With severe spasticity, you can experience stiffening of the muscles that makes your muscles feel like they are locked, or even jerk uncontrollably when you try to use them.
Q: What is TDD Therapy?
A: Targeted drug delivery is a treatment using prescribed medication that is delivered into the fluid around your spinal cord (intrathecal) to help manage severe spasticity. For long term treatment, the drug is placed into a pump that is surgically placed under the skin of your abdomen. The pump delivers prescribed medication through a small tube (catheter) into your spinal fluid. Your doctor can program the pump to deliver the appropriate daily dose for you. Before you can be considered for long term treatment, you must have a test dose to see how you respond to the drug when it is delivered in this way. After the test dose is done, your doctor will discuss the results with you and determine if you are an appropriate candidate for the therapy.
Q: Who is a candidate for TDD Therapy?
A: People who have severe spasticity resulting from conditions of the brain or spinal cord (such as multiple sclerosis, cerebral palsy, stroke, brain injury or spinal cord injury) may be candidates for TDD Therapy. If your spasticity is due to spinal cord injury or multiple sclerosis and is not controlled with medication taken by mouth or you have side effects that are not acceptable from oral medication taken to treat your spasticity, you may be a candidate. If you have had a brain injury due to trauma, you should wait for one year after your injury to be considered for TDD Therapy. Safety and efficacy in patients under the age of 4 has not been established.
Q: Who is not a candidate for TDD Therapy or a screening test dose?
A: If you are hypersensitive to prescribed medication, you should not use it. If you have an active infection, you should not have a screening test or implant until the infection has resolved. You should not receive TDD Therapy if you have a body size that is too small to hold the implantable pump.
Q: What do I need to know if I am using targeted drug delivery?
A: All patients and caregivers should receive information on the risks of the treatment. Your doctor should give you information of the signs and symptoms of receiving too much or too little medication (overdose or withdrawal) and what to do if you notice those symptoms.
Q: What can I do to prevent medication withdrawal or abrupt interruption of medication?
A: It is very important that you not miss refill appointments. If you plan to travel let your doctor know so that your refill can be scheduled so that you don’t run out of medication. If you are hospitalized for any reason near the time of your refill, you or your caregiver should let your doctor know before the refill date so that arrangements can be made to refill your pump. Not all hospitals have doctors that can refill pumps, so let your doctor know as soon as possible if it is near your refill date. You should be aware of what your pump alarms sound like. If you hear an alarm, contact your doctor immediately.
Q: What are the potential pump and catheter implant procedure complications?
A: The implanted pump and catheter are placed under the skin of the abdomen during a surgery. Some complications that you may experience with the implant surgery include infection, meningitis (infection of the lining of the brain and central nervous system), spinal fluid leak, paralysis, headache, swelling, bleeding, and bruising.
Q: What are the potential pump and catheter complications that can occur after implant?
A: Once the infusion system (the pump and the catheter) is implanted, device complications may occur that may require surgery to remove or replace the pump, catheter or catheter fragment. Some of these device complications may impact the flow of medication delivered, which may cause symptoms of overdose or withdrawal of prescribed medication.
Possible complications include an internal component failure which may result in a loss of therapy, or an inability to program the pump. The pump, catheter or catheter fragment could migrate within the body or erode through the skin. Tissue or an inflammatory mass may form at the tip of the catheter in the intrathecal space and may cause a loss of therapy or neurological impairment including paralysis. The catheter could leak, tear or become disconnected resulting in delivery of medication into the area under the skin where the pump is implanted and/or along the catheter path. The catheter could kink or become blocked resulting in no delivery of medication. The pump could stop because the battery has run out or because of a problem with one or more of its inner parts. Errors in locating the pump during the refill procedure can result in symptoms of overdose that may be serious or life-threatening.
Q: Can I undergo Magnetic Resonance Imaging (MRI) testing?
A: Under certain conditions, an MRI can be conducted with the pump. Always inform your doctor that you have an implanted infusion system before any medical or diagnostic procedure such as MRI or diathermy. Please ask your doctor to determine if the MRI scan can be used with the pump. The MRI will cause your pump to temporarily stop, which will suspend drug delivery during the MRI. The pump should resume normal operation and drug delivery after the MRI is complete. Your pump may also temporarily sound an alarm during the scan; the alarm should stop at the conclusion of the scan. Following your MRI, your doctor should check your pump to confirm that it is working properly.