This 6-year-old female was diagnosed with failure to thrive at 4 months of age. She had multiple gastrointestinal interventions and tried multiple medications, including neuropathic medications. They made no significant difference in her feeding or pain status. By 18 months of age she was on total parenteral nutrition (TPN) and had had two infections. Due to her limited life expectancy, she was referred to the pediatric chronic pain clinic for any possible interventions. A celiac plexus block was performed on using 0.25% bupivaciane which resulted in 3 weeks of feeding through her GJ tube without significant pain when she was two years of age. After it wore off, a second block was performed with similar results the next month. An epidural trial of bupivicaine was successful for GJ feeding, so an intrathecal pump was implanted. Her oral baclofen dose and bupivacaine were infused through the pump. She has continued with intrathecal pumps over the last four years. Her growth went from 2% to 60% and her length increased in a similar fashion. Her bupivacaine dose has not changed. She had a small amount of morphine added after the first year of the pump, which has remained stable. She was able to decrease a number of oral medications, such as amitriptyline and lyrica. No increase in bupivacaine has been needed. No signs of tachyphylaxis has been seen. No neurologic issues other than with her GI tract, which has continue to have issues with functioning correctly, have been noted. Long term use of bupivacaine has not been previously reported. This pump is still working and she is still doing well.