Hi ~ I had the implant for 6 months (it had to be removed) so maybe I can answer some questions.
I can't for the life of me remember how I washed my hair during the trial period. I know I must have because it was a week long trial. But that was 12 years ago, and I just can't remember. After the permanent implant, yes I could put my arms over my head to wash my hair but I had to be careful for the first few weeks. I couldn't really scrub my head hard or leave my arms up for too long. Also, there is NO vacuuming. Besides, a spinal patient is not supposed to vacuum anyway according to my neurosurgeon. but you are not to vacuum during your scs healing period. actually you never should. you never should rake either according to my neuro. gets you out of some nasty jobs, huh? lol
my doc put my 'generator' right above the waist on the side. that way my pants didn't rub on it and nothing pushed/pulled when i sat down. if it's on your butt, your pants are always going to be pushing on it. that would be quite uncomfortable. it turned out for me that i didn't have enough fat content, so mine tried to work itself out of me, and i ended up having to have it taken out after 6 months. ick. besides, during the trial, they gave me so many limitations that i didn't get a good assessment of pain relief. i thought it was covering the pain great, but of course i would cause they wouldn't let me do anything.

after i got the permanent one, i went on about my normal routine, and thought i was gonna die!

i had it reprogrammed many times to no avail, so make sure you give it a good going during your trial. go about your normal routine to make sure it covers your pain.
the incision for the leads is very small. i can't even see it now. but the incision for the 'generator' is about 4-5 inches long on my side and is still very apparent. as i said, that was about 12 years ago. the implant site wasn't really what i would call painful, but it was just weird feeling. now that they've taken it out i have scar tissue there and where the leads were, and it IS painful now. having it taken out is much worse than having it put in. the surgery to have it put in is a cinch. no problem at all. also, when you have the unit on, you will feel it 'zapping' you much more when you lean back against something. for instance, if you lean back against the leads, you'll feel alot of stimulation and you may have to turn the unit down. you'll learn how to work it as you go. that's one thing that surprised me, and they didn't tell me about it. lol
if i can answer any other questions, let me know, i'll try to check in again. hugs, lee