Successful SCS trial - which system to get implated?
 

I am in day 5 of an SCS trial with a medtronic device. This is the first time in many years that I have not needed muscle relaxers, patches, etc. to reduce my lower back pain. I have some questions but I'll start with some background.

I had an L5-S1 anterior fusion in 2001 that cured the major instability and awful pain episodes but left behind regular lower back pain. After years of facet blocks, RFI blocks, physical therapy I have spent the last five years reducing my activity levels to reduce the onset of activity-related spasms and pain. For 2 years, lidoderm and flector patched helped but no longer. This year, I've been reduced to one day per weekend on pain pills/muscle relaxers to get ready to go back to another week of work. If I didn't find a better solution my future was to be narcotics and stopping my work as an IT manager.

After talking with my pain management doc, we finally decided to try an SCS. I got the Medtronic leads placed last Wednesday and I've had the first five days of no pain, no muscle relaxers, no celebrex, and no patches in at least seven years. I'm still taking ultram but since I'm well adjusted to that (after 11 years) I'm okay with it. I'm SOLD on the effectiveness of the SCS and I'm ready to go forward with surgery. I WILL get one of these things implanted :).

I meet with my Neurosurgeon this Wednesday. He seems to favor Medtronic but I don't know why. For the trial I didn't have any preference; I just wanted to know whether it would work. Now I know an SCS will work for me I now need to know which system will work best for me. My pain specialist likes Boston Scientific but he doesn't install these things for a living. My Neuro seems to implant more Medtronics than the other brands.

Now for the questions:
Do I let my Neuro choose?
Do I follow my pain guy's lead?
How do I get enough information to make such an important decision?
Is there enough difference between the units that I should care?

There are several choices out there. Medtronic, Boston Scientific, st. Jude. If medtronic worked for you for your trial, that is a good notion. However, you can also google reviews on each of these as well. Good luck!

I have done quite a bit of googling and have seen reviews. I can't really tell much of a difference. There seem to be similar stories for each. The are surgical complications seem similar, the amount of good and bad experiences seem similarly frequent, etc. That's why I posted ;-).

This community seems both knowledgeable and supportive. Hopefully, I'll have something to contribute as I learn more.

I agree with alt, it is a good indication for Medtronic since it did work during your trial. I personally have two St. Jude stimulators implanted. I am very happy with the company. My dr recommended it over another brand and I can see why, the reps I have are fantastic and the units work well.

I did so much reading and googling before I decided to move forward with the stimulators and St Jude. They called me before the trial to explain and walk me through the whole process, of the trial and permanent, it helped me understand a lot better and be more comfortable with my decision.

If you are unsure of which to go with, ask your dr why he is recommending Medtronic's device over the others. YOU need to make the decision AND be comfortable with it.

Best of luck to you,
Nanc
:hug:

Hi Pizzaman!
 

....and WELCOME! Glad you found your way to this little corner of the universe.
How thrilling that your trial has gone this well! I can only imagine how elated you must be - not having to give up your job!

Alot of times (depending where you're from) a physician might work exclusively with one vendor. Ex: I live in a rural area where there aren't many choices to choose from. My surgeon only installs Medtronics. I'm very happy with it. No more horrific burning in my lower extremities.

Different vendors might give physicians bigger kickbacks and incentives, which could play a roll in which company your doctor prefers.

If you live in an urban area and have the choice options, I would probably lean toward the one your doctor prefers and is familiar with. You've done plenty of research on the different companies. Like you said, they each are going to have pro's and con's when you read the reviews.

Nanc has a good point if you want to dig a bit deeper. Ask doc why he prefers this certain company. The most important thing is how well you trust your doctor and the confidence you have in him.

I'm excited for you! Looks like you are on your way to a whole new quality of life again!
Please stick around and let us know how this unfolds. There's plenty of great support here, plus I'm sure you'll have some stuff to help US as well!

Glad you're here!
Rae
:grouphug:

I agree with what others are saying. Many people have had success with each of the different companies. However, if you're happy with how your trial's going and don't have any issues, I'd go with Medtronic. My rep (I have 2 Boston Scientific Units) told me something last week that I didn't know. She said that Boston Scientific and Medtronic units use different methods within the body in order to work. So I'd say it would be too risky to go for a device implanted permanently that you haven't gotten to test drive, especially if the one you did use for the trial worked well. Plus you'll be familiar with how things work and the protocols for the company, and you'll likely have the same rep as well, which will be good to have some consistency :)

surgery scheduled
 

I am scheduled to get the Medtronic RestoreSensor and 5-6-5 lead implanted on July 7th. My doctor says he uses all three brands and knows the strengths of each. He picked Medtronic because of my back pain and their new sensor in the battery. I am excited!

Pizza and a Movie
 

Oh Pizzaman, if you truly have such a career, I am grateful for your work as one who enjoys a bit of pizza and a movie to relax! A family favorite around here!

Your following your Doc's studied advice and approach is the best recommendation one can give, a path you appear to have chosen. Good reasons were articulated, and your Doc is on the leading edge of current information.

Regarding me and Boston Scienfic, the choice was last minute as I had anticipated trial of another model, but I was satisfied and espeicially appreciated being allowed to program the generator unit myself under the watshful gaze of my rep. It has now been two years since implant, and I have had tremendous success with the unit itself and the programs I set. Never a tweak have I needed or had.

My thread which discusses the whole saga has fallen to the second page as it is closed due to reaching the posting limit...... but you may click it here http://neurotalk.psychcentral.com/thread117854.html for a fairly complete discussion of the process, the ups, the downs, the results, and a heads up for the uninformed. Too many patients go forward with little more than the video disc hyping a particular product as their only source of information. The entirety of the process is SO MUCH MORE than zip you open, drop it in, and away you go. Healing is involved. Questions arise. BLAST is a good acronym to memorize, no bending lifting stretching or twisting during the healing phase. The thread continues under similar name followed by a 2 here, http://neurotalk.psychcentral.com/thread170843.html .

These are intended as resources for patient information beyond the skinny doc's offices can provide, and I bring them to you because I know many questions are thus answered. If you have others, chime in, because the more the information the better!!

Oh, and remember the all important Log Roll for arising from bed once you have been sent home from surgery! You will want to know that when through the pain of surgery the ever present need to visit the bathroom will first occur!

I am thrilled for you PizzaMan, and you most assuredly have my prayers in your embarkation on the adventure toward better pain management!
Prayin,
Mark56:hug:

Mark your calendars!
 

Your date has been set Pizzaman! And your doctor has a specific model customized to your particular situation. How awesome is that.

Mark speaks wisdom. We'll be right here with you every step of the way!
I'm happy for you!

Rae
:grouphug:

Hooray for pain relief!
 

Hi Pizzaman,

First of all, thanks a LOT--now you've got me craving pizza...lol!!:D Secondly, welcome to this wonderful forum! I'm so happy to hear that the trial SCS is working for you. What a wonderful relief that must be! I hope and pray that you continue to get relief and that you can very soon get "the real deal", the permanent implant. I'm scheduled to start my trial July 24th and can hardly wait, hoping that this will be a solution for me, too. Keep us posted on your progress!

Best of luck to you,
Jan

where to put the battery
 

Thanks for all the encuoraging words and advice. Now, my final decision to make us where to place the battery unit. I think there are to places to choose from. One is my love handle spot and the other is the side of my buttock.

I am leaning towards having it out in my love handle. That seems less likely to be bumped by wallet, cell phone, etc. it also means that the lead wire would not route through my waistline so there would be less possibility of discomfort.

Have any of got experiences that might help me choose?

Da Butt
 

It gives a place, where, if one is not female with the ever transitioning waistline of fashion designers, one can count on clothing not to interfere. Stick it in your love handles, and you may see a waist line of pants, a belt, a waist belt for a hiking pack providing you grief. I only point this out as a former avid backpacker, while also being a guy who can count on the waist being where the waist was anatomically placed.

Two Cents and this thought will buy you absolutely nothing, anywhere,
Mark56:)

Those are great points. I'm glad I asked! Doesn't a wallet in the back pocket put pressure on the battery?

Ahhhh Grasshoppa.......
 

Said wallet placed in the front pocket is both less likely a pickpocket target and does not press on a butt buzzer generator at all.

So says the sage, front pocket user,
Mark56

Hey Pizza...
 

I recall this decision being a very big issue for me. I'm happy with the location it ended up, which is my left hip/butt area....far removed from waist line of clothing. It sits down lower, outta the way. However, not once did I ever consider the wallet issue. That's a good point!
Whichever side you wear your wallet, maybe go with the opposite side for the battery. Also keep in mind - are you right-handed or left? I'm right handed, so it works out good for me to have my battery on left side. When charging, I have my right hand free to operate the charger controller while my left hand keeps the charger over the battery until I get in a comfortable position in a chair/recliner. I usually watch a movie or something to pass the time.

While trying to decide, I even put some tape over the area I was considering having the battery placed. Then, I went about my business around the house to see if there would be any problems with having it there. It didn't interfere with the chairs I would sit in, or clothes that I wore, so that helped to give me an idea.

Plus, your doctor pretty well knows where the most practical place would be. You'll be good to go in no time!

Rae
:grouphug:

It's in!
 

So, here i sit in recovery bored. It is 8 hours post surgery and i feel better than inthiught i would. There is some noticeble pain in my back and buttock from the wire and battery (I went dwith the left buttock because i like to sleep on my righr. In between my shoulder blades has a sharp pulling sensation when i move but there is little pain unless i move around. So far so good.

The surgery, recovery, and initial pain are a fraaction of my fusion surgery years ago. I use the morphine but not much is needed.

I am a happy camper!

I had an ans (st Jude) eon implanted. It's really small. My dr. Picked mine. I didn't really have a say lol. I think they're all about the same. I love mine and they just switched it on this morning lol.

Yay Pizza!
 

Go for the less pain...... that feeling between or just below the shoulder blades may be the entry point of your electrodes, whether percutaneous leads or paddles via laminectomy. It will abate over time.... one of my most significant pains was at t8/t9 where the laminectomy was done for the paddles, but I am SO glad I have them as they work quite well even now, two years plus later.

Prayin for all, and thrilled for TKaye too!
mark56:grouphug:

Yes!!
 

Hey Pizzaman,

So glad you sailed through the surgery and are now recovering! I pray that you will continue to get more and more pain relief and that you will heal quickly and completely from the surgery!

Take Care,
Jan

48 hour checkin
 

Okay, it has been 48 hours since my surgery completed so I thought I would give an update.

The overnight hospital stay was fairly typical. I didn't get much sleep with the frequent vitals checks and TBS (tiny bladder syndrome) 😊.

Actually, I had a real hard time urinating requiring that I push real hard to get a stream going and to keep it going. That has improved but is still far from normal. This is the strongest side effect I have had. Oh, and I know eventually I will have a bowel movement but not yet 😳.

My surgeon used glue and steri strips so I got to shower this morning. That was nice! The mid-back incision is quite small, less than an inch. The buttock incision is about 2 inches and has a swollen roll that some of you have described. I am icing that. If I press the path of the wires they are a little tender but not too bad.

I can be comfortable sitting straight up and lying down but my recliner causes my back iclncision to pull a bit when reclining or sitting back up.

The percocet seems to be doing its job.

Healing continues
 

So, it seems that I am healing because I get a sharp pulling sensation (like pulling against stitches) moreso today with less movement. I am taking that as a good sign.

My bowels moved and urination is better sobthat's a relief!

I took the proscribed muscle relaxants today because I had some minor spasms. They are making me a little loopy.

Today feels like a minor step backwards but yesterday was so good that it doesn't surprise me.

My next decision is when to first turn on my stimulator. The Dr and Medtronic rep said to wait 3-4 days but didn't give me any guidance on how to decide when. Any suggestions?

Mine was turned on right after implant. Will you see your doctor before you turn it on?
Glad you're feeling better each day is easier.

Sandy. :)

Don't know why
 

They said I should wait a few days. I think it might be about waiting for inflammation around the paddle lead.

It's on and working!
 

I emailed my Medtronic reps and they said I could turn on the device. They said the stimulation might be a little weird because of fluid and swelling.

One of the four programs they gave me works pretty well. It's providing some releif but I'm still adjusting to the buttock irritation, a smaller dose of percocet, and the new buzzing. I feel a little out of sorts but okay.

Yea Pizzaman
 

Reading your words..... "one of the porgrams they gave me works OK gives me pause to rejoice with you that the benefit you sought is being felt!! If it works OK, THAT is a Good Thing!

Prayin healing continues to bless you with less and less surgical pain so ultimately you will be managing yoru nerve pain with the device, and mainly with the device!!

Prayin,
Mark56:hug:zzzzz:grouphug:

I know this is not normal talk of people, but we are on the same schedule. I've had one tiny bowel movement with milk of magnesia (not to be confused with milk of amnesia which is waaaaaay better lol) I assume it's normal.

My booty incision hardly ever hurts. I believe this is due to my honkytonk badonkadonk lol.

I have mine unglued Thursday and hopefully can begin walking.

Glad you're doing well!!

TK

Let's be Frank
 

Hey you guys & gals,

Thanks SO much for "putting it right out there" and letting us know what you're going through, especially regarding the personal plumbing challenges. I'm a bit behind (pardon the pun) both of you, Pizza & TK, so your questions and concerns will soon be mine as well. It's good to read the responses so I can kind of plan of ahead and know what to expect, especially once the permanent implant is in place. Now I know to stock up on prunes, colace, dynamite, etc. Hey, every little bit of info and preparation helps!

Just don't let anyone make you the butt of their jokes or wisecracks. :wink:

Gentle hugs,
Jan

Jan,
 

The pain meds usually add to the constipation. Either the Phillips Milk of Magnesia or Miralax might be good to have on hand as well.
From someone with much experience.

(Gerry)

And for the Au Naturel
 

Prunes, Prunes, the amazing fruit..... the more you eat.... the more you.... welll....... you know. It worked for me, easily, naturally, a path in the direction of the restroom. Yup. : o)

Yup,
Mark56:grouphug:

You Never Know Pizza Man
 

Could give rise to a geriatric pizza....... Prunza,,,,,,, yup, the loosener of all older piza consumers, thing of it with a stuffed crust......


This is about the time Rrae would usually come along and pull in in line.....

Ha, Ha, Ha, Ha,
Mark56:grouphug:

:ROTFLMAO::ROTFLMAO:HA!! HA!! :ROTFLMAO::ROTFLMAO:

Ohhh my Lord! How can I possibly follow an act like THAT!
Between all the Stuffed-Crust- Dynamite-Butt-Crack remarks, it'll be awhile before I pick meself off the floor. :holysheep:

What a great thing to come home from vacation to!
Pizza and TK - I'm so glad your procedures have gone so well. In time you'll be normal again and your stimulation will be where it needs to be, even if it takes a couple of tweak sessions.
Take it easy on yourself and don't try to do too much too soon. YES I've earned the right to NAG you dearly! :Clever: as I have beentheredonethat. Lest you be next in line for a revision. :cool: DAWN'T DOIT.

Rae
:grouphug:

Thanks for the smiles and laughs this morning...I REALLY needed it! :ROTFLMAO:

So happy things are "moving along" for you Pizza & TK. It can certainly be a challenge!

Pizzaman - I had to wait until my staples were removed a week after surgery to turn my stims on...I was very anxious! Glad you got to go ahead and turn yours on and didn't have to wait any longer!

Nanc
:hug:

Too funny!!
 

I've been remiss in my posting and it looks like I missed some down to earth humor! I kept thinking "well, today was interesting. Let's see what happens and I'll post tomorrow". And a week went by.

Once I had my initial bowel movement, I became regular again. :o I used "smoothe move" tea a few times, metamucil several times but I think just time took care of things. What goes in will eventually come out. The antibiotic I'm on (cipro) seems to have some effect but it does seem to keep me regular.

Sunday was the last day I took the pain meds prescribed by my surgeon. The first three days I had the stimulator turned on I had a continual, slight muscle tension headache in my upper neck and head. By Wednesday it lessened and it was gone by Thursday.

Thursday, one week after surgery, was the first day I felt like a normal person. My mind was clear and I could think straight during the day instead of just during short intervals.

The first couple of days the stimulator was a little wierd - it was similar to the trial but a little less consistent. The location of the buzzing seemed to move around a bit. I think that must have been from the fluid or swelling my rep mentioned.

By Wednesday, the stimulator effect had settled down and is now pretty much identical to the trial. Woohoo! I'm getting pretty decent relief. Two of the programs work well but one is slightly too low and the other is slightly too high; I get a slight twinge in the sides of my diaphram that I wish wasn't there. All in all, I'm pretty pleased with it.

Now, the thing I'm dealing with most is the back incision. There is no pain in the incision itself. I have two areas of discomfort. The first one is just due to where the scar is. The incision is at the most curved location in my back and it sticks out a bit so whenever I sit down it's the first thing that hits the back of the chair. This is okay on soft chairs but firm chairs cause discomfort. The seats in my wife's car are nicely supportive; now that supportive, firm foam causes moderate discomfort whenever I'm in the car :mad: I'm sure that will reduce over time.

The bigger hassle is due to a "pulling" sensation in my back at the lower edge of the incision. It happens when I reach my hands more than 6-12 inches from my body. It also gets worse after I've been up and moving around more than a couple of hours. There is also a little bit of an ache after a few hours like the muscles around the lower edge of the incisions radiating down and out are worn out. I've spent time at my computer keeping up with work emails and doing a little programming and it wears me out.

I keep thinking that it should be getting better each day but it has not improved much. This is what kept me from posting - I kept thinking I'd wait to see what tomorrow was like and it was the same. I'm mentally ready to go back to work and I'm going stir crazy a little because I can't seem to find a way to reduce the discomfort other than laying flat in bed.

Is this pulling and achiness something you all have experienced? How long does it take to get better?

no prunes pizza - I refuse!
 

I put a lot of different things on pizzas. Check out www.passionateaboutpizzabook.com to see my picture gallery. But I draw the line on prunes. It just does NOT belong on pizza. :)

Hi Pizza
 

Hmmm. I'm a little uneasy about this pulling/aching you describe. I'd get it checked if I were you. Alot of times it seems the doc will downplay a complaint like that, especially right out of surgery. I had similar pulling sensation at the incision area. It kinda felt like a bug was biting me when I'd first ramp up the scs.
But I was having some severe lumbar pain also and only until I finally DEMANDED that an xray be done was it discovered that one of my leads had migrated down 6 inches. I suffered for 6 months with this! :eek:

I've always been a bit peeved that we generally don't get very good follow up care after getting the implant. I think it should be standard practice to get a visual on the leads a few weeks after implant, ESPECIALLY if the patient is in discomfort.
I don't want to assume you are dealing with anything like migration, but I do think it should be looked into further, before you scar in completely.

I spose 9 times out of 10 things like this can be resolved via tweak sessions. In hindsight however, I really wish I woulda spoke up sooner.

It would be good to be keeping a journal of sorts to keep track of these discomforts and such.

I hope this will work itself out soon. It's not fun having something like this naggin at ya.

Rae
:hug:

First follow-up tomorrow
 

I have my first follow-up appointment tomorrow. I will definitely talk withy surgeon about it.

Sorry Pizza
 

I did not realize you were truly passionate about pizza, but now do recognize the phenomenon, I will not suggest Prunza again.

Regarding your pulling and tugging..... I did experience pulling and tugging until the wires which connect my paddles to the generator of my Boston Scientific unit did scar in. Once scarring occurred in several months, the pulling and tugging stopped being of interest or recognition to me. Time will tell with you. Perhaps in speaking with your doc tomorrow will reveal you are experiencing common issues to the newly implanted patient. I very much hope this is the case with you.

Prayin,
Mark56:grouphug:

Good checkup, today!
 

I had a very good checkup, today. My incisions are healing well and the PA said I was a fast healer. They took off the steri-strips so they are bare.

Both the PA and surgeon said the pulling was normal as did Mark) and that it would Reduce in the coming weeks. They said to use ice and Aleve.

I also got my device reprogrammed. This gives me the ability to turn on the side electrodes and control the levels of all three separately. This gives complete. coverage of my painful area! I now need to play around to figure how to best adjust it. This is exactly what I was looking for :-)!

And i got to drive. All in all a good day!

Well AMEN! :Head-Spin:

This is what we want to hear! I think it's safe to say you are well on your way to getting your life back!

Way to go Pizza!

So Now!!!
 

We gotta get you through the healing phase so you can bring one or six of your favorite pizzas [yes, I did view your site!!] to a BBQ at Pooh's. Yep way out there in the middle of Nowhere!!!

Ahhhhhh I can see us now gathered around the pond, chowing down, swatting the gnats, flies and mosquitoes!! Yeah....... the life.

Well Pooh, when is the next one?

Mark56
:grouphug::grouphug::grouphug::grouphug::grouphug: