Any physician who would ever speak of surgery requiring general anesthesia, multiple incisions of the back [spine and pocket location], excission of bone regardless how de minimis, and all of those neatly typed disclosures every patient always has so sign off to regarding having been informed of all of the risks and things that could go wrong in the OR should likely not be treating you. I had permanent implant of SCS unit devices via partial laminectomy with insertion of paddles. It was taken very seriously by the whole team. Back surgery is back surgery. I had similar pain from the implant just not as severe as I had for prior fusion surgeries. But by gum, every movement made by me post surgery was painful, even rolling in bed. Every physician who has treated me has spoken of the care which is being taken to perform their professional work carefully but that sometimes things can go wrong. They do not want to needlessly worry the patient, but truth be told, there are risks anytime skin is opened. Typically this is why surgery is held off as a last resort treatment to a host of issues.

So, please do take the lead and ask questions to ensure your treatment is to be afforded the proper due care medical treatment, not non challant, not slapstick, but with propreity and seriousness. Why do I react this way..... because I personally knew a woman in my community who went in for a Selective Nerve Root Injection, typically done here in an OR, treated as surgery with extreme care, under fluoroscopy to assure proper placement because of the risks inherent to improper care. Her doctor did not perform the procedure thusly, instead opting to perform his work in a doctor's office examination room. Infection ensued. The woman, whom I knew, died.

Surgery is no simple matter, no laughing matter, no matter what. Ask PoohAC, she will urge questions, caution, and despite the routineness of the procedure for the physician speak to you of due care for the patients. Anyway, I do believe she would address you that way.

Caring for you, and hoping all will go extremely well,
Prayin,
Mark56 zz

This is one of a few post on any of these forums that truly address the real problems with having surgery of any type. I have seen several PM doctors over the past 7 months 5 in all to get options and all but one said before they ever looked at me I can cure your pain for ever by implanting a SCS. I ask the 4 PM Drs. for references since they all said that all their patients had great outcome. Not one could with one name. It seems that most not all but most PM Drs. take this SCS very lightly like it is doing a oil change. 3 Drs. out of the 4 said that this was a piece of cake to implant. The 1 Dr. told me that he does more SCS implants then any other Dr. in a 12 state area and it is no big deal. This same Dr. wanted to do a block that day and I told him that I did not bring a driver with me and he said no problem he does blocks different that most other Drs. do but I passed and never went back to this dr. again. I have had 5 blocks in the past and I was loopy for hours after each block. All blocks are for my right hand, entire arm, upper chest and back.

I have crps type II now for over 4 years and only been treated by PM Drs. for just over a year now. All these PM Drs. act like they want to implant SCS and be done with you. All 4 Drs. never said anything about possible complication of any type all said only good things about the SCS units. As I understand it this is to be used only as the last possible treatment. They all seem to want to do this first over any other other treatments.

Tinkster

I have found that to get a unbiased answer to your SCS problem I would find a Back Surgeon and tell that person what your problem is and what you want to do then see what options they come up with. These Drs. have worked with SCS and would have a clear understanding as to how they work and how to implant them. They will give you more answers that you will not get from any PM Dr. You have waited this long so take the extra time to find a answer from some else that has no connection to your case they may have a better way to fix this once in for all that no one else thought of. New eyes can see things in a clearer light.

Sorry for the long rambling.

Oh Hurting- I ache for you in your situation, and all the more feel blessed regarding the doctors whom I have had treat me. My Physiatrist [aka Pain Doc is a board certified fellowship trained Physiatrist and very cautious practitioner. For this reason, he offered SCS only as the last resort after I had been through all else. Never did he express the process was easy, because it is not, as the whole of the process is arduous with hoops to navigate, and the double surgeries to endure. It was he who did my TRIAL placement in an OR under sterile conditions, and it was good. The TRIAL period lasted a week, then we gathered for the verdict and removal of the Trial leads. Only then did he have me interview with a recommended and trusted Spine surgeon, and Orthopedist in this case, whom he believed to be highly skilled and very careful. My wife and I went and proceeded with the interview, resulting in our asking the surgeon would he be willing to permanently implant the device in me. These are all treated as serious decisions and not casually among the practitioners whom I so trust.

Then on 30 June 2010, my surgeon with a whole team of folks gathered with me in the OR after a big crew from our church gathered in the prep area and prayed over us [joined by my surgeon and anesthesiologist] and then we went to do the deed, and it was good. Painful, absolutely, carefully done, I am convinced, a success, yes, and later that summer I fully withdrew from all pain medications and have used the stim and my trusty cushion to fully manage my pain since. I truly feel blessed.

I do realize my situation is dramatically different from you Tinkster, who now wrestle with the difficult decision of whether removal or revision because the process seems to have gone wrong. Tink, for you I am most sad as to the outcome, as I am for Sarah. All I can really effectively do is caution you about good care since surgery is serious stuff, and pray that whatever the decision you make, that it ultimately lead to peace and resolution for you.

Prayin,
Mark56zz

Mark56

Thank you for your reply. I am glad to see someone has found good PM Drs. to treat them. Also what said about SCS surgeries in general and how serious they really are with risk. I have not found a local PM Dr. take has taken this very serious to date and this is what scares me.

I am looking for a new PM Dr. again and this time I will find the right one for my needs.

Sorry to take this post off subject.

Good luck with what you decide on your SCS implant Tinkster.

I am in the Denver Metro area, Colorado, so if you are anywhere near, I can PM you my doc's information GLADLY.
Mark56

Hurting
I 'feel' your frustration and I agree.....there are just too many cocky, high-and-mighty pain docs out there who are all gung-ho about doing these implants.....collect their VERY large sum of $$ and then basically don't want anything to do with us! They'll even go so far as to incinuate that we just want PAIN MEDS for the sake of having pain meds! .....which goes COMPLETELY AGAINST the song they were singing to us whilst making the 'sales pitch'...and REPEATEDLY stressing that we shouldn't expect more than 50% pain releif! .......So this leaves us hanging. On ONE hand, we are very grateful for the 50% pain relief.....but this does NOT mean that we've been 'cured', nor would we expect that! We KNOW the SCS isn't a CURE!
But they simply get irked when we come back needing revisions and breakthru pain meds......and eventually they'll send us off to a psychiatrist....because we've got MENTAL ISSUES!
There's nothing wrong with getting mental care. Chronic pain and depression certainly go hand in hand. I believe it's a GOOD thing and I've started seeing a psychiatrist....per the request of my pain doc. Why? because he doesn't want his reputation 'tarnished'. He wants me OUT of his hair!
Forget all the speal about the 50% pain relief. He doesn't want to mess with the OTHER 50%.....all of a sudden we become a 'pain in the @@$$' to them.

Ok, I'll shut up.
Obviously I'm a bit 'grumpy'
Not ALL pain docs are like this of course. Mine IS....and it sounds like 'Hurting' has experienced several of these.

Tinkster, you are in my prayers. I'm so sorry you have this decision to make.
I really wanted this to work for you!

Gonna go crawl back in to my hole now

I have been told from 4 Doctors due to my having crps type II I need to avoid most surgeries of any type due to trauma at all cost. I feel Implanting a SCS would cause trauma from placing the leads in the upper back then running them down to where they place the power pack control unit.

I have had 2 surgeries to try to fix the severed nerve in my wrist with no luck. The last surgery they did the block on all three nerves in my arm pit. This block hurt at the very beginning before it went numb which lasted for 4 days. Now I have permanent pain at a level 7 24/7 in my upper arm from this block.

So this is why I feel that having a SCS implanted will cause me more pain in a new area just as the block did.

When I went through PT after surgery they had me try a Tens unit. I tried it for 4 days and had to stop because it sent my pain throughout my entire arm to a 10+. After trying the Tens unit I cannot take any type of vibrations. It does not matter if it is sound or from riding in a vehicle. This tigers off my pain from a 7 that is my average level to a 10+ for hours.

So this is why I am not very gung-ho about even trying the tempt unit I just don't need more new permanent pain. And my back, hand, and reg Drs. tell me no stay away.

For many people these SCS implants work great and should give it a try;

As I keep tell these PM Doctors I know my body better then they do and I have tried many things that they asked of me and I am done being a test dummy for them. Only after in writing from one of these PM Drs. guaranteeing me that I will not get any new permanent pain in the area that they implanted the SCS I am done talking about this treatment.

Not one of these PM Drs. ever told me about possible complications when I asked. Need I say more. All I can say is it is about the mighty dollar. Now that I have made myself clear about the SCS the PM Dr. could care less as to how he treats my pain. I told them that there are other ways to treat my pain that has not been tried yet. They don't want to hear this.

I will keep trying to fine that right Dr. that is willing to do other cost effective treatments first.

I talked with my doctor today. He said that the doctor I saw monday supposedly is not all that experienced. Anywho, he said we will figure things out, also said the leads did not move, good news there! But said he can move the battery to better location.
The rep was there too and he did re program the stimulator, hope it helps.
Happy Easter everyone

I am worried about having the revision surgery. But at the same time I worried about giving up on SCS all together too. I know I don't have all the answers yet so I cannot possible make a informed decison.
I am going in tomorrow for another injection, hopefully I will have a few minutes to speak with my pm doctor, but he is pretty busy on surgery/injections day so it may be best to speak with him in the office at my next appointment. I do want his opinion about all this. He's a good doctor and was very truthful and very informative when he did the SCS, not like the doctor that filled in for him on Monday.
Did someone say that once the revision is done with paddle leads its not reversible? Also, is that type of surgery generally done the same way the SCS is done, with the other type of leads? Where they wake you up half way through the surgery to test it out and you are not under with general ansthesia? Also, its outpatient, so was wondering with a revision is it the same way?
Thank you again for the replies, you guys are awesome.

I have Paddles Tink, and it was major surgery, not taken lightly, involved general anesthesia, partial laminectomy at T8-T9 through which to place the leads. Whether is irreversible, I do not have a clue, but would not want to go there, as scar tissue would hold those babies tightly in there against the spinal cord.

Caring,
Mark56z