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Pain Management, Psych Eval, SCS Trial

kstarrkkstarr Posts: 19
edited 06/11/2012 - 8:27 AM in Pain Management
I posted several months ago because I was referred to a pain clinic for possible SCS for leg pain due to lumbar issues. Just thought I would provide a quick update on my PM experience to date.

I have had a few visits and the docs I have met seem great. I have not had any pain meds rx'd so can't say anything about a pain contract - it hasn't come up and I have not been drug tested either. My primary manages my meds and has not said anything either.

I finally had the psych eval yesterday and it was just a brief conversation and that's it. I was all nervous and worried for nothing.

My trial starts on 2/10, but I was told that the trial usually goes well. Sounds like a placebo effect. So for most people the expect they will install the SCS anyway....hmmm.

Anyway, I am kind of hopeful and looking forward to possible pain relief.


  • That's great news. When I did my trial, I worried about a placebo effect and nearly backed out of getting the permanent implant. If it weren't for my husband and a good friend telling me how incredible of a difference there was in me, being able to walk more than a few yards and of course the self torture of turning the trial unit off for a few hours ... the mind can play many tricks.

    I think one part of the trial, is to see if a person can get used to the feeling that the SCS creates. Many people just can't and therefore never get an SCS.

    I really believe that the trial is important on so many levels.

    Good luck with yours!

  • So glad your psych eval was quick and easy and you are moving forward! How exciting!!

    Like "C", I had a few moments where I thought I might not get the permanent even though my trial was amazing (long story). My husband was shocked because he had seen SUCH a humongous change in me. In fact, the photo you see in my profile was taken the day I had the 5 day trial finish and the leads removed. I could not believe the pain relief my eyes showed (after 4 years of burdened eyes) and had to capture that moment. I've had my permanent for 3 weeks and I'm still that happy!!

    Take care and keep us posted!!


  • Wow, I'm absolutely blown away to see this post...
    I had my Psych eval at 2:30 Eastern time this afternoon :) I was told by my shrink that I too passed!
    I don't have a date yet for the trial. I can't wait.
    I want so much for this to work. I don't expect all to be roses, well perhaps I do as roses have thorns. I expect and hope for about the same! Being able to not take 6 Lortabs a day. Being able to ride my bike and tinker with my cars or other things is all that I ask. I don't need perfection. 21 years of being married and staying at home for 11 years with my sons has led me to know all things do not go as planned!
    I gather that is the point of the psych test. To make sure you understand and are capable of dealing with failure.
    May we both have brilliant success with these things :)
  • Good luck to you too Wrambler. I wish you the best with your trial and hope you get it soonest!
  • That's great news for you both!!! Right on!!

    My Psyche eval was an "interview" with the doc and prior to that a sort of color in the bubble written "test" too. I know part of it is because they want to make sure that you can handle having something implanted in your body... I saw a news show years ago about a woman who tried to cut out her own breast implants because she freaked out!! GAG!! And it's also to make sure that you have realistic expectations from the SCS.... realizing it isn't a "cure' per se, but it's cure enough for me!!! Nothing short of the SCS ever came close to covering the nerve pain down my right leg. I don't know what I would do with out mine, as so many of us "electrified" spineys would attest.

    So Hip Hip HOORAY for today!! And may your trials and hopeful permanent implantations go well and give you the much needed relief you are seeking. I feel blessed many times over to have mine.


  • I am laughing at the prospect that they may have tested me to see if I can handle having something in my body!
    Get over it :)
    I had a Hemiarthroplasty [SP?] January 09,2008!
    Uh, That is a partial shoulder replacement! I have a section of my humerous covered with a titanium cap due to Avascular Necrosis (dead painful bone). Now, if they tested me to see if I can handle an implant I'd like to know why? Just goes to the right hand not looking at what the left hand has already done! My Psych test involved all the standard competency tests. Remember, three words for 5 minutes while answering other questions etc, etc, etc, He asked what I would do different. I said leave my wife and kids and hire a new doctor! no, not really! I just felt like saying that! A couple of times I did actually say things like, "oh, come on I been taking narcotics for years now, of course I can't remember that" He told me when I was done that he only did the test because he could not lie about administering it! He knew I was fine before hand!
    This guy is my regular psychiatrist. The Pain clinic uses whoever they can get to do the tests! They don't even have a "test". They just ask someone at the hospital to do a competency exam!
    So, it seems everyplace administers the tests different.
    Does medtronics or the other makers even have a "test"? I was told it was required by the SCS makers at both places I have been.
    My PCP called me this morning to say he has his scheduling assistant hammering on the Pain Clinic to get me in and get something done. YAY! :)
    kstarr, Got my fingers crossed you get yours first!!!
  • I thought the testing that I went through was pretty extensive but understood the reasoning as the SCS is really an expensive resort, and they try to limit those who can't "deal" with it in anyway. This doc was one chosen by my PM Surgeon, one whom I had never seen. First, they put me in a tiny room with a desk, a pencil, and the "fill in the bubble" test. After that I saw the doc and had my appointment with him. He asked me much of what you mentioned above... making sure that my expectations were realistic and that I had a realistic "plan" for if it DOESN"T work for me.

    I have a Medronic rechargable unit so I would have to say "yes" about the question of whether they have the Psych testing as a must do..... Now I have Medicare for insurance so I don't know how much of that is dictated by the insurance companies. Different ones may have different standards that have to be met prior to having the temporary unit put in place.

    Just my 2 cents.

    Peace, and I hope the time waiting for your SCS goes by quickly and smoothly. Best of luck to you!!


  • They're also looking to weed out the people who aren't going to improve with the SCS.

    We've all met the people who no medicine ever works for, no procedure ever works for, and that are a completely hopeless victim of their circumstances. For them, the SCS isn't going to work either because their life is psychologically centered around being in the patient/victim/sick person role.
  • When I first read the Subject on BionicWomans post I thought. "hmmm, I did not pee in a bottle!" Then I realized it said they are looking TO weed. NOT, Looking FOR weed!

    Ahhhh, this is a good place.
    Many thanks to those who keep it running!
  • Amen to that! I forgot about "those" folks!! Back in the good old days when I was still working, I worked for an Orthorpaedic Surgery practice. We saw our fair share of "those" people and it was frustrating for everyone, mainly the doctors, but it affected us too as we worked so closely to the docs/pt's. NO medication was ever strong enough, NO treatment ever worked at all, NO surgery ever improved anything..... like you said, their worlds revolved around being the eternal victim. We would try our hardest for these folks, as with all patients, but these guys are the ones that cause the most frustration, I think anyway. I mean who would actually CHOOSE this life we live??? But for some I guess the attention is what they really crave... and being a complete medical mystery!!

    Just wanted to say that I couldn't agree more!!


  • bongobuns2006 said:
    But for some I guess the attention is what they really crave... and being a complete medical mystery!!
    Good one Amy. Some days I feel surrounded by people just like that!

  • Hi,
    I went through the process. The psych eval was done by someone with credentials in pain management along with his psych degree. He was great! The SCS trial was painful, but I stood up for the first time in 2-3 years. It was great. I had the perm done 3 weeks ago. The pain was cut in half. The surgery pain is pretty severe, but the surgeons will treat you for that. I had the procedure that inserted the paddle in the top of my back, so the surgeon shaved bones and rearranged some things. That was quite painful for about 10 days. The rump hurts for 2 weeks. I'm like the lady who posted her pic. My family took pictures of me yesterday at my husband's birthday party. They said that I don't have pain in my eyes anymore.And I sat in a chair instead of lying flat for the whole party. Everywhere I go, the medical staff, everywhere, people tell me that my whole countenance is different. I run the SCS 24 hours a day and sometimes crank it up pretty high. I'm too inflamed still to have all of the patterns that I need, but that will come. Thank God for the SCS. I'm regaining my life back. I am still in pain, but for the first time I feel like I have the upperhand. I'm not thinking of my back and pain every step I take and every breath I take. I hope everyone has the same results I have had.
  • I think they also thrive on having been through more than anybody else with the same relative conditions.

    In one of the support groups I go to, there's a woman who is one of "those" people and anytime someone brings up a problem their having, she starts her response with this inane faux calculation of which surgery she had that problem after - "After my 14th surgery.. no.. my 12th.. no.. it was my 17th.. yes, that was it." Then she goes on to list whatever the original person's problem was in her amazingly long list of complications that were "the worst my doctor ever saw!" and lists off all the things she tried that "didn't help one bit."

    I want to slap the holy crap out of her on a very regular basis, because she's takes up an enormous amount of time dominating the conversation and people don't leave the group with any useful suggestions as a result of her input.

    But I digress.
  • That's fantastic that you have had such great success with your new SCS. It only gets better from here! I look forward to hearing more about your SCS experience.

  • So glad to hear of good results with SCS...I am cautiously optimistic.

    As far as Medtronic, my understanding is that the insurance companies are the ones who require the psych. Medtronic could (probably) care less - the more patients the better.

    Has anyone had the battery installed in the abdominal region? That's where I was told mine will be put - ouchy! But the psych thought I would only need 1-2 days out of work...so can't be too bad?
  • Hi Kstarr

    Glad you got the goahead for a SCS it has made a huge difference to me, I am 10 weeks post permanent implant.

    I wanted to pick up on the position of the unit. Mine is in my flank, just above my belt line - it is far more prominent than I was expecting & can be still quite tender. At my post op they said they could move it,but to be honest I can't face any more fiddling at the mo - I have asked to leave it 6 months & then I will see how it is. My point is make sure you have thought about it & discussed it with your surgeon. I would be interested to hear others thoughts too. (I have more fat on my abdomen so wonder if it might have been better there).

    I also wanted to say that I couldn't have gone back to work after 2 days - yes after the trial but not the full implant. I guess it depends on your job, but definitely think about it & plan longer I would say.

    Good Luck
  • That's great news you were approved for the SCS! I am so jealous.. Mostly because of all the positive things I've heard it's done for so many of our memebers here. I am so glad for you that you will have such a reduction in pain.

    USADogs - I'm equally happy for you too. There is nothing better than coming here and reading all the success stories people share - whether it be the SCS or surgery, or therapy of some sort.

    While I don't discount the fact that "those" people are out there, I'm not one. My expectations were (what I felt) realistic - I wanted the SCS to reduce my pain, thereby reducing the pain meds I take; which could only add to my quality of life. I was denied by the psych. He said I was too depressed. Well, I am now that's for sure! I'm not depressed; I get frustrated and anxious. Depressed sometimes, yeah, but never felt I was all THAT depressed.

    I'm not one to bask in the limelight. I have always been the one stepping back, hoping no one was looking at me. If attention was turned to me, I'd quickly mention someone else and re-direct the conversation. I find it so darned inconvenient to go to the doctor every month for medication refills and then to the pharmacy for the refills. That takes up a lot of time that could be spent doing other things. I just want to be who I was before all this and back to the life I enjoyed daily. I still enjoy it, but now I am distracted by pain.

    I am just tired of hurting all day. I know if I exercised more and maybe did a little less for the family (and a little bit more for me) I'd likely feel better.

    What I really dislike is the fact that I was so optimistic about the SCS and really felt it would do what I expected I guess I felt my perception would be my reality and wishing would make it so - and the psych just pulled all that away from me, and now has me doubting myself. Maybe he's right (and I'm wrong) and I won't benefit from the SCS. At first, I was willing to go on and have it done anyways (my PM wants to proceed), but now... I'm not so sure. I've got a good deal of mechanical as well as nerve pain, so... Maybe I'll just stay with the meds for now. rats. My next appointment with the PM we will discuss other treatment such as accupuncture!


  • Did they say why they do not consider you appropriate to try an scs?
    I know I'm still very concerned that between my insurance company and the PM and the clinic that they'll screw things up and I wont end up getting the trial!
    There are so many things that can go wrong yet. This area is pretty lame for PM care near as I can tell. To top things off I overdid it yesterday so I have that nice cozy campfire burning right dead center between my shoulder blades today!
    Anybody got any marshmallows? At least it is Friday and I won't have to come in here to work for a couple of days.
    I see my PCP on Monday. I expect to have to go through the whole, "You really need to take less of these" routine again.
    I really detest the whole situation. I so hope the SCS works.
  • Aw, Wrambler, I'm so sorry you aren't feeling well today. I hope you feel better soon, though.

    Actually, the psych said that the results of my test show that I am not a good candidate because of the way I answered the questions. It indicates that I am very depressed and that my expectations are unrealistic. Or something like that.

    I actually had it out with the psych who did the evaluation. I asked him if he had ever seen a patient who suffers from chronic pain to NOT have some form of depression, whether it be mild or severe? He said "That's a good question. I can't say that I have." I told him I do not find that I am depressed; mostly I suffer anxiety and frustration. He said the results of this psych eval did indicate that (anxiety). I told him I feel a person's attitude has alot to do with recovery. If I had felt the SCS would not be beneficial, I'd not be wasting his time or mine on the evaluation. He said my results were not proportionate and that I tend to "harp" on certain things. I explained to him that the test asked me the same questions over and over, and "I" was the one harping? Furthermore, if this were a "social" visit, I'd not have gone into the detail I had with him. But because he asked.... I asked him if my complaints of pain were disproportionate to my medical findings. He said, no they were not. I asked him if he actually thought I was the sort of person who would request a SCS just because? He said that, no he did not think so. I asked him if his opinion was that I hurt because I was depressed. Again his answer was no. I told him it was very hard to have my "specialist" - Rheumatologist - take my complaints serious; I had to go to my GP to have tests done to at least rule out any underlying problems. NOW, because HIS notes indicate I am depressed, I felt I would, once again, have to go through the tiresome act of CONVINCING medical personnel that I am in pain (and not just depressed). I also told him that I wanted desparately to be off the medication, or at least decrase it substantially, and that I felt HE stole that from me. THEN, (you are not going to believe this) he asked if I would like for him to ask my PM for some antidepressants. ?!? I told him I'm trying to decrease my medication intake (fool) not add to it!

    Now, it was MY turn... I asked him if he truly thought I was too depressed for the procedure and did he truly believe he could prepare me in "4" visits, or was it just that he needed another patient so he could pay his car note or house note (or something along those lines). He stopped typing on his lap top and looked at me incredulously. I had to smile at him. His look was really priceless. (Also, I was beginning to feel less depressed and angry - I had him on the ropes!) I asked "how does it feel to have your motives questioned? Not very pleasant, is it?" ("motion to treat as hostile witness, Your Honor?" "Motion granted")

    So, I get to see him again on February 27th to "discuss" that last office visit. It was scheduled for this past week, but I had to bring both my parents to their doctor appointments, and did not want to take off any more time this week.

    So we shall see how THAT plays out.

    Hope the fire between your blades dies down soon. And I truly hope you have awesome results with your SCS. There have been so many threads started on the SCS with new members asking questions and what not, and I can truly say that those who have benefitted outrank those who have not by about 8 to 2. I bet you will be in the majority as well!

  • Don't let someone else cause you to doubt yourself. Besides, that's why they have the trial. If its not going to work, you would surely know more after that week. You deserve every possible chance for pain relief. Susan
  • Hello folks... just wanted to drop a line and say that today I go in for my trial of the spinal cord stimulator... Im very nervous cause I have seen many good and about the same amount of bad on the net as well as here about it... will post as very soon as I possibly can after I get home and give my 2cents worth...

    Wish me luck, say a prayer...

    aka Theresa or April
  • Let me be the first to say best of luck to you today!!! I pray that your temporary SCS gives you relief beyond what you could have hoped for, and that it works for you!!

    Please let us know how the trial is going and feel free to ask ANY questions (there are no stupid questions when going thru this) and I know you will get the answers you will need.

    Big giant hugs and hopes coming your way,

  • Maybe a good slappin' is what she needs???? To know what real pain is??!! LOL

    Totally kidding..... well, not completely.


  • I'm sure everything will go fine with you today. I just know it will!

  • and everything Mrs. Wings! Hope it works!
    Comeback and tell us all the details!

    Jeaux, sorry I did not reply to you earlier.
    Sounds like your psych eval was rather different from mine!
    My campfire died down as it normally does after a day or so. I now have a nice old fashioned winter cold to keep me occupied. So much for saving sick days :(
    Saw my PCP monday night and he assures me the PM doc does indeed WANT to do the SCS trial on me after reviewing my charts. I really feel nervous about using him, but spousal leverage and insurance coverage demand I try here :(
    I just got to hope it all goes better than my ESI injections went! I think, and that's just me, You sound like you know exactly what is going on. If the PM is willing to do the trial anyway and insurance etc, says OK, Well I'd let them do the trial! A little shrink time never hurt me too, So I'd keep those appts and work towards feeling better on both fronts on the same time!

    I hope we here from MrsWIngs soon!

  • I sent you a PM


  • Can't wait to hear your update!! My case is one where my procedure was a total nightmare, but the pain relief I had once I got out of there was amazing. Took my mind off what I had gone through. lol (I had scar tissue and other problems).

    Let us know!

  • Hey all... here I am about 7 hours later. My stimulator is in temporarily for my trial. They told my boyfriend that it would be about 20 min to get me in and out... an hour later they were taping me up. So as you Cherish, I had some issues. My Dr called it tracking. They couldn't get my leads in the right area to help my area of pain.

    I have two lead wires in, and while they put those in I was in a pretty deep state of sleep if you will and don't remember that much, but they would wake me up a little bit to adjust the amount of stimulation from time to time. They were not able to get the stimulation to my worst pain areas. Even after I was back to my room and the medtronics guy came in to make adjustments, he still had problems. They did tell me that it could be all the little nerves are just super sensitive from having these leads poked around in there and that after a few days it may settle down and be ok. They said I could call any time to come in for adjustments from them as well.

    At this point I am far far far from optimistic about this thing. But I hurt a lot, walking is hard, moving, getting up/down from a chair... and occasionally that "got the wind knocked out of me" feeling.

    I will post more as/if things change for the better or worse.. thanks all for the thoughts, advice and support...


  • 1.) don't twist
    2.) don't raise your arms above your head
    3.) becareful of the long chord (I got mine caught on a drawer pull in the kitchen and about crapped my pants when I went to walk out of the room!!
    4.) give it alitte time.... I know you are sore as hell
    5.) rest rest rest.... and just see how this crazy ride turns out!!

    I wish you the best of luck during this time!! You have made it this far already!!!

    Hugs..... gentle ones,

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