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Dr recommended SCS



  • One of my SCS's works really good for my arm pain but does nothing for my back. The other one gets my neck and part of my head. Mine are both the Precision Plus model from Boston Scientific. My doctor has implanted a couple thousand of them and he said he has not had much success with the back. You will know what to expect when you have your trial. You will see exactly how much relief you get from it before you decide on getting a permanent implant. Best of luck!
  • This is not intended to start a "brand war" or anything, but if you need back and leg coverage, I wouldn't go with the Boston Scientific implant.

    In my opinion, Boston Scientific is way behind Medtronic and ANS these days. They haven't made any significant improvements to their implant since it was released in 2004, which astounds me at the rate medical technology is advancing. They also have a very limited number of leads to choose from - only 2 percutaneous leads and one paddle lead; they also don't offer a tripolar paddle lead, which I'll come back to!

    My SCS is for low back and bilateral hip, leg, and foot pain as a result of nerve damage, scar tissue, failed multiple back surgeries, blah blah blah. ;) Like you, I went the fusion route and it didn't stop the pain. Then I went the "anything but another surgery" route, and none of that worked either.

    I have the Medtronic RestoreUltra with the Specify 5-6-5 tripolar paddle lead. The tripolar lead in particular is important for people who are hoping for coverage of low back and leg pain. Recent research shows higher success rates with tripolar stimulation for people that need low back and leg coverage, because it drives the stimulation deeper into the spinal cord and is able to stimulate deeper nerve fibers.

    Now, that's not to say that you can't get both lower back and leg coverage with a Boston Scientific implant, because I'm sure some people do, but when it came to my SCS, I wanted to go the route that offered the most up to date technology, with the most options for my doctors to choose from. In my mind, those two things combined lead to higher success rates.

    There have been several (long and slightly heated ;) ) discussions on the SCS lately and there's a lot of good information contained within those threads, especially about how to approach the trial phase to get the best idea of what your life will really look like and a lot of ground that you'll benefit from discussing with your doctor prior to a trial, like what activities to do/not do, whether or not to reduce your meds ahead of time, etc.

    Good luck on your "journey" and hang on to your hat, 'cause there's definitely some portions that feel a lot like a roller coaster! 8}

  • Have you reapproached your surgeon since the PM doc made the suggestion to try the SCS? Some times docs try to do what they can with the tools and skills they themselves have and forget to tell you to check with the "other guy" too.

    All I know, is that if there were any surgical way of fixing my issue, without the need for an SCS, I would jump at it.

  • C-

    My surgeon was the one who sent me back to the PM Dr. for the SCS. My surgeon said that I was no longer a surgical candidate and there was nothing further he could do. I am now totally fused. My surgeon also said that in his opinion my pain management Dr. was the best Dr. in my area to do the SCS. When I went back to my pain management Dr. he tried several non-surgical things first before suggesting the SCS including a nerve block, radiofrequency ablation, PT, etc. Nothing else has worked. So I do feel that I have tried everything else I could including having lost weight.

    I appreciate everyone's imput about other brands, etc. My pain management Dr. did say that he works with different brands so I will ask him about them. I am going to do a lot of research so I go in fully informed.

    Again, I appreciate all of your input. If anyone has any other good sites for information, etc I would love it if you could share them with me.

  • That's awesome. Well I hope you understand what I mean. The fact that your docs are looking at everything and not just jumping to the "next best thing". If they have ruled out surgery and tried all their other tricks of the trade, then you will know you have tried. It's a sad but a good feeling to know that you have tried everything you possibly could.

    I think BionicWoman made a good point about the brands and functionality of different SCS's. Most docs who do a lot of implants do utilize different brands and your doc should be able to discuss this with you.

    The SCS that I have has the same IPG that BionicWoman has, however I have different leads because I have a different problem. What I really like about the IPG we have is size, functionality, reliability and above all the patient features that it allows. It is the one IPG made that allows the patient as much control as it does.

    Basically I don't need to go to the rep unless something really bizarre happens and I need professional intervention. I can reprogram my leads, from multi to single contact firing, shift the pattern from one end to the other of the lead, change to only one lead and choose which lead, change the amplitude, pulse width and frequency of the signal ... I can create 100's of different settings to gain comfort as needed. I can even run diagnostics on it and troubleshoot my system myself which helps eliminate the need to go to the doc or rep unnecessarily.

    So do your homework and be informed.

  • I would listen to "C" and discuss the differance in SCS brands with regard to user functions. My Boston Scientific SCS's give me very little control. I am able to change programs(each SCS has 4 programs)and adjust the level of stimulation - up or down. That's it. I can't do anything else. I need the rep to make any other changes. Meeting with the rep takes time and costs money. Also, I do not have control over the reps that I see. It seems that I am not permitted to request a specific rep. I have tried many times to get the ones I felt were the best and it just never works out.
  • "C" seems to be one of the chosen as far as control.
    There has never been a hint that I could get the access to my units controls like C has.

    Even though my Medtronic would be adjustable as C's is, I can't do it.

    One of the key ingredients to having an SCS and being "happy" with it is knowing you have done EVERYTHING else first. Sounds like you have that.

    Try to have the trial unit left in as long as possible. I know, not showering etc, is an issue, but you really want to be sure that you are getting coverage and pain control. Sometimes the first 2-3 days of the trial can be rough just from having the leads implanted. Some times you know instantly and forever this is exactly what you are looking for. It's best to be sure.

    Also do not be to upset if you feel you did not get the latest greatest unit on the market. The key is one that works for your pain!
  • I just got Medtronic love it cover all my back pian perfectly!! ps may i suggest if your PM dr is a anstesoiligist splelling , try a Nero dr i did was so much more happy after all he is a spine speaclist nothing but the best for my spine JMHO.
    GOOD LUCK dont be afriad to to ask questions..
    mine was done by lamiectomy for lower lumbar and back pain.
  • I really want to thank everyone for their posts!! It really means so much to me!!

    Wdwgranny, my neurologist actually referred me to my PM Dr. for the SCS. In his words my PM Dr. is, "the best one in town for the SCS" which is saying a lot since I live in a large metropolitan area.

    I tried to call them today to let them know that I want to go ahead with the trial, and their phones weren't working. On their business card they had an e-mail address so I sent an e-mail asking for someone to call me. My Dr. called me back very shortly afterwards. I asked him about the differences between the Medtronics and Boston Scientific models. He said he works with both and would use either one that I preferred. He did a trial of the Boston Scientific one for back pain coverage and in his opinion it worked better than the Medtronics model for this area. He discussed how it was better able to penatrate areas of scar tissue. He also mentioned that if one model didn't work well for me he can switch me to the other model. He did say that depending on the Dr's experience, etc that you can get back coverage with the Medtronics model.

    At this point I feel comfortable with his experience and told him that I wanted to go ahead with the Boston Scientific since that is what he has had the best outcomes with for back and leg pain. I believe that like fusion surgery, which model and procedure a Dr. has best success with can really vary. I really like the fact that if I am not happy with one model I have the opportunity to switch models.

    So, I have my appointment for the pschc evaluation on September 15 and my PM Dr. is going to have his nurse call me for a date for the trial. Here goes the roller coaster.

    Thanks again so much for all of your input. I really feel like I am going into this a much more educated person, which really gives me more piece of mind. I do have to say that as I have been thinking this over I haven't been sleeping as good just because my mind is going 100 mph.
  • That's awesome! I'm so glad that your doc was willing to come out and discuss the differences and his experiences with the different models and brands. Sounds like you have a great doc who is willing to go the extra mile for you.

    Rest easy now and keep us posted on how this all goes for you!

  • Anjuan, it is great that you have a good relationship with your doctor. That is so important.

    You might ask for clarification of your doctor's assurance that you can switch from Boston Scientific to some other manufacturer if you don't have a good experience. It would be relatively easy to switch manufacturers after the trial, because in this country the percutaneous lead almost always comes out after the trial.

    However, during permanent implantation, a percutaneous lead should be anchored. It is not so easy to remove, surgery is required to detach the lead from the anchor. What about replacing the IPG while using the original lead(s)? I am not sure the Medtronic IPG can be used with a Boston Scientific lead. You might ask your doctor.

    Another question is where does your doctor plan to put the IPG? I started another thread on IPG placement.

    Good luck with your trial. :) Keep us informed.
  • I've had two revisions on my SCS. The first to replace anchors and recreate strain relief loops, the second to repair a wire going into my IPG. Both revisions were easy and easy to recover from.

  • You have some good questions. My Dr. was taking about switching brands during the trial period. He even said that he has switched brands while the patient is in for the trial when the first brand he tried didn't work very well for the patient. (But his example was from a Medtronic to BS).

    As far as the IPG goes he said he usually puts them in above the belt line on the side towards the front unless someone asks for something different.

    I also found out from the staff that they can't schedule anything until after they get the psych report and then get preauthorization. They said that on average the schedule the trial about the week after the psych report, but that week won't work because of a work project. So I am guessing that I probably will have the trial around September 28.
  • That is the way it works.
    They don't want to waste any effort until they know you are approved. One step at a time. That schedule looks fast enough to me all things considered.

    I was first told I was a possible candidate for an SCS on December 20, 2008. I got my final placement on May 4, 2009.
  • Tomorrow is my therapist appointment for the SCS and I am getting nervous. I have seen a therapist previously so I have an idea how things might go, but just the fact that this person who doesn't know me has the potential to have a large impact on my potential pain relief scares me. They e-mailed an 8 page multiple choice questionaire for me to fill out. I really dislike those things because for many questions I think there are many ways to read them.

    Wish me luck!
  • I know it's easier said than done, but try to relax and answer everything as openly and honestly as you can. :)
  • They're not looking for little idiosyncracies but major psychological issues. If you are not seriously disturbed, you will pass. Susan
  • I am back from my appointment and according to him everything is a go. It wasn't that bad, but I was mentally and physically tired at the end. He asked a lot of the type of questions that I thought he would, and just basically took a history of my pain, etc. In addition to the 8 page questionaire I had to finish there was another questionaire that I had to do at the end. So all in all, everything went well!

    He said that he would have the report to my Dr's office within 24 hours, so now I just have to wait for my Dr's office to get the preauthorization done and set my appointment for the trial.
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