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post SCS trial no pain meds ?

edited 06/11/2012 - 8:40 AM in Spinal Cord Stimulation
:S HI,my name is Jake and like alot of you I have alot going on with my back ,DDD,Arthritis,blown disks pressing on cord on lumbar and mid back,neck problems Ect.I am 36 and hurt my back ten years ago and had cronic pain ever since.Tried most stuff, cryo,PT,ESI,TENS,inversion,ECT,been on pain meds for years,morphine for about two years I was on 120mg day .MY ortho said I am not a good canadate for surgery because of were the problem is and my weight. but if I lost 50lbs he would do a two level lumbar fuison. I weight 290.My pm doct wanted to do the scs I agreed. I was at the surgey center in pre-op waiting for the doc and when arived he said he did not have time to do the trial ,somthing about he would have to wait for the operating room to be open. But he told me he would do it in his office across the street,this man would not even anwser a simple question about the trial.I feel this should not be done in the office! So they unhooked the IV and I went and found a new PM Doc and he agreed to do the scs if I gave up the morphine :? . I felt that this was a better DR, so I was willing to give it up for a chance to have a life with less pain.SO he cut me off the pain meds for 2 1/2 months and I did the scs trial and near the end was able to tweak the unit to get reduced pain!I feel I should not had to go without any meds the first two nights after surgery.I will have the perm scs done on 2/4 ,I dont know about not having any pain meds for the recovery,I have suffered enough.What do you think ? For me the pain meds are like chruches when you have a broken leg ,you can live without them but it makes life very hard.If my Dr could walk in my shoes for a day I think he would give me back my cruches!I am doing my best to trust him as I think he is tring to get me better and seems to care and is not just in it for the money.


  • Welcome.

    It is my understanding that a SCS is done as a last resort when surgery is not an option. If you look at the websites for your brand, it probably even says that. SCS are something for the long haul, not a temporary thing. IMO, SCS should not be done if there are mechanical problems correctable by surgery.

    Don't have the link handy, but in the Back Surgery Forum, I posted a link to an article about obese patients not having different outcomes in certain types of fusions. Of course every pound helps, I'm not disputing that, but sometimes is difficult to lose weight when you're in pain.

    You said you had an ECT for the pain??? Surely you don't mean ECT like I think of ECT. What does your acronym mean?

    I wish you luck, it's hard to wade through everything, especially when you're in pain, but I really think you should either lose the weight or get a second surgical opinion. A SCS isn't something you get for 6 months, a year, or any short term while you await surgery. It is the end of the road treatment when surgery is not possible(according to many companies' websites.)

    Please post an update on what you decide to do and how you're feeling!
  • I really feel for you. Prior to my 2 level fusion 2 1/2 years ago, I was a little over weight. It took me 8 months to shed 50 pounds prior to having my surgery. My wife and I did Weight Watchers to accomplish the goal. My exercise regime was limited to walking and simple stretching, so its possible to lose the weight.

    As for the SCS, I agree with ERNurse. If you still have mechanical problems with your back, eventually you will experience more pain. The SCS may or may not help that new pain. I have an SCS because I have a fair amount of nerve damage in my back but I still take pain medications to make me more comfortable.

    The treatment option that will work best for you depends on your type of pain, how severe it is, and how you respond to pain treatment.

    Neurostimulation treatment might be right for you if:
    • Other treatment options have failed to adequately provide pain relief or produce uncomfortable side effects
    • Your doctor understands what is causing your chronic pain
    • Further traditional surgeries are not recommended
    • You don’t have a serious, untreated dependence on pain medication
    • You have passed a psychological evaluation
    • You don’t have medical issues that would make surgery difficult
    • You have had a successful neurostimulation screening test
    I wish you all the best in your decision, but please take the time to research what your about to do. Maybe a second surgical consult wouldn't be a bad idea.


  • I had a scs stim trial and it was put in in an OR setting, under fluroscopy! office procedure my foot! I was on my reg pain meds too. I also had dr.'s say that I needed to lose weight to have surgery...to bad they dont get that a person in debiltating pain isnt out exercising, huh? I ended up having PLIF surgery and had the useless stim removed at the same time. do you have a pain mgmt dr? if not, maybe you should. That is who put my stim anf the trial in and they never made me go without pain meds. that is just ridiculous. I know many people thing stim is last resort only after surgery fails, but I tried it prior to surgery to see if this less invasive option could work, but for me it did not. Also many say you need to off pain meds for the trial and I also disagree. Let me know if you have nay more questions I can help with! :)
  • Sorry I ment Etc not Ect. Thanks for the reply.
  • I'm sorry you're having so much pain awaiting your SCS. Please call the Dr. and let him know you need something to help you with the pain. That's why you're going for the SCS. Can your Primary Dr. help you with medications until then? I struggle with weight issues and know it's hard to get out to exercise or even walk if I had no pain meds. I had to make many appointments with my Primary Dr. to get something to help for pain. Drink lots of water and multivitamin if you're cutting back the portion size. Don't give up and keep looking for the Doctors to help you. I agree with the others about looking for another Neurosurgeon or Orthosurgeon to help you. Get another opinion for the SCS. I hope you get some pain relief. Even with pain meds I couldn't get to my Dr. today. While she was on vacation I went to the ER for some pain medications. Usually the ER Doctor may even call your PM Dr. to help you. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Thank for youre input,after doing the trial in the hospital I would not even think about having it in the ofice! Yes I agree that it is ridiculous about the pain meds and it is the new PM DR that took me off them he is a real pain in the back, but I still respect and trust him, just diagree with his choice with the meds,he was not quick to decide to do the trial and told me that lots of doctors would do it for me and if he just wanted to make money from me he would do it but he made me tell him why I should have it done.He also told me that it is not a "majic cure" and might not even work so I would not expect too much. My gut tells me this DR just wants to help me.It was a good thing to have that trust in him when he was putting those wires up the spine.
  • Thanks,I did call the office and he would not give me anything,He is not the normal DR he only agreed to do the scs if I lost 50# or gave up the morphine, I told him I could not lose that much weight but could stop morphine . He keeps telling me he can only do so much then it is up to me to do my part, diet,exercize.He might not do the perm scs if I broke are deal and got meds from another DR.The worst part was having morphine withdraw and have to take care of my father at the same time as my mother was having an operation. Now my father is at a hospice home and because of pain I cant spend as much time with him without some meds. Just bad timing I guess,I hope after I get the perm scs I can change the DR mind about the meds so the next person wont suffer so much!IMO No matter how much they are trained and how long they go to school they will never feel what we feel and will lack understanding,I wish I could change this.
  • My trial stimulator was placed in my doctor's office, with no sedation and absolutely no problems. I had local anesthetic injected at the insertion site and that's the extend of the medication that was involved.

    The setting isn't as important as the resources your doctor has at his/her disposal in that setting. It's really not major surgery and in the vast majority of cases, it doesn't require any anesthesia, so they really don't need a full blown hospital style operating suite to place the trial safely.

    If the doctor does injections in their office, then they most likely have fluoroscope. Beyond that, all they really need are the supplies to establish a sterile field on your back, around the insertion site.

    With that said - doctors who won't/can't/don't answer every question I have about a procedure don't lay a hand on my body. If they're unwilling to communicate with me until I'm reasonably comfortable going forward, that's where the relationship ends. I've given pain doctors, PCP's, and even veterinarians the boot for that very thing, because it's too important.

    I also think you need to be very clear, before the procedure, on how the post-op pain will be managed. If you're not comfortable with the plan, then don't go forward with that doctor and that surgery until you are.

    Personally, if it's just a matter of losing 50lbs in order to be able to go forward with the surgery that has the best chance of correcting the underlying problem, I would be seeking some assistance from a bariatric physician. They have medical options (non-surgical) at their disposal that will allow them to drop 50lbs off of you pretty quickly, and safely.

    If you don't correct the underlying problem, the SCS won't remain effective over time. Once you've got the SCS, surgeons aren't as willing to intervene, so you create a catch-22 type of situation.

  • Thank you BionicWoman for those words of wisdom!That is some good advice. The statement " doctors who won't/can't/don't answer every question I have about a procedure don't lay a hand on my body" makes me feel better about my choice. I must say I do not trust this to be done in an office setting.You can have no problems but what if you do, I had to learn the hard way you can die from an ESI. Had a reaction to the shot, it was the worst feeling in my life about a gallon of sweat came out of me in about a minute ! blood psi droped down and skin went pale felt sick in my brain I really thought I was going to die, they got the cart with the padles but did not have to use them just gave me some o2 and I came out of it after some time.At least in the hospital they can be ready for almost anything.My trial was great they would monitor vitals for over an hour ,and It wasent like I only had one person doing the job they had a team of about 4 people in the OR. I had great care. I guess I traded a office trial with full meds for no meds and a hospital trial.The first ortho told me that it is unclear if fusions help or not so he no longer does them,the ortho I have now first told me modern medicne does not have a anwser for me this was about two years ago and about 6 months ago he showed me what he could do that might help ,he would use two anterior lumbar plates one is called aegis and the other pyramid. I think they were just fda approved but I think for just one level so I think his idea was to use one brand for one level and the other brand for the second level .I asked him to give me the odds and he would not say anything.I asked him about SCS he said he used to implant them and said I could try it ,I asked him about causing perm nerve damage by not fixing the problem he did not feel it was an issue. but somthing tells me sooner or later it will be just like you say BionicWoman .In fact it was youre post that made me ask my ortho.Some people that had a fusion go wrong and then got a scs just wish they could of got the scs befor the fusion. I think what ever we chose we are taking a chance and every thing is a trade off.I just cant stand this pain anymore at least the scs can be taken out but the fusion cant. I feel like the docks are starting to change and go for the SCS more often now that they have many improvements to offer ,just my $.02 .BTW thanks to every one on this forum, witout it I dont think my trial would have worked at all! This site is helping lives good job!
  • Did you ever consider that you might have less pain if you lose the weight. You seem ok with giving up the morphine but not the extra pounds in search of better health.

  • Dave I gave up the morphine because it is a
    choice that I can control .Did you consider that for some people losing weight is not a choice because of pain that limits movement .I am built like a football player ,yes I have too much fat and want to fix this. The DR use the BMI index and acording to it almost all football players are morbidly obease, rember muscle weights more than fat. The BMI index just uses hight and weight .
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