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A list of questions for the trial...

Lala329LLala329 Posts: 283
edited 06/11/2012 - 8:44 AM in Spinal Cord Stimulation
Hi guys,

I had my psych eval last week and am going for my final appointment to go over everything with my PM doc to schedule my trial, and I'm brimming with questions getting ready for the appointment. Just as an update, it looks like my hardware is staying put- I get the final verdict this week, but with pelvic hardware they apparently usually like leaving it in place...

1) I'm very interested in tips for avoiding the placebo effect during the trial, or tips on how to best test things out with the trial. I'm a little worried because I know there will be pain from the trial implant as well as activity restrictions, so I guess I want to make sure I really get the most out of the trial and evaluate it to the fullest extent possible. I'd really appreciate any tips to help make the trial as successful as possible in terms of my ability to decide whether or not it helps enough to go forward with the permanent one.

2) Did you need pain meds the first couple days from pain from the trial implant? I'm going to be off all meds for the trial, but I was wondering if I'll be likely to need them the first few days from the pain of the procedure itself?

3) How much input did you get over the brand/model of your stimulator? My PM clinic uses 2 different brands, and I don't know if I will get any input. Obviously I know my doctor will make the best recommendation, but with all the different models and features I don't know if it'd be best for me to do my own research so I'll have an opinion?

4) Any recommendations for IPG placement on a thin female? I plan to go ahead and go over this with my doctor even though it is a little premature. We think the leads will be at T8 or T9, and I'm really thinking I would much prefer to have the IPG in my abdomen than my back but I know docs tend to prefer the back so they don't have to flip you. But, I'm thin enough I get uncomfortable in hard back chairs because I can feel the vertebrae poking out so I imagine a battery anywhere in my back will be uncomfortable.



  • Try not to over think the trial so much. I know it's difficult not to do that, but over analyzing is almost as bad as the placebo effect. I had so many questions and no one to ask, so I know how frustrating it is.

    Every doc has their own recommendations on what to do or not to do during the trial. I was told to just go out and do whatever I felt I could do. Only limitations were to be careful and not snag the wires or drop the controller, since the leads are only stitched to the skin where they exit. During the trial there's no concern with the leads scarring in, the concern is more about whether or not you feel any relief.

    One thing that I did when I was questioning whether or not I was getting a placebo effect, was I shut the unit off for a few hours. When I switched it back on, I knew just exactly how much it was actually doing for me.

    I did not experience much discomfort from the trial itself. My leads were threaded in from between C7 and T1, so I was just a tad sore between my shoulders. When the leads were removed, I didn't even feel them come out.

    As far as IPG placement, it goes a bit beyond what sticks out and what is convenient. I too am a thin individual and my IPG was placed in the standard area of the upper buttock. It's one of the few places on a thin individual that has enough fatty tissue to help comfortably place the IPG. Another concern with placement is the tunneling required for running the lead wires. When I had my revision done on my IPG (loose wire) I discussed at great length with the doc about moving the IPG to the abdomen. He explained to me that he has seen more complications with lead migration in those who have abdominal IPG placements. He feels that the strain on the wires is far greater with that placement and has also had more pocket complications there.

    As to what brand and model to go with, I would definitely discuss that with the doc. Many folks believe it is simply a matter of what brand the doc prefers, but it goes beyond that. Depending on which brand, one is a constant voltage system, while the others are a constant current system. Many docs have bought in to the constant current systems since they claim to automatically adjust for increases in impedance. Also some of those systems have wireless remotes that allow a person to make adjustments "easier". I have done a lot of personal research on all of these and although some folks do have good success with a few constant current systems, I have also seen more that report dissatisfaction, lack of good coverage and EMI issues with them. With the constant voltage system, I've yet to come across anyone that has EMI issues and they also tend to be far more stable once the leads have scarred in.

    Or the decision by your doc could be as simple as which company has better rep support in your area or which one your insurance company will approve.

    Bottom line, if it works for you, does it really matter which system it is ...

  • Haglandc answered all your questions very well. As for pain meds, you will probably get some for your discomfort. In my case, i only used one the night of the procedure. One thing i forced myself to do was get up and walk. I started a few hours after getting home and walk everyday. Only started out a short distance but went further each day. It seemed to keep everything sort of loose and not much soreness. Just remember that you do not want to bend, reach or lift over 5 lbs for about 6 weeks. This was the hardest part for me. But as stated, do not over think this thing.
  • You really need to settle down here and stop over analyzing this. Read the SCS Trial Faq's. Hopefully the trial will provide some answers for you.

  • Thanks Guys.

    C- You answered my questions so well. I especially appreciate the heads up on the whole constant voltage versus constant current. I was able to do a little research of my own on that before going to my doctor, so that was tremendously helpful because I could actually have a meaningful conversation about the differences between the brands.

    I know I overanalyze these things, but the more I research and analyze the more in control I feel over the chronic pain where really there is very little control. I do appreciate the reminder to chill out about it, though. Definitely something I need a reminder on!

    I've got my trial scheduled, so fingers crossed. I'm feeling much more prepared for it thanks to all the support from my SH friends :)
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