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Getting closer to having my SCS...have a question though

RwillRRwill Posts: 300
edited 06/11/2012 - 8:44 AM in Spinal Cord Stimulation
I saw my new PM doc on Wed. and thank the Lord it went really well. I like him and he was very supportive and sympathetic. He said I was a perfect candidate for a trial, hurray.

I have to get a medical Psycological eval for my insurance, did anyone else have to do this? It doesn't seem like a big deal they just need to talk to me and answer some questions. I just wish I didn't have to waste more time it took me two days and 20 some phone calls to find a Psycologist who would do it.

So I have lumbar issues and have a question as to where the generator will be placed after my trial. The booklet and video I have says generally in the stomach or buttock area. I am assuming since mine is being placed in the lumbar area it will probably be my buttock. So here's my question do you see/feel the pack when looking at the skin? I just picture this lumpy thing on my butt cheek. It might be a dumb question but I gotta be prepared.

Does anyone else have the St. Jude model?

Here's to hoping I can get the trial by mid July!!


  • I've got my trial next week, and I had my psych eval I guess 3 or so weeks ago. I think pretty much everyone has to do a psych eval. It is no big deal, and most of it was very standard questions about social support, lifestyle, career, expectations for the SCS, and history of my injury and treatments. It's really no biggie, and my guy told me at the end that I had passed so it's about the only result in medicine you don't have to wait for :)

    There is a really long, really helpful thread on the boards about IPG placement: http://www.spine-health.com/forum/pain-management/scs-ipg-placement. I'm assuming your stimulator is for low back pain? Mine is going to be too, and they usually place the leads much higher than where the pain is (though everyone is different). My doctor said for LBP the leads are usually placed around T8 or T9, so while it's for lumbar pain your leads will probably be mid-back (but again it varies- I think dave has leads at L1 so definitely just ask your doctor where he anticipates placing them). With the leads that high my doctor said they are really moving away from placing the IPG in the buttocks because it puts more strain on the leads (although all the vids and brochures I've gotten still always show it in the butt, and it seems like many on the boards have them in their buttocks). So, your abdomen or your side might be an option. I'd recommend talking to your doctor about comfort (because it sounds like the IPG pocket tends to get aggravated and be a minor source of pain), cosmetics, and any preference you may have. Those are the three areas I covered with my doctor besides the obvious one of where it is least likely to pull the leads. I felt like I got a vote, but ultimately my doctor is going to make the decision.

    Good luck with the psych eval, and hoping they get you scheduled for your trial really soon. The waiting is the worst part!
  • SCS yes you will see it and feel it But not if you have clothes on. Its has to be close to the skin to beable to recharge it. If you need more infor just PM me.

  • The only visible sign of my IPG is my scar. I'm a thin framed person and the IPG is in my upper buttock area. Even with clothes off you cannot see any lump or shape in the area. I think that each person's physical characteristics, coupled with the skills of the doctor doing the implant has a lot to do with how well an IPG is placed.

    Each doctor has their own preferences for placement based on the experiences they have had with their patients and the number of complications or revisions they've had.

    The way I see it, if it provides help with my pain management and is accessible for charging, I really don't care where it is and what it looks like.

  • From what I have read, here and other places, they don't like the abdominal placement as much because it is more invasive and they have to make incisions on front and back. Mine is on my left hip and treats cervical pain. You cannot see it (I am well padded, I'm afraid), but you can feel it. I think the cervical area where the paddle lead was placed is much more noticiable since a portion of the bone was removed there. Long hair covers that up though!
    I learned as I was going through this process that the psychological evaluation is very common for most insurance companies. I was offended at first, but got over that quickly. It was a simple process, but I had to sit a long time and that was not easy with my back pain. He mostly talked with me about my expectations and I felt all of that was to make sure I was being realistic about them and also to insure that depression was not an issue.
    Good luck to you with you trial. I hope it will go well.
  • Just about everyone does a a psych eval. They're trying to determine if you truly understand SCS treatment and whether you are able to deal with an implant. Don't worry to much, you'll be fine. Lala is correct my leads are much lower than the average bear. Cheri has leads in the same area as I do but doesn't seem to be as positional as I am.

    My IPG is a hair above the belt line on the left side of my back near the hip. I don't have anywhere near the irritation with my IPG that others do, but that's probably just me. I wish it was about 1 inch higher because when I sleep on my back my left SI Joint usually ends up being inflamed for a couple of weeks. Pretty much like a princess and the pea type of thing, very big pea.

    Painkiller is correct in that the IPG is fairly close to the surface so you can recharge the unit. I look at it this way, its behind me, I can't see it, if anyone else has a problem with it, its their problem.

  • I have had the ANS Eon ( St Judes) for about 11.5 months now. My IPG is in my right buttock area. It does stick out a little bit, but not really noticeable unless you look hard. And yes, you can feel it . Do not worry over the Psych eval too much. Its just like everyone has stated. My leads are placed at T10. Do not freak yourself out over this whole thing, its pretty easy compared to other surgeries.
  • My neuro said they have batteries that last 5-7years but you guys are talking about recharging...how do you recharge it?
  • Yes the batteries do last anywhere from 5 - 10 years. You will receive a charging system with your SCS. With my ANS system, you just plug it into the wall and place a rubber pad over your IPG. Your battery will recharge within a couple of hours. I only need to recharge about once every three weeks. Not to worry, they will give you manuals that instruct you exactly what needs to be done. The most important thing with a SCS is that if you feel its not hitting your pain correctly, get back with your Rep and get it reprogrammed. I've had to reprogram mine at least every other month so far. My Rep gave my her cell phone number to utilize whenever i needed. But you must tell them when things are not working out. They can not read minds.
  • Thanks for answering my question. I have a couple more. Does it give you a low battery notice? Also,when you charge can you sit for example and like watch tv or read or do you have to be laying down?
  • There are both rechargeable and non-rechargeable systems in use. Your situation and doctor will generally determine which is best for you. Each company has their own version of a recharger with slight variations in design. Depending upon placement of the IPG, (position, depth, muscle tone) some people can charge while walking around, others while sitting or sleeping. It just takes a bit of experimentation to figure out what method works best for each person once the pocket heals enough to allow a full charge. Many can only do partial charges early on as the incision and pocket heal. Each system has an indication system either audible, visual or both that will alert the user as to the charge status. It's smart to learn to monitor this and to learn consumption rates so you can plan your charging times around your daily activities and schedule.

  • Thanks C. It sounds like there is a definate learning curve to the SCS. It feels good that I have a place to go for questions.

    Lala- Glad to hear you SCS is coming up soon. The Psy eval seems pretty simple and I don't have any worries about passing. Most of my pain is in my legs, they drive me nuts. I have some back pain but it seems to be outshadowed by my legs. I am hoping they can cover both areas of pain.
  • My Psych Eval was with a pain specialist psychologist.
    He said the part for insurance permission was minor but we would take advantage of the time to work on how to evaluate if the trial is working. We came up with some goals to achieve during the trial. Mine were reducing some of my medications and increasing the time I can walk and stand by amount of time.

    It's more helpful to have concrete items to evaluate during the trial than the stupid pain scale.

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