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Too paddle or not to paddle???? that is the question....

RwillRRwill Posts: 300
edited 06/11/2012 - 8:46 AM in Spinal Cord Stimulation
So I'm a few days post op from my trial... I was talking to my St. Jude rep this evening she mentioned something to me I hadn't thought too much about. My PM doc puts leads in similar to what I have now during my trial. The rep said that I may want to consider having paddles put in due to my age and activity level (I have 3 young kiddo's) She said there is less chances that they might migrate or move. The rep mentioned that my PM doc doesn't like the reps to mention this but she wanted to in my case because she feels that if she was in my shoes that is what she would want. I don't want to tick my PM doc off by telling him that I want paddles (I'd have to go to a Neurosurgeon). He has been a great PM doc to me so I don't want to mess that up in anyway. Does anyone have any suggestions or have you been in a similar situation??? I just want to do the right thing for me.....Thanks a bunch Renea'


  • Just my opinion here, but I think it is pretty low for the rep to tell you and then tell you the doc doesn't like the reps to mention it. It is so incredibly important for the rep and the doc to work together and not instill any doubt or question in your mind. I believe the PM doc who did my SCS would refuse to work with a rep that was found doing that to patients.

    The way I see it, if the rep mentioned her opinion about the paddle leads being something to consider and never said a thing about "the docs don't like us mentioning this", then it shows integrity and confidence on the part of the rep.

    Your PM doc is "the medical professional" responsible for your care. The rep is not. Yes there's a good reason for the rep mentioning the paddle leads vs the percutaneous ones, but to undermine the relationship you have with your doc, is not cool. Besides, your doc is the one familiar with your spines' history and condition, not the rep. There may be a reason why the paddle lead would not be a good choice for you. That's something you would be smart to ask your doc about. I discussed all of this sort of stuff with my PM doc weeks before my implant surgery.

    Not sure about the hospital where you get your care at, but in the one I had my implant done, even though a neurosurgeon was required, the PM doc was still in the OR and responsible for the implant. My neurosurgeon also assisted on my revisions, not because the PM doc couldn't handle it, but just based on my history with surgery and the condition of my spine. He was there if need be.

    Personally I would asked my PM doc about a paddle lead if I were to get a lumbar SCS. Just on durability and programmability alone.

  • C I understand what you are saying about the Dr/Rep/Patient relationship. But isn't the ultimate goal to get the best treatment for the patient? The fact that the doctor might not be giving the patient all the options is the red flag. And that the underlying reason might be that this is because he would have to send her to another doctor is deplorable. I applaud the rep for not keeping quiet.

    Renea I agree with C that you need to talk to your PM doc about this today. If you don't want to "rat out" the rep then say you found this on the internet. And if you still had doubts after talking to him you might want to think about getting another opinion. In the end you are the patient and you deserve the best treatment available.
  • I agree with both Kris-ny and C I would ask pain DR what would be best for me. As for my DR and Rep they both agree. Do what you think is right.

  • I think it's one of those things that my PM doc doesn't do paddles so he doesn't talk about them. I really think my rep was speaking to me woman to woman mom to mom. She has spent a lot of time talking to me and knows my age and that I have 3 small children at home. She knows that I'm a busy lady who wants to be able to live life to the fullest that I can. I am actually disappointed that my PM doc didn't explain the different options to me. Of course I've been to his office 3 times and have only seen him once(I see his PA). I understand your frustration "C" and normally I would be right on the band wagon. I am just feeling that maybe the paddles might be the way to go. The interesting thing is my Neurosurgeon apparently places them I'm kind of wondering if he was planning on doing paddles if my trial worked. He of course in a Neurosurgeon fashion didn't tell me his final plan. I left a message with him today so hopefully I'll get the 411 soon. I'm just glad that someone brought this to my attention and that I know there's another option..... Thanks guys!!!
  • As someone who only has percutaneous leads, I can assure you that its possible to lead an active life style with that type of lead. No offense, but is your rep willing to risk you to further complications by having paddle leads implanted? Are you aware that the NS will have to a laminotomy to implant the paddle leads? Kris-NY comments are out of line. Starting an argument or putting your PM doctor on the defensive is a bad move if your planning to move forward with the SCS. The leads during your trial worked fine according to you. Are you willing to undergo a much more complicated surgery without any guarantee that the paddle leads will work better? Remember the Rep works for the company that will be selling you the leads and she doesn't have an implant.

    My best advice is to talk to your Doctor and try to understand what's best for you.

  • I don't think Kris is out of line. She was stating her opinion and that's ok. I'm going to make this decision for myself I will take everyone's post for what they are, recommendations. I understand that my rep doesn't have a SCS but she also sees a lot of patients. She was nice enough to put a bug in my ear that gives me another option. I don't think she told me about the paddle just to sell something more expensive. Yes she works for St. Judes but not all people are after money or something to get them ahead or more points at work. Like I said before I honestly believe she is trying to help me. My rep knows that my doc will not do anything but percutaneous leads. I'm glad your leads have worked for you and I know they work for a lot of people. If I can possibly have more coverage in my back and a better chance of the leads not moving, yes I darn well will take the risk. I am well informed that a laminectomy will be preformed. I will be an informed patient who talks to her Neuro and my PM to get their opinions on what would be best "for me". I appreiciate your opinion but I don't think Kris deserved your response.
  • My concern is over the fact that there's a big assumption being made that the PM doc didn't mention the type of leads available because he wants to do the surgery and only implants percutaneous leads.

    Until Renea specifically asks the PM doc about the different leads, and finds out from himwhat he plans, he is being blamed for something with no real proof.

    So who is the worst person to have a red flag go up over? The physician you have been trusting your care to? Or the company rep you just recently met who is being unprofessional by casting doubt about a patient's treating physician.

    Yes the ultimate goal is to get something that will last, be effective in helping manage your pain and something durable. It is important to have as many cards on the table before making such a huge decision. A discussion with the treating physician would certainly be a good place to start.

    One thing that I personally worry about on forums such as this, is creating an atmosphere of distrust towards one's physician. I don't want to cast doubt towards any of my physicians nor do I want anyone else to do the same.

  • You're right in the fact that sometimes in this forum Physicians sometimes get ragged on. I think it's a place where people can vent about care they have received or how they've been treated. With that said it is probably a good idea to really think about what we are saying and what kind of message we're really wanting to send. I will say I have been pretty lucky in what doctors have come across my path. They have taken care of me and are continuing to do so. I know that life is not very easy at times now but i can't imagine how I would be without their care. I'll always be very truthful and upfront to my Physicians that is the only way to get total complete care. It is not that I don't trust my PM doctor he happens to prefer a method that may or may not suit me. I am a little suprised that he did'nt tell me about the 2 types then his recommendation and why. I still trust him and will continue with his care but I'm also going to talk to him and be open about the paddle. I assume that he will give me his opinion then I'll have the information to make the choice for myself. I want to say that in no way has the rep dogged my surgeon. She thinks that he is one of the best doctors they have that places trials. She knows he has a preference but she also gave me something to check into. If she recommened something that was crazy or something that I thought was completely outregous I wouldn't have given her the time of day. The only reason I payed attention to what she said was because someone had posted about paddles. I didn't know there was an option I thought it depended on what brand of stimulator you had. I'm definately not a push over and I believe I can figure out when someone is sending up smoke and are trying to influence my care in a way that may not benefit me. I understand that we all should be careful how we take in information from others like someone here on the forum, doctors, Chiros, Physical Therapist, Radiologist the list can go on and on. I have learned over the years to gather as much information as possilble think about it, pray about it, digest it and come up with a plan that fits me. Sometimes good ideas can come in forms we didn't count on. i think we should all be open to that but also careful at the same time. I only have one spine so I will guard it and take care of it the best I can. I will put my trust in my doc but I still like to have my eyes and ears open, it has done me good so far. Wow sorry that's windy I was on a roll...well I think, sorry very tired....Have a good evening~
  • I just talked to the nurse at my Neuro's office. He was going to place the paddles this whole time but didn't bother to tell me...oops on their part. My PM doc knows and so things are working out. I'm really comfortable about getting the paddles and I trust my Neuro very much. If he wants to place paddles then that's what it will be... Renea'
  • My surgeon put paddles in, but I'd been told that was what was going to happen from the get-go. They've worked out really, really well for me, I hope they work out for you too! Good luck!
  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,730
    I've found that the St. Jude rep (technician) knows more about the medical device that is being installed and it's workings than the Dr. who installs it. Just my own personal observation with 2 Dr. and 3 reps.
    Good luck, Jim
    Click my name to see my Medical history
    You get what you get, not what you deserve......I stole that from Susan (rip)
    Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!
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