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Trial is in....

I have a few questions. I knew that the leads are "positional" especially in the cervical area. Well, when I'm up walking I occasionally get stimulation on the left side, but not the right. When I'm sitting, I have to tilt my head a weird way to get any stimulation.

Question is, who has gotten the perm (cervical), with paddles? Was this a prob with the perm implant?

I feel like my trial is not going to give me a true feeling of how it will work. I'm going to call my rep/program nurse and see what she can do.



  • One of the problems with the trial is that the leads are just stitched to your skin as they exit your back. What that means is you're very positional. Once the leads scar in, the positional aspect will subside. I'm curious why they are putting in paddle leads. Based on comments from HaglandC in the past, she always indicated that they rarely use paddle leads for a cervical SCS. She gave a reason for it, maybe you can check past posts in the forum if you can find out why.

    On a side note, how's it going? Be sure to take some time and turn the stimulator off for a little bit so you can truly gauge if its working. I sure hope you have a successful trial.

    GOOD LUCK!!!!!

  • I have been turning it on and off, which I'm glad I've read others mention, as you have.

    I'm calling this morning to see about getting with the programmer again. If she can get it tweaked in the right places, I can really see this being awesome. Between the leads being all over and not having the stimulation in quite the right places, I'm trying to base my decision on what the potential of it is. Does that make sense?

    The rep, from BS, told me the reasoning for the paddles, with the perm, is because leads are so positional in the cervical area. Up until last week, I thought the perm would be leads and not paddle...

  • Hi mine was really strange if I moved my head forward it would turn off and if I tilted it backwards it would come back on..I tried leaving mine off for a while and then turning it back on but it didnt help me , I hope it works for you good luck!!!!
  • B ~ is HaglandC still around? I've looked around at posts, but when I find ones she's posted on, her name isn't linked to where I can send her messages.... There aren't many cervical SCS peeps around, seem to more thoracic/lumbar, so I really wanted to get more info from a cervical to see if they can help answer more questions.

    I totally get that they are not put in real stable, so there's gonna be movement. I'm just wondering because every time I've asked a rep "is the perm implant as positional as the trial?," they will not answer me directly. I'm getting a roundabout answer, which I understand, to an extent. One, they don't want to guarantee that it won't be positional, two, because if they do say its 100% better, and it isn't, then their ass is on the line for making a claim that they don't know is true. I do get that, but at the same time it makes me double think whether its worth going thru all of it to find out I have to sit and stand in an exact position to get relief.

    I went in this afternoon to have the rep reprogram, and he is awesome. In a matter of five minutes he had the stimulation covering much better than it was the last two days.

    Also, I think some of it (a lot of it) may have to do with the way I have to sit on my couch.... I almost wonder if sitting in a recliner, where it makes you sit a little straighter, would help... Hmmmmm

    Ok, I'm done rambling. Just stressing as my trial is coming to and end on Monday and I am going to have to make a decision on what to do.

    Thanks for the comments, and as always, for listening.
  • RickilalasRRickilalas Posts: 559
    edited 10/24/2012 - 7:05 PM
    Hi Mel
    I waited for a bit hopeing some one with a cervical implant would comment for you.
    When I had the cervical trial it was more positional then my lumbar was and the lumbar implant is still
    positional with a paddle. With time my paddle has scared in and is less positional. When I lay flat on my back and on my side there is a large differance that I have to adjust for. When walking and sitting I can pretty much leave it alone on one setting. When I was set up for the cervical implant it was going to be done with a paddle also and then
    surgeon said no that I will have to wait for my next cervical surgery. He also said he would still like to use a paddle but for several reasons he wont be able to and I would probally have trouble with a lead migrating.

    My understanding about leads and paddles talking with my surgeon, pain mananagement doc and reps from two companies are that paddles scar in better and do not move as much as leads (if you do the right things so they stay in place and scar in right) they do do two small laminectomys to tie in the paddle to prevent migration but I feel its the way to go if there is room for the paddle. They have several sizes.
    I have also learned some PM will do the implants with the leads you have to not involve a surgeon.
    I think it was Back that posted she has the perc leads but they still did laminectomys to attach the leads.
    (If this is wrong back let me know and I will change it)
    This is the first time I have learned that was even done and with the leads attached it would not be much different.
    You can go to the websites and see the leads and the paddle, to me the paddle would just be more solid but either way may work the same. I would be asking questions if they were going to use perc leads and just leave them loose.
    In my case they will have to place the leads down from the top of the spine because they will not pass my cord damage again and the scar tissue too. I can wait on that one LOL

    There is a lot to this and it is not a easy deal to go through and everybody has different thoughts on it to.
    Most people but not all will say the implant is better then the trial but if the trial goes good and then they implant at a different level that changes everything too.

    To be a positive tool on pain it has to
    1. Work on the type damage and pain we have
    2. It has to be installed right
    3. It has to be programed right
    4. The unit and connection have to be right also ( find Jeromes post)

    Remember its just a tool to help and really 5 days or so isn't much time to test.
    I do know that after implant and a skilled programmer it gets better after the first year and you get to where you don't need it turned up real high. Most of the time I can set mine to a level that I do not feel very much of it and still get good help.

    If you are getting feeling on one side but not the other it could be that the leads need to be moved or just reprogramed to find the other area. I have four reps that are all good but one really stands out on doing mine.
    Last two thoughts for the night
    Be careful when asked how much it helps you, most insurance wants 50% or more to implant so if its 40% to me that's 40% better but not for them. I had trouble with both arms and arm pits and it helped both.
    OK last thought I found the post that BACK was referring to. I don't know how to cut and paste on this tablet so I can't get you the link. I found it by doing a cervical paddle search on this forum. It was in 2009 and she was talking about the covering of the spinal cord being thinner in the neck and the paddle sent to much power into the cord.
    That might be something to ask the doctor but I am sire they can put limits on it with a paddle.

    OK with all the time it took me for this your trial may be over. LOL

    I sure hope the SCS helps you and this all works out
  • When trying to post to Haglandc, you need to look at posts by chagland (same person) I think when the forum changed there was some problem that they had to change their user name. Chagland is a one of the moderators on spine-health.

    Hope that your trial goes well.
    >:D< >:-D< : Karen
    L3-S1 herniation and bulges, stenosis, mod facet,ddd,impinged nerves,coccydinia
    discectomy/lami July 2011-unsuccessful
    adr L5-S1 Feb 2012
  • I posted a comment to you earlier but I think it was at one of your other threads but I'll copy it here as well :-). Anyway, I am so happy that your wait for the trial is over! Hopefully you are adjusting well and finding some positive effects from it! The first few days take some getting used to--if I moved too suddenly in one direction I would get zapped only to have all stim stop by changing positions (nothing painful though!). I was at the grocery store one time and as I reached up to get a can of beans, I got a sudden zap through my arm and dropped the can! (Glad it wasn't something breakable!). I forgot about the instructions NOT to reach up above my head. The leads are only held in place by a stitch so changes in movement may increase or decrease the stimulation or the leads may slightly migrate-as mine did-leaving coverage slightly different than it was initially. I have the paddle lead SCS and after 6 weeks now with the permanent, i still find positional changes in stimulation but nothing like i did with the trial. if i lie on my stomach to read however, the stimulation becomes so strong that my arm actually vibrates! probably because my back is arched and my neck and head are tilted back which is not a typical every day position(nor is it a position i was in during any of my settings programmed by my Medtronics rep). As the swelling subsides the stimulation becomes more constant and i still have a ways to go. If you go with the permanent placement i would be happy to try and answer any questions based on my experiences so far! feel free to PM me as well! I am finally reaching a point where my SCS is working better and the post-op pain/recovery is both minimal and manageable :-). I'm also taking fewer meds and lower dosages which i think also contribute to feeling better! I am anxious to hear how you are doing and what you think! Good luck!
  • I hope your trial has worked for you , with me I couldnt tell any difference only that it made my pain worse..Its good when something works to get some of us out of pain..its Friday!!!!!
  • backbback Posts: 190
    edited 10/26/2012 - 3:32 AM
    I didn't have a laminectomy when they placed my percuntaneous leads. I did however have a much more open back surgery when they placed my stimulator, 6 inch incision. They needed the extra room to properly place and anchor the leads, plus lots of scar tissue to navigate. When my battery dies, the plan is to pull the current leads and replace it with a lead array. That won't happen for another 2-6 years, depending on the life of my IPG. It's supposed to last 9 years, but since I use so much power and have to charge twice a week, we're figuring that it's gonna start dying around the 5 year mark.

    Hope everything is going well for you Mel.

  • Thanks all! I'm on day five, so far so good. I really just got used to it yesterday. The first few days I thought I was going to go crazy. I wasn't too thrilled with the buzzing/vibration, or how positional the leads are, but that's to be expected considering they're kind of just in there for the trial.

    I get my leads out Monday! Woo hoo! I'll miss the stim, but not all this godforsaken crap taped to my back! It's irritating the hell outta me... I've cut way back on my in between meds during the trial. Normally, my allotted 3xdaily isn't even enough, even with my patch, so I can definitely tell a difference with that.
  • Hi Mel that tape is a pain , I got to itching about 2.30 in the morning so bad I thought I would go insane , I took the back of my hand and just rubbed it lol, I ended up taking benadryl which helped the itching ..
  • By the time I was finished with my trial, everything was hanging on by a band-aid.
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