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SCS adjustments

I'm 2 weeks post op, I have a St Jude stim and paddle leads implanted at T9. I have seen my rep 3 times now for adjustments. In my mind prior to surgery I assumed that once it was implanted they could set the stimulation to my lumbar section and right leg, however this seems to be a bit more complicated and the rep is having difficulty doing this. Either the stim ends up in my stomach, ribs or butthole area along with the areas that need coverage. Is it that much of an art to dial in the stimulator or will I always have stimulation in these additional areas. The areas I listed are incredibly uncomfortable, the coverage I'm getting is great but I really hope this isn't going to be the way it is. What is your experience with your rep setting your stimulator? Can I eventually expect coverage only in the areas that I want? Thanks.

Microdiscectomy/Laminectomy/Foraminalectoy L4/L5/S1 Oct 2009, Mar 2012
Laminectomy L4/L5/S1 Dec 2009, Oct 2012, Dec 2012
Microdiscectomy and Synovial Cyst removal Feb 2013
St Jude Spinal Cord Stimulator implanted January 2014



  • Hi, Richard!

    I am four weeks post op, with a Medtronic's unit. I understand your frustration with the programming, as I, too, have had trouble getting good coverage. It seemed that to get my lower back, legs, and feet (all the way to the toes) covered I was getting uncomfortable coverage in other areas as well - specifically my derrière and under my ribcage.

    What I have found (in my short time of having this) is that a LOT is determined by the skill-set of the programmer, as well as the fact that - as recently as your surgery was - there are issues with swelling, bruising, etc., which makes pinpointing coverage difficult, and changes may need to be made more frequently as the swelling goes down and healing sets in.

    My Medtronic's rep was unavailable for my appointment with her last Friday, and sent one of her associates. Who had the flu. Ugh! I came away from that programming appointment very unsatisfied. Part of it was my fault - as I was in such a rush to limit my posture to her germs - but also she didn't do a great job. I had to turn my power up WAY high, and the coverage was very uncomfortable. So I got in touch with my regular rep on Monday, and she met me yesterday. I am SO glad I called her - I almost didn't because I didn't want to appear to be a pest - but I came away from my appointment with the BEST coverage. Whereas the other rep had the coverage to where I had to have the power turned way up, my rep found awesome coverage that knocked my power down quite a bit, and that wasn't uncomfortable under my ribs.

    My advice would be three-fold. First, understand that the coverage you are able to get today may change significantly as your swelling, bruising, etc. goes down. That's a good thing. Second, don't be hesitant to have your rep take whatever time is necessary in your programming sessions to try and get the coverage you need. And finally, if your rep is not able to get good coverage for you, don't hesitate to have another rep try.

    Good luck with your programming and your SCS - I hope that it is a very successful and helpful thing for you!

  • Richard
    Becky said it perfectly. It's still early in your case and things will calm down. Your rep should be able to pull the stimulation from those areas with skill if they have it. I found that the skill of your rep is the most important and if your rep can't do it ask for another one.
    I don't know about your unit but I did talk to a St Jude rep before my first unit and went with medtronics. My second unit is a Boston SCI unit. The Boston unit was even easier to program then the medtronics.. In less then ten mins a Boston rep had my coverage moved to just where I wanted it and no where else.
    On my medtronics unit there is aprox 44,000,000 combinations of settings they can use so yes the rep is very important. There is no book on good settings we are all very different.

    On your St Jude unit do you have a pulse and width adjustments that you can make from your remote. If you can make these changes sometimes you can move the coverage in and out of some areas. Your unit may have these but you may be locked out of them right now. Ask your rep about it.
    Last thought when you get programmed make sure what ever position your setting in gives you good coverage. My medtronics unit I have to lean forward just a bit to get a better connection for programming. The BS unit doesn't matter. It depends on how the lead is placed not the unit.

  • I was told by my Medtronic rep that even though I don't have pain in my legs, the stimulation would always travel down my legs. I am hoping for an adjustment to cover more of my pain in the near future.
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