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Experiences with SCS Trial Needed

2

Comments

  • According to the St. Jude web site, the sustainable frequency depends on the number of Stim Sets in a program. There is a chart comparing St. Jude Eon Mini, Medtronic RestoreUltra, and Boston Scientific Precision. For all the vendors, the maximum frequency is 1200 Hz for one Stim Set. St. Jude and Medtronic have the same frequency limitations for one to four Stim Sets. Boston Scientific drops off faster than their competitors, to 130 Hz for two Stim Sets contrasted with 600 Hz for the EON Mini and the RestoreUltra.

    Does anyone know what frequency their favorite programs use?
  • Cheri, I don't know about North Carolina and Tennessee, but up here in the Northeast, neurosurgeons don't do SCS trials. Period. St. Jude reps know of none. The best I can do is find a Pain Management doctor, with lots of SCS experience, in a hospital with neurosurgeons on staff.
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  • I was twilighted during insertion but was alert enough to answer when I felt stimulation. My trial was unsuccessful due to stimulation was felt in both legs only and not in my left hip and buttock where I needed it. When they were taking it out they tried to move it and see if I could feel it elsewhere. The lower they moved it, the less I could feel it anywhere. Then I felt nothing anywhere. The Dr. says she felt that my scar tissue was hindering the signal from the stimulator and is sending me to the Neurosurgeon to try and make an inscision through the scar tissue and try while on the table to see if he can hit the right area. Yeah, I can hardly wait. I feel like I should change my name to Mrs. Guinea Pig. I still have hope though.
  • Thanks for correcting the record. Monib's entry was based on some old ANS literature I've read while researching everything. The biggest thing with the stimulation is to find a setting that you are comfortable with and is able to block out the pain. If you can accomplish that goal, who cares what settings you use except maybe to compare notes on what works for you so maybe someone else can see if those settings would benefit them. That's a pretty tall order being we're all wired a little bit different and the leads are in different locations.

    Dave
  • I don't know how it all works...I have four leads and favorite program is at 90 but it uses the battery in a day. I have the Eon Mini from ANS. The 60 works well too just not strong enough for me.
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  • My point exactly below.
  • Despite your experience and some of the others painful experiences with the trial, mine was a piece of cake. I had no sedation, no versed, only locally injected lidocaine to numb the insertion area prior to them cutting the small access. I had two trial leads inserted between C7 and T1 and when they were removed at completion of the trial it was painless.

    Monib, the Medtronic RestoreUltra is the SCS that is capable of more patient programming control than other SCS's. (called TargetMyStim) It is a very cool feature and one that I am lucky and grateful to have.

    Robert, welcome to Spine Health. I hope you don't give up based on this experience. I'm sure that the doc feels badly that he was unable to get your trial going. Speak to him about the experience and see what kind of conclusion he has come to.

    By the way, Acupuncture is very cool! Not long lasting relief, but any relief is better than no relief!

    "C"
  • Brothers, are you serious? That SHOCKS me that neurosurgeons don't do them? I would honestly refuse to have it done. Wow. Or fly further south. After what I experienced in my trial with the PM who didn't have enough experience with tough cases, nope.

    I talked to 2 neurosurgeons in 2 states since we moved in the middle of my treatment. Both did the final placement, but had pM anesthesiologists do the trial UNLESS a patient was difficult. That could be that the PM trial was unsuccessful or something about their case had the NS do their trial. When my rep called the NS to report how horrid my trial went and on the first night, didn't look like I would have any sort of trial, he gave her advice on what to try the next day, but if that didn't work, to pull my leads out and have him, the NS, do my trial again for me.

    So yes, Robert, I had the separate NS do my permanent. He was managing my care all along, and had only sent me to the PM to have an "acceptable to him" amount of conservative treatment, although i had already been through it all. We had just moved to a new state, and he had his own rules and regs about what he makes sure happens. Apparently what my other docs did or did not do did not matter to him. But he is the world-renowned NS and trains on the SCS internationally. Edited

    Also, Robert, yep - that was me always pushing into my buttock and hubby was trying to nicely tell me how while he was glad it made me feel better, did I really have to walk around like that? lol I asked if he would dig his fingers in hard for me in the center of that buttock, but he declined. Wonder why. lol

    I had had 3 surgeries worth of scar tissue. My rep also told me after the fact that my PM was not inserting the epidural needle at the right angle and that he had more experience with another brand than the one I had. I honestly think that with this clinic, folks go to PM first, THEN go for surgeries. I had already had my 3 surgeries and only got sent back to PM due to the reasons stated above. As I was in the recovery room after the trial trying to get ahold of myself, the pm doc actually walked in, sat down and nervously asked me if I had had any surgeries. WHAT?????? WTH did he think all those scars were??? Clearly, he did not look over my records and just walked in and treated me like a number. He will NEVER touch me again.

    For the paddle lead trial, my NS puts you in the hospital for 2 days, during which he puts in the lead but entirely differently - no threading of leads. Because of a higher risk of infection, you must stay in the hospital. But, if after 2 days you report you get relief, he goes straight to the permanent placement, so you are done in 2-3 days. (Paddle leads are placed by removing some bone, called a laminotomy, and sewing the lead right up at that level to the fascia, rather than anchoring down below as percutaneous leads are done.)

    Wow, I'm still in shock that neurosurgeons don't do them up north. Freaks me out a little! Move South!! lol

    Take care,

    Cheri

    Post Edited by Authority Member haglandc
    Name of medical professional removed.
  • Sorry, I stand corrected. The litature I was talking about didn't have a date on it, but was posted in early January of this year.

    I was not putting down one brand over another, so if anyone took it that way...I am sorry. I know that certain brands work better for different things. I think it has to do with the doctor and what they are comfortable with. I will say I wish I had a little more control like you do with the Medtronic but for some reason my doctor choose the ANS for me. All that matters is it is helping to control.
  • I just wanted to post a follow-up to my previous post. While I had a difficult trial, my permanent surgery implant this past Thursday was much easier. Even though my nerve anatomy was different, my Dr. had the staff take detailed x-ray pics during the trial so when it came to the permanent implant he had them to refer to for placing the leads. I do remember them talking to me about the lead placement a little, but that was about it. Afterwards he said that the procedure went extremely smoothly.

    Now, I am just referring to the procedure itself. The recovery for the permanent implant is obviously more difficult than the trial.

    Please note that my Dr. was board certified in pain management and anethesia. My neurologist had referred me to him because he didn't have experience with the SCS and in my neurologist's opinion my PM Dr. was the Dr. with the most experience for the SCS in my metro area. So, what I am trying to say is that I don't think that you absolutely have to have a neurologist for a difficult case. What I think you need is a Dr. who has a lot of experience with the SCS and that in my area a PM Dr. was the one with the most experience, not a neurologist. So, in my mind what you really need to find is a Dr. who has the most experience in your area whether it be a neurologist or a PM Dr.
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