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What is the down side to the perm SCS vs trial ?

2

Comments

  • How did you get so smart? =D> .That was what I needed to know. >:D< ,I was worried it might make exersize harder :?
  • Thanks Dave, I did ask the ortho the nerve damage question ,and he did not think it would be a problem.I am starting to think he might not be the DR for me.
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  • I agree, I would seek out a second opinion. Nerves are funny, they don't like things pressing on them. There is always the risk of some nerve damage whether you opt to do nothing, have an ESI, Fusion, or even a SCS implanted. Maybe this doctor sees you as having minimal risk of something bad happening. You're the one who has to live with the consequences of your decisions.

    Dave
  • MAJORPAIN said:
    How did you get so smart? =D>
    An obsessive research habit. :loll:

    Well, that and personal experience, combined with an excellent neurosurgeon and pain management doctor who are both willing to indulge my information seeking behaviors.

    The main issue with exercise is that exercise to lose weight is very different from exercise to maintain health. On a maintenance plan, it's easier to engage in "lighter" exercise or other less structured activities and still burn the portion of calories that balance your intake with your output. When you're trying to lose weight, you have to burn enough calories to create more burned than you take in, which is most easily accomplished through structured cardio exercises.

    With the SCS in the picture, things get complicated from the very beginning where exercise is concerned. Certain stretches can pose a problem, which automatically puts you at a higher risk of an injury during exercise.

    When we're trying to lose weight, the ability to exercise at a higher intensity is extremely helpful, even just for short periods of time. But, with the SCS in the picture, the higher intensity workouts also significantly increase the risk of damaging ourselves or the system. Jerking lead extensions, tearing anchors loose, and pulling leads out of place are all things we have to keep in mind, especially during those 3am infomercials, when P90X and Total Gym claims of losing 50lbs in 3 months start to look like a really GREAT idea! :wink:" alt=":wink:" height="20" />

    I've been able to strike a balance between lower impact exercise, longer durations, and increased frequency, but it hasn't been the easiest balance to find. Right now, I exercise 6 days a week. I'm in the pool doing water aerobics 3 days a week, for 1.5-2 hours each session. On the days I'm not in the pool, I spend about 45 minutes each day walking on the treadmill or with my dogs, another 30-45 minutes each day using my recumbent bike, and 10-20 minutes 2 days per week doing strength training exercises.

    With that exercise regimen and a healthy, well-balanced diet, I lose 1-2 pounds a week. That's healthy weight loss and I'm satisfied with it under the circumstances, but I also know that if I were putting in the time I am now doing the exercise I was doing pre-SCS, I'd be losing 2-3 times as much each week.

    Another trade-off is that a lot of days, the exercise is so exhausting, I have little energy to spare beyond that. Many days, I exercise, feed my pets and myself, and that's all the energy I have for physical pursuits. The reason I continue so diligently is because I'm seriously focused on the end goal, which is to get my job back. I'll be the first to admit there are many days I could just settle myself on my bed and accept the relief my SCS brings me, without worrying about anything more. I've been classified as totally and permanently disabled, so it's not like anyone else is pushing me to go back to work.
  • Hi dave ,I would not mind charging the batt but limits of motion could be a bummer but if a fusion turns out to not be an option I think it would a easy choice to make in order to treat this low back pain. Could you be more descriptive in reguards to how it would limit movement,and normal every day things like tying youre shoes ,getting dressed,showering,driving a car,.I was in love with the scs when I did not need a pain pill in the morning felt like a huge weight was lifted off me,but was not sure of what the trade off would be.I am bummed today because I could be buzzing right now but I had to change the inplant date so I can get a third opion.I think this is the right choice but a hard one, my body is so worn down from pain and my DR wont give me pain meds.
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  • I would assume that motion limits would be more specific to the individual based on where the leads are and the IPG is planted. My right lead is located at T11-T12 and the left lead is at T12-L1. From what I understand, this is a little lower than most folks. The next part to consider is where they put the IPG. Mine is on the left side about a 1/2 inch above the belt line and roughly 4 inches from the center of my spine.

    With all this in mind, I am supposed to restrict my movements so as not to put undo stress or sudden movements on the muscle groups where the implant and wires are located. That's a tall order to say the least. The doctor who did my implant has recommended that I give up golf. Time will tell if I decide to comply with this request. I can tell you that sometimes I'll turn a little or bend to put my socks on and I can feel the wires pulling under my skin. It's a bit of a creepy feeling to sat the least. I have also woken up to a dull achy pin point type of pain where the leads are within the spine, especially the right side (had this pain during the trial but it was much more severe, but it still takes your breath away).

    It seems most people are given 2 months of restrictions after their implant. My doctor has placed me on restrictions for 4 months. I'm only 2 months in, so I've not had the opportunity to really push it yet. As far as everyday life goes, I really haven't noticed anything different. You just have to play it by ear and move forward as best you can. I'm a pretty active person, so time will tell how much this is going to crimp my style.

    I am pretty pleased with the coverage and relief that the stimulator provides. There's always a trade-off. I hope that this new opinion can give you a new viable option that will allow you to get back to an active life style.

    Good Luck.

    Dave
    MAJORPAIN said:

    Hi dave ,I would not mind charging the batt but limits of motion could be a bummer but if a fusion turns out to not be an option I think it would a easy choice to make in order to treat this low back pain. Could you be more descriptive in reguards to how it would limit movement,and normal every day things like tying youre shoes ,getting dressed,showering,driving a car,.I was in love with the scs when I did not need a pain pill in the morning felt like a huge weight was lifted off me,but was not sure of what the trade off would be.I am bummed today because I could be buzzing right now but I had to change the inplant date so I can get a third opion.I think this is the right choice but a hard one, my body is so worn down from pain and my DR wont give me pain meds.
  • Thanks Dave I wish you the best also,I used to be very active and now about all I can do is sit in a zero gravity chair all day,every once in a while I will go fishing on a boat ,its my passion and exersize but its hard to enjoy when the pain gets were I cant stand or sit any more,I could not do it anymore intill I was put on the morphine,their is somthing about being on the water that just helps my mind even if I cant walk when I get back in. It is so hard to do nothing when you are the kind of person that needs to be active.I think the scs will still help me alot in some ways even if a fusion is not an option but like you said its a trade off ,I think this important to know .hopefully It wont stop from fishing ,I guess I am lucky that my passion is not golf!I think I did see someone swing a club that had a scs I think it was a add.The DR was going to use a boston scientific unit what brand do you have ? Two DR told me this was the best unit,I think it can do lumbar and mid back too maybe at the same time, that would be cool.
  • What determines "the best unit" is the same as asking someone what their favorite car is. It's so subjective, that if anyone tries to bank on which one is really "the best" tell them not to waste their money. There are differences, but those differences aren't really enough to showcase one over the other regardless of what you may read or be told. Doc's have favorites of just about everything they use, from meds to hardware to specific instruments and lights. Some have different features, some have more features. Some have larger batteries and some have rechargeable batteries. The charging systems are all somewhat different in size and attachment, but if it works it works. The more important differences are whether it is a constant current or constant voltage system along with the type of lead or leads being used. You have to really rely on your doc to hopefully choose the one that best suits your pain syndrome. Of course there's always the insurance companies dictating which one they will approve as well as company rep support in the area you are living.

    Some patients get hung up on the size of the IPG or the style of the patient remote. In the grand scheme of things those should be the least of the considerations, whereas how effective it works should be the most.

    My leads were inserted just above T1 and are slightly staggered to give me coverage from C3 to C7. My wires run down my back to my IPG that is just below my beltline about 3 inches to the right of my spine. (about where a wallet would be in a back pocket). I tore my anchors loose doing yoga and normal LB stretches and exercises. Was a mess. I can tie my shoes if I sit and rest my foot on a step or coffee table without pulling my wires. Today I was washing the truck and I squatted down to clean the rims and could feel the wires pull and had to back off. I don't have enough slack to allow me to play golf anymore, but most people do not notice any lack of mobility except my structural limitations in my neck.

    Like BionicWoman, I use the treadmill and also hike the forest trails in our area. I use light weights and work out 2kg and 3kg balls. It is a challenge to pull back from the serious stretching, strengthening and weight training I did prior to my SCS. I can still scuba dive, but have to be careful with regard to getting my gear on and off and entering and exiting the water. It's a trade off I had to make, especially after tearing my anchors loose last year. That wasn't much fun and I don't wish to repeat it.

    Being out on the water is easy with the SCS as well as in and under the water. Fishing is easy, you just have to make modifications as to placing tackle boxes and bait up on a bench or cooler so you don't have to bend over as far. Now I wouldn't want to try and land a billfish with an SCS, but bass, trout, salmon, cod ... no problem.

    "C"
  • Did you say yoga and scuba wow ,It must be hard to over come the lead issues and do what you are doing.Maybe they will invent leads that streach.Looks like I will just have to make modifications for the billfish.I alredy make modifications when bending and try to put every thing were I dont have to bend to get it.What brings up My question about the brands of scs is I think most of the brands say for use after other surgerys have failed or somthing like that but the boston scientific site says somthing like after failed back syndrome OR intractable pain. This made me wonder if this unit might be more advanced and thats why they could say that and maybe thats why both my PM DR use them and both were willing to implant before fusion maybe it could be that independent 16 channel thing ?I am starting to think I would need to prepare for the scs implant and work on the weight and do alot of the exersize that I would not be able to after implant, I have a strong feeling that the DRs should have book to give to us before we have a scs temp and perm thak not only tells us the benifit but also the DOWN SIDE so we get the whole picture. Because like most things it is a trade off,and we need to know this.Maybe my DR would be willing to use this info to make this happen.For me the trial gave me an idea of the pain relief but not a good understanding of the drawbacks, but it did let me know that I needed to know more.
  • Jake, now you're starting to see the bigger picture. As C stated, the biggest difference between the different simulators is constant voltage vs constant current. The main reason they are recommended for usage after all other surgeries is that having the implant is life altering. Another reason is that the problem with your back still exists. Basically you may be able to have better pain control which will enable you to do more which can and most likely will cause additional damage to your back. This opens you up to suffering permanent nerve damage and I wouldn't wish that on my worst enemy.

    Take me for example, my back is stabilized. Odds are, I'm not going to do any further damage to my back. Granted I still have pain but that's from the nerves be broken. Basically the stimulator is most useful when your probably not going to do any further damage to your back.

    I suspect that your PM Doc is proposing whatever he can to help you. He doesn't do the fusion surgery, so his bag of tricks is limited. Although your docs means well, I believe they just aren't thinking it completely through as far as your total care goes and your long term prognosis.

    Keep us posted on what the second opinion doc has to say.

    Dave
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