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Getting my permanent SCS on Wednesday...questions!!

BionicMomRNBBionicMomRN Posts: 37
edited 06/11/2012 - 8:52 AM in Spinal Cord Stimulation
I am getting my permanent SCS placed on Wednesday (May 11).

Both my PM doctor, and my neurosurgeon are telling me that I will have to stay a night or two for pain control...I thought this was an outpatient procedure, they think I will have too much pain to go home that day. Just how painful is this gonna be?!? I'm having the pulse generator placed in my abdomen and the 20 electrode paddle lead placed via laminectomy around T8-T10. I am a nurse, at the hospital where I'm having surgery, I really don't know why I am so scared about this procedure...even more so than my original fusion surgery. I have my pre-op appt with my neurosurgeon this afternoon, then my pre-admit, labs, EKG later today.

I think part of the anxiety is knowing that they are going to wake me up during surgery, I need to ask what type of anesthesia they will use...if I have to talk, it won't be a general with ET tube like last time.

I have been on pain meds daily for almost two years. I take Norco 10/325 four times a day, just got switched to Zanaflex yesterday from Flexeril, 2400mg of Neurontin, Vistaril three times a day. They have not asked me to decrease my pain meds before surgery, as a matter of fact, my PM doc yesterday told me to keep taking them the way I have been.

So, all this rambling boils down to...
How painful will this be
How long does the surgery usually take
How long did you have to stay for the implant surgery
Anethesia, what did they do for you?
I'm off work for three weeks, is that enough?

The trial worked really well for me, I am hopeful that this will be the answer for me, nothing else has worked for my pain so far. A pain pump is not an option as I am an RN and I cannot use ANY narcotics while working...

Thanks for any input you may have :) Yes, I am beyond being a nervous Nelly.


  • Calm down and take a deep breath. Its not surprising that they'll keep you overnight to make sure everything is right as rain. The laminectomy is gonna add some discomfort to the procedure but probably no where near as bad as the fusion. Its not like there drilling 2 inch screws into your spine this time. Every one is woken up during the procedure while your opened up. I vaguely remember when they woke me up because I cannot stand my stimulator being set to 60hz and that was the setting the Medtronic Rep had it set at, so I spoke up when I was awake. The whole room was laughing after that and then they put me out.

    I took two weeks off from work but I was put on no BLT restrictions for 4 months. Something about they didn't trust me to take it easy or something so they turned my family on me.

    You'll be fine.

  • How painful will this be ... not as painful as your fusion if you're like me, but I was pretty uncomfortable. My surgeon required me to stay overnight to get another dose of antibiotics, but never mentioned anything about the pain. I did not have a morphine pump, but I do think they gave me an injection for pain relief during the night, but I was up and moving around within a couple of hours after surgery.
    How long does the surgery usually take...mine was cervical and I think the actual surgery was 1 1/2 hours. But I was not awake at any point until recovery and that is when they turned on my stimulator and did the initial programming. I think with the cervical, they cannot have you be awake. At least that was my surgeon's stance on it. Plus, my battery is in my hip so I didn't have to be flipped over and you probably will be, right, since you're having your battery in your abdomen?
    How long did you have to stay for the implant surgery...I was in just overnight (23 hours so I wasn't ever really admitted)
    Anethesia, what did they do for you?...general anesthesia for me, with tube down the throat and everything
    I'm off work for three weeks, is that enough? My surgeon made me stay out for five weeks the first time around, but luckily I was able to work from home and started back after about a week, working a few hours/day and by week 3, I was putting in a full day of work. Could drive after two weeks. I'm unfortunately having a complete revision of my SCS on May 17 and everythign is pretty much the same as it was in Nov. 2009 when I had my original surgery. She told me 4 weeks off from work (no going to the office), and two weeks at least for driving, but she is putting me in a hard cervical collar this time so I might not be interested in driving at the two week mark. We'll see about that when the time comes. Like Dave, no bending, lifting, twisting for at least 6 weeks and probably more like 8 weeks. That is the way it was the last time anyway. Did your surgeon not instruct you about going back to work? If you're a nurse, I seriously doubt you will be released to go back after only 3 weeks unless you are able to do your job without the lifting and bending. Of course, every surgeon is different and you're having yours placed in a different area than mine was (and will be).
    I can't believe I'm facing this all over again so soon, but I've had a complete failure in the device and no one knows why, only that this is possible with electronics and I'm the one in a million that it has happened to. And I miss it terribly! Just ready to get it over with!

    Best wishes to you. Check in when you feel like it and let us know how you are doing. You'll be just fine, I'm sure.

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  • Exactly what my surgeon says about me!

    Okay, so he is definitely keeping me overnight, get a PCA again and hopefully go home the next day. I will have conscious sedation (propafol)...so yeah mostly awake. I had a terrible experience when I had the stim trial placed, I've had four kids and it didn't hurt near as much as having those leads placed. Not done by my neurosurgeon and I was 100% awake for that. My next door neighbor is the chief of anesthesiology at my hospital so, I'll get him if he's available. I had planned on working the night before, coming home to shower and going back in for the surgery. Surgeon says "no way"...I guess since I'm staying instead of coming home to my own bed, it's okay, better that I go in somewhat rested...besides it's a night I usually work so I'll have my own crew working (hmmm, maybe I should clock in...LOL).

    I'm still scared spitless about the pain, but my surgeon was very very thorough with me today, which does put me at ease. I know my St Jude rep, he was fantastic during the trial so I know I'll be in good hands there. I guess the reason he is putting the IPG in my abd is because I am not a very large person and I have severe pain right where he would have to put it if he placed it in my posterior. As a nurse, my job is very physical...but he said that because everything will be anchored that I won't have very many restrictions (that and the fact I just spent a year in a LSO brace...my body mechanics are pretty good). Like you said, I won't be getting all that hardware put in this time...but because I will have incisions front and back, and the laminotomy, and tunneling of the leads that I should expect to be quite uncomfortable, but in a different way, and that should resolve a lot quicker than the fusion surgical pain.

    I am so much more prepared this time. I've spent the last 4 days deep cleaning my house and spent $600 on groceries to stock up (4 kids, 3 of which are teenagers...it won't last long). I bought a recliner to relax in (I'm also working on my Bachelor's degree so I'll be doing homework from my recliner). I even bought a new Dyson vacuum, I know I'm not supposed to vacuum but I'm hoping the kids will think it is a new toy and use it for me :D.

    I wrote all my questions out ahead of my appointment and my surgeon and I went over them together. It doesn't hurt that I work there...I can chose my anesthesiologist and nurses. whew, I guess I feel better and just want to get this overwith already! I hope recovery will be better than the last surgery, not looking forward to being stapled front and back...but I don't wanna take all these meds anymore either. I know I'll never be completely pain free, but I hope this will make a significant reduction...working kills me, because I can't take pain meds and work, I'd risk losing my nursing license. Thanks for your input Dave, I hope your SCS is working well for you. I had a great reduction in pain with the stim trial so I am very hopeful that this will make my life more about me and not about my back!

  • So, nope they won't have to turn me over. I think that because I'll have incisions front and back, as well as tunneling around to the front...he expects me to be pretty uncomfortable.

    My St Jude rep will be in surgery with me, they will make the first incision while I'm out with the propofol, they wake me up for the lead placement to ensure the correct areas are being covered, they put me back to "sleep" for the lead tunneling and IPG placement. My rep will be in recovery with me to ensure I'm still being covered in the right areas and teach my husband and I about the SCS.

    For my fusion surgery I was off work for 8 weeks, then part-time light duty for a while, and I had to wear my LSO brace for a year. He really makes it sound like I will have limited restrictions this time...but he also knows I've had some political BS at work because of my back. We'll see I guess. There aren't any desk duty jobs available to plunk me into during recovery...and I work night shift so we are a skeleton crew most of the time, but very teamwork oriented (we have to be).

    My surgeon told me that because I'm having the paddle lead and IPG anchored that I shouldn't have many restrictions after my initial recovery...he told me it won't be like the restrictions I had after the fusion. My husband will be going out of town right after I have surgery (great timing :( ) I have 3 teenage daughters that will probably be just fine caretakers...two that drive, so I can send them to the store, to pick up their brother, to drive me around.

    Thank you for your input! I think I'll start another list of questions for the doctor to ask before surgery...especially about work!

    I'm sorry your SCS up and quit on you and you have to endure that surgery all over again, not to mention the weeks of pain you've experienced waiting for your new one! We are just a bunch of statistics out here aren't we. The percentage of "bad outcomes".

    I'm getting geared up to be a total pain in the ass patient (nurses are bad patients...LOL). :D
  • Like Dave said, don't fret. When I had my permanent implant, I can remember being woke up and talking with the rep. I was face down with my face in one of the open cushions used in spine surgery. I was coherent yet felt no real pain.

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  • I was going to add that the post surgery pain was not nearly as bad after the SCS as it was after my fusion (also cervical), but the post surgery restrictions were much tougher with the SCS and I'm sure that is because of the placement of the paddle up at C5/6 and the battery in my left hip. Gotta have time for all the stuff to scar in before they'll let you move around too much.
    At least this time with mine, the laminectomy is done so she won't have to mess with any more bone and I'm hoping that will help to make for less pain.
    I also didn't have staples in any of my 3 incisions. I guess they were stitched internally, then there was a glue like substance to hold them together along with tape. I was not allowed to shower for 5 days and could not submerge in the tub, hot tub or a pool for six weeks and that was the hardest part! I wanted a bath so badly becaue it is my best form of pain relief.
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