[QUOTE=vlaud;4314907]i would think twice about getting a spinal cord stimulator its another surgery. i hear the leads migrate and break which requires surgery. There is also the risk of infection. and the batter pack can do the same. the trial is around seven thousaand and the surgery close to 60 thousand insurance pays but still. it sounds profitable and the compaines who make the devices bid for it.[/QUOTE]
Before simply skipping the Neurostimulator as a viable option for your pain management, I would undergo the trial and see if in fact you find the stimulator beneficial. I have had a Spinal Neurostimulator after 3 different fusion and a laminectomy procedures (the Laminectomy procedure was the first surgery, I just want to clarify that).
Do the Stimulator leads migrate? Yes. However, I found that the best possible approach for my situation was to have two leads installed. I did a tremendous amount of personal research on the various stimulators available and their strengths and weaknesses. Finally, I ended up at odds with the surgeon who was to do the stimulator implant and when he refused to use the stimulator brand which I felt was best for me, I found a surgeon who worked with the specific brand I wanted implanted.
I chose the Boston Scientific Spinal Neurostimulator for several reasons. [B][U]Please keep in mind that my selection was based upon the equipment available when I had my stimulator implanted and although it has only been about 30 months ago, the technology and features of these units is constantly being upgraded.[/U][/B] So, based upon the time I was to have a Stimulator implanted, the Boston Scientific 2 lead unit with each lead having 7 different programmable levels on EACH LEAD provided me with the best possible coverage opportunities and also allowed reprogramming of the leads should they migrate, which they did. I also preferred the specific battery used by Boston Scientific and the recharge methods were more flexable with the Boston Scientific unit than the others I considered. The Boston Scientific unit uses a battery which does not develop a "memory" and draining the battery completely before recharging it does not damage or impair the battery in any way.
[B][I]My spinal neurostimulator has been a tremendous device for pain management.[/I][/B] Yes, it took some getting used to. Yes, I had to have the programing adjusted a handful of times (maybe 3 or 4 in 2.5 years). Yes, the leads migrated slightly and with the flexability of the style of leads I had implanted, no surgery or any procedure is required to change the leads generating position and strength. Simply attach a patch which looks like the EKG leads which are used over the stimulator location and the technicians can make the changes necessary. Would I do it again now knowing what I know? Yes.
It is extremely important to realize that until the leads "scar in" to your body, the sensations generated by the stimulator will in fact move around in your body to some degree. The stimulator will often produce different sensations and even intensity strenghts based upon your physical position at the time of programming. Therefore, it is important to try different positions (lying flat, lying on your side, sitting in a chair, standing, etc.) while the technician is programming the unit. With the two lead option as well as the multiple programming levels available on each lead, you have numerous options of how the signal is delivered.
One of the things which I found particularly annoying is the fact that the stimulator unit itself is commonly surgically implanted in your upper butt, lower back area, which makes attaching the charging belt or stick on patches tricky for you to do alone until you get used to it. I am told the reason why the units are not implanted in the front abdomen is because during the implanting of the unit, to install the stimulator in the front of the patient would require the surgeons to "break scrub" and have to flip the patient over and clean and sanitize the frontal implant area. Well, I can only say that the inconvienence which the surgeon would incur seems minimal to the permanent challenges the patient must deal with in charging a device which is behind you.
I figured out the best way to do this was to lie on my stomach and have my wife mark the exact location of the stimulator unit with a permanent black marker. That way, I could stand in front of the mirror and see exactly where I needed to apply the battery charging unit and it allowed me to charge the unit without any assistance. It is important that the charging unit be as centered over the stimulator as possible to make the charging of the battery as effecient and quickly as possible. Even having the charging unit off center by 25% would sometimes almost double the time requirement to completely recharge the units batteries.
By also having the unit in your backside, you can not apply the charging unit and "sleep or lie" on it as the battery charging unit shuts off automatically when the unit overheats or reaches a specific temperature. On more than one occasion, I would fall asleep lying on the charging unit only to find that it shut itself off soon after I applied it so even though I had worn the charging unit all night, the battery was not charged and still required me to reapply the charging unit.
You can charge the unit while moving around the house, setting there reading the paper, etc. as long as the charging unit stays centered on the stimulator. Boston Scientific provides these double sided tape devices which allow you to stick the charging battery on the skin and for the most part, it will stay where you put it. Depending upon what I am doing when I charge the unit, I usually will use either just the belt unit or just the double sided tape to hold the charging unit in place. Again, having the area marked makes aligning the charger easier when doing it alone. Oh, and don't worry, the permanent marker usually wears off or washes off in a few days so in my case, using the permanent marker has not been a permanent ink spot on my back!
Sadly, it seems as though the years of taking narcotics for my chronic pain has severely affected my hearing, especially in my left ear. The stimulator beeps when the charging unit is not charging to inform you to address the problem. Often, I can not hear the beeping and my wife will finally have to inform me that I am "beeping" so I can fix whatever the problem is. The good which has come from this is it confirmed to my wife that in fact my hearing is impaired, not that I had been ignoring her as she thought. Of course I am kidding, well at least in part.
I just underwent a second stimulator trial for severe chronic pain in my shoulder. Three surgeries and the pain is worse each time so if in fact the problem can't be surgically repaired, I may as well at least attempt to "cover up" the pain, which is precisely what the stimulator are for. My doctor had to place the temporary trial leads 5 times, as everytime I got off the procedure table, the leads would have migrated so far that the unit could not be programmed to address the specific pain area. Finally, after extensive stitching of the lead and it's cover to my back, the lead stayed in place for the first 5 days of the trial. By time I had the lead removed, the doctor specifically said that he wanted the live xray image taken before removing the lead to see where it had ended up and sure enough, it has moved again, down out of the correct area by about 3".
I am still not certain if I am going to proceed with the implanting of this second stimulator as the surgeon informed me I would have to wear a neck brace for 8 weeks and would be unable to turn my head or move up and down during this period, which I find too restrictive and unacceptable.
In closing, I would have to say I am a HUGE FAN of the spinal neurostimulator and it has been extremely beneficial in my quest for pain control. Yes, it was extremely expensive, with Blue Cross paying almost $80,000.00 between the surgeon, facility and with the majority of the cost being for the device itself. My personal opinion is that if you are unable to manage your pain in the other acceptable methods, consider the stimulator and give the unit a try in the trial program. At least then you will know if the unit can help you. Best Wishes.