spinal cord stimulator again

[metronycguy]

here we go again, tried a scs percuteous trial 2 weeks ago, couldnt get coverage, so now schedules for a laminectomy
lead implant this week.
i dont know why i am so anxious worried about this, i guess becuase of all the complications i had with the previous implanted scs. the original one never really worked, it never had good coverage of the affected area. it end of abscess and forming a granualar at the lead. i had a staph infection in there that went unreported after i was cultured and sent home . this doctor doing the surgery is a neurosurgeon and specilzes in scs implants, he does not do any other neurosurgery anymore.
i guess the reason i am so anxious is because the doctors office sucks IMO. my original PM doc and implanter referred me to him.
i had problems with his office from the get go, and with the last percutaneous procedure i was unhappy with the follow up.
about 4 or 5 holes were made in my epidural , and when moved off the table to the stretcher in the or i had a extreme headache. in the recovery room the headache lessens while lying down over time , and withing a couple hours it was down to a slight to moderate headache and i was able to be picked up. the hospital or doctors office never followed up , even though the epidural lead had to be removed in the recovery room, since they couldn't duplicate the converge in the or, so i was sent home with nothing inside me . just a bunch of holes in my epidural and even one in the caudal area.
now a laminectomy lead implant is scheduled, however no one from the doctors office ever called me to go over what meds i am supposed to stop taking 3 to 5 days before surgery. on Friday i even called the office and inquired about this , and they said they would have the nurse call me back. which never happened.
when the original epidural trial was scheduled someone called and wen through my meds and i asked if i could take mobic , and they said yes no problem. i get to the outpatient sign in and they they are saying mobic has to be stopped 3 to 5 days before. they almost did not do the trial and i had traveled about 60 miles with arrangement for overnight made.
the representitive for the scs device is havign all the contact witht me, and i dont know if he is lying or being a used car lying salesaman.
allegedly this surgean is the biggest implanter for these scs in this area and also teaches for the the company.
the numbers i was quoted was hundreds with zero infection rate. if this is true, it is great.
however i ran this by someone i know from another online forum that implants them in another part of the country a Anesthesiologist, and he said the zero rate sounds too low and the hundreds sounds too high, the average infection rate is 5 percent so 1 % would be great.
he asked for the reps name and is going to do some checking on Monday when he is doing surgery and his rep is there.

[GoBig]

Just a word to my brother from another mother. The fact that you did not get results from your trial tells me you may not get results from the implanted device.

there are two main companies with devices. Medtronic and Saint Jude. The SJ device has more programability. The fact that you are even talking with the rep is inconmprehensible. You should be working with the Docs office. Estim devices are not always the best choices for neuropathy. I was told that by the rep after surgery. I will check in on the post before morning.

[metronycguy]

in the usa the big names are medtronics, ans and now Boston scientific , which is a previous advanced bionics company. i never heard of st jude
the interaction with the rep rather than the doctor does concern me. i never had this before with my other implnat.
in fact i was so pissed after not receiving a pre surgical phone call to check on my meds the customary 5 days before the surgery , i requested to speak to the surgean, they said he wasn't going to be in till Monday, i have to travel 60 miles to the hospital one way for pre surgical testing, i told the office i had an appointment for presurgical testing at 2pm on monday. i needed to leave by noon to make the appointment , if i didnt get a call back from the surgeon, i wasnt going to show up.
i also emailed the rep stating my frustrations, the rep went on to answer all the questions the doctor should have answered, however i noticed he prefers i call, not email, seems he doesn't want a paper trail. the rep does seem a bit too pushy , i know it should work and if it does work it will be great.
as far as the trial not working and going on with the implant. i have had the epidurual types leads before , i have a lot of scar tissue and i big epidueal space, so lead placement using the percutaneous method is not working. i am sure if it did work it would move.
the laminectomy procedure is a bit different, they put you in twilight, do a micro laminactomy to expose the dura. position the lead, wake you up on the table , turn it on and check for coverage, if the coverage is satisfactory , they put me back to sleep and implant the device. they cant do a trial on a laminectomy , infection factor i think would be too high. from the coverage i had on the table 2 weeks ago, with the epidural , i have a good feeling it will actual work, i di feel the coverage in my big toe and than in my pinky toe. i think if with the lamy procedure if had full converge of my foot , or at least the toes, it would be a success, the coverage of the big toe felt quite nice on the table, however i need all 5 toes covered.
the doctor it turns out is out of the country till today, i was expecting a call from him today. i still have time tomorrow to make a couple more cals , and as far as i am concerned , i don't have to show up, if i dont feel my questions are adequately addressed before the day of surgery ,By THE DOCTOR.
the guy i know who implants them said make sure the doc has done 5 in two years, this guy is saying 100's, so maybe he is the man.
laminectimy are supposed to be a better procedure from what i have reAD today, a couple studies show that 3 years after the surgery the lamy types were still doing well as compared to the percutaneous leads.
anesthesiologist are the primary implanter's of the percutaneous leads, only neurosurgeons can implant the laminectomy type.
i also think the lead for the lamy is larger, more of a paddle, it is inserted in the duramatter and secured better then a percutaneous lead.
where

[GoBig]

The rep does not want a paper trail. Keep the email on your computer. That would be called a direct sell. I would be curious to know the company of the rep.

SJ baught ANS this last year so it would also have a viable product. So you are correct in calling it an ANS device. I dont know of any anesthesia docs implanting devices unless neuro is not around.

I would still go and see your doc. You can always make an informed decision later. I am glad to hear that your trial seem to be helpful. I was only told by the rep and my doc that the devices had a lower rate of being effective in CE Pt. Thats you and me.

I take 3600mg of neurontin and only gas up the estim when the pain is at its worst. It acts more as a distraction than a pain relief. Many pt have great relief with the device I was on eof the very few that did not have luck. My surgeon did not want to take a second shot at it because of hardware and scare tissue.

Get a diet coke and a bag of bbq pork rines for the road. Enjoy the sceenery, its only 60miles.

peaceout

[metronycguy]

boston scientfic is the owner of advanced bionics now , the precision plus system is their scs.
i think the majority of scs now are placed by anesthesiologist .
they can only do the percutaneous procedure so that is why more of the placement nowadays are epidural.
think about it , most of your pain management doctors are anesthesiologist, they will make a hell of a lot more money implanting scs than writhing prescriptions.
the manufactures have evolved the device over the last 30 years to make the placement of the epidural leads a lot easier with less technical expertise needed, they do not have to be a surgeon.
i am more confident with a laminectomy implantation than a epidural, epidurual tend to migrate a lot easier than lamy. surgeans have better technique than anesthesiologist.
if i had known about a neurosurgeon that specialized in implanting the devices , and know what i know now,
i would have went with a experienced neurosurgeon.
i am on about 100 mg of oxycontin/oxycodne a day , plus lyrica and usually 100 mg of ultram a day , i have many nights where the pain starts breakthrough at 8 pm and and i have some vicious nights where i could double the normal amount .

[metronycguy]

well i had the implant, still down near the hospital staying at my friends House assumed i would be able to drive home today, but in way too much pain. pain at the incising, they made 2 holes the lamini, the first one did not have good coverage , so i i believe he did another lamina one level lower.
used the bone between the laminia to secure the paddle
i was a wake the whole procedure, seems no mater what they did i couldn't get coverage of my toes 234. the paddle lead was placed in the right spot, so i am hoping that even though i don't feel tingling inn my toes . it will cover the area. doc said the nerve damage may be so bad that they cant get me to feel tingling there,but will still scramble the pain signals from that area. there was a lot of scar tissue , the doc tried to remove some to get a better connection
i am not sure if it is working since my regular med level is double due to the pain from the incision, so i don't have any pain yet in my toes, a couple times i thought i was getting pain in my foot and i changed the scs program , and so far it has gone away.
i had a 101.5 fever the night of the surgery, i called the doc , he said ithad to be coincidence , since what went on in the or woulnt cause a fever that fast.
i have gotten the fever down to 99 and lower without tylenol now.
i have this weird blister about 4 cm by 3cm just ourside where the battery bandage is. it kooks like amber color and poddible plasma filled, will have to all the doc about that tomorrow .
theu used a lot of novocaine on my back and pain killer through the iv...

[dejerine]

Metro,

Thanks for sharing details of your experience. I don't dare predict success to anyone for fear it might add to disappointment if things fail, but I am very happy you got through this, admire your brave attitude, and hope it is worth it. We are pulling for you.

[metronycguy]

htnaks dejerine,
i still have a lot of pain in the incision where the laminectomy's were performed to insert the lead,
i thought i was getting some pain relief , but now i am not.
same scenario as the other ones i had implnated , cant get the stim to reach the area or kill the pain. for some reason my pain has been in my big toe this week, it is either big toe or toes 3,4 , and sometimes ankle top.
i am going in this week to see the surgeon for the follow up and get it reprogrammed. there are 4 programs on the scs,
they did say that not to worry about it if it isnt working , that it takes a couple programing sessions to get it tuned in, especially in the healing process. so we will see.
at this time i am not very confident that it will work.
i guess i have been hearing these claims by the reps and doctors that make all the money implanting these things.
however if it does work obviously i will be exceptionally happy.
i hear there is a new version of oxycodone out that is the metabolized version , i will ask my pain management doc .
this scs should work on me, but they just can seem to get the right spot. i dont know why there is so much scar tissue at t11/t12 i have never been opened there before