http://www.nytimes.com/2008/01/08/he...tml?ref=health

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Pain Relief for Some, With an Odd Tradeoff

By TARA PARKER-POPE
For people with chronic pain, relief comes with a tradeoff. Bed rest means missing out on life. Drugs take the edge off, but they also dull the senses and the mind.
But there’s another potential option: implantable stimulators that blunt pain with electrical impulses. In this case, the tradeoff is living with a low-grade buzzing sensation in place of the pain.
The devices, which are implanted near the spine, are not widely used. They are expensive, don’t work for everyone and rarely offer complete relief. Industry officials estimate that fewer than 10 percent of eligible patients opt for the treatment.
But when they do work, they can be life-changing. Carolyn Stewart, 45, of Clifton, N.J., has lived with chronic back pain since she was 18, when she had surgery after a car accident. Then four years ago, a procedure for a collapsed lung accidentally resulted in nerve damage that caused excruciating pain. “I just want to sleep normally and not have pain that wakes me up every 20 minutes,” she said.
Ms. Stewart has been using pain drugs to cope, but side effects, including fatigue and constipation, only add to her discomfort. A few years ago she did a “test drive” of a spinal cord stimulator and experienced a significant drop in her pain. Insurance troubles delayed a permanent implant, but this month she is finally undergoing surgery to attach the device to her spinal cord. “It’s not going to be 100 percent,” she said. “But I will be happy with a 50 percent change.”
Not every patient feels that way. Ms. Stewart’s physician, Dr. Andrew G. Kaufman, director of interventional pain management at Overlook Hospital in Summit, N.J., described a patient who tested a stimulator and experienced “unbelievable” pain relief, yet simply couldn’t adjust to the sensation created by the device and decided not to keep it. “She couldn’t get over the background buzzing,” Dr. Kaufman said.
Still, most patients accept this vibrating version of white noise, says Dr. Richard North, a retired neurosurgery professor at Johns Hopkins who developed several patents related to the technology, although he no longer receives royalties.
“When they first feel the sensation they say, ‘That’s weird,’” said Dr. North, who treats patients at the LifeBridge Health Brain and Spine Institute in Baltimore. “It quickly becomes clear that ‘weird’ is going to be just fine if it replaces the pain.”
Chronic pain is a particularly difficult problem to understand and solve. Pain is normal after an injury or because of a health problem. But sometimes the nerves misfire and continue sending intense pain signals to the brain even after the injury heals. Dr. Vijay B. Vad, a sports medicine specialist at the Hospital for Special Surgery in Manhattan, compares the problem to a thermostat in a cool room. “If it’s 65 degrees in the house, but the thermostat thinks it’s 50 degrees, the heat keeps running,” Dr. Vad said.


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This is an article on spinal cord stimulators. The neurosugeon mentiond near the beginning of the article (North) is the doc who dealt with my SCS in 1986 before removing it, and the doc who just looked at my MRI reports and said there's nothing to do.