Wednesday, March 23, 2011

Q and A: Neurostimulators

As you know from the last post, I am considering having a Spinal Cord Stimulator (SCS), aka neurostimulator, implanted in my back to help with my flank pain. After I researched the neurostimulator on my own, read the packet provided by my doctor about the device, trial period, and the surgery, and watched the video from St. Jude Medical, I was asked to come up with a list of questions to ask the rep. I am showing these in case any of you are considering this surgery. The answers to these specific questions were not clear in the reading material or on the site. Some of my concerns were addressed on the website, but these answers were given to me over the phone by my rep (summarized):




Is this permanent?
It's not permanent. It can be reversed – it can be taken out if it doesn’t work – if there are issues, infections, etc.


Does the battery ever run out or need changing? How do you I change them?
I would have a rechargeable battery – the rechargeable battery lasts the longest, is the smallest. The type of SCS I would have is called the Eon-Mini. The battery in it lasts 10 years or longer if used on the highest settings. It could last longer, just depends on how much I use it and how high of settings I use it at. To replace the battery after 10 years, they make an incision over the battery pack, take it out and replace it. It is a lot less invasive than the actual implantation surgery and heals a lot quicker. A 2”-3” incision is made over the battery pack to access it and replace it. The battery pack is inserted about 1/2"-3/4" below the skin. The battery replacement surgery takes about 20 mins.
The battery is charged wirelessly, at home, transcutaneously (through the skin). There is a "wand" that is placed over the battery pack for an hour or so, while sitting (watching TV, etc.); this is done every couple of days to once every couple months, depending on how much I use the SCS determines how often I need to recharge….can take like an hour or so….
I can check my battery's charge anywhere from once a day to once a week, it takes about 10 seconds.


Does it need maintenance other than charging the battery and replacing the battery after 10 years?
No


Can I shower or swim once everything is healed? Take baths? While healing?
Not while healing. Once healed there is no problem with any of these.


Can I use my cell phone while using the SCS?
There are no problems with cell phones that are known to date.


Can the ER use a defibrillator, a regular one?
Yes, generally, especially in the ER. If they need to use a lifesaving device they will. They will turn off the SCS first via a magnet in the ER and use the defibrillator.  


Would I need to wear a medical bracelet or carry something on me to let EMTs know I have a SCS?
I would have a medical ID card (like my EDS ID card from EDNF). No need for bracelet unless I want one.


What happens if the leads moves or how do I even know if they do? If they move do they have to go back in and re-place them? How do they do that?
The leads moving, called migration, doesn’t happen that often. If it does I will know because the sensation will be in a different location than it was when the device was placed. They can do a test to see. If need be, if the leads migrate, they can go back in and replace them or put them back in their location. There isn’t any way to know if something will move in a patient ahead of time. This would require an incision to reach the leads and re-situate them.


Would my battery pack be placed in my buttocks or stomach? Can I lay and sleep on your back with this in? I lay in bed often because of other issues in my body besides my back, would this be an issue?
Not an issue at all, I can lay on them as much as I want. If the device is turned on too high for comfort while laying on it, I can just turn it down.


How big of an incision do you have in your back when they do the actual surgery?
2"-3” incision where battery goes in (in the buttock area) and roughly 2" in the spine where the leads are placed.


Can I use an electric heating pad on my back afterward? Electric heating blankets, etc.? Can I use electric massagers?
Yes, may have to turn SCS off while using massager if uncomfy, but heating pads are fine.


Can I see chiropractors?
Yes, as long as they know where the leads are and be very gentle, no twisting of the body in rough ways. They must be very gentle for the first bit of time while leads are healing/settling inside of me.


Can the leads break inside of me? Has he ever seen the leads break in his patients or the battery pack leak?
Could happen, but he (the rep) hasn’t had anyone that it has happened to. This is just like all of the precautions; anything can break, but unlikely.


What’s the difference between SCS and occipital neuromodulation? 
Occipital neuromodulation devices are generally used for patients with severe migraines, though they’re not FDA approved for that. Can use a SCS and ON at the same time. It would require two separate devices with two separate battery packs, used simultaneously.


Can you hear the buzzing of the SCS while it is on?
No 


Is St. Jude Medical affiliated with St. Jude’s Children's Hospital?
No. St. Jude’s Medical is the largest medical device distributor, but not in any way associated with the hospital network. 

xo
dani

2 comments:

vivisonga1111 said...

Very helpful, thanx!

www.encontactos.com said...

It cannot have effect in reality, that is what I think.