Medtronic Neurostimulator Questions

Has anyone had success with your stim? Has anyone had success in resolving issues past the basic technician level?

I had a Medtronic Stim placed last year after a semi-successful trial. I have not had any sort of success at pain management with it, period.

First, I've had 3 laminectomies(sp?) and a fusion at L-3-4-5. I suffer from pain in the lower back and into my legs, at times debilitating. Stenosis is the diagnosis but it can't be identified in any testing.
After the primary installation we were never able to get coverage in the areas needed. So we did x-rays and it was determined the lead had moved and we did a revision. Placed the lead back exactly where it had been previously and again there was NO coverage in the areas needed and we were dealing with the signal in my ribs.

So, a new doctor and another revision. And again the coverage would not go into all areas needed and we were dealing with a lot of signal in my abdomen and ribs. We have done many reprogrammings to no avail. In the PM's office we can get some coverage but after a few hours or days after, the energy moves up into my ribs or abdomen. I went through several Medtronic field techs including a senior tech, all to no avail.
I asked for more advanced help from Medtronic and as of yet all I have received is advice that my problem was probably due to lead migration, so we did multiple x-rays and the lead is exactly where it's supposed to be!

At this point I am receiving no help from Medtronic, they are not responding to me, or my PM doctor. I would love to hear any advice or thoughts in how to proceed? Has anyone else had help in resolving issues with Medtronic?

Thanx straydog.

At this point I use email primarily to contact Medtronic. For 2 reasons, first, after years of pain medication, sometimes my memory isn't good. So I have any response or instructions in written form. Second, it does provide proof of my attempts and good intentions.
My PM is also trying to motivate them into helping to no avail.

Sending a certified/registered letter in my mind is the 1st move in a legal battle. I'm not ready to cross that bridge. I also don't want them to think that's my goal.

Hi cwby - I'm sorry to have missed this. What sort of leads do you have? You mentioned laminectomy - so I'm guessing paddles? (which -should- be more stable)

Going back maybe 3-4 years, I had major problems with unstable stim patterns and the sort of back pain that would drop me to my knees. PM and tech both agreed that it sounded as though a lead (mine at the time were both simple perc. leads) had migrated and was stimulating tissue outside the epidural space. X-ray showed no migration. Pain kept occuring - there was a general ache, with a sensation of severe electric shock when tissues other than nerve were accidentally stimulated. More x-rays eventually showed the lead at a different level. That, and a very kinked end to the lead when it was removed, lead my PM & tech to believe that the lead was actually slipping in and out of place.

Does the pain change with any movement or posture? If it's not immediately obvious, maybe try keeping a record for a couple of weeks and see if something pops out to you.

What I'm getting at with all that - is that it seems based on what I've experienced with mine that it's quite possible to have lead migration that is dyamic and position dependent. I'm sure you know yourself the way your stim patterns can change whether you're sitting vs standing vs lying down? The lead moves relative to the cord while staying at same spinal level it's been placed at - or at least that's how I've been taken to understand it.

So - it may be that your lead is always going to appear 'in place' on x-ray because it's taking a particular movement to pull it and cause the pain you're experiencing. Then when you lie flat on the x-ray table the lead returns to its original position.

I hope that makes some sort of sense - I'm going on day four with little/no sleep and really struggling.

Really hope you can get it sorted out x

Laura

Laura,

We've done X-rays both laying down and standing. Leads are where they're supposed to be.

When the signal moves to my abdomen/ribs, it stays there. We program it and are semi-happy with the results and then the signal moves a couple hours later to a couple days. Once the energy moves, it stays moved, it doesn't bounce back and forth.

Each time we program, the tech runs a diagnostic. I've asked (begged) for a more intense, intuitive check but I'm always told there isn't one. The techs will shake their head, mumble about how unique my situation is and that they don't have a clue, but Medtronic will not respond to anything asking about whether it's possible the unit is bad.
Medtronic always refers me back to my doctors, who default to the field reps. 3 different doctors, 2 neurosurgeons and one PM, all default to the field reps who do the same thing over and over and it doesn't work!

Hi all-

Wow, Mine is doing the same. We try and try to get it where it needs to be, then a few hours or a day later it moves. Mine has the paddle leads and they are still where they were implanted also. In order to get it where I need it after it changes, without a reprogramming, it is to intense and buckles my knees.

From time to time during the reprogramming mine also looses signal. The last time the tech used my controller as he thought his had something wrong. I also have some issues getting it to charge all the way.
I really don't want to go through the surgery again if I can help it.

Take care,
Bill