SCS…finding the right one & imaging post implant

Yes, Med Tronics makes a MRI safe unit. I have it for low back pain. After many tweeking sessions, we finally have a good setting for me.

I do agree, although mine has helped so much. I still have bad days. I live in fear of what could happen with this device inside of me. What if I ever want it out or if it ever needs taking out? I ask myself prior to surgery but the pain at the time made me go for it.

My unit can be tweaked at anytime as long as I have free of charge. I have verified this with the medtronic reps and my doctor. I am not sure why this is not everywhere. My reps are great though.

Do your homework. It is not as easy of a surgery as the doctors makes out. I would not do it again. But it has helped me.

Hi Sunny,

I would suggest talking to the technical support people (NOT just the regular reps) at whatever company you are considering. I can tell you that I have a 6 yr old Medtronics unit (I believe that it is the Medtronic Restore Ultra), and I am NOT allowed to have MRI's. I actually had a very detailed conversation with Medtronics about this issue just a month or so ago, as I am a veterinary student about to start my clinical rotations, and I needed to know exactly what the safety margin was for me in regards to working around MRI machines (knew I couldn't have an MR myself, but needed to know whether or not it was even safe to be around the magnet when it was not actively scanning). I was told by the two technicians I spoke to on the phone, that the unit cannot be exposed to magnetic fields of greater than 10 gauss, as it could 1) irreversibly destroy the unit's programing, and 2) heat up & give me one hell of an electrical shock. I just met with the hospital director/chief of radiology here this week to find out where the 10 gauss line is, and it turns out that not only can I not go in the room with the MR unit, but I cannot go into the control room, nor can I even get within about 20 ft of the MR room from the hallway (that's how strong and penetrating the magnetic field is)!

Now, my unit is 6 yrs old, and they may have improved them since then. But that being said, my guess is that even if you do find a "MR safe unit," they still aren't going to want you to get MRI's of the area where the unit & leads are implanted. They'd probably only approve them as safe for MR's of things like heads (if the unit is in your back) or distal extremities, and my guess is that they'd be limited to low-field MR machines (lower strength magnet). But again, it is something that you are going to have to clarify with whatever company you choose. And one other potential problem with MRI's is that even if it was 100% safe to MR your back with an SCS implanted, there is no way that they are going to be able to get a good image, because even the teeniest tiniest fragment of metal (think a tiny metal shaving from the tip of a nail, barely visible on radiographs) causes a HUGE artifact on MR that basically obscures everything in the vicinity. So the SCS leads and battery are likely to cause an ENORMOUS susceptibility artifact, basically making the MRI completely worthless.

Skeye

Post Edited (skeye) : 3/17/2016 7:02:22 PM (GMT-6)

Well there is a lot of homework for you to do, it will not be a easy decision.
One thing to ask about is if there will be wires hanging down on the outside of your body and if you could get those tangled up...or get them caught on anything...
So read everything, make a list of questions, don't just talk to reps and clients and then think about how it will effect you...
If the tens units help you then this might also help, my take on these is that its supposed to distract you from the pain like a super charged tens unit. I was given this decision a few years back and declined, but because 1. I don't heal up good because of other auto immunes that I have and I would need to be on a prophlaxsis antibotic, so the risks of infection for me is higher than normal so I chose not to do this......

Hi Sunny I understand you having intestinal problems with taking long term opoid medications. But what about the possibility of getting an implanted pain pump that infuses pain medications directly into the spinal canal? There are several of us that have them and I was told when I got mine that it was MRI compatible. Might that be a viable avenue for you to consider with your condition?? Just a thought I had when reading your post.

I wish you well! and Good luck to you!

White Beard

Sunny, there is a huge difference between oral medication & the medications used in pumps. The medications used in pumps is in concentrated form, much stronger than oral medications. Usually when a person gets a pump they have exhausted oral medications, meaning none of them are effective in helping to reduce their pain & have ran out of options. A trial is done to see if someone is a candidate for a pump. I would do a pump any day over an SCS unit. The thing with a pump is you receive the medication around the clock, no clock watching waiting until its time to take another pill. Because the medications are so strong in a pump most patients end up on a smaller dose than what they took orally. This has been my source of pain mgt since 2005. Visit Medtronics web sites & read about the pumps. Take care.

@Straydog and White Beard:

After looking at the procedures for both the pain pump and the SCS, I don't know if I can have either done. I have a very abnormal spinal cord--for one thing, it's 8" longer than normal. Stretched b/c of Spina Bifida going undx until age 20. Cannot have lumbar punctures or anything like that. Typical spine ends at L1. Mine ends at S1-S2. Very dangerous to do any messing around near my spinal cord. Also have trouble with spinal cord deformities further up, like at the levels that control bowel and bladder. I am panic easily, so I guess I should consult my doc BEFORE I do any further reading about either. I have to say though that the pump looks like a fairly good option!

Thanks again.

My doctor made me believe it was a breeze. It was not. My back surgery was less pain and easier to get over. I was frustrated with charging the unit over the incision and really not knowing what I was doing at first and being in pain. The device is just under your skin but it is a four inch cut. When you have the trial you can't take a bath for the whole time you have it. UGH I wouldn't go through it again. But fortunately it is working pretty well at the time.

Sunny - it is correct that you cannot shower during the trial - it is sink/sponge bath only as your trial leads are connected to an external stim unit. They'll often give you a bag/carry case thing to carry it round in to make sure it doesn't catch on anything, but you've basically got a lead running from the external unit to your spinal cord - it's the main reason (or at least I would imagine so) why trials have to be kept relatively short.

Admittedly my experiences with my stim surgeries (3 battery, multiple lead revisions) don't seem to be the norm, but aside from one lead replacement (several years in) that required the removal of substantial amounts of scar tissue & partly due to how rough the doctor was also caused nerve root bruising, my stim surgeries haven't been overly painful - and certainly far less so than either of my pump ones have been. But I would think this would also depend on what sort of leads you have ... all mine have been percutaneous or micro paddle, which don't require laminectomy for placement as the regular paddles do.

Have had plenty of healing issues with both though...my healing is poor anyway, but on average my incisions have taken 3-4 months to close and have had issues with them opening again down the track, foreign body reactions to sutures and that sort of thing.

I am not off pain patch! I have tried but currently on Fent patch. I want off so bad and going to try again soon.

I healed just fine from the surgery. The trial everything is on the outside so you can only sponge bath. (so they say) I put what I could in ziplock bag and slipped right down in shallow bath. I am OCD about bathing. I take one every am and one every pm.

My problem was anxiety of what have I just done? I let someone put a foreign object inside of me. OMG! What if something goes wrong? I really don't understand how to operate it. How to charge it. Now I have to sit still a few times a week for 2 to 3 hours and charge this thing up. I don't have time for this. Now I have a program that I only charge once a week and I it is not a big deal.

Every time I have pain on left side I think it has to be the unit. It never is. Oh but it is a sensitive area. I don't know about holding a child on that hip.

These are just some things that cross my mind.

Sunny you know with a pain pump (if it is a viable alternative for you) you might not have the intestinal problems with the pain meds. Oral pain meds circulate all through your entire body and affect all your systems. The pain pump by passes all that and the pain medication is put right at the source of the pain, in the spine. That is why it takes so little to have such a great affect, and also it is not getting into all the other systems of your body.

For me I am no longer taking any oral pain medications, all I have is the pain pump that constantly infuses a minute amount of morphine into my lower spine. For break through pain, I have a PTM ( Patient Therapy Management) it is a small device about the size of a small flip style cell phone, it came with the Medtronics Pain Pump, and it is preprogramed by my pain doctor. Anyway for break through pain I just put the device on my stomach right above my pain pump and press a button and it will cause the pain pump to infuse a preprogrammed bolus infusion into my spine. Mine is programmed so I can only give myself a bolus every two hours, and a maximum of ten bolus's in a 24 hour period. If I try and give myself a bolus and it hasn't been two hours since my last one, the PTM will simply let me know it is not time yet and how long I have to wait before I can give it. So there is no chance of over dosing with giving bolus. Also when you go and have the pump refilled the doctor will down load the information from the pump ( he puts a device similar to the PTM over your stomach where the pain pump is) and he can tell how many times you used the PTM to give your self a bolus dose. He can also reprogram your pump to increase or decrease your infusion rate and amount of the bolus dose and how often you can give them. Really a neat device!

For me this has been a real Godsend! I only have to go in every six months for a refill. Of course if I have a problem I can always call them and go in. I will say I haven't had the problem with constipation that I had with taking the oral pain medications. Before I was on 40mg OxyContin every eight hours and had Percocets for break through. I don't miss those days! The pump has been so much better!

Just thought you might want to hear an bit more about it. Talk with your Pain Management Doctor and see what he thinks is the best solution for you. I might add not all pain centers do the pain pump. My pain management doctor referred me to the University of Indiana Pain Center in Indianapolis which is a good three hour drive one way. They done the evaluation and implanted the pain pump and they have taken over my pain management.

I wish you well!

White Beard

Sunny, before visiting with your dr, at least go to www.Medtronics.com & read up on the pumps. They have a very user friendly website. Its very informative for people to read about them.

Everything WhiteBeard stated is true about pumps. I am on much less pain medication in my pump than what I took orally. Plus the pump saves the liver, nothing from the pump hits the liver.

Char, I will answer your questions about pumps & multiple areas of pain. No, the pump can only target one area of pain. People with pain in more than one area have to decide which area is the worst & if a pump will work for the particular dx.