Yesterdays post was an overview on Spinal Cord Stimulators. I find that as an option for treating pain, these devices are under represented in the online CRPS community. Many people feel they are a bad option because they rule out other treatment options (Hyperbaric Oxygen Therapy is a no go with any spinal implant). However, unlike the old days, SCSs are NOT permanent. People I've spoken to who've had their SCS removed in the last decade say it's an extremely easy surgery with minimal recovery time to have one pulled. So for me, right now, the SCS feels like a good option. It should help prevent the further worsening of my CRPS by stimulating proper signals from the Sympathetic Nervous System, thus improving blood flow, skin growth, hair growth, etc. And if I ever stop responding to it or it malfunctions, then I can turn it off, have it removed, and seek other treatment options. Easy peasy.
Having an SCS implanted is a multi-stage smorgasbord of doctor appointments. Honestly, I've had over half my femur replaced with far less pomp and circumstance. But, they're expensive and don't work for everyone, so it's a longer journey than most surgeries.
Part I- Referal from a pain doc.
Once I got clearance from my orthopedist, I still needed an official referral for the procedure. My pain doc immediately referred me to his boss, the head of the interventional pain clinic, for the trial (my normal doc does not have the training needed to do SCSs). I actually never met with the doc I was referred to- instead, I saw his Physicians Assistant. I'd met her before, during my initial intake into the clinic, and our appointment was short and brief. The meeting was primarily to make sure I understood the device and the procedure. Since I was a long time patient of the clinic, the appointment was about 20 minutes. I understand if you're new to the clinic, it's a 1.5 hour appointment with the PA.
Part II- Psych Eval.
Once the docs involved all sign off, insurance companies require a psychiatric evaluation. They want to make sure you're mentally up to the care and management of an SCS. SCSs aren't simply have a surgery and be done- once the device is installed, it has to be charged once every 1-3 weeks. You have to keep a remote control on you at all times for remote changes to the frequency- many people adjust the current if they'll be switching between sitting and standing, and for things like driving and sleeping.
The psych eval was pretty simple. There was a short interview done face to face, then there's a written assessment to make sure there are no underlying psychological conditions that need addressing before moving on with the surgery. There is also a pen and paper questionnaire about your pain. All told, I was in the eval for about 2 hours.
Part III- Questions and Answers.
This part is not a standard part of the procedure, I just happened to get lucky and my doctors office was hosting an information session on SCSs yesterday evening. The 2 doctors from the clinic who do the actual trials were there, as were 2 representatives from one of the manufacturers of the devices. It was nice to be able to ask all the questions I had, though out of 20+ prospective patients, I was the only CRPS patient there. Everyone else had spine issues. I have chosen to go with the Boston Scientific brand of implant for a wide variety of reasons. It's probably more than most people want to know, so I'll skip it for now, but if you're curious about my reasoning, please ask.
Coming up is Part IV- the Trial. To receive the final implant, a trial period is done. I should be receiving a call in the next week or so to schedule my trial. I'm worried about the trial, since I really want this to work, but my doctors office has a good success rate. Normally, 60% of patients who do a SCS trial move on to the final implant. My doctors office boasts an 81% success rate. I just keep telling myself that if it doesn't work, I'll find another option. Now if I could just make myself believe it...
Any questions about SCSs? Feel free to ask! If I don't know, I'll try to find out for you. And yes, personal questions about why I chose this are 110% welcome, too, not just technical questions.