I wrote previously about the advice I would give someone who is thinking about getting a Spinal Cord Stimulator (SCS). I focused primarily on the potential for what I call “phantom pain,” and what the device manufacturer calls “overstimulation.” That’s an important feature to understand.
But I realized there is one more thing I would like to have known before I got the SCS - the fact that there are literally hundreds, if not thousands of settings they can try with you, to try to find a mix that works. There are three different settings they can change on your device, each with multiple choices in it:
(1) Voltage - Your remote control has, for each program, seven different power levels (1-7). But the tech can change those so that 1-7 now mean something different. For example, power level 1 may be 1 millivolt and power level 7 may take you up to 7 millivolts. But the tech can reprogram it so that power level 1 is now 2 millivolts, and power level 7 can take you to 14 millivolts. The key thing to know here, though, is that while sometimes a stronger power level might help you, it is also possible that it can irritate your nerves to such an extent that you start feeling new neurological pain that you never felt before, even before the surgery (this is what they call “overstimulation,” and it can be painful). Safest thing to do if that happens is to power it down (or off) and leave it down until you feel better.
(2) Pulsing - The signals sent to your spine are not necessarily sent continuously. The power might be sent for 20 seconds and then be off for 10 seconds, then on for another 20 seconds and off for another 10 seconds, and so on. These pulse settings can be varied to all different cycling approaches. The time spent with the pulse “off” can allow your nerves to relax, and thus perhaps allow your body to tolerate an overall higher voltage level.
(3) Location Stimulated - Your SCS will likely have one lead going up one side of your spine, or possibly a different lead going up each side of your spine. The computer that is built in with the battery device implanted in you can send the power up either lead (together or separately), and can even “light up” individual spine levels (each one inch section of each lead can be turned on or off separately from all the others). The tech can experiment, based on where you feel your pain, with which segments of your spine to “light up.”
When you count up all the different combinations possible from these three tools in the toolkit, there can be literally thousands of different programs they can try for you. Your remote control can hold 21 different programs at once - after you have tried all of them the tech can, essentially, wave a wand over you and give you another 21 different programs to try.
Some of you probably already know all this but I thought it would be helpful for those who are considering getting an SCS. No one told me about all this prior to implantation, so I hope this helps some of you…