ONS implant Day

Today was the big day.  I had my ONS trial put in this morning and the day has been rather interesting.  They only used local anesthesia to do the entire procedure which was sufficient for the most part.  As they advanced the needle to place my left side lead, the very end of the area wasn’t numb, so I had a little discomfort there, and a little discomfort w/ one of the stitches, but otherwise everything went smoothly.

Once everything was implanted, the leads hooked to the control wires and everything tegaderm’d in place I was taken back to the pre/post-op room and worked with the reps to program everything.  We ended up identifying 3 treatment spots on my R side and 2 on my left since I predominantly have right sided migraines.  We then worked into putting those spots into 4 different programs for me work with from today (Friday) until Monday when I regroup with the Boston Scientific reps to reprogram.  The interesting part was trying to program while I was partially/mostly numb.

Afterwards my mom and I stopped for lunch and then I went home and took a nap.  The interesting and painful part happened when I woke up and felt like I had multiple needles being stuck in my head.  After trying to ice and only getting more intense pain, I decided to turn off my stimulator and that resolved a lot of my pain.  What had happened is that when I went to sleep, the back of my head was still mostly numb so my stimulator was on higher than I needed when I woke up and my head was no longer numb.  After some time with the stimulator off I was able to turn it back on at a much lower level and get relief from even some of my procedure pain.  So far, I would say I’m still waiting to see exactly how much this can help me.  I remember the first 2 days of my SCS being hard to make any decisions due to the procedure pain, and I’m at the same point right now- having to let the procedure pain ease more before I can truly see how well this is going to help with my headaches.

The Big Day…. SCS TRIAL

Well, today was the big day of my Spinal Cord Stimulator Trial.  I was told to be at my local hospital, Holy Name Medical Center, for 10 am, for an 11 am procedure.  My mom came with me as I was getting some sedation and wasn’t allowed to drive home.  We arrived an extra 15 minutes early, but it only helps with all the paperwork that has to be done.  I got my bracelet and got registered, was brought over to the pain management pre/post op area just like I had for all my epidurals.  This time they had me put a gown on, where as previously, I was allowed to keep my clothing on.  The representative from Boston Scientific arrived and started unpacking her stuff.  Then the anesthesiologist arrived and my pain management doctor.

My pain management doctor went over everything and explained that they would give me some sedation, then place the wires where they should go.  After that, they would wake me up and plug the leads into the rep’s computer to see what kind of coverage we had.  From there it would depend on how the first part went.  He also told me, that when I was waking up from the anesthesia, it was natural for patients to reach for the epidural needles and leads so don’t be afraid when u wake up and have people holding your arms down so you can’t reach for the needles and wires.  Once everyone was ready I walked to the procedure room and got on the table and they started hooking me up to the vitals machine and the IV medications.  I was given one dose of sedation which made me groggy, but I was still helping them hook me up to the machines, so when everyone was in position to get started, I got another dose of propofol and out I went.

I woke up a while later and the started asking where I could feel the tingling.  No matter what changes the rep made to the program, they could not get the tingling to occur in my back.  My pain dr reassured me that they would readjust it and get it there.  He started to move the leads and it was rather painful and i couldn’t help but moan.  After a few more adjustments didn’t resolve the issue, the anesthesiologist gave me more sedation so they could manipulate the leads without causing me more pain.

The next thing I knew, I was waking up in the post-op room.  My pain dr had already spoke to my mother and told her things had went well and felt he got the all the coverage he was looking for.  As soon as I was awake enough, the rep from boston scientific began working on fine tuning my stimulation and putting programs on my remote control.  While we were doing that by pain dr. popped his head in to say good bye and he would see me Monday.  Once I was done with the rep, I was offered something to eat and drink, so I had some cranberry juice.  Then the nurse took my IV out and I was given permission to get dressed.  My mom helped me get dressed since there is no bending, twisting, or lifting with the stim in.  The rep gave a good analogy to help you decide if you can do something- you can’t do anything that would untuck or put significant tension on a tucked in shirt.  To move in bed, the best way is to sit on the edge, lay onto your side and then log roll into the position you want to sleep.  Glad I learned how to move like that during PT school!!

Unlike past epidurals, I decided to take the optional wheelchair ride down to the lobby.  My mom ran ahead to get the car.  We then took a nice easy ride to the local kitchenette for a light lunch since it was after 2 and I hadn’t eaten yet.  Then we went home so I could take some of my pain medication and lay down.  It is not 8:20pm and the pain/soreness I’m feeling is really from today’s procedure and not the usual pain and burning that I have from my back injury.  Hopefully over the next 2-3 days the procedure pain will go away and I can tell for sure if this is just procedure pain.

All the wires and two batteries are taped to my back and a pulse generator in an elastic strap that goes around by waist/stomach.  This whole area/taped down section is very tender to pressure so when sitting against anything (especially my couch) I am putting a pillow above the area, behind my shoulder blades, to make me comfortable and decrease the tenderness!  I am more sore and tender than I expected I would be, but nothing I can’t deal with.  However, the representative did talk about using the paddles for the perm, which I know are more painful since a laminectomy has to be done to appropriately place the paddles.  That decision in down the road though and not something I should worry about just yet!!  For now, I’m gonna enjoy the buzz and pain relief it is giving me!! 🙂