Spinal Stimulator implant for chronic pain?

@Gremlinertia I had a follow up with the consultant today and based on my response to the Dorsal Ganglion ablation and post procedure pain diary. He has recommended that I proceed with a neuromodulation implant.

I need a psych assessment and insurance approval but op should be within 3 months. The plan is a 2 lead implant along L1 L2 spinal cord. A Medtronic Intellis with adaptive programming.

I'll let you know how it goes and fingers crossed it makes a difference for me.

My implant surgery is set for Wednesday.
I have had an education session this week and will have another in the afternoon after the implant.

The device won't be switched to active for a couple weeks, I'm due in for a programming session in November and it may take quite a while before it's fully effectively dialled in.
I was surprised to learn just how much I'll be restricted movement wise for 8 weeks post surgery but, hopefully it will be worth it.

I'm hopeful that it will make a difference, that it will ensure I can resume a more normal life and not rely on opioids 🤞

I had the implant surgery yesterday.
Both surgeon and the Medtronic rep are happy with how the op went and the lead placement.

The op itself, was done via twilight anaesthesia as you are woken up after the leads are placed in your spinal cord to have sensate testing to ensure the leads are covering as much of the affected area as possible.
I remember portions of that, and there was even a bit of craic during it.

I had a programming session with the rep in the afternoon. Enough to get me using the device and learning the ins and outs of settings.
Lead placement has covered from left foot to my hip, and from my groin over my left hip and to my left kidney/mid back.

In use, I can turn on 1 at a time or both.
The control options allow both leads to be controlled as "1" as in I can increase or decrease both leads via up/down.
Or
I can use 1 lead active at a time, which is quite handy as it means when pain isn't firing everywhere that you can take a more tailored approach.
Similarly, being able to raise or lower the SCS output on the fly does mean that you can react quickly to increased or decreased pain.

The effect of the SCS is very uch affected by body position too.
For example, I might be sitting whilst I have the device on 3ma output and feel a bare tingle.
If I then raise my arms or lean my back on a cushion, the apparent strength can jump to the effect that a mild tingle becomes a very strong impulse, almost like an electric fence.

Since the op and in my 1st 24hrs of using the device.
It's definitely a welcome distraction, part of that is no doubt due to my having "new" pain at y incision sites.
The device itself, is very straightforward to use esp if you are anyway app savvy.

The stimulation certainly distracts from my usual pain, I don't know if that's purely the novelty of it.
I don't want to get too excited as over the years, I have had multiple interventions that gave me huge initial hope.
Via nerve blocks, peripheral ablation, dorsal ganglion ablation, MSCD and other procedures that all gave me an initial improvement before that benefit fell away.

I'm trying to balance my sincere hope that this works for me.
With the cynicism years of failure have hammered into me 😉
I'll keep the thread updated and my next programming session is the 11/11 and then I get the self monitoring option switched on too.

I was in with the PRI team yesterday to have some additional programming undertaken and to have the closed loop function switched on.
That function has made an immediate difference to my pain and comfort levels.
Hopefully the adpative nature of the function will further improve my pain management and will stay effective.

An update from a little further down the road since the "neurostim" adaptive programming was switched on.

The effect and improvement when the hertz pulse was widened from 20hz to 200hz was immediate.
I was sitting outside the waiting room before I went in debating whether to take opioids immediately or wait until the programming session was over.
I "knew" that I should wait until the programming session was over to ensure I could give best feedback on changes.

I was that sore going in, I really was near my limit.
Yet, 20 minutes with the rep, the nurse and the programmer and I left not only not needing to take a painkiller but travelled from Cork to Limerick without needing more.

Just being upright, let alone mobile has over the course of this affliction always been a trigger for fairly severe pain.
From the locus above and behind my left testicle and iliac crest, to radiating/referred pain over my left side from my outside toes to my left kidney.

The implant has made a huge difference to my referred pain.
I am still very sore when the pain strikes but, I am sore over far less of an area.

Still more to try via programming and neurological intervention so fingers crossed for continued improvement.

I had another programming session with the Medtronic Rep yesterday.
I had been disappointed over the past few weeks with the resurgence in pain at my primary locus.
The implant has been excellent at knocking back the referred pain, and I found the first few weeks after the last programming session also did a decent job at dialling down the primary locus, but in December it really did start ramping up again.

Over the course of Late December to yesterday, I would describe myself as being just as sore but in a far smaller area.
Rather than my entire left side, flank to toes.
It was primarily just my groin and iliac crest.

I kept a pain diary, kept tied in with the clinic and for yesterday's programming session.
The rep made quite a few tweaks and added an additional programme to the device repertoire.

I think that it's a case of my CNS adapting to the wafeform and pulse repetition over the course of use.
If I stick to a single programme or output level, within 3/4 days the primary locus will break through and spike my pain.
The plan for now is that I rotate my device across the output programmes on a more regular basis and the hope is, that will prevent my CNS adapting to and filtering a constant output.

In related news for anyone interested.
The invoice was added to my Laya account last week.
The total cost for the implant, including surgery and overnight stay in Hospital was €21734.
My insurance covered it all bar €200.

You're more than welcome.
In my case, the updates are as much for anyone else who finds themselves with intractable groin pain as it is anything else.
I know from trying to get on top of it here in Ireland, and indeed even the use of a spinal cord stimulator for the issue.
Is rare, published papers on cord stimulation use for this is vanishingly rare and with not enough participants to be really meaningful IMHO.

Yes by CNS, I mean central nervous system.
It's really quite amazing how quickly it will adapt and filter pain back in if left at a steady state on the implant.

I hope your post injection recovery goes well.