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Does Spinal Cord Stimulation work?
My new PMD is asking the insurance to approve Spinal cord stimulation for my pain, I'm worried about it please any info is appreciated thanks. also he wants me to go to Aquatic therapy, I have CRPS IN right great toe, foot, up to my lower back. also he put on there transpertation is needed and my husband told him that he wants to be there for me but the pmd still put it on the papers what should i do? When we went to the PMD today a nurse told my husband that men usurally don't stick or go to these DR. appt. with them, I can't imagine not having him there, and I do give him credit for putting up with me you could say, brave soul. I love him so very much.
Life is like the ocean, it can be calm one minute and the next a wave will knock you off your feet, it's up to you to get back up and take control.
Sunshine, Bill went to all my appt.s he also stayed in the hospital when I had surgery....I also love him very much...cuz I am a real handfull
........I love cats, I just cant eat a whole one by myself......

What can I do about the dr. requesting transportation for me? I didn't ask for it. Well I'm going to go watch a home movie talk to ya tomarrow, take care.
Life is like the ocean, it can be calm one minute and the next a wave will knock you off your feet, it's up to you to get back up and take control.
Sunshine, if your dr. feels you are a candidate for SCS, and the insurance company approves it, you will have a trial stimulator for about a week or so. If you obtain 50% or more pain relieve from the stimulator, then your doctor will arrange for a permanent SCS.

Aqua Therapy has been a life saver for me. In the water, you can move around freely and it feels so good to be able to move. For RSD it's a great way to get exercise and regain some range of motion. The warm water also reduces swelling. For me, it is also a good psycho-therapy and has restored some self-confidence.

As far as transportation, call your doctor and tell him you have arranged for your own transportation. There should not be a problem with that.

Also, if you want someone at your medical appts. with you, that's your decision and no one elses. I've been to many physical therapy sessions where husbands or wifes or caretakers attend. So long as your husband doesn't interfere with your therapy, I can't see why there would be a problem.

Take care!
Let Go, and Let God......

Some of these offices these days have and offer transportation to and from their office. In a way, they get the Mileage money and not you, but you save on gas, and risk of accidents. Makes good sense. I also like the idea.
Reply's are intended solely for informational purposes. They are based on personal opinions, experience, or research and are "not to be taken as fact or legal advice", otherwise, always consult an attorney or a doctor.
go to spinal cord stimulation crps in your google bar, Read this, I started taking Lyrica 50 mg. today also. well have a nice morning!
Life is like the ocean, it can be calm one minute and the next a wave will knock you off your feet, it's up to you to get back up and take control.
SCS does work for some but it's not for everybody. As they said if your doctor thinks you should try it and it gets approved do the trial. It lasts any where from a few days to a week and you will know if it will help you. In the trial they place the leads in your back and everything else is on the outside so it's not too bad and the only thing they have to do to remove it is cut the stiches they put in to hold it in place and then pull the leads out. No pain with this part at all. After you try it you and your doctor will talk about how well it did for you and if your pain was improved by 50% or more then you can have the perm one. You should know from a trial how it will do for you.
http://www.rsdrx.com/CRPS-SCS%20Article.pdf, I checked you need to copy and past it I guess, read this it is very important.
Life is like the ocean, it can be calm one minute and the next a wave will knock you off your feet, it's up to you to get back up and take control.
OOOOpppps didn't work, here ya go! Complex Regional Pain Syndrome (CRPS) and Spinal Cord Stimulator (SCS)
H. Hooshmand, M.D. and Eric M. Phillips
Neurological Associates Pain Management Center
Vero Beach, Florida
Abstract. The following is a summary of our experience with treating complex regional pain syndrome (CRPS)
patients who have undergone spinal cord stimulator (SCS) treatment for one year or longer. The success or failure of
the treatment with SCS depends on how early in the course of the illness the SCS treatment started, and depends on the
nature of the original nociceptive pain.
Descriptors. complex regional pain syndrome (CRPS), failed back syndrome (FBS), failed neck syndrome (FNS),
infrared thermal imaging (ITI), spinal cord stimulator (SCS).
Spinal cord stimulators (SCS) are effective in treatment of somatic chronic pain (e.g., failed back syndrome
(FBS) and failed neck syndrome (FNS)) but it does not help CRPS patients. Usually, the beneficial effect of SCS in
management of CRPS is brief (a few weeks to a few months in more than 70% of patients). The SCS as a foreign
body, may aggravate the CRPS pain, cause vasoconstriction, and inflammation in late stages of CRPS. Interferential
surface skin stimulator, a modified form of transcutaneous electrical nerve stimulation (TENS), is a good noninvasive
In our experience, the type of patient that we see in our clinic is different from most other centers. The
patients that end up in our clinic have been to primary, and secondary referral centers. We are a tertiary center of the
last resort where late stage CRPS patients are treated. Most of the patients that we receive already have had on the
average of one to two surgical procedures, e.g., carpal tunnel syndrome and SCS treatment, and in many cases more.
The majority of the cases who have had SCS treatments have had the original invasive procedure plus revisions,
replacements, or the adjustments of the position of the electrodes, etc.
To begin with, we have to divide the effect of CRPS into two separate types of nociceptive pain, i.e.,
somesthetic pain such as FBS, versus neuropathic pain such as CRPS. The neuropathic pain has a neurovascular
component to it whereas the somesthetic pain usually does not have a neurovascular component.
SCS is a digital stimulator utilized for treatment of an analog symptom (the analog pain modality is random
and not time locked or digital). It is not a type of treatment that would be successful in every form of chronic pain.
In CRPS, the immune system is rogue. This is because the immune system is modulated by the sympathetic
system. The sympathetic system, under pain input, responds by releasing T-cell lymphocytes (in early stages CD4 or
helper lymphocytes, and in late stages CD8 or killer T-cell lymphocytes)(1,2). So, after the SCS has lost its effect, the
sympathetic system considers the foreign body of the SCS as a source of sympathetic dysfunction. This causes
neuroinflammation manifested as skin rash, edema, and infection(1,3).
Life is like the ocean, it can be calm one minute and the next a wave will knock you off your feet, it's up to you to get back up and take control.
A 32-year-old police woman while on duty was chasing two criminals. One of the criminals was obviously an
expert in shooting, and shot the police woman in both legs. She developed severe CRPS because of this incident. A small
fragment of the bullet in the left leg was not able to be removed surgically because it was too close to the sciatic nerve
that the surgeon decided not to disrupt the circulation in that area.
Because of the severity of the pain, four months after the injury, the patient had received an SCS implant. Every
time the SCS was turned on, the patient would develop a moderate edema of the left lower extremity, edema and water
retention (serous fluid) under the scar of the SCS insertion, and she would have severe electric shock feeling in the left
lower extremity in the area of the bullet scar. The patient complained of severe chest pain and dizziness. Her blood
pressure would rise from 130-140 systolic up to 210-220 systolic until the current of the stimulator was turned off.
This complication which was obviously due to spread of the electrode stimulation to the metallic body of the
bullet fragment and echoing back to the spinal cord canal and to the cardiac plexus, and was mistaken for “infection”
due to the surgical procedure. Obviously, there was no infection, and no infectious agent would grow from the serous
fluid accumulation area. This was obviously a classical neurogenic inflammation(2). The stimulator was removed,
replaced and the electrodes were repositioned for quite a few months, and all along the patient was kept on unnecessary
and on large doses of antibiotics. An infectious disease consultant kept claiming that this was because of some sort of
infectious agent even though nothing could be grown on culture.
The patient continued to run a temperature of 101.6-102.4/F every time the SCS was on.
The temperature would go back to 99- 100/F after the SCS was turned off. As soon as the stimulator was
turned off, the tachycardia and hypertension would partially subside, but the stress of the SCS electrical stimulation
would leave the patient with a baseline hypertension significant enough that she had to be on two different types of
alpha blocker and calcium channel blocker medications.
The doctors who were treating her did not understand that the sympathetic system has three main functions.
(i). Control of vital signs, in this case in the form of hypertension and tachycardia. (ii). Modulation of the body
temperature, in this case a significant degree of fever. (iii). Modulation of the immune system which is the main
domain of the sympathetic system function (2). I also discussed all of these phenomena in the book that I wrote in
1993 titled Chronic Pain: Reflex Sympathetic Dystrophy, Prevention and Management, published by CRC Press in
Boca Raton, Florida(4).
The patient received treatment of IV Mannitol for the problem of neuro-inflammation and water retention,
and that eliminated the neuro-inflammation and the areas of inflammation that were mistaken for abscesses.
The main goal of treatment for CRPS is reversal of the course, amelioration of suffering, return to work if at
all possible, avoiding surgical procedures such as SCS and amputation, and improvement of quality of life. The key to
success is early diagnosis and early assertive treatment. Lack of proper understanding and proper diagnosis leads to
improper treatment with poor outcome. There is a desperate need for future research in the treatment of CRPS. Delay
in diagnosis is a factor in therapeutic failure. According to Poplawski, et al, treatment, and its results, are hampered by
delay in diagnosis (5). Early diagnosis (up to 2 years) is essential for achieving the goal of successful treatment results.
Simple monotherapy with only nerve block, only Gabapentin, or otherwise, is not sufficient for management of CRPS.
Treatment should be multidisciplinary and simultaneous: effective analgesia, proper antidepressants to prevent pain and
insomnia, physiotherapy, nerve blocks, proper diet, when indicated channel blockers, and anticonvulsant therapy should
be applied early and simultaneously. Administration of piece-meal, minimal treatments is apt to fail (2).
Life is like the ocean, it can be calm one minute and the next a wave will knock you off your feet, it's up to you to get back up and take control.

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