Sunday, March 3, 2013

Oh Blog - How I have Neglected You...2 Revisions Later

It has been a roller-coaster.... Since my last update, I have had not one, but two revisions to document for you. I so wish I'd felt up to blogging along the whole time...but just couldn't seem to get it done.

In September, I did experience lead migration which required surgical intervention. This surgery was in October, 2012. This surgery ended up being much more involved than originally planned and riddled with small complications.


In addition to replacing the leads in my head, the decision to relocate my battery was made immediately pre-op. It was previously in my chest, which was fine in the beginning. But, with the slight weight-loss from additional activity, the corner of the battery would often protrude and bruise with with minimal movement of my right arm. So, the decision was made to place the battery in my right upper buttock during the procedure. (Which has been so much more comfortable than I thought it would be.)

Because it wasn't planned in advance, when they moved my battery, it turned out the leads they had on hand that day were not long enough to go the full distance and they were forced to add an extension connection around my shoulder blade area.

Enter complications: The placement of leads in my head, as well as the running of the rest of the leads from shoulder to hip, had to be tunneled several times (at least 4) due to technical difficulties. Apparently, they would run a set of leads, turn them on, and have either errors or failures. Not intending on such a long surgery, after several hours...the surgeon basically had to make the call that 15/16 working points on two leads was good enough and they closed.

So...needless to say, post-op was pretty rough. And on top of the soreness from all of that tunneling...were the staples. Oh the staples!

Since I'd had issues with infection due to the glue on my head in my first surgery, I requested staples be used on my head (and sutures would be fine elsewhere). I guess there was a communication failure somewhere. I woke up with staples in my head, chest, shoulder, and hip... I felt like Sally from Nightmare Before Christmas. I think it was a case of "I already have the stapler in my hand, CACHUNK CACHUNK, and done." It wasn't so bad until they started to heal, they loosen and become sore. (I had them for about 20 days). They also caused trauma to the skin which triggered my Psoriasis to flare at the staple sites.

So, after all was said and done, I was doing alright. I had even better coverage for my pain than before, and I was healing well.


My stimulator started behaving strangely. I was having a particularly bad headache and thought, "Maybe I need to turn up my stim or change my program..." So, I tried to do just that, only to have the program start to run, or the amplitude start to increase, when the hourglass would disappear, the amplitude would go back to zero. (Not the standard auto-reduction from scar tissue, but completely off.)
So, I scheduled an appt. with my rep. We ran diagnostics and a few more points on the dominant lead were coming back "bad". So, though it wasn't perfect, we reprogrammed using the existing good points and I went home. For a few days, everything was fine. And then, nothing. No stimulation. I checked my programmer and it appeared to be functioning, though I couldn't feel anything. So, I called my rep. Again, we ran diagnostics. Completely different results, but this time, we couldn't program anything. So, they sent me for X-rays to see what the problem was.

The X-rays showed us the problem. The leads were no longer connected to the battery. But not because they were yanked due to slack issues...they were just hanging out in there.

So, third surgery was scheduled.


My second surgery was in January 2013. Less than three months later. I went into this surgery not knowing how involved it would be. I was a giant "if, then" problem, all assuming the diagnostic readings from the IPG were due to the introduction of fluid once it became disconnected.

The Plan:
Possibility 1. If leads are good from extension to battery, replace battery and done. (What we were hoping for.)
Possibility 2. If leads are bad from extension to battery, but good from extension to head, relocate new battery to under right arm (Side-Boob) to avoid re-running head leads and to remove extension from the equation.
Possibility 3. If all leads are bad, replace entire system using long leads (pre-ordered this time) to eliminate an extension to prevent future points of possible failure.

Yup...Possibility 3 it was. The entire system was replaced. Instead of the leads being unplugged as previously thought, instead they had somehow become severed from the battery.

Now, the way I explained this one was, "It was worse than the first surgery, but better than the second."

And this time, though I had one additional incision, (mid-back to run the longer leads) I had staples in my head and sutures everywhere else, so that was much more confortable.

As far as the placement, I'm getting good coverage and we were able to program well. But...


Unfortunately, as of a few days ago at my second post-op appointment. It looks like I'll be going back one more time. (This time should be far less involved.)  The leads have tethered somewhere around my shoulder (most likely due to scar tissue) resulting in them being very tight in my neck/shoulder preventing me from being able to comfortably look down or put chin to chest. The surgeon's concern is if we leave it, we run the risk of dislodging them from either end, which would be a bigger problem longterm.

I have orders for X-rays and an appointment to discuss the plan of attack.

So...we're almost there. As far as my HC goes,  the stimulator is doing a damn good job of keeping it under control as long as the weather is good, I keep stress low, and I get enough sleep. And the pain from the tightened leads responds to painkillers which is more than I can say for the headaches. So, although it has been up and down...I'd still do it all again.

Throughout this entire process, I've had so much support and assistance from friends and family I couldn't ask for more.

Both my St. Jude rep and my surgeon have both been very patient, understanding, and willing to get this right no matter what.

I could complain, but I would have a tough time justifying it.

I hope you are all well. If you're not, I hope there is relief in your future. Stay positive.