Although the technical outcome of the surgery was good, the impact of the implant will unfold over time. Rod had to wait until this afternoon for the consult with the Nevro technician (Misha). Misha arrived at 2:00 pm to explain the system to us and do the programming, but everything came to an unexpected halt when he realized that an x-ray of the implant had not yet been done. About an hour later the x-ray had been completed and Misha was looking at the image only to note that it seemed that one lead had migrated slightly closer in relation to the second lead. In the land of spinal cord stimulators, any time that you hear electrodes have moved, it is not good news. Misha disappeared to talk with Dr. van Praagh and we waited anxiously while trying not to jump to any conclusions.
When Misha returned, he was with Dr. van Praagh who reassuered us that although the one lead with 8 electrodes had migrated slightly, it was still within a good overlapping range with the 8 electrodes on the second lead. This required some programming changes, but like many things, "the proof will be in the pudding"... over the next two to three days, we will begin to learn how well this first program will cover Rod's pain. For the next three months Rod will have to be very careful in how he moves his torso so as not to cause further migration of the leads.
The device was turned on at 4:00 pm and we were told that the effect will start to phase in over the next 24 hours. Rod can increase amplitude every 24 hours and on the third day he can switch to the second program if he wants to. It was a little mind-blowing to hear Misha speak of the way that Nevro operates, which seemed counter-intuitive given the way that conventional spinal cord stimulation works. One of the major differences is that a Nevro program provides pain relief from the waste down. Unlike conventional stimulators, you can not "zero in" on a specific region and it does not respond immediately to changes made to the program. This is an inevitable difference because Nevro silences pain without creating alternate electrical sensations. This is only the beginning of the differences. Rod will be able to list more as the theoretical descriptions given to us by Misha today hopefully become reality for him.
This is Dr. van Praagh's first implant of a Nevro system, so he is as curious as we are. As Rod left the hospital this afternoon, Dr. van Praagh said he wasalready anticipating Rod's scheduled visit at 9 am on Thursday, March 22. In the meantime, you have the advantage of getting updates as Rod becomes aware of the impact of the stimulator on his pain.