After the trial, the permanent one is inserted during general anesthesia, but they pull out the first implant while you're awake. "It feels like a very long IV being taken out." The permanent one comes with a remote -- you have to keep it with you at all times to make adjustments. You're also meant to turn it off while driving or operating heavy machinery. The remote has two parts: a disk you put over the device implant, and a thing with buttons that lets you choose programs. You can even set it to pulse.
So ... does it actually work?
Well, an SCS implant isn't considered a complete cure: It's a success if it decreases your pain by 50 percent or more, and it doesn't work on everyone. But for Amanda, the implant made the pain go away from the moment she woke up after surgery. "For the first 24 hours, I was giddy. Pretty much laughing hysterically. You wake up from the surgery, and you feel it working. Very strange to wake up and not be in so much pain after you've gotten so used to it being there all the time."
If you're curious, studies show that the implants do nothing at all for about 20 percent of patients. For the rest, though, most of them get at least some relief, and still get it years later. The ones who get great results from the start usually can expect to keep getting relief long term. That means Amanda's huge, initial dose of pain relief bodes well for her future, assuming the implant doesn't become sentient and turn into a Doctor Octopus situation. So far, so good. Or in Amanda's words, "This is awesome."
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