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3 Recovery and

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care after surgery

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Recovery from surgery

It takes several weeks to heal from surgery. It
is normal to feel some discomfort from the
incision(s) and to have some pain at the
implant site for 2 to 6 weeks.

Your doctor may also prescribe physical
therapy or medication to help manage your
pain. Always follow your doctor’s instructions.

w Warning: DO NOT use the recharger on an

unhealed wound. The recharging system is
not sterile, and contact with the wound can
cause an infection.

Activities

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Some movements can cause changes in
stimulation. For example, leaning back may
cause the lead to move closer to your spinal
cord; this can increase the sensation of
stimulation.

Other movements may cause the lead to move
further away from your spinal cord and
decrease the stimulation sensation. Sudden

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changes in stimulation are most common while
you are recovering from surgery.

Avoid activities where you must bend,

•

stretch, or twist your body; these
movements can move your leads, which
affects your stimulation.

Avoid lying on your stomach.

•

Avoid reaching over your head.

•

Avoid turning from side to side.

•

Avoid bending forward, backward, or from

•

side to side.
Avoid lifting more than 2 kilograms

•

(5 pounds).

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As you begin to feel better, you should be able
to perform activities such as:

Bathing or showering

•

Sexual activity

•

Working at home or at your business

•

Hobbies or activities, such as walking,

•

gardening, cycling, or swimming

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Traveling

•

Remember, returning to your daily activities
should make you feel better, not worse.

Note: As you adjust to life with better pain
management, you may want to try activities
that you could not perform before your surgery.
Discuss your activity level with your doctor.

When to call your clinician

Contact your clinician if any of the following
events occur:

You have pain, redness, or swelling at the

•

incision(s) later than 6 weeks after
surgery.

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You feel discomfort or pain during

•

stimulation. Turn your stimulation off and
call your clinician.

Your system is not working properly.

•

You cannot turn stimulation on or off.

•

You cannot adjust stimulation using your

•

controller.

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Care schedule

Your clinician will schedule follow-up visits to
make sure you are receiving the most
appropriate therapy.

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4 Using your

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How your controller works

The controller communicates wirelessly with
your neurostimulator by sending signals to and
receiving signals from the neurostimulator.
Your neurostimulator only accepts
communications from the controller or clinician
programmer. Sending information from the
neurostimulator to the controller will only occur
after the controller and neurostimulator are
"paired".

Your neurostimulator will not be able to send
information to anything except for the controller
that it is paired with. Your doctor will pair your
controller and neurostimulator. If you receive a
new controller or for some other reason it is not
paired with your neurostimulator, see "Setting
up a new controller" on page 208, for
information about how to pair the controller and
the neurostimulator.

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Note: Make sure to keep your controller with

you at all times in the event that you need to
adjust or turn your stimulation off.

Use the controller to:

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Turn your stimulation on or off.

•

Check the neurostimulator and controller

•

battery status.
Change stimulation settings.

•

Notes:

The controller can be used with all the

•

neurostimulator models referenced in this
manual; however, the available functions
will be different for each model. Be sure to
note when a specific neurostimulator is
referenced to determine if the information
is applicable for your neurostimulator.

The controller is an electronic device that

•

should be used in accordance with any
restrictions while traveling (eg, airplane
takeoffs).

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Controller screen and keys

Your controller has a touchscreen, a display
screen that reacts to your touch and allows you
to press buttons and functions that are
displayed on the screen. Use one finger when

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pressing buttons or functions. Having multiple
fingers at once on the front face of the
controller may not allow the function or task to
be performed. There are 3 different ways to
use the touchscreen depending on the function
or task:

Short, light presses for a button selection.

•

Pressing and holding to unlock a screen.

•

Pressing lightly and dragging a slider bar to

•

view additional selections.

In addition to these on-screen buttons and
functions, your controller also has a number of
keys (Table 4.1).

Table 4.1 Controller keys

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Key Function

Stimulation
On/Off

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Turns stimulation on or off.

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Table 4.1 Controller keys (continued)

Key Function

Increase/
Decrease

Note: To perform most functions on the

controller, you must first press the
Increase/Decrease key to wake up the
controller.

There is a charging port on the bottom of the
controller and a recharging light above the
touchscreen. The charging port and
recharging light are used with rechargeable
neurostimulators (Figure 4.1).

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Adjust stimulation.

•

Select and navigate settings

•

displayed on the screen.
Wake up the controller.

•

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Figure 4.1 Controller keys.

Home screen

The Home screen is the first screen to appear
after unlocking your controller. The Home
screen provides an overview of your
stimulation settings (Figure 4.2).

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Stimulation On/Off key

Recharging light

Touchscreen

Increase key
Decrease key

Charging port

Note: The Home screen may look different for
each patient depending on which mode your
clinician has programmed for your
neurostimulator. The modes are: Single and
Group mode.

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Details about what is displayed on the Single
and Group mode Home screens are provided
in "Programming modes" on page 100.

Battery status button Lock button

Pain area

stimulation

on/off buttons

Figure 4.2 Home screen (Single mode shown).

The number of Pain areas displayed on the
Home screen depends on how your clinician
has programmed your neurostimulator. There
can be up to 4 pain areas.

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Menu button

Pain area buttons

The buttons at the top of the Home screen
allow you to perform the following tasks:

Check the battery status of the controller.

•

Check the battery status of the

•

neurostimulator.

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Lock the controller.

•

Access the Menu screen.

•

Refer to Table 4.2 for more information on
these buttons.

Table 4.2 Home screen buttons

Icon Description

Battery
status button

Lock button Press this button to lock the

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The left icon on this button
displays the controller battery
status. The right icon on this
button displays the
neurostimulator battery
status.

Press this button to check the
battery status in detail. For
more information on checking
batteries, see "Checking the
battery status of the controller
and neurostimulator" on
page 75.

controller.

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Table 4.2 Home screen buttons (continued)

Icon Description

Menu button Press this button to access the

Unlocking and locking your
controller

Unlocking your controller

When the Increase/Decrease key is pressed
to wake up the controller, the Unlock screen
appears (Figure 4.3).

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Menu screen.

For more information about the
Menu screen options. Refer to
"Changing controller
preferences using the Menu"
on page 80.

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Figure 4.3 Unlock screen.

Notes:

If the controller does not display the Unlock

•

screen, the controller may not have been
properly set up. Call your clinician if the

Unlock screen does not appear.

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When the controller is locked, pressing the

•

Stimulation On/Off key will provide the
option to bypass the Unlock screen and to
turn stimulation on or off.

1. Press and hold the Lock (
Unlock screen.

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As the Lock button is held, bars appear on
the screen and move toward the Lock
button (Figure 4.4).

Figure 4.4 Unlocking the controller.

2. Stop pressing the Lock button when the

screen changes to a circle of dots
(Figure 4.5). The controller is searching for
your neurostimulator.

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Figure 4.5 The controller searching for your

After unlocking the controller, the first
screen you see is the Home screen
(Figure 4.6).

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neurostimulator.

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Single mode Group mode

Figure 4.6 Home screen.

If the Home screen does not appear, see
"Troubleshooting" on page 163.

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Locking your controller

Your controller can be locked, so if buttons or
keys are accidentally pressed, there will not be
an unexpected change in your stimulation.

If you have stimulation on, locking your
controller will not turn stimulation off.
Stimulation will remain on even when the
controller is locked.

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Note: The controller screen will dim after 30
seconds of inactivity, and will automatically
lock itself after 2 minutes of inactivity. You can
also press the Lock button to lock the
controller immediately.

1. From the Home screen, press the Lock

) button to lock the controller.

(

Turning your stimulation on or
off

You can turn stimulation on or off at any time.
Follow these steps to turn your stimulation on
or off for all pain areas.

To turn stimulation on or off for individual pain
areas, refer to "Turning stimulation on or off for
individual pain areas" on page 110.

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Turning your stimulation on for all
pain areas

1. To turn stimulation on, firmly press the
Stimulation On/Off key, which is located

on the top of your controller.

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2. Press the Stimulation On button to turn
stimulation on (Figure 4.7).

Note: If you do not wish to turn stimulation
on or off, but want to access the Home
screen, press the Go To Unlock button
and unlock your controller.

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Figure 4.7 Turning stimulation on.

3. The Home screen will appear to confirm

that stimulation is on (Figure 4.8).

Single mode: The Pain area

–

stimulation on/off buttons will display
checkmarks highlighted in green when
stimulation is turned on.

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Group mode: The Group button will be

–

highlighted in green when stimulation is
turned on.

Single mode Group mode

Figure 4.8 Home screen with stimulation turned

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on.

Turning your stimulation off for all
pain areas

1. To turn stimulation off, firmly press the
Stimulation On/Off key, which is located

on the top of your controller.

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2. Press the Stimulation Off button to turn
stimulation off (Figure 4.9).

Notes:

If you do not wish to turn stimulation off,

–

but instead wish to access the Home
screen, press the Go To Unlock
button.

If your controller was already on,

–

instead of the Go To Unlock button, the

Lock Controller button will be shown.

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Figure 4.9 Turning stimulation off.

3. The Home screen will appear to confirm

that stimulation is off (Figure 4.10).

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Single mode: The Pain area

–

stimulation on/off buttons will display
gray dashes when stimulation is turned
off. An orange message will also be
shown that reads "Stimulation is off".

Group mode: The Group button will be

–

shown in gray when stimulation is
turned off. An orange message will also
be shown that reads "Stimulation is

off".

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Single Mode Group Mode

Figure 4.10 Home screen with stimulation turned

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How to maintain
neurostimulator batteries

It is very important that you maintain your
neurostimulator batteries, whether you have
an external or an implanted rechargeable
neurostimulator.

# Caution: Check battery status and charge

the battery regularly. Battery capacity will
continue to slowly drain, even when the
neurostimulator is off. If the battery
becomes completely discharged, therapy
will be lost.

Though you will not need to recharge the
external neurostimulator, you should check the
battery status regularly and report any low
battery messages to your clinician.

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Checking the battery status of the
controller and neurostimulator

Check the status of the batteries in your
controller and your neurostimulator every day.
You can check the status of the batteries at any
time.

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Note: The battery levels of the controller and
the neurostimulator are shown on the Battery
status (
further detail about battery levels, follow the
steps below.

1. If necessary, unlock the controller by
pressing and holding down the Lock (
button on the Unlock screen.

2. From the Home screen, press the Battery
status (

appear (Figure 4.11).

Controller battery status

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) button on the Home screen. For

)

) button. Two battery figures

Neurostimulator (device)

Figure 4.11 Batteries screen.

3. Press the Exit ( ) button at the top right

corner of the touchscreen to exit.

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Table 4.3 lists the different battery indicators.

Table 4.3 Battery indicators

Indicator
icon

Description

Controller battery.

Neurostimulator (device) battery:

External neurostimulator.

•

Implanted neurostimulator.

•

Table 4.4 lists several battery level definitions
and whether action is needed.

Table 4.4 Battery level definitions

Battery
icon

Definitions

Battery icon is green. Battery level is full. No
action is needed.

Battery icon is green. Battery level is half full.
No action is needed.

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Table 4.4 Battery level definitions (continued)

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Battery
icon

Definitions

Battery icon is orange. Battery level is low.
Action is needed soon.

If you have an external neurostimulator.
Replace the controller batteries soon. See
"Replacing the type AA controller batteries"
on page 206.

If you have an implanted neurostimulator:

Recharge the controller battery pack.

•

See "Recharging the controller battery
pack" on page 158.

Recharge the neurostimulator battery.

•

See "Recharging the implanted
neurostimulator battery" on page 146.

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Table 4.4 Battery level definitions (continued)

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Battery

Definitions

icon

Battery icon is red. Battery level is nearly
depleted. Action is needed now.

If you have an external neurostimulator:

Replace the controller batteries. See

•

"Replacing the type AA controller
batteries" on page 206.

Stimulation may not be available, the

•

external neurostimulator batteries will
need to be replaced. Do not replace the
external neurostimulator batteries by
yourself. Call your clinician.

If you have an implanted neurostimulator:

Recharge the controller battery pack.

•

See "Recharging the controller battery
pack" on page 158.

Stimulation may not be available.

•

Recharge the neurostimulator battery.
See "Recharging the implanted
neurostimulator battery" on page 146.

"Controller screens" on page 164 lists the
warning and alert screens associated with the

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batteries for the controller and
neurostimulators.

Changing controller
preferences using the Menu

Controller preferences affect the way
information displays on the screen or the way
alert/vibration tones sound or are felt. These
controller preferences include audio/vibration,
brightness, date, time, language, and number
format. Other features can also be accessed
from Menu screen. Table 4.5 on page 81 lists
the preferences associated with the Menu
screen and where to find information for other
features.

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To access the Menu screen

1. Press the Menu ( ) button on the Home

screen.

2. Drag the slider bar, or use the Increase/
Decrease key to view other preferences on

the Menu screen (Figure 4.12).

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Figure 4.12 Menu screen.

3. Select the Menu preference. Refer to

Table 4.5 for preferences and instructions.

Table 4.5 Controller preferences on the Menu

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Exit button

Slider bar

screen

Menu
preference

Audio/Vibe This option is used to adjust the audio

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Description

and vibration settings.
Refer to "Changing the audio and

vibration settings" on page 84.

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Table 4.5 Controller preferences on the Menu

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screen (continued)

Menu

Description

preference

Check
Position

This feature is only used with the
implanted neurostimulator. It is used to
check your current body position if your
physician has enabled the
AdaptiveStim feature.

Refer to "Checking your body position"
on page 121.

MRI Mode This feature is only used with the

implanted neurostimulator. It is used to
turn stimulation off to prepare for an
MRI examination.

Refer to "Placing your neurostimulation
system in MRI mode for the MRI scan"
on page 133.

Brightness This option is used to adjust the

brightness of the touchscreen.
Refer to "Changing the brightness of

the controller display" on page 86.

Date This option is used to change the date

displayed on your controller.
Refer to "Changing the date" on

page 87.

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Table 4.5 Controller preferences on the Menu

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screen (continued)

Menu

Description

preference
Time This option is used to change the time

and format displayed on the
controller.

Refer to "Changing the time" on
page 88.

Language This option is used to change the

language displayed on the controller.
Refer to "Changing the language" on

page 90.

Numbers This option is used to change how

numbers are displayed on the
controller.

Refer to "Changing the number format"
on page 91.

About This option is used to review technical

information about your
neurostimulation system.

Refer to "Viewing information about the
controller and the neurostimulator" on
page 92.

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Table 4.5 Controller preferences on the Menu

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screen (continued)

Menu
preference

Recharging This feature is only used with the

Description

implanted neurostimulator. It is used to
change the battery recharging speed
and temperature while recharging.

Refer to "Changing the recharging
temperature and speed" on
page 155.

Changing the audio and vibration
settings

The controller will play an audio tone to alert
you of any problems during recharging of the
implanted neurostimulator. The Audio option
can be set to off, low, or high.

The controller will vibrate every time you press
a key or screen button to confirm your press.
The Vibration option can be set to off or on.

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1. Select the Audio/Vibe button from the
Menu screen. The Audio/Vibe screen

appears (Figure 4.13).

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Low
HighOff

Off

Figure 4.13 Audio/Vibe screen.

2. To change audio settings, press the
desired button for Audio Off, Low, or
High.

3. To change vibration settings, press the
desired button for Vibration Off or On.

4. Press the OK button to return to the Menu

screen.

5. Press the Exit (
Home screen.

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On

) button to return to the

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Changing the brightness of the
controller display

1. Select the Brightness button from the
Menu screen. The Brightness screen

appears (Figure 4.14).

Figure 4.14 Brightness screen.

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2. Using the touchscreen or the Increase/
Decrease key, select the circle below the

desired brightness level.

3. Press the OK button to return to the Menu
screen.

4. Press the Exit (
Home screen.

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Changing the date

Note: Date settings cannot be changed while

recharging the implanted neurostimulator.

1. Drag the slider bar, or use the Increase/
Decrease key to view additional
preferences on the Menu screen.

2. Select the Date button from the Menu

screen. The Date screen appears
(Figure 4.15).

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Month
YearDay

Figure 4.15 Date screen.

3. To change the Day, Month, or Year, press

the touchscreen button with the incorrect
value, then use the Increase/Decrease
key to change the value.

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4. Press the OK button to return to the Menu
screen.

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5. Press the Exit (

) button to return to the

Home screen.

Changing the time

Note: Time settings cannot be changed while

recharging the implanted neurostimulator.

1. Drag the slider bar, or use the Increase/
Decrease key to view additional
preferences on the Menu screen.

2. Select the Time button from the Menu

screen. The Time screen appears
(Figure 4.16).

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Figure 4.16 Time screen.

3. To change the Hour, Minute, or Time
format, press the touchscreen button with

the incorrect value or format, then use the
Increase/Decrease key to change the
value or format.

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Minute
Time formatHour

Note: Time format selections include: AM/
PM and 24-hour.

4. Press the OK button to return to the Menu

screen.

5. Press the Exit (
Home screen.

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Changing the language

1. Drag the slider bar, or use the Increase/
Decrease key to view additional
preferences on the Menu screen.

2. Select the Language button from the Menu

screen. The Language screen appears
(Figure 4.17).

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Slider bar

Figure 4.17 Language screen.

3. Select the desired language from the

options available. Drag the slider bar, or
use the Increase/Decrease key to view
more language options.

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4. Press the OK button to return to the Menu
screen.

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5. Press the Exit (

) button to return to the

Home screen.

Changing the number format

1. Drag the slider bar, or use the Increase/
Decrease key to view additional
preferences on the Menu screen.

2. Select the Numbers button from the Menu

screen. The Numbers screen appears
(Figure 4.18).

Figure 4.18 Numbers screen.

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3. Using the touchscreen or the Increase/
Decrease key, select the circle next to the

desired number format for the controller.

4. Press the OK button to return to the Menu
screen.

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5. Press the Exit (

) button to return to the

Home screen.

Viewing information about the
controller and the neurostimulator

1. Drag the slider bar, or use the Increase/
Decrease key to view additional
preferences on the Menu screen.

2. Select the About button from the Menu

screen. The About screen appears
(Figure 4.19).

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Figure 4.19 About screen.

3. Use the Left/Right button or Increase/
Decrease key to view information about the

controller and neurostimulator.
Note: The following information may be

available through the About screen.
Information shown may be different
depending on the type of neurostimulator
that is paired with the controller.

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Right buttonLeft button

ERI (Elective Replacement

–

Indicator): The estimated date that the
implanted neurostimulator may be
replaced.

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INS (Implanted Neurostimulator):

–

The model number, serial number, and
system information for the implanted
neurostimulator.

ENS (External Neurostimulator): The

–

model number, serial number, and
system information for the external
neurostimulator.

! (Last Error): The date that the last

–

warning or alert screen was displayed
on the controller.

PTM (Controller): The software

–

version that your controller is using.
This screen may also show the
recharger compatibility for the
implanted neurostimulator.

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4. Press the OK button to return to the Menu

screen.

5. Press the Exit (
Home screen.

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