Medtronic 97745 97745 User Manual part 3 of 6

Medtronic, Inc. 97745 part 3 of 6

User Manual part 3 of 6

5 Adjusting yourstimulationFilename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-04
IntroductionVarious features are available for adjustingyour stimulation. Each type or model ofneurostimulator provides a unique set ofstimulation features.Stimulation featuresUsing the basic neurostimulation features, youcan adjust the intensity, pulse width, and ratesettings for your stimulation. For completeinformation, see "Changing parameter andstimulation settings" on page 101.For information about Single and Groupmode, refer to "Programming modes" onpage 100.For information about AdaptiveStim, refer to"Using AdaptiveStim" on page 117.Adjusting stimulation settingsAs your activities vary throughout the day, yourtherapy needs may change. The controllerallows you to turn stimulation on and off, switchfrom one programmed stimulation option toEnglish  97745 2013-04Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-0496Adjusting your stimulation 5
another, and adjust the intensity, pulse width,and rate of the stimulation. Talk to yourclinician about the settings that apply to yourtherapy.Your clinician programs the available functionsand specifies the settings you can adjust withyour controller. Discuss this with yourclinician.There is often more than one way to changestimulation settings. These instructionsdescribe the most common ways.Note: When a stimulation setting is changed,you will see the change when accessing a Painarea through the Home screen.To receive the most effective therapy, somedays you may need to adjust your stimulationseveral times; other days you may not need toadjust it at all. Your clinician will providecomplete guidelines about when you may wantto adjust your stimulation.Table 5.1 provides general guidelines foradjusting your stimulation. For additionaladjustment guidelines, refer to the sections on97745 2013-04  English Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-0497Adjusting your stimulation 5
the specific features associated with yourneurostimulator. Table 5.1 General stimulation adjustmentguidelines Situation ActionStimulation is too strong Decrease intensities or pulsewidth(s).Stimulation is not strongenoughIncrease intensities or pulsewidth(s).Stimulation covers toomuch areaDecrease intensities or pulsewidth(s) or change to adifferent program or group.Stimulation does not coverpainful areaIncrease intensities or pulsewidth(s) or change to adifferent program or group.The pulses (tappingsensations) feel too slowIncrease rate.The pulses (tappingsensations) feel too fastDecrease rate.English  97745 2013-04Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-0498Adjusting your stimulation 5
 Table 5.1 General stimulation adjustmentguidelines (continued)Situation ActionYou have unexpectedchanges in stimulation1. Turn off theneurostimulator.2. Decrease intensities,turn on theneurostimulator, adjustparameters, and slowlyincrease intensities tothe desired level.orChange to a differentprogram or group andturn on theneurostimulator.You have tried adjustingstimulation but are unableto find an effective setting.Contact your clinician.97745 2013-04  English Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-0499Adjusting your stimulation 5
 Table 5.1 General stimulation adjustmentguidelines (continued)Situation ActionYou will be passing througha theft detector or securitydevice Before engaging in theseactivities, consult "AppendixA: Electromagneticinterference (EMI)" onpage 225 for details.You will be usingpotentially dangerousequipmentYou will be having amedical procedureProgramming modesYour clinician will choose one of twoprogramming modes, Single or Group modein order to best meet your stimulation needs.•Single mode–This programming modeallows you to adjust stimulation settings forindividual pain areas.•Group mode–This programming modeallows you to adjust stimulation settings fora group of pain areas.English  97745 2013-04Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-04100Adjusting your stimulation 5
The programming mode selected by yourclinician determines what is displayed onthe Home screen (Figure 5.1).Single mode Group modeFigure 5.1 Programming modes displayed on the Home screen.Changing parameter andstimulation settingsThe Home screen displays the Pain areas thatyour clinician has programmed for stimulation(Figure 5.2). You may be able to adjust certainparameters and stimulation settings set up byyour clinician.97745 2013-04  English Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-04101Adjusting your stimulation 5
Single mode Group modePain area buttonsFigure 5.2 Pain area buttons on the Home screen.Note: If you have only 1 pain area and noadditional parameter or stimulation settings,you may not be able to access pain areasettings through the Home screen.After pressing a Pain area button on the Homescreen, the Pain area will display the availablesettings (Figure 5.3).English  97745 2013-04Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-04102Adjusting your stimulation 5
Exit buttonSettingsDown buttonFigure 5.3 Pain area settings.Refer to Table 5.2 for a description ofparameter and stimulation settings and whereto find information for those settings.Note: Some settings may not be availabledepending on what your clinician hasprogrammed for your neurostimulator. Table 5.2 Parameter and stimulation settings Button DescriptionIntensity—Controls the strength of thestimulation.Refer to "Increasing or decreasing aparameter (intensity, pulse width, orrate)" on page 106.97745 2013-04  English Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-04103Adjusting your stimulation 5
 Table 5.2 Parameter and stimulation settings (continued)Button DescriptionStimulation—On or off setting forstimulation.Refer to "Turning stimulation on or off forindividual pain areas" on page 110.Rate—Sets the speed of the stimulationpulses.Refer to "Increasing or decreasing aparameter (intensity, pulse width, orrate)" on page 106.AdaptiveStim—Turns AdaptiveStim onor off. This feature is only available forthe implanted neurostimulator.Refer to "Turning AdaptiveStim on or off"on page 124.Pulse width—Sets the length of thestimulation pulse. It affects the strengthand coverage area of the stimulation.Refer to "Increasing or decreasing aparameter (intensity, pulse width, orrate)" on page 106.English  97745 2013-04Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-04104Adjusting your stimulation 5
 Table 5.2 Parameter and stimulation settings (continued)Button DescriptionCycling—Turns stimulation on and off atpreset times as programmed by yourclinician.Refer to "Turning cycling on or off" onpage 112.Program—A custom combination ofstimulation settings programmed byyour clinician.Refer to "Changing a program forindividual pain areas" on page 114.Note: If your neurostimulator is usingGroup mode, the Program setting is notavailable. Refer to "Viewing andchanging a group" on page 115.Up/Down buttons— Press to viewadditional parameter and stimulationsettings for a pain area. These buttonsmay not appear depending on how yourclinician has programmed yourneurostimulator.97745 2013-04  English Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-04105Adjusting your stimulation 5
Increasing or decreasing aparameter (intensity, pulse width, orrate)Complete the following steps to adjust aparameter.Notes:•To increase a parameter, theneurostimulator must be on.•To decrease a parameter, theneurostimulator may be on or off.1. Press the Pain area button on the Homescreen for the pain area you want toadjust.2. Select the parameter setting button thatyou want to change. If applicable, use theUp/Down buttons to view additionalparameter settings. Buttons that may beavailable include:–Intensity ( )–Pulse width ( )–Rate ( )English  97745 2013-04Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-04106Adjusting your stimulation 5
Notes:–You may not see every parametersetting displayed on your controller.Only the parameter settings that wereset up by your clinician will appear onthe controller screen.–Adjusting the Rate for 1 pain area willaffect the rate of all other pain areas.3. Press the Increase/Decrease key to adjustparameter settings.–Press and release the Increase/Decrease key to slowly increase ordecrease parameter settings.–Press and hold the Increase/Decreasekey to quickly increase or decreaseparameter settings.4. Press the Exit ( ) button at the top rightcorner of the touchscreen to exit.97745 2013-04  English Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-04107Adjusting your stimulation 5
Adjusting intensity for all pain areastogetherIf your clinician has enabled the option toadjust intensity for all pain areas together, thenyou can quickly increase or decrease intensityon the Home screen. Discuss this option withyour clinician.Notes:•To increase intensity for all pain areastogether, the neurostimulator must be on.•To decrease intensity for all pain areastogether, the neurostimulator may be on oroff.1. From the Home screen, press theIncrease/Decrease key to adjust yourstimulation intensity (Figure 5.4).English  97745 2013-04Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-04108Adjusting your stimulation 5
Figure 5.4 Pressing the Increase/Decrease key.–All pain areas will change at the sametime when you press the Increase/Decrease key.–The names of the pain areas will bereplaced with the intensity values whenyou press the Increase/Decrease key.97745 2013-04  English Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-04109Adjusting your stimulation 5
–Press and release the Increase/Decrease key to slowly increase ordecrease the intensity setting.–Press and hold the Increase/Decreasekey to quickly increase or decrease theintensity setting.2. When you are finished adjusting intensity,press the Lock ( ) button to lock thecontroller.Turning stimulation on or off forindividual pain areasYou can turn stimulation on or off at any time.Follow these steps to turn your stimulation onor off for individual pain areas.To turn stimulation on or off for all pain areas,refer to "Turning your stimulation on or off" onpage 70.1. If you are using Single mode, press thePain area stimulation on/off button on theHome screen (Figure 5.5).English  97745 2013-04Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-04110Adjusting your stimulation 5
Battery status button Lock buttonMenu buttonPain area buttonsPain areastimulationon/off buttonsFigure 5.5 Pain area stimulation on/off button on the Home screen.2. Or, refer to steps 3–5.3. Press the Pain area button on the Homescreen for the pain area you want toadjust.4. Press the Stimulation ( ) button. TheStimulation screen is shown (Figure 5.6).97745 2013-04  English Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-04111Adjusting your stimulation 5
Figure 5.6 Stimulation screen.5. Press the On or Off button to turnstimulation on or off for the selected painarea.6. Press the Exit ( ) button at the top rightcorner of the touchscreen to exit.Turning cycling on or off1. Press the Pain area button on the Homescreen for the pain area you want toadjust.2. If applicable, use the Up/Down buttons toview additional stimulation settings.English  97745 2013-04Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-04112Adjusting your stimulation 5
3. Press the Cycling ( ) button. TheCycling screen is shown (Figure 5.7).Figure 5.7 Cycling screen.4. Press the On or Off button to turn cyclingon or off.Note: When you turn off cycling for onepain area, it will be off for all pain areas.5. Press the Exit ( ) button at the top rightcorner of the touchscreen to exit.97745 2013-04  English Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-04113Adjusting your stimulation 5
Changing a program for individualpain areas1. Press the Pain area button on the Homescreen for the pain area you want toadjust.2. If applicable, use the Up/Down buttons toview additional stimulation settings.3. Press the Program ( ) button. TheProgram screen is shown (Figure 5.8).Figure 5.8 Program screen.4. Press the 1, 2, or 3 button for the programyou want to select.English  97745 2013-04Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-04114Adjusting your stimulation 5
5. Press the Exit ( ) button at the top rightcorner of the touchscreen to exit.Viewing and changing a groupIf your clinician has programmed yourneurostimulator to use Group mode, you maybe able to adjust your stimulation settings byselecting a different group from the Homescreen. Up to 3 different groups may beavailable. Groups are viewed by the letters: A,B, and C.Your clinician will explain how your groups areset up to deliver stimulation and when you maywant to change groups.Complete the following steps to change to anew group. To turn stimulation on or off for agroup, refer to "Turning your stimulation on oroff" on page 70.1. Press the Group button on the Homescreen (Figure 5.9).97745 2013-04  English Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-04115Adjusting your stimulation 5
Group buttonFigure 5.9 Home screen (group A shown).2. Using the touchscreen or the Increase/Decrease key, select the circle next to thedesired group. (Figure 5.10).Figure 5.10 Which group? screen.English  97745 2013-04Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-04116Adjusting your stimulation 5
3. Press the OK button. The Home screen willdisplay showing the selected group(Figure 5.11).Figure 5.11 Home screen (group B shown).Using AdaptiveStimIf your clinician has programmed theAdaptiveStim feature, and AdaptiveStim isturned on, the implanted neurostimulator canautomatically sense your body position andadjust the intensity of the stimulation based onyour body position. Your clinician may programa maximum intensity setting based on yourstimulation needs.97745 2013-04  English Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-04117Adjusting your stimulation 5
Note: AdaptiveStim must be turned on to viewor change AdaptiveStim settings. Refer to"Turning AdaptiveStim on or off" on page 124to confirm that AdaptiveStim is turned on.When you are adjusting your settings for aspecific position, you may need to make surethat your body is in the desired position beforeyou make the adjustments. DiscussAdaptiveStim adjustment settings with yourclinician.•As you make adjustments to the intensitysetting, the new setting is recorded for thatposition.•You may need to stay in this position for upto 5 minutes before the new intensity isrecorded. Your clinician can adjust thislength of time, confirm the length of timewith your clinician.•The next time you return to this position, thestimulation intensity automatically changesto the recorded setting.For example, if you want to decrease theintensity of your stimulation when you are lyingEnglish  97745 2013-04Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-04118Adjusting your stimulation 5
down on your back and your clinician hasprogrammed AdaptiveStim settings so that youmust be in the desired position before makingadjustments, first turn off stimulation. Then getinto the position, use the controller to adjustintensity to 0.0. Next, turn on stimulation andthen slowly increase intensity to the desiredsetting for that position. Be sure to discuss yourAdaptiveStim settings with your clinician.Note: When the AdaptiveStim setting is turnedon, the intensity of the stimulation may notchange immediately when you changepositions. This delay is intentional and keepsthe neurostimulator from making unnecessaryadjustments based on temporary changes inyour position. Your clinician can adjust thelength of this delay.AdaptiveStim groups and positionsYour clinician can program specific intensitiesfor each of 7 positions or your clinician canprogram AdaptiveStim to adapt the intensitysettings based on the adjustments you maketo your stimulation while in one of the positions.97745 2013-04  English Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-04119Adjusting your stimulation 5
Refer to Table 5.3 for an overview of the 7different positions recognized byAdaptiveStim. Table 5.3 Positions recognized byAdaptiveStim Position graphic DescriptionLying BackLying FrontLying LeftLying RightStandingMobileEnglish  97745 2013-04Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-04120Adjusting your stimulation 5
 Table 5.3 Positions recognized byAdaptiveStim (continued)Position graphic DescriptionRecliningUnrecognized positionChecking your body positionIf you want to check to make sure that theneurostimulator recognizes your bodyposition, use the Check Position feature.1. Press the Menu ( ) button on the Homescreen.2. Select the Check Position button. TheCheck Position screen is shown and willdisplay your current position and programintensities (Figure 5.12).97745 2013-04  English Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-04121Adjusting your stimulation 5
Figure 5.12 Check Position screen (lying back position shown).Note: If the Check Position button is notavailable, check to make sureAdaptiveStim is turned on. Refer to"Turning AdaptiveStim on or off" onpage 124.3. To check a different position, move yourbody into the next position.4. Press the Recheck button. The CheckPosition screen is shown and will displayyour new position and program intensities(Figure 5.13).English  97745 2013-04Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-04122Adjusting your stimulation 5
Figure 5.13 Check Position screen (standing position shown).Note: If your new position is not displayed,press the Recheck button again. It mayrequire up to 1 minute to recognize aMobile position. If you are still havingproblems with this feature, contact yourclinician.5. Press the OK button to return to the Menuscreen.6. Press the Exit ( ) button to return to theHome screen.97745 2013-04  English Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-04123Adjusting your stimulation 5
Turning AdaptiveStim on or off1. Press the Pain area button on the Homescreen for the pain area you want toadjust.2. If applicable, use the Up/Down buttons toview additional stimulation settings.3. Press the AdaptiveStim ( ) button. TheAdaptiveStim screen is shown(Figure 5.14).Figure 5.14 AdaptiveStim screen.4. Press the On or Off button to turnAdaptiveStim on or off.English  97745 2013-04Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-04124Adjusting your stimulation 5
Note: When you turn off AdaptiveStim forone pain area, it will be off for all painareas.5. Press the Exit ( ) button at the top rightcorner of the touchscreen to exit.Making adjustments to AdaptiveStimIf you make an adjustment to your stimulationand want to have that adjustment rememberedfor your current position, you may have to stayin your current position for up to 5 minutes.Your clinician can adjust this length of time,confirm the length of time with your clinician.Even with AdaptiveStim enabled, you mayneed to make adjustments to your stimulation.Table 5.4 provides general guidelines foradjusting your stimulation when usingAdaptiveStim.97745 2013-04  English Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-04125Adjusting your stimulation 5
 Table 5.4 AdaptiveStim adjustment guidelines Situation ActionAdaptiveStim stimulation fora specific position isuncomfortable.While in the applicableposition, decreaseintensities and remain inthat position for theduration programmed byyour clinician.You are unable to adjustAdaptiveStim stimulationwhile in a specific position.Make the desiredstimulation adjustment,then get in the desiredposition within the timeprogrammed by yourclinician and stay there forthe duration programmedby your clinician.Stimulation becomesuncomfortable while riding ina car or another type oftransportation.Turn AdaptiveStim off.Stimulation becomesuncomfortable while movingin an elevator, escalator,etc.Turn AdaptiveStim off.You want AdaptiveStim toturn your therapy off when ina certain position.Adjust your intensity to 0.0to turn your therapy offinstead of turning theneurostimulator off.English  97745 2013-04Filename Date TimeUC200xxxxxx EN4.625″ x 6.0″ inches (117 mm x 152 mm)Medtronic ConfidentialPPManual.xsl - PatientProgrammerTemplate.fmVersion: 05-01-2012M948515A001 Rev X 2013-04126Adjusting your stimulation 5

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