Medtronic 97745 97745 User Manual part 3 of 6
Medtronic, Inc. 97745 part 3 of 6
Contents
User Manual part 3 of 6
5 Adjusting your
stimulation
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Introduction
Various features are available for adjusting
your stimulation. Each type or model of
neurostimulator provides a unique set of
stimulation features.
Stimulation features
Using the basic neurostimulation features, you
can adjust the intensity, pulse width, and rate
settings for your stimulation. For complete
information, see "Changing parameter and
stimulation settings" on page 101.
For information about Single and Group
mode, refer to "Programming modes" on
page 100.
For information about AdaptiveStim, refer to
"Using AdaptiveStim" on page 117.
Adjusting stimulation settings
As your activities vary throughout the day, your
therapy needs may change. The controller
allows you to turn stimulation on and off, switch
from one programmed stimulation option to
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another, and adjust the intensity, pulse width,
and rate of the stimulation. Talk to your
clinician about the settings that apply to your
therapy.
Your clinician programs the available functions
and specifies the settings you can adjust with
your controller. Discuss this with your
clinician.
There is often more than one way to change
stimulation settings. These instructions
describe the most common ways.
Note: When a stimulation setting is changed,
you will see the change when accessing a Pain
area through the Home screen.
To receive the most effective therapy, some
days you may need to adjust your stimulation
several times; other days you may not need to
adjust it at all. Your clinician will provide
complete guidelines about when you may want
to adjust your stimulation.
Table 5.1 provides general guidelines for
adjusting your stimulation. For additional
adjustment guidelines, refer to the sections on
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the specific features associated with your
neurostimulator.
Table 5.1 General stimulation adjustment
guidelines
Situation Action
Stimulation is too strong Decrease intensities or pulse
width(s).
Stimulation is not strong
enough
Increase intensities or pulse
width(s).
Stimulation covers too
much area
Decrease intensities or pulse
width(s) or change to a
different program or group.
Stimulation does not cover
painful area
Increase intensities or pulse
width(s) or change to a
different program or group.
The pulses (tapping
sensations) feel too slow
Increase rate.
The pulses (tapping
sensations) feel too fast
Decrease rate.
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Table 5.1 General stimulation adjustment
guidelines (continued)
Situation Action
You have unexpected
changes in stimulation
1. Turn off the
neurostimulator.
2. Decrease intensities,
turn on the
neurostimulator, adjust
parameters, and slowly
increase intensities to
the desired level.
or
Change to a different
program or group and
turn on the
neurostimulator.
You have tried adjusting
stimulation but are unable
to find an effective setting.
Contact your clinician.
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Table 5.1 General stimulation adjustment
guidelines (continued)
Situation Action
You will be passing through
a theft detector or security
device Before engaging in these
activities, consult "Appendix
A: Electromagnetic
interference (EMI)" on
page 225 for details.
You will be using
potentially dangerous
equipment
You will be having a
medical procedure
Programming modes
Your clinician will choose one of two
programming modes, Single or Group mode
in order to best meet your stimulation needs.
•
Single mode–This programming mode
allows you to adjust stimulation settings for
individual pain areas.
•
Group mode–This programming mode
allows you to adjust stimulation settings for
a group of pain areas.
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The programming mode selected by your
clinician determines what is displayed on
the Home screen (Figure 5.1).
Single mode Group mode
Figure 5.1 Programming modes displayed on the
Home screen.
Changing parameter and
stimulation settings
The Home screen displays the Pain areas that
your clinician has programmed for stimulation
(Figure 5.2). You may be able to adjust certain
parameters and stimulation settings set up by
your clinician.
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Single mode Group mode
Pain area buttons
Figure 5.2 Pain area buttons on the Home
screen.
Note: If you have only 1 pain area and no
additional parameter or stimulation settings,
you may not be able to access pain area
settings through the Home screen.
After pressing a Pain area button on the Home
screen, the Pain area will display the available
settings (Figure 5.3).
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Exit button
Settings
Down button
Figure 5.3 Pain area settings.
Refer to Table 5.2 for a description of
parameter and stimulation settings and where
to find information for those settings.
Note: Some settings may not be available
depending on what your clinician has
programmed for your neurostimulator.
Table 5.2 Parameter and stimulation settings
Button Description
Intensity—Controls the strength of the
stimulation.
Refer to "Increasing or decreasing a
parameter (intensity, pulse width, or
rate)" on page 106.
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Table 5.2 Parameter and stimulation settings
(continued)
Button Description
Stimulation—On or off setting for
stimulation.
Refer to "Turning stimulation on or off for
individual pain areas" on page 110.
Rate—Sets the speed of the stimulation
pulses.
Refer to "Increasing or decreasing a
parameter (intensity, pulse width, or
rate)" on page 106.
AdaptiveStim—Turns AdaptiveStim on
or off. This feature is only available for
the implanted neurostimulator.
Refer to "Turning AdaptiveStim on or off"
on page 124.
Pulse width—Sets the length of the
stimulation pulse. It affects the strength
and coverage area of the stimulation.
Refer to "Increasing or decreasing a
parameter (intensity, pulse width, or
rate)" on page 106.
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Table 5.2 Parameter and stimulation settings
(continued)
Button Description
Cycling—Turns stimulation on and off at
preset times as programmed by your
clinician.
Refer to "Turning cycling on or off" on
page 112.
Program—A custom combination of
stimulation settings programmed by
your clinician.
Refer to "Changing a program for
individual pain areas" on page 114.
Note: If your neurostimulator is using
Group mode, the Program setting is not
available. Refer to "Viewing and
changing a group" on page 115.
Up/Down buttons— Press to view
additional parameter and stimulation
settings for a pain area. These buttons
may not appear depending on how your
clinician has programmed your
neurostimulator.
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Increasing or decreasing a
parameter (intensity, pulse width, or
rate)
Complete the following steps to adjust a
parameter.
Notes:
•
To increase a parameter, the
neurostimulator must be on.
•
To decrease a parameter, the
neurostimulator may be on or off.
1. Press the Pain area button on the Home
screen for the pain area you want to
adjust.
2. Select the parameter setting button that
you want to change. If applicable, use the
Up/Down buttons to view additional
parameter settings. Buttons that may be
available include:
–
Intensity ( )
–
Pulse width ( )
–
Rate ( )
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Notes:
–
You may not see every parameter
setting displayed on your controller.
Only the parameter settings that were
set up by your clinician will appear on
the controller screen.
–
Adjusting the Rate for 1 pain area will
affect the rate of all other pain areas.
3. Press the Increase/Decrease key to adjust
parameter settings.
–
Press and release the Increase/
Decrease key to slowly increase or
decrease parameter settings.
–
Press and hold the Increase/Decrease
key to quickly increase or decrease
parameter settings.
4. Press the Exit ( ) button at the top right
corner of the touchscreen to exit.
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Adjusting intensity for all pain areas
together
If your clinician has enabled the option to
adjust intensity for all pain areas together, then
you can quickly increase or decrease intensity
on the Home screen. Discuss this option with
your clinician.
Notes:
•
To increase intensity for all pain areas
together, the neurostimulator must be on.
•
To decrease intensity for all pain areas
together, the neurostimulator may be on or
off.
1. From the Home screen, press the
Increase/Decrease key to adjust your
stimulation intensity (Figure 5.4).
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Figure 5.4 Pressing the Increase/Decrease key.
–
All pain areas will change at the same
time when you press the Increase/
Decrease key.
–
The names of the pain areas will be
replaced with the intensity values when
you press the Increase/Decrease key.
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–
Press and release the Increase/
Decrease key to slowly increase or
decrease the intensity setting.
–
Press and hold the Increase/Decrease
key to quickly increase or decrease the
intensity setting.
2. When you are finished adjusting intensity,
press the Lock ( ) button to lock the
controller.
Turning stimulation on or off for
individual pain areas
You can turn stimulation on or off at any time.
Follow these steps to turn your stimulation on
or off for individual pain areas.
To turn stimulation on or off for all pain areas,
refer to "Turning your stimulation on or off" on
page 70.
1. If you are using Single mode, press the
Pain area stimulation on/off button on the
Home screen (Figure 5.5).
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Battery status button Lock button
Menu button
Pain area buttons
Pain area
stimulation
on/off buttons
Figure 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 Home
screen for the pain area you want to
adjust.
4. Press the Stimulation ( ) button. The
Stimulation screen is shown (Figure 5.6).
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Figure 5.6 Stimulation screen.
5. Press the On or Off button to turn
stimulation on or off for the selected pain
area.
6. Press the Exit ( ) button at the top right
corner of the touchscreen to exit.
Turning cycling on or off
1. Press the Pain area button on the Home
screen for the pain area you want to
adjust.
2. If applicable, use the Up/Down buttons to
view additional stimulation settings.
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3. Press the Cycling ( ) button. The
Cycling screen is shown (Figure 5.7).
Figure 5.7 Cycling screen.
4. Press the On or Off button to turn cycling
on or off.
Note: When you turn off cycling for one
pain area, it will be off for all pain areas.
5. Press the Exit ( ) button at the top right
corner of the touchscreen to exit.
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Changing a program for individual
pain areas
1. Press the Pain area button on the Home
screen for the pain area you want to
adjust.
2. If applicable, use the Up/Down buttons to
view additional stimulation settings.
3. Press the Program ( ) button. The
Program screen is shown (Figure 5.8).
Figure 5.8 Program screen.
4. Press the 1, 2, or 3 button for the program
you want to select.
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5. Press the Exit ( ) button at the top right
corner of the touchscreen to exit.
Viewing and changing a group
If your clinician has programmed your
neurostimulator to use Group mode, you may
be able to adjust your stimulation settings by
selecting a different group from the Home
screen. Up to 3 different groups may be
available. Groups are viewed by the letters: A,
B, and C.
Your clinician will explain how your groups are
set up to deliver stimulation and when you may
want to change groups.
Complete the following steps to change to a
new group. To turn stimulation on or off for a
group, refer to "Turning your stimulation on or
off" on page 70.
1. Press the Group button on the Home
screen (Figure 5.9).
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Group button
Figure 5.9 Home screen (group A shown).
2. Using the touchscreen or the Increase/
Decrease key, select the circle next to the
desired group. (Figure 5.10).
Figure 5.10 Which group? screen.
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3. Press the OK button. The Home screen will
display showing the selected group
(Figure 5.11).
Figure 5.11 Home screen (group B shown).
Using AdaptiveStim
If your clinician has programmed the
AdaptiveStim feature, and AdaptiveStim is
turned on, the implanted neurostimulator can
automatically sense your body position and
adjust the intensity of the stimulation based on
your body position. Your clinician may program
a maximum intensity setting based on your
stimulation needs.
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Note: AdaptiveStim must be turned on to view
or change AdaptiveStim settings. Refer to
"Turning AdaptiveStim on or off" on page 124
to confirm that AdaptiveStim is turned on.
When you are adjusting your settings for a
specific position, you may need to make sure
that your body is in the desired position before
you make the adjustments. Discuss
AdaptiveStim adjustment settings with your
clinician.
•
As you make adjustments to the intensity
setting, the new setting is recorded for that
position.
•
You may need to stay in this position for up
to 5 minutes before the new intensity is
recorded. Your clinician can adjust this
length of time, confirm the length of time
with your clinician.
•
The next time you return to this position, the
stimulation intensity automatically changes
to the recorded setting.
For example, if you want to decrease the
intensity of your stimulation when you are lying
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down on your back and your clinician has
programmed AdaptiveStim settings so that you
must be in the desired position before making
adjustments, first turn off stimulation. Then get
into the position, use the controller to adjust
intensity to 0.0. Next, turn on stimulation and
then slowly increase intensity to the desired
setting for that position. Be sure to discuss your
AdaptiveStim settings with your clinician.
Note: When the AdaptiveStim setting is turned
on, the intensity of the stimulation may not
change immediately when you change
positions. This delay is intentional and keeps
the neurostimulator from making unnecessary
adjustments based on temporary changes in
your position. Your clinician can adjust the
length of this delay.
AdaptiveStim groups and positions
Your clinician can program specific intensities
for each of 7 positions or your clinician can
program AdaptiveStim to adapt the intensity
settings based on the adjustments you make
to your stimulation while in one of the positions.
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Refer to Table 5.3 for an overview of the 7
different positions recognized by
AdaptiveStim.
Table 5.3 Positions recognized by
AdaptiveStim
Position graphic Description
Lying Back
Lying Front
Lying Left
Lying Right
Standing
Mobile
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Table 5.3 Positions recognized by
AdaptiveStim (continued)
Position graphic Description
Reclining
Unrecognized position
Checking your body position
If you want to check to make sure that the
neurostimulator recognizes your body
position, use the Check Position feature.
1. Press the Menu ( ) button on the Home
screen.
2. Select the Check Position button. The
Check Position screen is shown and will
display your current position and program
intensities (Figure 5.12).
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Figure 5.12 Check Position screen (lying back
position shown).
Note: If the Check Position button is not
available, check to make sure
AdaptiveStim is turned on. Refer to
"Turning AdaptiveStim on or off" on
page 124.
3. To check a different position, move your
body into the next position.
4. Press the Recheck button. The Check
Position screen is shown and will display
your new position and program intensities
(Figure 5.13).
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Figure 5.13 Check Position screen (standing
position shown).
Note: If your new position is not displayed,
press the Recheck button again. It may
require up to 1 minute to recognize a
Mobile position. If you are still having
problems with this feature, contact your
clinician.
5. Press the OK button to return to the Menu
screen.
6. Press the Exit ( ) button to return to the
Home screen.
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Turning AdaptiveStim on or off
1. Press the Pain area button on the Home
screen for the pain area you want to
adjust.
2. If applicable, use the Up/Down buttons to
view additional stimulation settings.
3. Press the AdaptiveStim ( ) button. The
AdaptiveStim screen is shown
(Figure 5.14).
Figure 5.14 AdaptiveStim screen.
4. Press the On or Off button to turn
AdaptiveStim on or off.
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Note: When you turn off AdaptiveStim for
one pain area, it will be off for all pain
areas.
5. Press the Exit ( ) button at the top right
corner of the touchscreen to exit.
Making adjustments to AdaptiveStim
If you make an adjustment to your stimulation
and want to have that adjustment remembered
for your current position, you may have to stay
in 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 may
need to make adjustments to your stimulation.
Table 5.4 provides general guidelines for
adjusting your stimulation when using
AdaptiveStim.
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Table 5.4 AdaptiveStim adjustment guidelines
Situation Action
AdaptiveStim stimulation for
a specific position is
uncomfortable.
While in the applicable
position, decrease
intensities and remain in
that position for the
duration programmed by
your clinician.
You are unable to adjust
AdaptiveStim stimulation
while in a specific position.
Make the desired
stimulation adjustment,
then get in the desired
position within the time
programmed by your
clinician and stay there for
the duration programmed
by your clinician.
Stimulation becomes
uncomfortable while riding in
a car or another type of
transportation.
Turn AdaptiveStim off.
Stimulation becomes
uncomfortable while moving
in an elevator, escalator,
etc.
Turn AdaptiveStim off.
You want AdaptiveStim to
turn your therapy off when in
a certain position.
Adjust your intensity to 0.0
to turn your therapy off
instead of turning the
neurostimulator off.
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