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Why do doctors push InterStim?

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  • palmtree
    replied
    I realize I didnít answer your question. You ask why do doctors push for Interstim? Answer:$$$

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  • palmtree
    replied
    Snowdrift,

    I am in 100% agreement with you. Cathing works just fine.

    A urologist diagnosed me with a neurogenic bladder before my MS dx. He was really pushing for Interstim and I couldnít imagine myself with one. I read that it is not recommended for patients with MS. So now I am very glad I stuck to my instincts.

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  • REG53
    replied
    Sparticle,

    I am sorry also that the interstim is not working for you. I wanted to get this done but because of not being able to get an mri I decided against it. After reading your post, I think it was a good decision not to do it.

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  • Mamabug
    replied
    Sorry for your experience, Sparticle. I often remind myself that we need to be our own best advocates. Often, our health care professionals advocate well for us too, but, unfortunately, sometimes they may have other agenda and motivations.

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  • Sparticle
    replied
    Realize this an old thread, but I'm glad to hear that others (well, I supposed glad isn't the correct word) got the hard sell on getting an Interstim placed.

    I had mine placed in 2015 - the sales rep actually came to "watch" the placement. I asked them (urologist and sales rep) if having this placed would cause a problem with MRI's. The sales rep sat on the edge of my bed just before I went into surgery and said there'd be no problem and that "there were special MRI machines where I could have MRI's performed".

    Yes, obviously they both lied to me (when I asked the rep my MRI question I already had received pre-op sedation, so talk about an easy sell) - since then I haven't been able to get an MRI except for one of my head. I've been less than thrilled with how the Interestim has worked for me; I'm scheduled to meet with CNP next month to get instruction on how to do self cath's- despite the settings the Interstim has not worked for me; very disappointed and would like to have it removed. When I told my neurologist, he said that he'd only had a couple patients that had Interstim's neither really helped with neurogenic bladder.

    I'm sure the push to have mine placed was $$$ motivated. At the time I had Medicaid, so there was guaranteed payment, add to the fact that my procedure was at the end of the year; I'm sure the rep had a sales quota to reach. (I used to work for a cardiologist, saw first hand how many of these reps "push" procedures when they get close to end of quarter/year). Physicians aren't "supposed" to get paid by companies to use their products - but I have a feeling that the trip my urologist took to Aruba for a conference was most likely sponsored by Medtronic.

    So thanks for giving me the opportunity to vent - I'm on another course of antibiotics for ANOTHER UTI, something "else" I was told that would be greatly reduced by Interstim placement.

    At this point, I just want to get the damn thing removed -!!!!!!

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  • ZSP
    replied
    My urogynecologist is pushing this too and I am resisting. I self cath and as you posted, it's the easiest thing to do for now.

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  • Snowdrift
    replied
    Ps: thanks so much for your comments. Especially about MRI. That actually gives me a reason beyond "I don't wanna!" to hold off for now.

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  • Snowdrift
    replied
    I only had one retention-related UTI before I started cathing, and one since. And only because I got lazy and skipped too many times, because it felt like I didn't need to.

    Thanks for the MRI info. That could seriously complicate determining if I have MS. I've only had a brain MRI and it was clear. I've been referred out to a more specialized place bc of so many signs and symptoms that seem to indicate motor neuron issues, despite clean MRI. I need cervical and probably thoracic MRIs.

    And anyway, if I have MS, it is, as you say, less likely to help. And if I don't have MS (or another chronic/progressive condition) I want to be able to ride horses and do judo. Without worrying about breaking off a lead.

    And for sure I have c-spine arthritis and a bulging disc, whether I have ms or not, that will have to be monitored for stenosis and such at some point.

    I did some reading on the 87% though--and their definition if "success" left something to be desired. I feel better off cathing full-time playing guessing games if I need to or not, trying to figure out if I'm retaining or not. That is just an exercise in frustration.

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  • Kimba22
    replied
    Hi Snowdrift,

    It's warranted for patients who fail or can't tolerate other treatments. I don't know if you've still had chronic uti's while self cathing, as that would be a reason. But maybe they are also worried about the potential for bladder or kidney damage?

    InterStim therapy has an overall 85.7% effectiveness rate for retention http://www.ncbi.nlm.nih.gov/pubmed/18242368, but not necessarily for MS. It works by stimulating one of the sacral nerves, which may not work for people with MS.

    "Safety and effectiveness have not been established for pregnancy and delivery; patients under the age of 16; or for patients with neurological diseases such as multiple sclerosis." http://www.medtronic.com/patients/ur...y-information/

    If you have a MS diagnosis, your insurance may not even approve it. (Maybe that's another reason they are pushing it now for you?) Something else to consider is MRIs. You could only have a brain MRI, not any of your cervical or thoracic spine. (Besides the brain, the only other MRI that's been ordered for my MS since my dx is the c-spine) https://professional.medtronic.com/p...#.VHVsNYxOnMIr

    If you aren't having any other problems because of the retention, I can totally understand why you would be hesitant to try this. People self cath indefinitely.

    Otherwise, who knows, it might just be something worth looking into further.

    Best of luck

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  • hunterd
    replied
    i`ve never heard of it, so no, he`s not pushing it.

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  • Snowdrift
    started a topic Why do doctors push InterStim?

    Why do doctors push InterStim?

    I don't have an ms dx (yet) but I do appear to have neurogenic bladder with retention.

    My urologist has really been pushing InterStim. Hard. I don't get it. Self-cathing works fine for me. I have way more freedom and feel way better than I did before.

    The idea of two surgeries and multiple office visits and testing a such for a device that will probably help to some degree is totally unappealing. I feel like I've already devoted more of my life than I ever wanted to to trying to pee. Why go back there, even it it's a little easier with the implant?

    I'm very active too, and hope to remain so. But with the specter of possible/likely ms dx out there and an uncertain future, I don't want to give up months of activities in order to heal from surgeries. (I inderstnad the basic healing process is very quick, but a much longer period of being cautious with activities).

    But my urologist keeps pushing. And then my neuro started pushing. Even my primary doc mentioned it. I'm a little frustrated by the whole thing.

    Have others experienced this push to get InterStim implanted? I guess it might help with bowel issues, as well, which are a relatively minor problem for me. If I had incontinence, I'd be more interested in trying InterStim. But for retention? Self-cathing just seems a much better solution for me. Can't seem to convince doctors, though.
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