Posted by manowar on January 12, 2002, at 2:56:22
In reply to Re: Old School nailed it, posted by BarbaraCat on January 10, 2002, at 23:11:16
Horse pucky! -- Such foul language:):):)
> Very fascinating. Correct me if I'm wrong, but I didn't think that Dr. Amen was doing SPECT scans any longer but treated based on symptomatology, or gut reaction he arrived at after seeing so many SPECTs? At any rate, given the fact that many of us have insurance with brain imaging facilities on-site (I belong to Kaiser - lotsa neuroimaging stuff at their disposal), how does one go about demanding to receive realistic and beneficial tests? I've had MRI's done at the drop of a hat for a neck injury. I've brought up the subject about getting my brain scanned for my depression and my pdoc says "oh, the science isn't in for sure yet". Horse pucky! It's a lack of education, or buckling under to Management's financial dictates, but WE are the ones paying their bills! What are your opinions on how we, as big-buck paying subscribers, can go about getting what we NEED. I think that many of us in this group are more informed than our pdocs regarding the myriad issues that hit-or-miss psychopharmacology specialization does not address. How do we educate/work with them and insist upon getting tests that are available, right now, that could alleviate or at least provide good info on why we're suffering? It's not even a cost issue since proper diagnosis and treatment would save insurers beaucoup bucks.
Regarding your question, "Correct me if I'm wrong, but I didn't think that Dr. Amen was doing SPECT scans any longer but treated based on symptomatology, or gut reaction he arrived at after seeing so many SPECTs?"
Uh, I don't understand what you're saying. If you mean that in the beginning when he first started using the technology he was a bit skeptical, and had the attitude that most pdocs have today--you're right. He wouldn't order a scan normally. Only after lots of frustration using typical psychiatry for refractory patients with little benefit, he began to use scans. He really didn't think it would be much of a benefit, but he started noticing abnormalities, which completely changed his psychiatric paradigm.
If you mean that since he has so much experience and that he can arrive at a diagnosis of a problem and prescribe treatment without the use of SPECT, you're right. Normally though, people want to spend the money and have the scans done. Why not? The more information, the better. Most people that go to the Amen clinic INSIST on having scans done.
>How do we educate/work with them and insist upon getting tests that are available, right now, that could alleviate or at least provide good info on why we're suffering?
Bring books, journals, abstracts, reports, anything you can get you're hands on. For me it was very difficult to find a progressive, foward thinking doctor. It's hard work. But don't settle for second best.
If they don't listen, walk.
Out of total frustration, I called the Amen Clinic on my own. I talked to a person that basically interviewed me over the phone and told me how the procedure works and what the charges are etc. I didn't need a referral, even though my pdoc was happy to give me one if I needed it. I made a phone appointment with a doctor at the Amen Clinic before I made the decision to go there. It really didn't matter to me if the clinic was 200 miles or 2000 miles away; luckily I have lots of sky-miles. I'm in Knoxville TN.-- I could have called Emory in Atlanta or have even called the University of TN, which has an excellent program. There are a million options. You've just got to research, and make phone calls, and be vigilant. I ultimately decided on the Amen Clinic because I believed the guy, and I was at the point where I decided not to waste another minute.
Of course, the clinic filed for my insurance, but I had to pay then and there. But I knew that going in. When I got a check for $2,300 in the mail from my insurance company a month later- it was one of the happiest days of my life. I honestly never counted on it!
Have a great weekend,
> > > ************************************************
> > > Old School,
> > >
> > > Don't be sad, be glad:)
> > >
> > > Actually, there are some Psychiatrist that are beginning to 'see the light' and recommend scans for patients with 'treatment resistant' depressions. Luckily, I had a pdoc that referred me to the Amen Clinic in CA last summer. The scans were a wake up call for my physicians and me. I've already written about my experiences before, but Dr. Bob’s server is running very slowly, and I can’t find my posts (it could be a conspiracy:)
> > >
> > > In brief:
> > > I'm a firm believer in the viability in using modern SPECT equipment to HELP diagnose and treat depression and other psychiatric ailments. It's my humble opinion (I’ve had the scans done) that it really works in showing what areas of the brain are not functioning correctly. The fact is-- when certain parts of your brain are not functioning correctly it is FAIRLY predictable how a patient functions (i.e. Schizophrenia, Major Depression, Parkinson’s, Alzheimer’s)
> > >
> > > There are many on this board that disagree and think that its use is only for 'testing purposes'. --I dissent. Modern SPECT imaging is absolutely unreal. You really 'see' a three dimensional FUNCTIONAL image of your brain on a computer screen. And BTW: Changing your thought patterns during the tests have very little impact, if any, on the completed image- that’s baloney- Well maybe if you’re thinking of sex or of eating you’re favorite food. But who in the hell does that when he is in a tube that turns every 15 seconds and makes weird noises?
> > >
> > > By using this type of technology, a pdoc can, in many cases, save a patient years of agony and frustration and actually 'target' treatment, instead of forcing a patient through endless trial and error with psychoactive drugs—which can in many cases makes problems worse, and can cause irreversible brain damage.
> > >
> > > And yes, I do think that people with hard to treat psychiatric disorders should all have ‘their heads examined’. Why not? I think most people in America that have heart ailments get either an MRI, SPECT, or any number of imaging studies for it. Why should the brain be any different?
> > >
> > > Again, I think most pdocs are fat and lazy. If they kept up with Neurology along with Psychiatry (which overlap-tremendously), we as patients would be much better off. I don’t think Psychiatrist and Neurologists mingle much at all. There are but a few exceptions. BTW: Dr. Amen is both a Psychiatrist and a Neurologist.
> > >
> > > There is a growing number of pdocs that are beginning to use this technology in their practices. Most of them are on the West coast, though.
> > >
> > > People, please don’t casually dismiss this argument, by saying, “Its just a scam”, or “Junk science” without putting effort into examining the information that’s out there! That’s just a cop out.
> > >
> > > Take care,
> > >
> > > --Tim
> > Tim...I totally, absolutely 100% AGREE with everything you just said. I couldnt have put it better myself. You and I think exactly the same in regards to mental illness. Its your BRAIN, not your "mind" or some "psychological" problem.
> > I didnt realize Dr. Amen is dually trained in both Psychiatry and Neurology. Thats good. I was in the rTMS clinical trials back in 99 at the Medical University of South Carolina. That program with rTMS, VNS, DBS, etc. is run by another guy who is board certified in both Psychiatry and Neurology, Dr. Mark George. And Dr. George is very heavily involved in this functional neuroimaging stuff. He is doing things like taking treatment resistant folks, giving them an initial brain scan using functional MRI, SPECT or PET. Then doing VNS implant, rTMS, DBS or some other depression treatment on them. And then giving a POST TREATMENT brain scan afterwards. The results of before treatment and after treatment show up on these functional neuroimaging scans. Its real neuroscience for a change, rather than the usual psychology/psychiatry subjective psychobabble.
> > I think many are afraid or intimidated by these new ideas within Neuropsychiatry research. That is my personal opinion. Many people, including many with severe mental illness, just cannot get over the hump in regards to truly accepting that their problem is IN YOUR BRAIN!
> > You are 100% correct Tim and Ive thought about getting a SPECT scan myself.
> > Old School