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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by glenn on January 9, 2003, at 4:51:06
Lovely to see you back, how is your husband?
Well I hope, what's this about Transcranial? have you stopped the Tianeptine?
If you would prefer to answer this privately my email is g.macauley@ntlworld.comGlenn
Posted by Pfinstegg on January 9, 2003, at 11:29:08
In reply to To Pfinstegg, posted by glenn on January 9, 2003, at 4:51:06
Hi Glenn! And thank you for the warm welcome! I am in the midst of TMS treatments. To my amazement, after 8 treatments, my depression is completely gone! Here, they evaluate your progress by using the Beck Depression Inventory(available on Google if anyone wants to take it). It's sort of simple, but I think it's accurate. The ratings are:
1-10 : within the range of normal
11-16 : mild mood disturbance
17-20 : borderline clinical depression
21-30 : moderate depression
31-40 : severe depression
41 + : extreme depressionDuring the two months prior to treatment, I was asked to fill out the inventory every few weeks, in order to give the doctors a good baseline. My scores then ranged between 35 and 41. But after 8 days of TMS, my score is 2! I am scheduled to have 7 more treatments, with a possible option of having 10 more afterwards.
The treatments themselves were more painful than I had thought they would be- like an electrified ice-pick being plunged into my brain! However, taking Tylenol with codeine helps enough to make them quite bearable. I haven't had any side effects other than the discomfort, and can drive myself to the daily appointments without any difficulties- no memory problems or getting lost!
Each treatment consists of 400 pulses of high frequency electromagnetic energy, just below the threshold which would give you a seizure, delivered in groups, with a few seconds pause between each group- it goes to a precise location over the left pre-frontsl cortex: while you're being treated, you walk around with an indelible black dot marked on your skull. Each day's session takes about 20 minutes.
I am still taking the tianeptine, not because it's a good AD (it isn't) but because of the possibility that it will have a long-term protective effect on the limbic system. I also rely on fish oil, B vitamins, synthroid and Cytomel.
You were a dear to ask about my husband: while I am here in Atlanta having TMS, he is at Sloan-Kettering in New York undergoing the latest in radiation for recurrent prostate cancer- IMRT (intensity-modulated radiotherapy). His prognosis is excellent with this new form of radiation- about a 92% chance of cure.
TMS is not yet FDA-approved, so insurance does not cover it. I hope it will be approved soon, as it is in Canada and Europe, because it is a terrific treatment- based on my experience!
It was so nice to hear from you, and
I do hope things are going well.Pfinstegg
Posted by McPac on January 12, 2003, at 0:19:43
In reply to Re: To Pfinstegg » glenn, posted by Pfinstegg on January 9, 2003, at 11:29:08
Is the positive TMS effect supposed to LAST? How much did it cost and are there any side effects? Thanks!
Posted by Pfinstegg on January 12, 2003, at 10:04:46
In reply to Pfin Re: To Pfinstegg, posted by McPac on January 12, 2003, at 0:19:43
No-one is sure. They have been giving it privately here at the North Atlanta Psychiatric Associates for only two years. They have had people come for a course of it, and then do fine, but others need to come for "maintenance" at about six month intervals. They do keep track of everyone, as they, too, want to know how long-lasting it is.
The side effect profile is non-existent. Because the magnetic coil is able to deliver an electromagnetic current right through your skull, without scattering as ECT does, it is targetted very precisely at the left dorsolateral prefrontal area. It increases the blood flow there, and tends to normalize neurotransmitter function also- this from rat studies. There is some spreading of its effects into the hippocampus, where the same changes have been shown to occur. There is no memory impairment whatsoever (the city is unfamiliar to me, and I'm able to drive around alone and get everywhere I need to). I never got a headache during or after the treatments. The treatments themselves, however, are more painful for me than they are for most people, and I need Tylenol with codeine to get through them. With it, however, I am OK- able to talk to the technician about anything; your mind just goes on working as usual during the treatments.My insurance covered all my appointments with DR. Hutto, but none of the TMS treatments. They charge for it on a sliding scale here, with the top payment being $150 per session: a typical course of treatment is 15 sessions, so the total full cost would be $1650. To that, you need to add the cost of travelling to Atlanta, plus living costs and a car rental. The Center does help with finding relatively inexpensive places to stay; they suggested a residence motel about 15 minutes away that costs about $200/week- it has a laundry room, small fridge, stove and microwave, so all of that has helped keep the cost down.
If the TMS works well, as it has for me, it begins to seem priceless- more than worth the trouble and expense. I like, also, that they do careful, on-going follow-ups by telephone; you don't just disappear after your final treatment.
Pfinstegg
This is the end of the thread.
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