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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 17 to 41 of 49. Go back in thread:
Posted by pseudoname on July 19, 2006, at 14:21:45
In reply to ECT and Memory Loss, posted by Denise190466 on July 19, 2006, at 13:49:55
> so if you found that your memory was getting progressively worse during the treatments, couldn't you stop them?
That seems reasonable. You could, I suppose, find or devise memory tests to give yourself both now and after you've started ECT for comparison. "What did you have for breakfast yesterday?" that sort of thing.
> I can remember everything right up to lying on the table and waiting for them to anaesthetise me beforehand.
I can remember getting to 97 when counting backwards and the anesthesiologist saying "Goodbye" and the rush of going under, which was pretty cool. The only time I've ever been out.
> that I should have bilateral because otherwise I would end upstairs like this other guy on a drip because of all the anaesthetics he'd had beforehand!
I don't understand this. They put you out with anesthetics for bilateral, too.
> this lovely beauty clinic room, lovely smells pervading the air, listening to lovely relaxing music and I was thinking why couldn't the atmosphere be a bit more like this in the ECT Clinic??
What a great idea!
Posted by Denise190466 on July 19, 2006, at 14:57:24
In reply to Re: ECT and Memory Loss » Denise190466, posted by pseudoname on July 19, 2006, at 14:21:45
Hi,
That was a quick response. Yes I know they put you out with bilateral as well but this awful woman was trying to force me to have it because she said I would need less of them to get better and therefore less anaesthetics.
Did ECT help you?
Denise
Posted by pseudoname on July 19, 2006, at 15:50:35
In reply to Re: ECT and Memory Loss, posted by Denise190466 on July 19, 2006, at 14:57:24
> That was a quick response.
Well, I'm avoiding doing other stuff. LOL!
> Did ECT help you?
Nope. 18 sessions unilateral. But, in fairness, nothing else helped either — 36+ meds & combos, tons of therapy, exercise, light, life changes, love, sex, travel, and that other one I sometimes hear promoted, the passage of time…
Until my current med, when things finally seem to be starting to fall into place.
I speculate bilateral ECT zaps some of the limbic parts and stimulates them to grow (in the process producing, as link says, BDNF). In other versions, it would stimulate growth in various cortical areas. Seems like they could pick out better (like with EEGs or MRIs) who should get which version.
It also seems like the low-dose direct-current brain stimulation would work just as well without all the anesthesia fuss, but it's hardly spoken of.
I would not be absolutely opposed to ECT, but it makes my head spin that docs and insurers are so blithe about trying it and so unwilling to try, oh, to pick an example at random, buprenorphine, which costs a few bucks and produces results within days.
Posted by linkadge on July 19, 2006, at 18:32:52
In reply to Re: Anyone had ECT? » linkadge, posted by Crazy Horse on July 18, 2006, at 21:44:25
>What a CROCK OF SH*T!! Although, i'm not >surprized that you would as usual reply with a >negative post..kind of your preference >don't .you think? LOL..unbelievable!! "Devils >Advocate" is a huge understatement!
>Monte -(sorry if i was a little harsh..forgive >me as i have severe brain damage from ECT).I honestly don't know what you mean, I was being sincere. Clearly, not everbody's experience with ECT is negative, that does not negate the fact that ECT is, and will for a long time be, a very controversial treatment.
Long term results with ECT are very unpredicatable. I am glad you are lucky with your encouter.
Linkadge
Posted by linkadge on July 19, 2006, at 18:57:27
In reply to Re: Chill out Crazy Horse, posted by Crazy Horse on July 19, 2006, at 10:02:10
That is not a probelm. I am not really out to try and piss people off.
I have encountered a number of people who have had the procedure. Some I met while in the hospital and some I met online and also around the university area.
There is no doubt that ECT can "quell" some forms of severe depression.
The main idea I got from the people I talked to was that it worked well in the short term, but most of them relapsed (without medications) to a state worse than prior. The people I talked to said they felt it was a big mistake because it had affected their jobs and their memories, and the thereaptutic effect against depression was only temporary. One guy said he didn't know who he was for about a month.
One lady said she lost all memories of here children's childhoods and teen years, and said that nothing could be worse.
I'm not trying to make life difficult for people, I just think that its unrealistic to not give to give some stories from the other side of the table.
I think that med-empowered felt the same way. I think he said he had some relatives who did not fair well on ECT.
If you take a drug, and it doesn't work, then you can stop taking it and most things go back to normal. If ECT doesn't work, and suppose you loose something as precious as the memory of your kids' childhood, thats a pretty big price to pay.
You will find psychiatrists who simply refuse to give their patients ECT, based on what they believe about the procedure.
There is not an overwhealming conscensious in the medical community that ECT is a safe procedure. The same thing goes with antidepressants. Antidepressants may not be safe for some children. They may prompt some children to take their lives. For years we were told they were unquestionably safe. Thats really how it can work sometimes. "They" say its safe...well who are "they"?
There are plenty of opponents, and not just shawdy Breggin types of people. The doctor I talked to at the univeristy of Toronto said that nobody had asked him that question before.
He said people had asked him how or why it worked, but nobody had asked him if he thought it was safe.
Linkadge
Posted by SLS on July 19, 2006, at 23:07:59
In reply to ECT and other options » Denise190466, posted by pseudoname on July 19, 2006, at 15:50:35
> It also seems like the low-dose direct-current brain stimulation would work just as well without all the anesthesia fuss, but it's hardly spoken of.
Is that bilateral?
Is there anywhere on the Net where information about this can be found?
Thanks.
- Scott
Posted by Crazy Horse on July 20, 2006, at 0:02:32
In reply to Re: Chill out Crazy Horse » Crazy Horse, posted by linkadge on July 19, 2006, at 18:57:27
I know, and you are right..i told you i was sorry..even sent you a babblemail. I'm just frustrated and angry at the world right now. Please forgive my rude behavior.
Monte
Posted by Karen44 on July 20, 2006, at 0:10:07
In reply to Re: Chill out Crazy Horse » Crazy Horse, posted by linkadge on July 19, 2006, at 18:57:27
>>
> The main idea I got from the people I talked to was that it worked well in the short term, but most of them relapsed (without medications) to a state worse than prior. The people I talked to said they felt it was a big mistake because it had affected their jobs and their memories, and the thereaptutic effect against depression was only temporary. One guy said he didn't know who he was for about a month.
>
>> Linkadge
>This is exactly why I refused ECT when it was recommended for me April 2005. My job depends on having a very good memory. I felt insulted that the doctor even suggested it and told him so; it would have meant me losing my job, and thus no insurance for all of the medical problems I had acquired all of a sudden and that were contributing factors to me being depressed. I just quit Parnate three weeks ago, and I can see it was helping some as I am now very depressed again. But as I did in the past; I plod on and go to work every day and do my job and get my work done even if I am not as efficient and it takes me 12 hours to do what I would normally do in eight hours. So, what to do; try yet another medication. There are also other things being tried now too--like the magnetic stimulation thing. I don't know much about it and if one takes medicaitions too along with it?? Has anyone tried this approach.
Karen
Posted by SLS on July 20, 2006, at 6:12:15
In reply to Re: Chill out Crazy Horse, posted by Karen44 on July 20, 2006, at 0:10:07
> There are also other things being tried now too--like the magnetic stimulation thing. I don't know much about it and if one takes medicaitions too along with it??
Yes, you can take medications along with it. You will find some debate about its success rate, but I believe it is worth a try as long as the expense isn't coming out of pocket. I don't think its limited success rate justifies the investment if you are treatment resistent. One of the foremost researchers of this procedure, formerly of the NIMH, recommended one of his former treatment resistent patients that she not bother with it. However, this was 5 or more years ago. They are constantly tweaking the settings on the machine. I believe they are currently using 20Hz on the right fronto-temporal placement. rTMS should be approved in the not too distant future. Insurance might cover it then.
- Scott
Posted by SLS on July 20, 2006, at 6:31:07
In reply to Re: Chill out Crazy Horse » Karen44, posted by SLS on July 20, 2006, at 6:12:15
Posted by pseudoname on July 20, 2006, at 8:56:31
In reply to Re: ECT and other options » pseudoname, posted by SLS on July 19, 2006, at 23:07:59
Hi, Scott.
> Is that bilateral?
My understanding is they use various pathways.
> Is there anywhere on the Net where information about this can be found?
There's a nice summary & more links here:
•The Body Electric: What is electrical brain stimulation used for? And is it safe?
By Amanda Schaffer in Slate, Jan 11, 2005
http://www.slate.com/id/2112151/
Posted by SLS on July 20, 2006, at 14:13:09
In reply to direct current polarization article » SLS, posted by pseudoname on July 20, 2006, at 8:56:31
Posted by linkadge on July 20, 2006, at 16:24:21
In reply to Re: Chill out Crazy Horse » linkadge, posted by Crazy Horse on July 20, 2006, at 0:02:32
No problem at all. Feel free to say what you feel.
Linkadge
Posted by Crazy Horse on July 20, 2006, at 17:43:22
In reply to Re: Chill out Crazy Horse » Crazy Horse, posted by linkadge on July 20, 2006, at 16:24:21
> No problem at all. Feel free to say what you feel.
>
> LinkadgeThanks Linkadge, but i was way out of line. Like i said, insomnia makes me mean and just flat out pissed off at the world..but that still doesn't give me the right to act like a total *ss at PB or anywhere else for that matter..and that's what i did. I am embarrassed and ashamed of that mean spirited post, and again i am truly sorry.
Monte
Posted by stargazer on July 20, 2006, at 20:02:00
In reply to Re: Anyone had ECT? » linkadge, posted by Crazy Horse on July 18, 2006, at 21:44:25
Hi,
Haven't posted in a long while. I worked in the ECT dept at a major university hospital in the Northeast and never had a good feeling about ECT. Although some people improved initially, many just went onto maintenance ECT which means you come back "forever" to maintain your mood status. I'm not even sure the mood was ever that great to sustain. And the chief MD did not seem too sympathetic towards the patients and he NEVER said "it's not working" or ever decided to stop the treatments. I felt his motivation was $$$(big surprise?)and his biggest goal for the day was to treat as many pts as he could in the least amount of time. I eventually had to leave because I didn't feel the patients were being treated as I would want any patient to be treated, especially depressed patients, unable make good rationale decisions. It was always the patients who decided to stop and in my opinion, they were blamed for not continuing treatment, never was their reluctance to continue ECT understood. Go figure, isn't psychiatry supposed to understand this type of resistance? I also saw people I felt should never have ECT, i.e. demented elderly, who couldn't give their consent yet "signed" forms saying they were agreeing to treatment. I told the MD they were confused and couldn't sign a consent but he minimized this and basically ignored my concerns.
Sorry for being negative, but that was what I saw and feel anyone who considers it should know. I you do decide it is your last chance, make sure you have a friend who can be your spokesperson, who knows you and will speak for you because you won't remember sh*t.
Posted by linkadge on July 20, 2006, at 21:24:33
In reply to Worked as RN in ECT dept., posted by stargazer on July 20, 2006, at 20:02:00
I think that what you have said is very important.
Linkadge
Posted by SLS on July 20, 2006, at 22:01:38
In reply to Re: Worked as RN in ECT dept. » stargazer, posted by linkadge on July 20, 2006, at 21:24:33
Individual experiences with ECT vary widely. Although I know that it works well for some people and can be free of side effects, such that it is deemed by many to be a miracle, I am reluctant to subject myself to another course of treatments. I guess I'm a little scared of them.
It is difficult to ignore the horror stories regarding memory loss and cognitive deficits as the result of ECT. It should be noted, though, that there are people whom have had over 100 treatments and whom seem none the worse for it.
I don't regard the necessity of taking maintenance treatments to be a monumental failure of the modality. It is what it is. It is an inconvenience. So is dialysis.
- Scott
Posted by Crazy Horse on July 20, 2006, at 23:23:47
In reply to Worked as RN in ECT dept., posted by stargazer on July 20, 2006, at 20:02:00
> Hi,
>
> Haven't posted in a long while. I worked in the ECT dept at a major university hospital in the Northeast and never had a good feeling about ECT. Although some people improved initially, many just went onto maintenance ECT which means you come back "forever" to maintain your mood status. I'm not even sure the mood was ever that great to sustain. And the chief MD did not seem too sympathetic towards the patients and he NEVER said "it's not working" or ever decided to stop the treatments. I felt his motivation was $$$(big surprise?)and his biggest goal for the day was to treat as many pts as he could in the least amount of time. I eventually had to leave because I didn't feel the patients were being treated as I would want any patient to be treated, especially depressed patients, unable make good rationale decisions. It was always the patients who decided to stop and in my opinion, they were blamed for not continuing treatment, never was their reluctance to continue ECT understood. Go figure, isn't psychiatry supposed to understand this type of resistance? I also saw people I felt should never have ECT, i.e. demented elderly, who couldn't give their consent yet "signed" forms saying they were agreeing to treatment. I told the MD they were confused and couldn't sign a consent but he minimized this and basically ignored my concerns.
>
> Sorry for being negative, but that was what I saw and feel anyone who considers it should know. I you do decide it is your last chance, make sure you have a friend who can be your spokesperson, who knows you and will speak for you because you won't remember sh*t.Damn, that's just flippin heart breaking. It makes me sick! All about the fu*kin' almighty dollar?? One thing for sure, if it does work..the effects are short lived. My pdoc wanted me to travel to Seattle 250 miles from my home town for maintenance treatments, which i did not do...i could tell even in the state i was in, that he was after money too! One thing is sure, i will/would never do ECT again!
Monte
Posted by stargazer on July 21, 2006, at 9:25:17
In reply to Re: Worked as RN in ECT dept. » stargazer, posted by Crazy Horse on July 20, 2006, at 23:23:47
I know how frustrating it is since I had considered ECT priorto working in that environment. My doctor said we should try more meds and I'm glad we waited because once your brain is traumatized like that it would never be the same. Many studies say the memory loss is short term but I'm not convinced of that based on what I saw. I would rather try a nerve stimulators than ECT.
One thing of interest was that although many people of all socioecomonic backgrounds try ECT, the more educated ones seem to stop the treatments and the ones who continue seem to just blindly continue I guess for lack of knowing what else to do. It's sad to see and wonder if they are being taken advantage of. If you have Medicare you can have ECT but most insurances limit the number of treatments.
I only saw one doctor's family members try it and they stopped after a few treatments. I would be to intrinsiclly fearful of brain damage that if I tried it I would only use it to get me from commiting suicide and then once out of that despair go back to medications.
who knows...it's not an easy choice especially when you are desparate. And for those of you who have gotten good results, God bless. I'm not a religious person, but someone is looking after you.
Posted by pulse on July 21, 2006, at 16:21:06
In reply to ECT and Memory Loss, posted by Denise190466 on July 19, 2006, at 13:49:55
< I'm thinking of pushing to have ECT again (this time the whole course and not just two treatments). I was thinking though, surely you would be aware of the memory loss and how bad you were being affected during the course of the treatments and the intervals inbetween.
so if you found that your memory was getting progressively worse during the treatments, couldn't you stop them?
The two treatments I had didn't seem to affect my memory at all, I know only two not enough to really know. But I can remember everything right up to lying on the table and waiting for them to anaesthetise me beforehand.
I remember the conversation I had with the ECT Nurse, the people who were with me in the waiting room and everything I said to them.
Neither do I have any other memory loss as far as I am aware. ...... >
(snipped)
i'm the ultimate believer in - and advocate for - ECTs.
yes, of course, you will know immediately (IF you ever even experience one iota of memory loss upon the initiating of ECT tx...or later). you then have the option -and supreme right - to simply leave.
denise 190466's above excerpt w/description has been exactly my experience, with one BIG exception:
i insist ALWAYS and ONLY on BILATERAL. i walked out ama, the only time unilateral was performed on me, and, after only 1 treatment.
unilateral FOR ME = extreme memory loss + migraine -level headaches. i'd no memory of talking to this incompetent doc. i have no idea what he even looks like (i was in need asap and was taken straight to from another center; my ECT doc was of vacation.) also, no memory of going to operating room, table, applying of electrodes, talking with this doc, nurse, or anesthesia person, as i'd always before, and right up to the seconds i was counting down from 100.
with bilateral, i've never once had memory loss upon initiating, nor, at any time, during the course of txs, nor afterward. i still have an extremely good memory at age 54. also, no headaches and no side-effetcs of any kind. this was from tx #1 through tx #12, i.e., the usual full-series length.
results were always the same, both in the other 2 full course series i've had, with years in between, and, also, when i only needed a 5 tx. course.
reiterating what i've posted numerous times: imo, the key is the expertize of the ECT doc. mine have both now retired.
i have no magic formula for finding such a doc.
*to randy - i don't find it odd at all that you were taken off meds. i always was.
as i'm now so side-effects intolerant (physical ones) to all ads, all classes, i will never take one again....no matter what. if i ever need ECT again, i will refuse to take them, afterward. that is a certainty. i could care less what the doc advises. this is my life.
i am now in full remssion without any ad. my correct diagnosis is mdd, recurrent & moderately severe to very severe. there is doubt re: this. so as not to confuse you, my last ECTs were in 1997. also, i don't mean to imply that any of the above is the reason that i'm now in remission, because i know that is most definitely NOT. but, at least, the ECTs sure didn't hurt.
monte, wishing you a good to great outcome!
pulse
Posted by pulse on July 21, 2006, at 16:27:06
In reply to ECT/Memory Denise190466; Randy:FYI; Monte, posted by pulse on July 21, 2006, at 16:21:06
correcting re: my dx, near the end of my above post.
it should read: there is NO doubt.
pulse
Posted by pulse on July 21, 2006, at 16:43:08
In reply to Re: ECT/Memory Denise190466; Randy:FYI; Monte, posted by pulse on July 21, 2006, at 16:27:06
long thread; 1st cup of coffee; bad sinus. please choose an excuse for my lapse.
monte, sorry for your experience.
pulse
Posted by pulse on July 21, 2006, at 16:58:11
In reply to Re: Worked as RN in ECT dept., posted by stargazer on July 21, 2006, at 9:25:17
really?! i've found just the reverse to be true of the many i've been in with for ECTs - who DID continue. my IQ is 160. several other's had higher to ...much higher.
my therapist was formerly the head psych nurse in a hospital (patients from all socio-economic brackets, such as your's) for 25 years. she would agree with my assessment, just for the record.
pulse
Posted by Crazy Horse on July 21, 2006, at 17:03:41
In reply to Re: Worked as RN in ECT dept. » stargazer, posted by pulse on July 21, 2006, at 16:58:11
> really?! i've found just the reverse to be true of the many i've been in with for ECTs - who DID continue. my IQ is 160. several other's had higher to ...much higher.
>
> my therapist was formerly the head psych nurse in a hospital (patients from all socio-economic brackets, such as your's) for 25 years. she would agree with my assessment, just for the record.
>
> pulse
>
>Dang, 160 I.Q. that's awsome! Isn't anything 160 or higher considered genius? Mine is 125-130..not too bad i guess..LOL.
Posted by linkadge on July 21, 2006, at 19:16:08
In reply to Re: Worked as RN in ECT dept., posted by Crazy Horse on July 21, 2006, at 17:03:41
I guess my argument was that the community of psychiatrtic patients is often taken advantage of based on the fact that treatment side effects are often pawned off to the underlying illness.
Memory loss from ECT does not necessarily have to present itself right away. The loss may not be obvious right away since you may not use a specific certain part of your brain everyday. Its just like how memory loss in Alzheimer's can often progress for a while without the patient being aware. The idea is that if you don't remember somthing, then you may not detect its absence.
The *dammage* detected in some animal models of ECT, extend beyond possable alteration to hippocampal formation. There is a lot of collateral damamge. You are sending an electic charge through the brain. It is not always 100 percent certain which path the current will take.
Its just like how two people can be physically electrocuted and one can die while the other doesn't, it really depends on the path that the current took through the body.
Many of the molecular actions of ECT are seen in patients who have had epileleptic seizures. Long term memory and cognitive complaints can often be seen in this patient group.
There is an article here which may be usefull.
http://www.ect.org/resources/memory_cognitive.pdf
For a psychiatrist to convince me its safe, I'd like to have him jump down on the table, and zap himself...."see.....its safe". They're not going to do that.
Linkadge
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