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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 90. This is the beginning of the thread.
Posted by johnLA on August 3, 2014, at 10:56:55
hi all-
today, yes on a sunday :), i will be meeting with one of the few docs using the newer tms therapies called 'deep tms.'
i am hoping that i can get started right away. i have spoken to her over the phone a few times already and she says there is 'significant' efficacy over regular tms with the newer deep tms. she does both.
i have to come-up with the monies upfront, but my insurance does cover it. she told me that she has not had anyone denied reimbursement after filing a claim with blue shield california. fingers crossed on that!
i asked a friend if pre-paying $9k for a chance at getting better was a wise move. he asked about the chances; i said it seems the therapy gets 30% to 50% of people improved. he said go for it. he's my roommate and childhood friend. he knows/remembers what i was like before i got depressed.
so, i will report my experience (if, she thinks i am a good candidate and i start it) here as i did with the ketamine trial and even the marijuana trial for those of you who remember.
there are very few links/studies regarding deep tms. if anyone wants to link any on this thread go ahead.
i am pretty tired of researching about depression treatments to be honest. guess i could use some help if someone feels like it. (hugh? :))
wish me luck please.
godspeed good health to all of us.
john
Posted by SLS on August 3, 2014, at 11:44:58
In reply to going for deep tms..., posted by johnLA on August 3, 2014, at 10:56:55
Good luck!
- Scott
Posted by Hugh on August 3, 2014, at 13:30:00
In reply to going for deep tms..., posted by johnLA on August 3, 2014, at 10:56:55
I'll be pulling for you, John. And I'll be pulling for Blue Shield California to come through.
Posted by Phillipa on August 3, 2014, at 13:58:16
In reply to Re: going for deep tms..., posted by Hugh on August 3, 2014, at 13:30:00
John the very best of luck to you. Phillipa
Posted by phidippus on August 3, 2014, at 14:06:45
In reply to going for deep tms..., posted by johnLA on August 3, 2014, at 10:56:55
Why not DBS?
Eric
Posted by Hugh on August 3, 2014, at 14:20:03
In reply to going for deep tms..., posted by johnLA on August 3, 2014, at 10:56:55
John,
Did you see this study?
"Each patient underwent a series of 5 treatments a week at a high frequency, with double the amount of pulses used in previous studies."
I'm not sure if they mean that 20 hertz was used instead of the standard 10, or that twice as many 10 hertz bursts were used.
Posted by Tomatheus on August 3, 2014, at 14:42:28
In reply to going for deep tms..., posted by johnLA on August 3, 2014, at 10:56:55
John,
I wish you the best with the deep TMS. Here's to hoping that you'll benefit from the procedure.
Tomatheus
Posted by ihatedrugs1 on August 3, 2014, at 19:30:07
In reply to Re: going for deep tms..., posted by Tomatheus on August 3, 2014, at 14:42:28
> John,
>
> I wish you the best with the deep TMS. Here's to hoping that you'll benefit from the procedure.
>
> TomatheusJohn,
I did six weeks of regular tms and my depression improved, though didn't go into full remission. Nonetheless, I felt the best I had in several years. Unfortunately, my depression came back around a month after the treatments and I'm now in the process of appealing my claim to the insurance company. If they decide to cover it, I'll be first in line for maintenance treatments (I hope I don't have to start from scratch again). The hospital is now offering deep tms and if my doctor concurs that would be the route I'd take.
I wish you the best of luck.
ihatedrugs
Posted by ihatedrugs1 on August 3, 2014, at 19:32:03
In reply to Re: going for deep tms... » Tomatheus, posted by ihatedrugs1 on August 3, 2014, at 19:30:07
Posted by johnLA on August 3, 2014, at 20:44:08
In reply to Re: going for deep tms... » johnLA, posted by SLS on August 3, 2014, at 11:44:58
thank-you so much scott.
you are one of my 'heroes' here. to fight as long as you have is just absolutely inspiring.
i hope in a small way that i can help you with all these different things i am trying; ketamine, marijuana, etc. and now deep tms.
i have more up my sleeve too. ;)
god bless you scott. i am hoping for both you and i and others that this treatment might get us back to life.
john
Posted by johnLA on August 3, 2014, at 20:47:31
In reply to Re: going for deep tms..., posted by Hugh on August 3, 2014, at 13:30:00
thanks so much hugh.
as i told you, you are the one that let me know a deep tms doc was just down the street.
thanks so much for the push.
you are a generous soul to provide info about new treatments here on babble.
i'll take your wish on the blue cross deal too! :)
john
Posted by johnLA on August 3, 2014, at 20:51:34
In reply to Re: going for deep tms..., posted by Phillipa on August 3, 2014, at 13:58:16
thnx my dear phillipa, my fellow anosmic. :)
remember to focus on color, texture and temperature when it comes to food.
it sucks not to be able to smell or taste i know. but, try your best on the suggestions i made. sometimes i actually get enjoyment from 'feeling' my food. it's true.
john
Posted by johnLA on August 3, 2014, at 20:57:56
In reply to Re: going for deep tms... » johnLA, posted by phidippus on August 3, 2014, at 14:06:45
ah eric...
how much i would have enjoyed having you as a student in class. always questioning. thinking of other ways to solve problems or look at life.
these were often my fave students...
to answer your specific question; i am not ruling anything out. dbs specifically for me would be down the road. as i mentioned earlier, i want to try less invasive approaches first. or, hoping some new things come in the years ahead.
yes, i want to feel better right now. but, i am willing to be patient and fight a bit more before i do brain surgery.
still, it's on my list. just not very high right now.
Posted by johnLA on August 3, 2014, at 21:01:28
In reply to Re: going for deep tms..., posted by Tomatheus on August 3, 2014, at 14:42:28
thank-you tomatheus.
as a greek i have told you i really like your nick. :)
i hope that you too will find some peace soon. i told you before, i think you are an amazing writer. i hope that talent can be shared with others soon my friend.
Posted by johnLA on August 3, 2014, at 21:03:12
In reply to Re: going for deep tms..., posted by johnLA on August 3, 2014, at 21:01:28
Posted by johnLA on August 3, 2014, at 21:14:26
In reply to Re: going for deep tms... » Tomatheus, posted by ihatedrugs1 on August 3, 2014, at 19:30:07
thanx dear colleague.
the doctor asked me what i would do if i got well. i didn't hesitate to repond; i said teach again of course. plus, maybe fall in love again. ;)
more and more insurances are covering tms/dtms she also told me. she said the key is that the doc/office needs to really document past failures and fight for you to get covered. again, she says it is becoming easier to get coverage. also, both tms and deep tms use the same psych pricing codes with insurance. so, if one is covered so will the other.
she also described a scenario like yours; where stubborn depressions usually need a 6 month 'booster' maintenance. and no, not a full treatment (20 to 30), but a week or so. so, people do not have to start from zero again.
i told her i want off drugs too cuz i hate them. lol she said, ok let's shoot for that...
Posted by johnLA on August 3, 2014, at 21:15:44
In reply to going for deep tms..., posted by johnLA on August 3, 2014, at 10:56:55
Posted by Hugh on August 4, 2014, at 11:59:59
In reply to i start tomorrow 7pm... (nm), posted by johnLA on August 3, 2014, at 21:15:44
As far as I know, you'll be the first Babbler to try Deep TMS, so you're our trailblazer. Happy trails to you.
Posted by Phillipa on August 4, 2014, at 17:38:35
In reply to Re: i start tomorrow 7pm... » johnLA, posted by Hugh on August 4, 2014, at 11:59:59
John how did it go today? Phillipa
Posted by Beckett on August 4, 2014, at 23:42:34
In reply to Re: i start tomorrow 7pm... » johnLA, posted by Hugh on August 4, 2014, at 11:59:59
Hey, good luck! I hope you do well. There is tms in my town, but for deep tms, I would need to drive about 80 minutes each way (gotta love California). However, if it's an appreciative advance it treatment, I'd find a way.
I hear you about researching depression treatment. I used to spend time reading other things more enjoyable.
Posted by johnLA on August 5, 2014, at 3:41:15
In reply to going for deep tms..., posted by johnLA on August 3, 2014, at 10:56:55
thanks again for all the good wishes. really appreciate it.
well, i did the first treatment. i feel strangely calm and ok. been listening (and feeling) music too...been a long time since that has happened.
i know it's placebo, but i will take it.
the doc was kind enough to schedule a 7pm appointment. i got there having a pretty good idea of how things go with deep tms. i just didn't know how it would feel.
it took her a while to 'calibrate' the headgear, my brain and the machine. they do this by a trying to find a 'sweet spot' (her words) that when the machine pulsates it will make your right hand/thumb twitch. from there she then set the threshold/intensity at 95%. we will get to 120% threshold within a few days.
she had some trouble finding my sweet spot. (lol) she actually said that she had one patient she had to switch to regular tms due to not being able to get the person's thumb to twitch. this got me a bit worried. but, eventually she found it. i have always been hard-headed...
you wear a headgear that looks like a 1920's football helmet or a 1920's flapper's swim head piece. take your pick. has a chin strap too. felt very secure/safe in it.
you put in ear plugs. there is also cool air running thru the machine's helmet. all comfy so far.
she lowers/positions the machine's 'helmet' over your headgear with all the electrodes and the whole thing is connected to some type of monitor that graphs your brains response to the pulses. the monitor looks like a ekg/eeg.
the procedure is 4 seconds of 'pulses' 20 seconds off. the goes on for 18 minutes. i think she said a total of 55 4 second pulses.
i took some tylenol beforehand. no headache after.
it's hard to explain, but it feels like your brain is vibrating for this 4 seconds. doesn't hurt. not quite uncomfortable. but, she had warned me before that some people have difficulty in the jaw/facial muscles. this happened to me.
my teeth would chatter as if i was cold with every pulse. so, tomorrow i will be wearing a mouthguard.
so, not too troublesome at all overall. i am looking forward to getting to a higher threshold. :)
i can again say i had a very pleasant night out with a friend tonight and the music thing was pretty cool too. i listened to some miles davis and mozart and could really enjoy it. long time for that to have happened as previously mentioned.
i feel a little tired now. in a normal good way. ruminations are almost zero.
it's strange; i have to say the calmness i feel is a bit like what i felt with ect. but, i now realize there was a almost euphoric unnatural feel goodness with ect. that is not the case here. just a more overall normal homeostasis. (love when i can use my greek!)
also, i am on klonopin only. no ad's right now. god i want off the k.
overall i am very pleased and cautiously optimistic.
let me know if you have any questions.
i'm praying for me and all of us that this thing is another tool in the box against this mofo of a condition.
john
Posted by johnLA on August 5, 2014, at 3:46:11
In reply to day 1 deep tms, posted by johnLA on August 5, 2014, at 3:41:15
here is how they set you up;
Posted by johnLA on August 5, 2014, at 3:59:30
In reply to Re: i start tomorrow 7pm..., posted by Beckett on August 4, 2014, at 23:42:34
here is a video of regular tms. the 'calibration' is the same with deep tms; make that right thumb move involuntarily;
Posted by Hugh on August 5, 2014, at 10:31:49
In reply to day 1 deep tms, posted by johnLA on August 5, 2014, at 3:41:15
> been listening (and feeling) music too...been a long time since that has happened.
That's a good sign. I used to feel a warm glow in my chest when I listened to music I loved. It's been years since I experienced that.
I watched the videos. That blue headgear does look like a Red Grange helmet.
Posted by johnLA on August 5, 2014, at 11:15:12
In reply to Re: day 1 deep tms, posted by Hugh on August 5, 2014, at 10:31:49
> > been listening (and feeling) music too...been a long time since that has happened.
>
> That's a good sign. I used to feel a warm glow in my chest when I listened to music I loved. It's been years since I experienced that.
>
> I watched the videos. That blue headgear does look like a Red Grange helmet.thanks as usual hugh. yeah, i was almost tearful from joy to 'hear' my beloved miles and a few aria's from nozze di figaro by mozart. something 'familiar' was being felt. i hope it can continue and that it will come for you again. i have been driving my car w/the radio off now for almost 3 years and almost no music in the house as well. i have a huge portrait of billie holiday that a student painted for me and 3 claxton photos of miles, sarah vaughn and chet baker all up in my living room. they have all been 'silent' for many years.
i am so sorry about your anhedonia. i think at times it is the worst characteristic of my depression. i think i told you i used to be a music history teacher, so i find it so bizarre to simply not care about something i truly loved.
lol on your red grange comment. i said the exact same thing to the doc as she was initially getting me strapped-up! no lie. i also threw-in bronco nagurski's name for good measure. she did not know these names. he-he. to continue the football theme, she was all smiles when i scored '51' on the depression intake. i had put a note at the end that this was a good sign since i was #51 in high school and college football. i asked her if she knew who dick butkis was. she said of course!
thnx again hugh.
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