![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 25. This is the beginning of the thread.
Posted by stargazer2 on November 16, 2013, at 16:00:15
Does anyone have personal experience with any clinical trials for their depression?
I live in New England and would like to have TMS but I've been told that Medicare will not pay for it.
Does anyone have any knowledge of TMS being paid for by Medicare? Meds are not working and one course of ECT failed to help me and I want to try TMS. Is there any help for me?
Stargazer
Posted by Hugh on November 16, 2013, at 17:07:51
In reply to Clinical Trials/TMS, posted by stargazer2 on November 16, 2013, at 16:00:15
They're currently recruiting for a clinical trial of Low-Field Magnetic Stimulation (LFMS) for treatment-resistant depression. One of the test sites is Massachusetts General Hospital in Boston. In early clinical trials, LFMS appears to be superior to TMS. If your ECT was for your current episode of depression, it would disqualify you.
About the treatment:
http://www.news.harvard.edu/gazette/2004/01.22/01-depression.html
Details about the clinical trial:
Posted by Phillipa on November 16, 2013, at 17:15:19
In reply to Re: Clinical Trials/TMS, posted by Hugh on November 16, 2013, at 17:07:51
Hugh how come exclusion for hypothyroidism? Phillipa
Posted by stargazer2 on November 17, 2013, at 1:06:18
In reply to Re: Clinical Trials/TMS, posted by Hugh on November 16, 2013, at 17:07:51
Thank you Hugh. That is just what I was looking for. I will contact them this coming week.
Stargazer
Posted by Hugh on November 17, 2013, at 10:05:20
In reply to Re: Clinical Trials/TMS » Hugh, posted by Phillipa on November 16, 2013, at 17:15:19
> Hugh how come exclusion for hypothyroidism? Phillipa
I guess they don't want it clouding their results. If the person's hypothyroidism is poorly controlled, LFMS, or any other treatment, wouldn't be all that effective for depression.
Posted by Hugh on November 17, 2013, at 10:19:22
In reply to Re: Clinical Trials/TMS/Hugh, posted by stargazer2 on November 17, 2013, at 1:06:18
> Thank you Hugh. That is just what I was looking for. I will contact them this coming week.
> StargazerYou're welcome and good luck.
Posted by Phillipa on November 17, 2013, at 20:15:53
In reply to Re: Clinical Trials/TMS » Phillipa, posted by Hugh on November 17, 2013, at 10:05:20
In all seriousness when nursing and checking patients histories and labs it was amazing how many had thyroid problem. Hence I asked. As that is also a cause of depression. Phillipa
Posted by Hugh on November 18, 2013, at 11:10:48
In reply to Re: Clinical Trials/TMS » Hugh, posted by Phillipa on November 17, 2013, at 20:15:53
> In all seriousness when nursing and checking patients histories and labs it was amazing how many had thyroid problem. Hence I asked. As that is also a cause of depression. Phillipa
There are probably millions of people suffering from depression because of untreated hypothyroidism. And probably millions suffering from depression because of untreated sleep apnea. I have a friend who was depressed for years. He was prescribed Pamelor and it caused suicidal ideation. He was prescribed Paxil and it didn't help. His wife noticed that he would stop breathing in his sleep sometimes, so she made him go to a sleep lab, where he was diagnosed with severe sleep apnea. He was given a CPAP and his depression was gone overnight.
Posted by Phillipa on November 18, 2013, at 20:36:26
In reply to Re: Clinical Trials/TMS » Phillipa, posted by Hugh on November 18, 2013, at 11:10:48
I've heard this a lot bout CPAP. But my observation was that patients with thyroid disease and treated were inpatient too. So my Conclusion was and still is that thyroid illness is very common in mental disorders. Where if you checked charts on a medical floor you didn't see all the positive thyroid results. Phillipa
Posted by stargazer2 on November 21, 2013, at 22:18:01
In reply to Re: Clinical Trials/TMS » Hugh, posted by Phillipa on November 18, 2013, at 20:36:26
I called Yale and spoke with the research person who asked me some questions and then said she felt that I was a good candidate. She asked if I could come in next week and I think we will move ahead with this trial. I guess my main concern would be if I get the real treatment or not. So this could be a whole new approach to my treatment options. I had one course of ECT but always felt the memory impairment was not something I wanted to go through again. Plus it is so invasive and unregulated. No one (docs) ever followed up with me to see if there were positive outcomes or side effects after the procedure was done. It's as though no one gave a damn about whether the procedure workled or not and that is a procedure not to be taken lightly.
More voodoo medicine practiced on the most vulnerable patients.
Posted by Phillipa on November 22, 2013, at 18:04:56
In reply to Re: Clinical Trials/TMS, posted by stargazer2 on November 21, 2013, at 22:18:01
Congrats and I know you know the Yale team. Are you excited? Phillipa
Posted by stargazer2 on November 22, 2013, at 23:42:53
In reply to Re: Clinical Trials/TMS » stargazer2, posted by Phillipa on November 22, 2013, at 18:04:56
Jan,
No excitement yet, that's the depression talking. and as far as the Yale team goes...that leaves alot to be desired. I have alot more faith in the Boston team for sure, at least between Mass General and Mclean you are definately in more qualified hands than YAle. But I'll try to remain optimistic since coverage for TMS doesn't exist for Medicare at least that is what I was told. Does anyone know differently?Stargazer
Posted by Phillipa on November 23, 2013, at 18:11:44
In reply to Re: Clinical Trials/TMS, posted by stargazer2 on November 22, 2013, at 23:42:53
I do know how you feel about Yale. So you would need to pay for a trial? Thought was free? Jan
Posted by stargazer2 on November 23, 2013, at 19:35:59
In reply to Re: Clinical Trials/TMS » stargazer2, posted by Phillipa on November 23, 2013, at 18:11:44
Clinical trials are free since you are essentially
a guinea pig and you are contributing to their research and you may not get the treatment since it is a double blind study and you may get the real treatment or a fake one.Yeah, Yale is big name but my experience there was less than impressive. I said I would not let my dog get treated in their psychiatry unit, only the indigent or those too sick to know better were
there for long. Silver Hills in New Canaan or IOL in Hartford have better reps for excellent care or Mclean in Boston.Oh well, such is the state of health care in the US, especially in psychiatry.
SG
Posted by Phillipa on November 23, 2013, at 20:28:52
In reply to Re: Clinical Trials/TMS, posted by stargazer2 on November 23, 2013, at 19:35:59
I lived before moving from CT very near to Silver Hills. Beautiful grounds, scenery, a lot of money goes there for sure. Phillipa
Posted by Hugh on November 24, 2013, at 12:06:59
In reply to Re: Clinical Trials/TMS, posted by stargazer2 on November 22, 2013, at 23:42:53
I'm very interested in hearing about how all this turns out. Please keep us posted. If the larger trials go as well as the smaller ones, LFMS could mean the end of ECT.
Posted by stargazer2 on November 24, 2013, at 21:12:40
In reply to Re: Clinical Trials/TMS » stargazer2, posted by Hugh on November 24, 2013, at 12:06:59
Hugh,
The end of ECT would be a blessing. At X Hospital the interest was in ECT numbers not outcomes. Why doesn't anyone care how someone does after ECT is completed and if it is effective enough to do maintanence treatments rather than just do them? And should ECT be done on a demented person who has stopped eating? As far as I'm concerned when someone stops eating they are at the end of their life and doing ECT to make them eat is being done for the wrong reasons. I would never put my family member through such a procedure and can't understand why anyone would do this with medical urging. Someone in their 80's has lived a full life and a demented life is not be one worth living and you don't even know it nor can you consent to it. Everyone is not supposed to live to 90 just because others have had good healthy lives and have avoided dementia. Most of us will live alot less than 90 and that OK with me.
Sorry I digress. Just my observations from working wth ECT patients and having it once myself.
Posted by Hugh on November 25, 2013, at 11:55:48
In reply to Anyone receiving TMS recently/Hugh, posted by stargazer2 on November 24, 2013, at 21:12:40
My uncle's 93-year-old father had dementia and was dying of congestive heart failure. They wanted to give him a valve replacement, a surgery that would have most likely killed him. And even if the surgery had been a success, he wasn't expected to live for more than a year. Luckily, my uncle had power of attorney and nixed the idea. Just a surgeon looking to earn a big paycheck.
Posted by stargazer2 on November 25, 2013, at 16:31:34
In reply to Re: Anyone receiving TMS recently/Hugh » stargazer2, posted by Hugh on November 25, 2013, at 11:55:48
Exactly. Health care is often not for the patient but for the wrong reasons like profits or experience of doctors...No wonder there will be no money left after putting hips, valves and other parts in those that are demented or so ill that they would just as well die a more natural death than one hooked up to a ventilator or with a new hip in someone that is unable to tolerate rehabilitation. The latest technology needs to be carefully implemented in those patients with sound physical and mental capacities that have a chance of benefitting from the technology.
I hope the mentality is not what I have see in those with insurance...that they want the benefits since they feel entitled to getting them
since they have "paid" for them.
Posted by Phillipa on November 25, 2013, at 18:07:17
In reply to Re: Anyone receiving TMS recently/Hugh, posted by stargazer2 on November 25, 2013, at 16:31:34
I've not heard of people with Dementia getting ECT? If they stop eating sometimes a feeding tube is inserted. If an older person who is of sound mind wants to prolong their lives with surgeries then it's their right. I know a lot of people who pay with cash now. Since this new health plan many are seeking cash only docs. At least around here? I don't think insurance will pay for those proceedures after the lst. People are different and even euthanasia is alive and well in some hospitals here. My husbands Mother chose this when she found out she had Lou Gerhigs. Got a morphine drip, a last drink and chose to die. No vents for her. She had been to artistic to not be able to do what she loved. Phillipa
Posted by stargazer2 on November 25, 2013, at 22:02:27
In reply to Re: Anyone receiving TMS recently/Hugh » stargazer2, posted by Phillipa on November 25, 2013, at 18:07:17
My point was that a demented person should not be given ECT as they are not able to consent to the procedure. The pdoc was unconcerned when I pointed this out to him, his concern was to nuke as many people as he could in a given day with disregard for ones quality of life, not to even get into the risk of anesthesia at that age. The pdoc had convinced her family that ECT was the right choice when someone had stopped eating. My concern was that in order to do the procedure there needed to be a court order or conservatorship to be legally appropriate. The
pdoc felt otherwise. This is abuse of the elderly
and an abuse of medical ethics. I'm afraid it happens more often than is commonly known.Health care still is abusive when it come to those patients that are elderly or depressed, anytime ones capacity to reason is compromised.
Posted by Phillipa on November 25, 2013, at 22:19:22
In reply to Re: Anyone receiving TMS recently/Phillipa, posted by stargazer2 on November 25, 2013, at 22:02:27
I agree find it hard to believe that a pdoc would resort to this and yes to me abuse to elderly also. Phillipa
Posted by stargazer2 on November 26, 2013, at 21:07:39
In reply to Re: Anyone receiving TMS recently/Phillipa » stargazer2, posted by Phillipa on November 25, 2013, at 22:19:22
Hi, I went to be evaluated for inclusion in the TMS study today and I think I am pretty certain they believe I am a good candidate for the trial.
Lots of questions, review of my history since 1972, yikes and tons of medications too many to remember but knowing the majority were useless except for MAOS. They were very kind and professional and I got a good feeling about the group, so that was reassuring.
If it happens, it won't be until early January because you have to wait 8 weeks after beginning a new medication.
Thought some of you migt be interested.
Posted by Hugh on November 28, 2013, at 12:49:29
In reply to Evaluated for TMS Clinical trial, posted by stargazer2 on November 26, 2013, at 21:07:39
Sounds promising. (Knock on wood.)
Posted by sigismund on November 30, 2013, at 17:18:57
In reply to Re: Anyone receiving TMS recently/Phillipa » stargazer2, posted by Phillipa on November 25, 2013, at 22:19:22
They do similar things to old people. Mastectomies on 90 year olds, operations for cancer that don't help. They seem to think they should offer hope (for what?) no matter what the consequences (except for them).
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.