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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by bodhisattva_guy on February 5, 2011, at 1:31:22
Hello,
I was wondering if anyone has tried this treatment for PTSD or pain - it is called stellate ganglion block.
I did a search on this forum, but nothing specific came up - it seems this topic has not been extensively debated. I have considered stelleate ganglion block for facial pain few years back. But have not heard much about it lately. I wonder if this treatment has been implemented. I first read about it as being used for Vetarans coming back with PTSD. a procedure of injecting the stellate ganglion (which is a main switching station for the sympathetic nervous system in the neck and controls the blood flow and certain pain sensors) This ganglion nucleus is injected with local anesthetic while you are out and they do live floroscopy to make sure they inject in the right place. The procedure mentioned in news was about vets coming back with PTSD. They were getting relief from this injection ( at least it was reported that few patients had this done and were relieved). It is thought to work by regulating sympathetic system - calming it down.
I didn't go for procedure - as there are risks associated. And also, it is generally agreed that patient should first try clonodine patch to see if my pain gets better. Clonodine also calm down sympathetic system.It is said when a traumatic event is experienced, it leads to an increase in the nerve growth factor. This spike causes nerves to sprout, leading to feelings of anxiety. By applying the local anesthetic to block the specific nerve group in the neck, the growth factor returns to normal and symptoms subside.
Here is a free medical article for those who would like more details.
http://www.hindawi.com/journals/prt/2010/963948.html
Pain Research and Treatment
Volume 2010 (2010), Article ID 963948, 5 pages
doi:10.1155/2010/963948
Case Report
Successful Use of Stellate Ganglion Block and Pulsed Radiofrequency in the Treatment of Posttraumatic Stress Disorder: A Case Report
Eugene Lipov
Abstract:Objective. To report our successful treatment of acute symptoms of posttraumatic stress disorder (PTSD). By the use of stellate ganglion block (SGB) and pulsed radiofrequency (PRF) to the stellate ganglion(SG) , sequentially. Background. A 48-year-old male a victim
of armed robbery , who presented with extreme symptoms consistent with the diagnosis of PTSD. He was treated with antianxiety medications, as well as psychotherapy, but his symptoms persisted.
Methods. Fifty-five days post trauma, we administered a SGB to the patient. One month later, we administered PRF to the right SG . We repeated the pulsed radiofrequency 30 weeks post trauma and performed a second SGB two weeks after that. Results. After the SGB , the patient experienced a major reduction in anxiety. Over the next week his improved allowing a significant reduction of antianxiety medications. One month later the symptoms returned and again subsided substantially following PRF , and that relief lasted four months. The patient than required another following PRF and a SGB with good responses. Conclusion. We report that selective blockade of the stellate ganglion via injection and the treatment with PRF, relieved our patient's symptoms of PTSD. And we also provide a plausible explanation of the effect.
Posted by bodhisattva_guy on February 5, 2011, at 1:38:09
In reply to Stelleate ganglion block for PSTD and pain, posted by bodhisattva_guy on February 5, 2011, at 1:31:22
I am sorry, this procedure is actually performed under local anesthesia, not general as I mentioned.
Posted by Phillipa on February 5, 2011, at 11:02:20
In reply to Re: Stelleate ganglion block for PSTD and pain, posted by bodhisattva_guy on February 5, 2011, at 1:38:09
My Son works extensively with PTSD vets and have not heard of this he's in DC. Phillipa
Posted by Bob on February 5, 2011, at 15:01:44
In reply to Stelleate ganglion block for PSTD and pain, posted by bodhisattva_guy on February 5, 2011, at 1:31:22
I saw this awhile back and it looks interesting. Problem is, how does one get this treatment? Like many other treatments with promise it's almost impossible to get - especially in the US.
Posted by bodhisattva_guy on February 5, 2011, at 20:02:51
In reply to Re: Stelleate ganglion block for PSTD and pain » bodhisattva_guy, posted by Bob on February 5, 2011, at 15:01:44
I would suggest major local university neurology/pain center - it might take a while, but you will be surprized. Local University here in Illinois was performing brain stimulation via implanted electrodes (think of new Parkinson's treatment). It is probably on a small, patient to patient basis, but I was surprized when I went to a pain specialist (private) and after a quick evaluation he said let's schedule the procedure.
Nerve blocks are generally paid by insurance (I think). As far as PTSD: here is an excerpt from one of the first sites found on google:"What happens during and after the procedure?
A local skin anesthetic is given near the base of the neck on the affected side. A needle is inserted by the anesthesiologist near the transverse process of the cervical spine (usually at the cervical-6 level). A sterile tubing is attached to the needle and anesthetic medication is slowly injected through the tubing.
Will my insurance cover the procedure?
Most insurance companies currently cover facet joint injections. They are covered by Medicare and other government funded insurance plans. However, coverage may vary depending on your specific plan and policy."
Posted by Phillipa on February 5, 2011, at 21:17:54
In reply to Re: Stelleate ganglion block for PSTD and pain, posted by bodhisattva_guy on February 5, 2011, at 20:02:51
Medicaire pays seriously?
Posted by bodhisattva_guy on February 6, 2011, at 3:34:55
In reply to Re: Stelleate ganglion block for PSTD and pain » bodhisattva_guy, posted by Phillipa on February 5, 2011, at 21:17:54
T the following search on google gives some idea:
" stellate ganglion block insurance PTSD"RADICAL PTSD TREATMENT GETTING MORE NOTICE -- Some veterans says ...
Apr 13, 2010 ... Right now, the procedure, called stellate ganglion block, or SGB, isn't approved by the government for use for PTSD, but Lipov has treated a ...http://www.vawatchdog.org/10/nf10/nfapr10/nf041310-2.htm
Another search finds this:
stellate ganglion block blue cross"
BXBS policy:
The following services, regardless of whether they are performed as an inpatient or outpatient, require preauthorization:
- Aspiration of a joint;
Pain management (including facet joint injections, triggerInjecting a local anesthetic next to a group of nerves in the neck, known as the stellate ganglion, is a fast-acting and effective way to treat combat-related post-traumatic stress disorder (PTSD), U.S. military researchers report.
The 10-minute procedure, called a stellate ganglion block, has been used to treat chronic pain and certain other health problems since 1925, according to background information in a news release about the research.
The team at Walter Reed Army Medical Center in Bethesda, Md., tested the block procedure on two patients: a 36-year-old man whose PTSD symptoms began after the battle of Fallujah in Iraq and a 46-year-old male veteran whose PTSD symptoms began 18 years ago in the first Gulf War.
Both men had been receiving drug treatment for more than a year, but it had been ineffective in treating their PTSD symptoms, according to the Walter Reed report. In addition, both men suffered side effects from the drugs, including depression, sleepiness and erectile dysfunction.
"Unlike conventional treatments for PTSD, SGB appears to provide results almost immediately," Dr. Sean W. Mulvaney, the Army lieutenant colonel who led the Walter Reed research, said in the news release. "Both patients experienced immediate, significant and durable relief."
r. Lipov is the first to use a local anesthetic to treat PTSD. It's called stellate ganglion block (SGB). It's been used since the 1920s to ..
woundedtimes.blogspot.com/.../stellate-ganglion-block-offers-hope-for.htmlJab to the Neck Treats PTSD-- In-Depth Doctor's Interview ...
Jun 9, 2010 ... We did the block and it got better, and it led to the first publication in '08 about using stellate ganglion block for PTSD. ...http://www.ivanhoe.com/channels/p_channelstory.cfm?storyid=24608
[PDF]
MEDICAL PUBLICATIONS AND PRESS COVERAGE OF SGB (CB)
File Format: PDF/Adobe Acrobat
Apr 30, 2010 ... PTSD. Journal Star Apr 11, 2010. PEORIA. By ANDY KRAVETZ. Peoria veterans says stellate ganglion block has helped get stress disorder ...chicagomedicalinnovations.org/files/ptsdbook/07_WinningPTSD_Lipov.pdf
---
Dr. Eugene Lipov, a Chicago-based anesthesiologist, pioneered the modern-day use of stellate-ganglion block (SGB) in 2004, to eliminate hot flashes among post-menopausal women. SGB, which has been used to relieve migraines and chronic pain since the 1920s, involves a single injection into the sympathetic nerve tissue on the right side of a cervical vertebra.
After finding a Finnish paper on the use of SGB to treat anxiety, Lipov started trying it out on patients with post-traumatic stress.
My first patient had been robbed at gun-point, Lipov tells Danger Room. She walked into my office with extreme anxiety, and walked out changed. That was three years ago, and shes still doing fine.
Lipov went on to try SGB in 12 veterans from Iraq and Afghanistan. His first patient, a vet who awoke to find himself strangling his wife, said the procedures impact was immediate. The effects took only seven minutes to kick in, but subsided nearly instantly after a fireworks display re-triggered the condition. A second shot, in 2008, alleviated the PTSD again. Since then, its so far so good, Lipov says.
According to the article, Barack Obama has been supporting this possible treatment since 2007 but the Pentagon has twice rejected Dr Lipovs requests for military funding.
detailed article above, check it out..
I hope the military will start looking closer at this and perhaps cover it for PTSD. As for private insurance, I couldn't find any info, good luck finding this out - best option would be to call insurance company directly. Or even medicare. And of course, request coverage for this procedure from insurance, and if they tell you there is not sufficient evidence - contact your local gov rep for necessary funding. Definitely the vets deserve a chance to see if this treatment works. I cannot think of all the suicides and breakdowns that those in service experience. My heart goes out to them and all others who were traumatized one way or another.
Perhaps Dr. Bob can contact above mentioned ganglion block pioneer who seems to work in same area as him - Chicago, to determine the prospects of insurance coverage of this procedure for PTSD, and as to the exact process to making changes in current insurance coverage on this.
Tommy
Posted by Phillipa on February 6, 2011, at 18:57:39
In reply to Re: Stellate ganglion block for - PTSD- and pain, posted by bodhisattva_guy on February 6, 2011, at 3:34:55
Will have to ask Son as disabled in Desert Storm and heads Veterans of Modern Warfare. In DC now And was a patient on return from war injuries blindness and loss of two fingertips. Working for helping Vets get appropriate tx and care. Phillipa
Posted by bodhisattva_guy on February 8, 2011, at 19:16:15
In reply to Re: Stellate ganglion block for - PTSD- and pain » bodhisattva_guy, posted by Phillipa on February 6, 2011, at 18:57:39
On God, my utmost respect to you. I just found their website, and it seems like PTSD is major concern for soldiers, and surely for their families and friends. I am not propagating this procedure, because it has it side effects as well, but as an option, for those who are on the verge.
Posted by Phillipa on February 9, 2011, at 0:52:53
In reply to Re: Stellate ganglion block for - PTSD- and pain, posted by bodhisattva_guy on February 8, 2011, at 19:16:15
I feel we should post all we find. Phillipa. Yes they have a website.
This is the end of the thread.
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