Anthony agreed. I have used many relaxing techniques, acupuncture, massage, chiropractic, meditation, herbs,exercise,proper diet. Along with therapy and quitting alcohol and drugs. It's every hour of every day work to stay as stable as possible. Then processing with a good therapist. It seems to me those of us with PTSD have to learn our triggers. It takes time. But bit by bit we can figure it out and help ourselves. I had the SGB 2 weeks ago now and it has helped me immensely. Sleep is greatly improved. Nightmares lessened. My reaction to triggers greatly lessened. I am considering a second shot because it's not 100%. More like 70% better, which I am thrilled with.
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News SGB PTSD Treatment Article
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- #242
anthony
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Will a second shot so soon actually make any impact within that gap?
Lipov office said I could come anytime for a second shot, it is up to me. If you read his website he explains how he thinks it works. That the nerve going from the stellate ganglion up to the brain grows to many nerve sprouts that shoot out adrenaline when someone with PTSD is triggered. The block stops that from happening. There are several ptsd cases that people have gotten 2 shots. Other people with severe hotflashes or severe pain get a series of 3,4 or 5 shots in as many weeks.
I am so happy to be hearing more positive reactions...
trixie: I continue to feel what you have described so nicely...being in potential trigger events but not being overwhelmend by the physical disruption of the anxiety (rapid heartbeat, panic, etc.) Cognition is less interrupted, so decisions and acceptance of the events are easily "digestible" and manageable. You may not want to give credit to the injection as of yet, but I just bet that is what is allowing you function better. The removal of the excessive flood of adrenaline clears the mind and eliminates, if not reduces, the PTSD adrenaline trigger mechanism....at least for me.
It is now 5 1/2 months since my first and only SGB injection for PTSD and whatever this injection's benefit is, it has endured still. For me the change has been durable and I hope it will stay. In the mean time, hopefully, I am becoming accustomed to this new way of coping and building new skills as the calmness allows. It is not uncommon, as acudoc mentioned, however, for some folks to need more than one injection.
My SGB has eliminated all that remained for me in terms of anxious discomfort. Keep in mind, though, that I did do 25 years of serious cognitive work and all other anti-anxiety therapies as well prior to the injection. I agree with Anthony that the SGB is not to be relied on as a singular answer to all trigger anxieties. No doubt other self-motivated work may be needed to accompany the injection. Still, it is a profound treatment of the relief that can be achieved and would likely help at any stage of healing. For me it was the only thing that "did the trick" in the end.
I do consider SGB a PTSD cure, if you look at PTSD as a specific brain disruption. Other anxieties that the SGB may not address are probably not PTSD anxieties, in my opinion. Many of us have multiple reasons to be anxious, and not all are actually PTSD.
Recently, I was sexually harassed and this would normally bring a flood of panic and anxiety due to my original PTSD being linked to sexual and physical abuse. I am anxious about this new situation and sadly had to quit some very important committees and my core social group to escape my predator, but I am coping logically and calmly. There is still anxiety if I see this predator, of course.....anyone will still have anxiety in their lives when stressful events comes around. The PTSD question is how you manage the anxiety...or I should say....how it manages you. I feel the SGB has allowed me control to respond and react appropriately and without blinding panic; and from control comes confidence and comfort.
Girl3 - yes, as I mentioned in earlier posts, there is a movement by Lipov and others to reclassify PTSD as a traumatic brain injury due to the new discoveries in imagery and new understandings of its pathology. PTSD is visible with MEG brain imaging, and then gone after the SGB injection for those that were examined as such.
As an update on testing, I am assisting Lipov currently as he awaits a 1.6 million dollar US Department of Defense grant application to go through, and my local Senator's staff is working with me and monitoring the progress to keep the grant process from stalling. Once this grant is complete, there will be more studies from which to gather results. I am very optimistic and eager for this grant to be approved.
Kudos again to those who are having success. I am so very happy for you all. Your courage, patience and determination is paying off!
trixie: I continue to feel what you have described so nicely...being in potential trigger events but not being overwhelmend by the physical disruption of the anxiety (rapid heartbeat, panic, etc.) Cognition is less interrupted, so decisions and acceptance of the events are easily "digestible" and manageable. You may not want to give credit to the injection as of yet, but I just bet that is what is allowing you function better. The removal of the excessive flood of adrenaline clears the mind and eliminates, if not reduces, the PTSD adrenaline trigger mechanism....at least for me.
It is now 5 1/2 months since my first and only SGB injection for PTSD and whatever this injection's benefit is, it has endured still. For me the change has been durable and I hope it will stay. In the mean time, hopefully, I am becoming accustomed to this new way of coping and building new skills as the calmness allows. It is not uncommon, as acudoc mentioned, however, for some folks to need more than one injection.
My SGB has eliminated all that remained for me in terms of anxious discomfort. Keep in mind, though, that I did do 25 years of serious cognitive work and all other anti-anxiety therapies as well prior to the injection. I agree with Anthony that the SGB is not to be relied on as a singular answer to all trigger anxieties. No doubt other self-motivated work may be needed to accompany the injection. Still, it is a profound treatment of the relief that can be achieved and would likely help at any stage of healing. For me it was the only thing that "did the trick" in the end.
I do consider SGB a PTSD cure, if you look at PTSD as a specific brain disruption. Other anxieties that the SGB may not address are probably not PTSD anxieties, in my opinion. Many of us have multiple reasons to be anxious, and not all are actually PTSD.
Recently, I was sexually harassed and this would normally bring a flood of panic and anxiety due to my original PTSD being linked to sexual and physical abuse. I am anxious about this new situation and sadly had to quit some very important committees and my core social group to escape my predator, but I am coping logically and calmly. There is still anxiety if I see this predator, of course.....anyone will still have anxiety in their lives when stressful events comes around. The PTSD question is how you manage the anxiety...or I should say....how it manages you. I feel the SGB has allowed me control to respond and react appropriately and without blinding panic; and from control comes confidence and comfort.
Girl3 - yes, as I mentioned in earlier posts, there is a movement by Lipov and others to reclassify PTSD as a traumatic brain injury due to the new discoveries in imagery and new understandings of its pathology. PTSD is visible with MEG brain imaging, and then gone after the SGB injection for those that were examined as such.
As an update on testing, I am assisting Lipov currently as he awaits a 1.6 million dollar US Department of Defense grant application to go through, and my local Senator's staff is working with me and monitoring the progress to keep the grant process from stalling. Once this grant is complete, there will be more studies from which to gather results. I am very optimistic and eager for this grant to be approved.
Kudos again to those who are having success. I am so very happy for you all. Your courage, patience and determination is paying off!
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- #245
anthony
Founder
That has zero substance at all Kim. TBI is a physical medical condition through a physical impact upon the head itself, thus usually involving such high impact force that it creates a "physical" and permanent damage to the brain in no specific area.
PTSD does not require any type of "physical" impact to the head, it is purely psychological that creates a physical component of varying degree.
Lipov is rejecting severe and complex trauma cases, as it seems treating those at the severe and complex extreme is not showing his work to be as favourable as first thought, hence why the majority of studies also exclude these two areas, being the two very areas of most concern about PTSD, from studies, as they lower result outcomes.
Most mental illnesses can be seen under current neurological imaging technologies. Does this mean we should reclassify mental illness to mainstream medical instead, as you are now talking about psychological becoming physiological? That is the difference between medicine and psychology after all.
I think Lipov could be stepping beyond his boundaries of expertise as an anaesthesiologist.
The impression I got after having spoken with Dr Lipov is that he is including all types of PTSD, short term, long term, severe, and complex. The SGB interupts a nerve pathway that generates to much adrenalin in the body that is causing the PTSD symptoms. So if people are getting sustained relief that might eventually be called a cure. All medical research is based on a hypothesis then the researcher goes about trying to prove the theory right. This can be a long process. This is the process we are in with the SGB for PTSD. And really we are in the beginning stages of the research. I say we because I have had the SGB. I do not believe Dr Lippv is over stepping any boundaries and he is doing valuable research and a big favor for those of us suffering from this problem.
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- #247
anthony
Founder
There have been mentions in this thread of rejections already...
Update: Lipov has withdrawn his US Department of Defence applications for grants. The DoD is nit-picking him to death and after 4 years of their rhetoric and unreasonable demands, he is out of the DoD "business". No idea if he has plans to pursue another route for funding, but a Chicago Hospital has taken up his cause and may be offering some help or facility usage. A study is currently underway under the Navy in San Diego.
The brain is a delicate organ, and must be considered differently than other body parts in terms of "injury". The thinking here is to remove this type of insular cortex abnormality from the guarded possession of the psychological world - where in my opinion, little has been accomplished, relatively, to dramatically help PTSD as much as the SGB has- and place it in the domain of plain ol' biological systems. Psych treatments should be used as a close secondary support in my opinion. I would like to see PTSD victims treated in this order, ideally.
And at the end of the day, psychiatrists already inevitably turn to bio knowledge and meds to help with whatever area of the brain may be dysfunctional - so yes, maybe many "mental" issues are ultimately another type of injury as well.
If the brain is somehow damaged or caused to malfunction as a result of any occurrence, be it merely observed, heard, or via impact, these are all still injuries in my way of thinking. Radiation causes no real physical impact, and yet we all accept it can cause significant damage, physically and probably mentally as well.
Is it that much of a stretch to think of the brain "injuring" itself in a situation where life feels completely threatened? The brain will make the "last ditch" sacrifice of malfunctioning its own adrenaline production if it can mean extra energy for "fight or flight" in what it may perceive as the final minutes of survival. It seems, sadly, that the mechanism to stop this adrenaline production is not so well developed, resulting in PTSD. If this is what is happening, and I think it is, then why would this be considered a "mental" illness" at all? There are other instances where the brain shuts on and off systems (pain for one) when life is threatened. None of these is considered psychological.
Perfectly functional soldiers will suddenly turn into paranoid, under-functioning and terrified souls as a result watching a single brief and brutal battle. I do not consider them mentally ill at all. I consider them to have been injured in some way.
I think that PTSD is not out of line with traumatic brain injuries. Lipov is truly on to something, especially if treatment can be expedited and the very low-risk and minimally invasive SGB can become a first line of treatment, and not the last. Other trauma-skilled doctors are on board with this this re-classifications as well. It feels intuitively correct to me. Yes, I think the world of psychology will need to start accepting that the physiological is a real player. What is so wrong with that? Can shrinks and docs not play nicely together and share toys?
Refusal of the psych world (actually all sciences) to "let go" of their precious tenets frustrates me on a daily basis. When sciences will not open up to consider change in the morays on which older premises are built, time is wasted and egos clog the path to progress.
It has been firmly believed for ages that nothing travels faster than the speed of light, and yet this week, scientists have discovered that something else does. So many of Einstein's theories must now be reconsidered, and many scientists hate this sea change after spending careers focusing on what they were sure was completely indisputable. The "truth" is not the problem here, the stubborn and concrete scientists are.
Again, I cannot stress enough how important it is to those of us who have had profound success with the SGB, and those who hope to try, to try to keep a positive attitude about this procedure. Any ethical issues about Dr. Lipov and his choice of patients can only be resolved by a direct convo with the doctor himself. My procedure was NOT done by Lipov, so it is not all about him.
I still hope to encourage any sufferers to strongly consider this potentially fast-acting treatment if you can make it happen.
The brain is a delicate organ, and must be considered differently than other body parts in terms of "injury". The thinking here is to remove this type of insular cortex abnormality from the guarded possession of the psychological world - where in my opinion, little has been accomplished, relatively, to dramatically help PTSD as much as the SGB has- and place it in the domain of plain ol' biological systems. Psych treatments should be used as a close secondary support in my opinion. I would like to see PTSD victims treated in this order, ideally.
And at the end of the day, psychiatrists already inevitably turn to bio knowledge and meds to help with whatever area of the brain may be dysfunctional - so yes, maybe many "mental" issues are ultimately another type of injury as well.
If the brain is somehow damaged or caused to malfunction as a result of any occurrence, be it merely observed, heard, or via impact, these are all still injuries in my way of thinking. Radiation causes no real physical impact, and yet we all accept it can cause significant damage, physically and probably mentally as well.
Is it that much of a stretch to think of the brain "injuring" itself in a situation where life feels completely threatened? The brain will make the "last ditch" sacrifice of malfunctioning its own adrenaline production if it can mean extra energy for "fight or flight" in what it may perceive as the final minutes of survival. It seems, sadly, that the mechanism to stop this adrenaline production is not so well developed, resulting in PTSD. If this is what is happening, and I think it is, then why would this be considered a "mental" illness" at all? There are other instances where the brain shuts on and off systems (pain for one) when life is threatened. None of these is considered psychological.
Perfectly functional soldiers will suddenly turn into paranoid, under-functioning and terrified souls as a result watching a single brief and brutal battle. I do not consider them mentally ill at all. I consider them to have been injured in some way.
I think that PTSD is not out of line with traumatic brain injuries. Lipov is truly on to something, especially if treatment can be expedited and the very low-risk and minimally invasive SGB can become a first line of treatment, and not the last. Other trauma-skilled doctors are on board with this this re-classifications as well. It feels intuitively correct to me. Yes, I think the world of psychology will need to start accepting that the physiological is a real player. What is so wrong with that? Can shrinks and docs not play nicely together and share toys?
Refusal of the psych world (actually all sciences) to "let go" of their precious tenets frustrates me on a daily basis. When sciences will not open up to consider change in the morays on which older premises are built, time is wasted and egos clog the path to progress.
It has been firmly believed for ages that nothing travels faster than the speed of light, and yet this week, scientists have discovered that something else does. So many of Einstein's theories must now be reconsidered, and many scientists hate this sea change after spending careers focusing on what they were sure was completely indisputable. The "truth" is not the problem here, the stubborn and concrete scientists are.
Again, I cannot stress enough how important it is to those of us who have had profound success with the SGB, and those who hope to try, to try to keep a positive attitude about this procedure. Any ethical issues about Dr. Lipov and his choice of patients can only be resolved by a direct convo with the doctor himself. My procedure was NOT done by Lipov, so it is not all about him.
I still hope to encourage any sufferers to strongly consider this potentially fast-acting treatment if you can make it happen.
There are a number of anesthesiologists in the US as well as other places who are participating in research regarding PTSD. Anesthesiologists deal with the brain daily as well as the autonomic nervous system. Stellate ganglion blocks have been part of the repetoire of anesthesiologists for decades. The doctor who taught me to do stellate ganglion blocks finished his anesthesia training in 1952. Blocking the adrenergic system is the method by which alpha receptor inhibition, beta receptor inhibition, and presumably in part some of the novel treatments surrounding cortisol, work.
What people must remember is that placebo effect accounts for 30-40% of beneficial results. The best illustration of this I remember was a study looking at purple pills versus white pills. Both pills in the study were placebos in that they contained no medicine. But when they looked at effect, purple pills were far more effective than white pills.
When no randomized blinded studies have been conducted, one must be very suspicious of results. I know of many sacredly held beliefs in medicine that were blown out of the water when randomized controlled trials were done.
What people must remember is that placebo effect accounts for 30-40% of beneficial results. The best illustration of this I remember was a study looking at purple pills versus white pills. Both pills in the study were placebos in that they contained no medicine. But when they looked at effect, purple pills were far more effective than white pills.
When no randomized blinded studies have been conducted, one must be very suspicious of results. I know of many sacredly held beliefs in medicine that were blown out of the water when randomized controlled trials were done.
Yes, but having the placebo effect mentioned must be pointed at the Rx industry primarily. When I was put on SSRIs I was told by my Dr that Placebo accounted for 30-40% of that effect also. He said that is nothing to be ashamed of, for whatever does no harm and makes you feel better is fine, and the other 60-70% is what they need to use to see results.
If a single procedure is helping someone with PTSD be able to feel "normal" and calm without meds, then that person cares not for all this. S/he feels better and no longer needs pills to sleep or remove depression. S/he no longer cannot orgasm for the high level of meds taken. S/he may finally be able to eat without issues, or escape daily shaking, flashbacks or headaches. So why ask for double-blind trials and randomization, when person after person is well? For me, it is a little of both. I believe that it's working, so I myself would consider it. However, I'd like it tested further so that insurance covers it and so that it can be done correctly, timed right, and offered to more of us.
If a single procedure is helping someone with PTSD be able to feel "normal" and calm without meds, then that person cares not for all this. S/he feels better and no longer needs pills to sleep or remove depression. S/he no longer cannot orgasm for the high level of meds taken. S/he may finally be able to eat without issues, or escape daily shaking, flashbacks or headaches. So why ask for double-blind trials and randomization, when person after person is well? For me, it is a little of both. I believe that it's working, so I myself would consider it. However, I'd like it tested further so that insurance covers it and so that it can be done correctly, timed right, and offered to more of us.
Stellate ganglion block is not a totally benign procedure, even in experienced hands. While deaths and permanent injury are not frequent, they do happen. Also, the effect of stellate ganglion block is relatively short lived - I have used them for reflex sympathetic dystrophy (now called CRPS) and typically more than one injection is needed. Also, for RSD/CRPS, you continue medical therapy to get the best chance at eliminating the underlying "wind up" phenomenon. The reason for randomized controlled trials is to give doctors/patients a better idea of risks and benifits whether we're talking about medication, psychotherapy, or procedures. There are case reports of patients dying, being permanently paralysed, seizing, bleeding, etc. even when the procedures are done under fluoroscopy.
There may be only a certain subset of PTSD patients that respond to this procedure: so not every PTSD patient should be exposed to a potentially harmful procedure. How many blocks are needed? What kind of follow-up/oversight should there be: a patient might feel super for the first 24 hours after a block but then a couple of days later the original problem comes back with a vengeance.
Insurance typically will not pay for experimental therapy for a good reason. If reimbursement for each procedure is 3000-5000 dollars (depends on which state you practice in), the insurance companies want to make sure they're spending money wisely.
There was a period in 1990s where surgeons were doing permanent disruption of the stellate ganglion for a condition called hyperhydrosis. It was a bandwagon event. But until a university finally did a randomized controlled trial (surgery versus no surgery just medication) they found that doing the procedure didn't give a permanent result in many patients and when the condition came back six months to a year later, it was worse and less responsive to medication. Also, there were a certain percentage of patients who were harmed or even died.
I have no problem with any doctor adapting a procedure to be used for another indication as long as the reasoning behind it is good science AND the doctor gives a truly informed consent for each patient, keeps precise records, does long term follow up with patients whether they were helped or not, and has plan B for the patients who didn't get the desired result. Doing something to someone and declaring it a success without proper follow up isn't good medicine.
There may be only a certain subset of PTSD patients that respond to this procedure: so not every PTSD patient should be exposed to a potentially harmful procedure. How many blocks are needed? What kind of follow-up/oversight should there be: a patient might feel super for the first 24 hours after a block but then a couple of days later the original problem comes back with a vengeance.
Insurance typically will not pay for experimental therapy for a good reason. If reimbursement for each procedure is 3000-5000 dollars (depends on which state you practice in), the insurance companies want to make sure they're spending money wisely.
There was a period in 1990s where surgeons were doing permanent disruption of the stellate ganglion for a condition called hyperhydrosis. It was a bandwagon event. But until a university finally did a randomized controlled trial (surgery versus no surgery just medication) they found that doing the procedure didn't give a permanent result in many patients and when the condition came back six months to a year later, it was worse and less responsive to medication. Also, there were a certain percentage of patients who were harmed or even died.
I have no problem with any doctor adapting a procedure to be used for another indication as long as the reasoning behind it is good science AND the doctor gives a truly informed consent for each patient, keeps precise records, does long term follow up with patients whether they were helped or not, and has plan B for the patients who didn't get the desired result. Doing something to someone and declaring it a success without proper follow up isn't good medicine.
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