![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 10 to 34 of 49. Go back in thread:
Posted by mayzee on July 18, 2006, at 21:28:07
In reply to Re: Anyone had ECT?, posted by SLS on July 18, 2006, at 18:15:00
Scott, Do you know what's different about ECT treatments today compared with 1991. Have there been improvements in the procedure? Thanks, Mayzee
>
> In a correspondence with Max Fink, MD, he recommended to me that I not judge the treatments of today by the failures of 1991. I would consider high dose unilateral right.
>
>
> - Scott
Posted by Crazy Horse on July 18, 2006, at 21:44:25
In reply to Re: Anyone had ECT?, posted by linkadge on July 18, 2006, at 19:49:45
> Well to play the devils advocate, I'd have to say that ECT is not a good idea.
>
> To say that something like 80% of people get better with ECT is misleading. For starters, ECT has an extrordinarily high relapse rate. So whatever sucess you get, for whatever dammage it causes, the results aren't going to last.
>
> The problem with trying to quantify its sucess rate is that many people who have the procedure suffer significant memory problems and so how are we to trust their accounts of how they feel in comparison to how they felt?
>
> If you go to a hospital which offers ECT, do you think they are going to not recomend it? If a nurse or doctor said, its going to fry your brain, like perhaps some of them may believe, they'd get fired on the spot.
>
> Many of the so called "theraputic" effects of ECT are consistant with a severe and traumatic brain injury. The induction of BDNF, is also consistant with a brain injury. BDNF, for instance, is one of the brains major neuroprotective proteins. If the brain feels that it is being insulted or dammaged in any way, it will release BDNF to try and protect itself from dammage. BDNF expression is high after traumatic brain injury. GFAP, is another protein that is markedly increased after ECT. This protein is also increased after traumatic brain injury.
>
> I had it pointed out (and its often true) that if you go to the section of the hospital that deals with traumatic brain injury, they can often be the most chipper section of the hospital.
>
> Not everbody gets better from ECT, infact some get profoundly worse. If you don't improve, then you also have to deal with the possability that your brain will be altered in an irreversable way. Sometimes too, a patient will improve for a while, but then relapse is more profound accounting to the fact that they feel they have lost many of their faculties.
>
> There is one doctor out there who claims he can tell how many ECT procedures an animal has had just by looking at the post mortem brain.
>
> I knew a few people who had the procedure, and at firt they felt better, but a little later they said it was the biggest mistake of their life.
>
> There is **not** an overwhealming conscensious within the medical comunity that ECT is a safe procedure. I spoke to a biology professer from the University of Torotono, who essentially said that we don't have the evidence to suggest that ECT is without long term consequence to neural functioning.
>
> When most doctors agree that we don't really have any idea how ECT works, how can you believe them when they say that it is completely safe. In my opinion, one would need to know how it works before knowing for sure that it is safe.
>
> There is memory loss which may be permanant and can sometimes lead to greater future impairment and depression. There are complaints of significant lasting cognitive impairment too. Though, doctors can pawn off a lot of side effects as being a result of the "underlying depression"
>
> I understand the suffering of an individual who is prepared to try ECT, but I would urge them to keep trying other things, for the sake of your long term mental health.
>
>
>
> Linkadge
>
>
>
>
> Your post is hilarious..did you get your info from the Enquirer Magazine? 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).
>
Posted by UgottaHaveHope on July 19, 2006, at 0:49:07
In reply to Re: Anyone had ECT? » linkadge, posted by Crazy Horse on July 18, 2006, at 21:44:25
Linkadge has just as must rights to express his opinions, along with share his experiences and stories as you do on this board. This place is to help and encourage others, or just share your own personal journey, and NOT to take personal shots at someone else.
From everything I've read from your other posts in the past, you've always been great at helping people and I hope that continues.
Posted by SLS on July 19, 2006, at 6:32:34
In reply to Re: Anyone had ECT?, posted by mayzee on July 18, 2006, at 21:28:07
> Scott, Do you know what's different about ECT treatments today compared with 1991. Have there been improvements in the procedure? Thanks, Mayzee
>
> >
> > In a correspondence with Max Fink, MD, he recommended to me that I not judge the treatments of today by the failures of 1991. I would consider high dose unilateral right.I described my procedure to him. I know this is going to provoke cynacism, but he recommended that I obtain his book. There was only so much he could tell me in a short email.
I think the main difference is the switch from unilateral left to unilateral right and the finding that high-dose unilateral right is almost as effective as bilateral, but without the memory and cognitive side effects.
- Scott
Posted by Crazy Horse on July 19, 2006, at 10:02:10
In reply to Re: Chill out Crazy Horse, posted by UgottaHaveHope on July 19, 2006, at 0:49:07
> Linkadge has just as must rights to express his opinions, along with share his experiences and stories as you do on this board. This place is to help and encourage others, or just share your own personal journey, and NOT to take personal shots at someone else.
>
> From everything I've read from your other posts in the past, you've always been great at helping people and I hope that continues.You're right..his post just really hit a nerve with me. I'm Sorry Linkadge. Not trying to make a bunch of excuses..but i've been in a real pissy mood for the last week and yesterday was extremely bad. I have been having bad insomnia, and well..it effects me in a bad way, i become angry and irritable. Again i'm sorry, and i appreciate you (UgottaHaveHope) for diplomatically pointing out to me that i was wrong.
MONTE
Posted by gardenergirl on July 19, 2006, at 12:35:04
In reply to Re: Chill out Crazy Horse, posted by Crazy Horse on July 19, 2006, at 10:02:10
> Again i'm sorry [Linkadge], and i appreciate you (UgottaHaveHope) for diplomatically pointing out to me that i was wrong.
>
> MONTEThanks to both.
gg
Posted by Denise190466 on July 19, 2006, at 13:49:55
In reply to Thanks UGottaHaveHope » Crazy Horse, posted by gardenergirl on July 19, 2006, at 12:35:04
Hi,
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. But then like I said two treatments is probably not enough to know. Maybe you get to the fifh and then whoosh it's all gone.
The only thing I would complain about is the horrible grey pokey waiting roomm, the big burley ECT nurse who didn't exactly have good interpersonal skills and kept telling me, when I told her I only wanted Unilateral and would accept nothing else, 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! That made me feel really good before going in. Hardly reassuring!
I was having my legs waxed today lying in 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?? You'd think they'd do all they could to put the patient at their ease.
Denise
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
Go forward in 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.