Hi again.

Jeanne, that was just about the kindest words that have ever been directed my way. If any one note could have made writing this worthwhile, that was it. Thank you.

And as far as the insurance and short-term memory loss issues are concerned, I have a couple of thoughts. First, medically refractive depression (not responding to medication) is a hardcare psychiatric diagnosis. But if the shoe really and truly fits, why not wear it?

Secondly, on short term memory loss, I agree completely that medication can be crippling in that department. I learned early on in this disease that I could take Baclofen and practice law for that bery reason. However, once I was no longer working as a lawyer (because the stress of litigation exacerbated the pain beyond any manageable level) the concern became moot and I've been popping Baclofen with some regularity for a while now. That said, as I alluded to earlier, recent research suggests that using ketamine as a general anesthetic may do away with the short-term memory loss issue altogether, once the ketamine has cleared from your system, at most 72 hours after any given ECT treatment. McDaniel WW, Sahota AK, Vyas BV, et al. "Ketamine Appears Associated With Better Word Recall Than Etomidate After a Course of 6 Electroconvulsive Therapies," The Journal of ECT, 2006, 22:103-106. This is a tremendous advance, and one that may not yet be fully recognized in the psychiatric community. On the other hand, it's just one study and others may be in the offing.

That said, if anyone wants a copy of that article to share with your doctors, drop me a PM with your email address and I'll send it on. Other particularly relevant articles include the following:

Rasmussen KG and Rummans TA, "Electroconvulsive Therapy in the Management of Chronic Pain," Current Pain and Headache Reports, 2002, 6:17-22;

McDaniel WW, "Electroconvulsive Therapy In Complex Regional Pain Syndromes, The Journal of ECT, 2003, 19:226-229;

Wolanin MW, Gulevski V, and Schwartzman RJ, "Treatment of CRPS With ECT," Pain Physician, 2007, 10:573-578, and

Sackeim HA, Prudic J, Fuller R, et al., "The Cognitive Effects of Electroconvulsive Therapy in Community Settings," Neuropsychopharmacology, 2007, 32:244-254.

Once more, I would be happy to share copies of any of these articles. I fact, I have pdf files of most of the stuff cited in my article and could share it if requested, but I think that the five articles I've listed would probably be of the greatest immediate value in securing RUL treatment, for anyone who wants to go there. Let me know. (It may take me a day or three to get back to you though, for which I would request your indulgence.)

Mike

Great article!!!

I was wondering... if anyone knows what this kind of treatment costs?? Ball park figure???

Thanks,
Abbie

Just want to clear something up I wrote yesterday about the SCS. I haven't had problems with it...in fact it has been my life saver. However with that said if I would have gone with the ECT route I might not have the SCS today or the need for medication.

Mike...I will print your article and take it with me to my pain management Dr. who I will be seeing on the 10th of this month. I will also take down the 3 articles you mentioned. I'm sure he has access to all of them and he has a staff who can pull anything he needs. I will also print out a copy for the Doctor I worked with who still performs ECT...I'm sure he will enjoy it.

As far as cost goes I would think it would still be out of pocket and expensive.
Hugs, Jewells

Abbie and Jewells -

I am told that the approximate cost per session is anywhere between $1,000.00 and $1,200.00, and those figures may be a couple of years old. Multiplied by - say - 8 sessions, an you're in the range of $9,600.00, $14,400.00 if you go for all 12.

So the issue of pursuading the insurance companies to pick this up is of some obvious importance.

Mike

Kudos on the article. It is superb.

It's very interesting as well. One of the many docs I've seen (and the oldest) suggested that much chronic pain is thalamic in nature. ...or at least this was the common wisdom many years ago.

Thanks for the research Mike- Looks like we need some guinea pigs and some money!

Deb

Thank you so much for this. I've been away for awhile & am so glad I didn't miss this post. I don't think you give your short term memory enough credit. If it was really bad you wouldn't have been able to do this research or article. Mine is so bad, I have a hard time just reading through your post.

This sounds so exciting. If it can get rid of the pain, it's worth the $.

Thanks again,
Linmarie

If it's done on an outpatient basis (and no reason it can't be), then the cost is in the range of $1500 per treatment. Of course that's only if you don't have insurance. Otherwise they'll pay for it.