Stellate Ganglion Block for PTSD

DevilDoc

DevilDoc

PEB Forum Regular Member
PEB Forum Veteran
Registered Member
Those who are suffering and want relief, may I suggest SGB. I had my first injection today and I haven't felt like this since before my first deployment in 2003. Google Stellate Ganglion Block, it's a procedure that been going on since early 1900. After the injection, I didn't have the feeling of ripping someone's throat out for being a dumbass. Hopefully this last for a while.
 
I am headed to Chicago the 24th of this month to get the shot. There are very few people posting on here they've actually tried the block. I am nervous I am getting taken advantage of.
 
@DevilDoc
I am glad you are one of the 70% who experience relief from the SGB procedure.

@DavidK184
Hope your procedure goes well. I guess anytime we do something new it can be nerve wracking. The risk is 0.0017 of all complications combined. That is pretty low risk. Best wishes.
 
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DevilDoc DavidK184 chaplaincharlie- Might be interested in below:

“Evidence Brief: Effectiveness of Stellate Ganglion Block for Treatment of Posttraumatic Stress Disorder (PTSD)” by “Department of Veterans Affairs Health Services Research & Development Service” for example at web-address: https://www.hsrd.research.va.gov/publications/esp/ganglionblock.pdf accessed on 23 AUG 2018 at appx. 0243 AM EDT (see attached file from above named web-site: “ganglionblock.pdf”)- Below – in “italics” quoted/cited from above article:
“CONCLUSIONS Findings from the first RCT of SGB for PTSD were inconclusive, neither confirming nor refuting findings of rapid and high rates of clinically relevant improvement and low risk of serious adverse events from unblinded, uncontrolled case series. It is appropriate to listen to criticism of the RCT, envision a better study of SGB for PTSD, and investigate whether SGB should be a higher priority than other innovative treatments for PTSD. “

US DVA study (see attached) “cites” a “1992” German study for side-effect’s,” etc… oddly.. is the US that far behind rest of world treating its “veterans” and soldier whom are deplyed more than any other Nation’s just about……..???????

Also, might want to see “Stellate ganglion” From Wikipedia, the free encyclopedia at web-address: https://en.wikipedia.org/wiki/Stellate_ganglion accessed on 23 AUG 2018 appx. 0250 AM EDT

Finally, Also see YouTube Video, search words: “stellate ganglion block ptsd” at web-address: https://www.youtube.com/results?search_query=stellate+ganglion+block+ptsd accessed on 23 AUG 2018 appx. 0254 AM EDT as well as “Stellate Ganglion Block procedure at WAMC” from above YouTube Video menu at web-address:
View: https://www.youtube.com/watch?v=bmHYFHkzuXg
(accessed on 23 AUG 2018 appx. 0258 AM EDT)
Funny or not, VET’s I know GULF Coast VA System/ VISN16 whom get deep “tissue” injections at US DVA, claim not done with “aide” ultrasound, etc…. as per cited You Tube Video Clip above…..hummph….????

Hope this helps, and beware, appears, as per “studies,” in US at least, not quite clear which to believe as did as suggested and “googled” this procedure…..??????????????

PS: Might be interested- as well- Forums Transition Forum: Veterans Affairs and SSDI Veterans Affairs, SSDI, and other Benefits “Question: Anyone Sue US DVA ‘Malpractice’ Etc… ‘Successfully’- IMO Thoughts- 2-Centavos-Cents-Pfennigs-Ruble-Franc?!?”

ANYONE ELSE HAVING ISSUES THIS WEB_SITE, ETC.......?????!!!##%%%?????
 

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Wow this was from six years ago but this is news to me thanks for the heads up I will look into it.
 
Forums PEB and Disability Evaluation System Overview Conditions and Ratings PTSD and Mental Health Conditions Stellate Ganglion Block for PTSD Thread starterDevilDoc
Start dateJul 4, 2012

oddpedestrian – stated “Wow this was from ‘six years ago’ but this is news to me thanks for the heads up I will look into it.”

Roger oddpedestrian bizzare is it not, I and others, have never been offered this nor has it even been discussed as an option by US DVA either Gulf Coast VA System/VISN16- nor any other VA System have been to including other VA System’s PTSD Programs….. kind of bizzare- is it not??????

Furthermore from attached file in Post#-4 above from: “Evidence Brief: Effectiveness of Stellate Ganglion Block for Treatment of Posttraumatic Stress Disorder (PTSD)” by “Department of Veterans Affairs Health Services Research & Development Service” for example at web-address: https://www.hsrd.research.va.gov/publications/esp/ganglionblock.pdf accessed on 23 AUG 2018 at appx. 0243 AM EDT (see attached file from above named web-site: “ganglionblock.pdf”)- Below – in “italics” quoted/cited from above article:

“EXECUTIVE SUMMARY Posttraumatic stress disorder (PTSD) is the third most common psychiatric diagnosis among Veterans seen in the Veterans Health Administration (VHA). PTSD can be debilitating, leading to a decline in quality of life (QoL) and causing significant medical, mental health, interpersonal, and social impairment. First-line treatments for PTSD include psychotherapy, pharmacotherapy, or their combination; however, several challenges have been identified in their effectiveness and reach. Stellate ganglion block (SGB), also called cervical sympathetic block, has been promoted as an adjuvant in individuals with PTSD who have not fully responded to conventional therapies. One proposed mechanism of action is that SGB might inhibit connections between the peripheral sympathetic nerve system and regions of the cerebral cortex thought to be abnormally activated in PTSD. Some proposed benefits of SGB for PTSD include (1) it may destigmatize treatment by offering a biologic approach to PTSD management, (2) it may offer a fast-acting treatment alternative with improvements reported within minutes to days of the procedure, and (3) it may increase compliance as it does not require continuous daily or weekly administration.
Our objectives were (1) to determine to what extent SGB provides clinically relevant benefits for patients with PTSD, (2) to determine SGB’s potential harms, and (3) to identify Veterans who are most likely to benefit from SGB.
In uncontrolled, unblinded, retrospective case series, SGB for PTSD had high rates of rapid clinical improvement in PTSD symptoms (70% to 75%). However, findings from the first randomized trial (RCT) of SGB for PTSD were inconclusive, neither confirming nor refuting findings from case series. In the RCT, the range of mean percent PTSD improvement after one round of SGB was 5.4% to 14.7%, and was 12.1% to 21.2% after the second round, which was no better than an injection of saline. However, certain population characteristics and intervention and comparator techniques used in the RCT were suboptimal for determining efficacy and it was too small to estimate rates of serious complications. The majority of study participants were active-duty military personnel with unknown psychological and medical comorbidities and previous conventional therapy trials.
The pattern of very encouraging results in a few case series, followed by a negative RCT, is quite common. The pattern suggests that, while it is possible that some patients benefit, the response rates seen in case series will not hold up in actual practice. Substantial uncertainty remains about the potential harms of SGB as well. The RCT, as well as RCTs of SGB for complex regional pain syndrome (CRPS), were inadequately powered to support or refute findings from the frequently cited, but methodologically weak, 1992 German questionnaire survey of 45,000 SGBs that found 1.7 instances of severe complications per every 1000 individuals.”

Weird- is not, oddpedestrian this is just now receiving US Veteran, etc…attention…apparently? Furthermore, having been, along numerous other Us Service members, in GE in 1992- “I am assuming” the 1992 Study done (cited above) in GE contained quite a few German World War II veterans (perhaps even some US WWII vets as lot of US MiL once liked retire and/or separate, vic. GE, etc…) as one met them all the time when out and about on local ‘economy,’ etc……?????” (If get around to or feel like might try find this ‘cited’ 1992 GE study and post!)

PS: Might want to see below as well-perhaps:

Forums Service Specific Forums Service Specific Forums Navy/US Marine Corps Forum “Bipolar II, active duty 3 years from retirement... to enter into medical record or not?” Thread starterskyvstorm
Start dateTuesday at 10:49 AM

Forums PEB and Disability Evaluation System Overview Conditions and Ratings PTSD and Mental Health Conditions “Help to stop drinking” Thread startertony292 Start dateFeb 17, 2018 (see for example Post#-7 & Attachments, etc….as well other PEBForum Threads)

ANYONE ELSE HAVING ISSUES THIS WEB_SITE, ETC.......?????!!!##%%%?????
 
Tried, as stated 'might', find “original” copy of “cited” – 1992 German study- but came up short, this attempt, however found below “resources” might be of assistance or for “thought” anyone considering this procedure for PTSD and or Pain- see (perhaps) per PEBForum Resources VA Resources Saunders v United States 2018-04-12 AuthorJason Perry Creation dateApr 12, 2018

See below and attached perhaps:

“Complications and side effects of stellate ganglion blockade. Results of a questionnaire survey].” [Article in German] Wulf H1, Maier C. Author information For Example Only at web-address: https://www.ncbi.nlm.nih.gov/pubmed/1570888 “PubMed.gov” accessed on 24 AUG 2018 appx. 0530 AM EDT
“Interventional therapy in Complex Regional Pain Syndrome type 1 Predicting the outcome” PROEFSCHRIFT Ter verkrijging van de graad van doctor aan de Universiteit Maastricht, op gezag van de Rector Magnificus, Prof. mr. G.P.M.F. Mols volgens het besluit van het College van Decanen, in het openbaar te verdedigen op donderdag 26 januari 2012 om 16.00 uur door Frank van Eijs- UNIVERSITAIRE UPERS MAASTRICHT- at FOR Example Only web-address: https://cris.maastrichtuniversity.n...557c4152-d550-468b-a757-6563902a3b88-ASSET1.0 accessed on 24 AUG 2018 appx. 0533 AM EDT (see attached file downloaded from cited above web-address- “guid-557c4152-d550-468b-a757-6563902a3b88-ASSET1.pdf”)

“Ultrasound-Guided Stellate Ganglion Blocks Combined with Pharmacological and Occupational Therapy in Complex Regional Pain Syndrome (CRPS): A Pilot Case Series Ad Interim” From “Pain Medicine 2014; 15: 2120–2127 Wiley Periodicals, Inc.” for example only at web-address: https://watermark.silverchair.com/1...-cFRkmjQqOY15cEq9hNh6gVxVqFJEzMNvhNJ_HPdWfPz9 accessed on 24 AUG 2018 appx. 0518 AM EDT (see attached file downloaded from cited above web-address- “15-12-2120.pdf”)

“TMU-Joint Institutional Review Board- Effects of Linearly Polarized Near-Infrared Irradiation in Patients with Sympathetically Maintained Neuropathic Pain Syndrome” For example only at web-address: http://www.chictr.org.cn/uploads/file/be659882160a406da58214a82da4db4e.pdf accessed on 24 AUG 2018 appx. 0524 AM EDT (see attached file downloaded from cited above web-address- “be659882160a406da58214a82da4db4e.pdf ”)

“Biomedical Research 2017; 28 (4): 1677-1682- ISSN 0970-938X www.biomedres.info- Complications and success rates of stellate ganglion blockade; blind technique vs. fluoroscopic guidance.” By Haktan Karaman* Department of Pain Management Centre, Dicle University, Diyarbakir, Turkey For example only at web-address: https://pdfs.semanticscholar.org/1a9c/587ef15d8a05af8dedb51a3a976cb59b7175.pdf accessed on 24 AUG 2018 appx. 0525 AM EDT (see attached file downloaded from cited above web-address- “587ef15d8a05af8dedb51a3a976cb59b7175.pdf”)

PS: If Interested might want to see below link and attached file-???:

“The Declaration of Independence & the Constitution of the United States- US Citizenship and Immigration Services- M-654 (rev. 07/08)” For Example Only at web-address: https://www.uscis.gov/sites/default...ource Center Site/Publications/PDFs/M-654.pdf accessed on 24 AUG 2018 appx. 0544 AM EDT (see attached file downloaded from cited above web-address “M-654.pdf”)

Anyone else “issues” this website other than myself- would really like to know…..?@#$???
 

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ALL_ just thought would follow-up here with a question: "Has anyone had success in getting the US DVA to provide this procedure- and if so did it help at all with PTSD/Insomnia/Depression?"

As per usual know a local vet, that with things like Alpha Stim (https://www.alpha-stim.com/get-started/); Cane Master's, Yoga, etc... cannot get a straight answer nor even answer- nor Gulf Coast VA/VISN16 to support in any manner what so ever.....????????

Also, it is odd that per another "local" vet- sent, considered by most unjustly, to a US Federal Medical Facility (FMC) for quite some time, that the "psych" staff was forcing inmates/patients to "take" injection "psychotropic" medications, not for their own- patient/inmate- benefit, so much as, per staff "looked good for Federal Judges" and not all staff were wise enough to try "patients" on "oral" medications, as a test to see any adverse reaction prior to "injection"....etc.......???????? So one would think the US DVA being a Federal System, this procedure, would in fact be a more than viable option, unless of course something like cost, etc... is a factor in the decision making process.....perhaps.....????????

It is odd per Alpha Stim website - https://www.alpha-stim.com/get-started/- that "Outside of the United States, you do not need a prescription or order from your healthcare practitioner. To purchase an Alpha-Stim, you can buy now on our webshop or by going through your local authorized Alpha-Stim distributor. "

(PS: It is also very odd, that IAW local doctors TEN's units are no longer covered under most "insurance" plans, etc.... which is very odd as "good" alternative pain therapy/management etc... and given extent of Opioid Epidemic/ Crises not a viable option apparently anymore- IMO- kind of a major contradiction..... but of course could be wrong......??????)

Thanks, and look forward any response......?????

(Anyone else issue this website......?????!!!??)
 
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The technology is promising, however as a medical professional, I find many of the words and phrases used in their marketing material challenging. No where are they able to state they are FDA approved and if the treatments are accepted by any insurance companies.

Here is a study published in Military Medicine (2016) that discussed the use of the technology in the field. https://www.alpha-stim.com/wp-content/uploads/2014/08/miltary-medicine-11-16.pdf

This technology is commonly used by alternative medical providers such as Chiropractic treatment. You may want to consider asking your PCM for a referral to chiropractic care through the Veterans Choice program and then find a provider in your area that employs the technology.
 
The SGB procedure is an off label use of one of two FDA approved medications used for head and neck anesthesia. The medications are FDA approved, the SGB procedure is not FDA approved but legally used.
 
chaplaincharlie “@DevilDoc I am glad you are on of the 70% who experience relief from the SGB procedure.”

gsfowler “Here is a study published in Military Medicine (2016) that discussed the use of the technology in the field. https://www.alpha-stim.com/wp-content/uploads/2014/08/miltary-medicine-11-16.pdf
This technology is commonly used by alternative medical providers such as Chiropractic treatment. You may want to consider asking your PCM for a referral to chiropractic care through the Veterans Choice program and then find a provider in your area that employs the technology.”

The below is from link provided by GSFowler:

https://www.alpha-stim.com/wp-content/uploads/2014/08/miltary-medicine-11-16.pdf (see attached file downloaded from above listed website at 0016 AM CST; 01 OCT 2018: below “cited” in “italics” from attached/downloaded file “miltary-medicine-11-16.pdf”)

“CONCLUSION The use of CES and the model of establishing an outpatient clinic were both extremely beneficial to the mission. In many instances, this treatment option appeared to carry less stigmathan the options of medication and therapy, branding the treatments as “performance enhancing” rather than a medicine for “sick and broken” individuals with COSR. This approach made CES popular among many ranks and occupational specialties. CES does not necessitate constant licensed providers to supervise sessions, so it was cost and manpower efficient in the deployed setting. In consideration of the mission requirements, prevalence of COSR, MOD 12 implications, and limited behavioral health assets, CES was ahelpful tool in conserving the strength of the fighting force.”(“Vol. 181, November/December 2016 1411 Cranial Electrotherapy Stimulation Therapy in a Combat Operational Setting Downloaded from publications.amsus.org: AMSUS - Association of Military Surgeons of the U.S. IP: 050.026.136.184 on Dec 27, 2016. Copyright (c) Association of Military Surgeons of the U.S. All rights reserved.”)

Yes, the article also, states that “should” state FDA approved…. However per previous post’s this Device is “apparently” already being issued by other US DVA System’s and was approved by former Head US DVA himself…..

Also, if as per Chaplain Charlie 70% receive relief symptoms, and US Military Hospital’s are in fact “providing” the STG Procedure then why is it not FDA approved…..?????

Not being a medical professional myself, would simply be curious to know, as well as if it is in fact true under new “Health Care Rules” if in fact most “insurance” such as Ticare for Life, Medicare, etc.. will not in fact “support” TENs units etc…???

Perhaps one could assist in providing some clarification here…..for the benefit of ALL????

As Always thanks GSFowler and ChaplainCharlie……
 

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Here is a link to an FDA post on the use of approved medications for off label use.

https://www.fda.gov/forpatients/other/offlabel/default.htm

The reason many off label uses never become FDA approved it there is no profitability. A pharmaceutical company is already getting income from the medications that is being used off label (at no additional cost) and the additional market for the off label use (with FDA approval) is too small to offset the high cost of the FDA approval process.
 
DavidK184 said:
I am headed to Chicago the 24th of this month to get the shot. There are very few people posting on here they've actually tried the block. I am nervous I am getting taken advantage of.
Click to expand...
DavidK184

I’m considering having the shot but have the same concerns you were having. Can you tell me anything about you have learned and whether you had it done or not? Thanks
 
Former MiTT Team Leader said:
ALL_ just thought would follow-up here with a question: "Has anyone had success in getting the US DVA to provide this procedure- and if so did it help at all with PTSD/Insomnia/Depression?"

...
Click to expand...

I realize this is an old thread but found it when looking for info on the SGB procedure. I was offered this treatment by my VA psychiatrist (local clinic) through a civilian provider in town.

I'll post back if I opt to get it for treatment resistant depression and PTSD. It's definitely an option as a VA referral but I'm not sure about through a VA facility.
 
jp_over said:
I realize this is an old thread but found it when looking for info on the SGB procedure. I was offered this treatment by my VA psychiatrist (local clinic) through a civilian provider in town.

I'll post back if I opt to get it for treatment resistant depression and PTSD. It's definitely an option as a VA referral but I'm not sure about through a VA facility.
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I'm still Active Duty so I can't help answer the VA treatment availability question, but I've received 5 SGB's so far and they have been a huge relief to my anxiety/PTSD issues. It's a relatively quick outpatient procedure and I've felt instant relief. The effects have lasted for a longer period with each procedure. Everyone may react differently to the SGB, but for me, they have been far more effective than medication.
 
StillWaiting21 said:
I'm still Active Duty so I can't help answer the VA treatment availability question, but I've received 5 SGB's so far and they have been a huge relief to my anxiety/PTSD issues. It's a relatively quick outpatient procedure and I've felt instant relief. The effects have lasted for a longer period with each procedure. Everyone may react differently to the SGB, but for me, they have been far more effective than medication.
Click to expand...
Thank you for sharing. How far apart have the five procedures been?
 
Thank you
 
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