Vagus nerve stimulation for depression

Recently my doctor recommended a vagus nerve stimulation procedure to reverse depression. Does this work? Part 1

Many people with depression struggle and are always searching for a treatment that lasts long. While drugs have been the primary therapy for depression, many people do not always respond to them. Even when they respond, the benefits are short lived and plus the drugs also have potent side effects.

 Recently vagus nerve stimulation has been introduced as a treatment for depression. Vagus nerve stimulation has been used for the treatment of certain epileptic disorders. Over time, it became obvious that these individuals started to develop an improvement in their mood. So now vagal nerve stimulation is being tried as a therapy for chronic depression.

 Vagal nerve stimulation is a small surgical procedure. A thin electrode is placed near the vagus nerve in the neck and the wire is then connected to a pulse generator, which is implanted in the upper chest. The pulse generator emits electrical signals which stimulates the vagus nerve. Vagus nerve stimulation in turn results in mood improvement- at least that is the theory.

Vagus nerve stimulation is not standard therapy and only used in people in whom the standard anti-depressant therapies have failed. In addition, vagus nerve stimulation may be an option for people who are taking multiple drugs and have failed electroconvulsive therapy. Unfortunately, vagus nerve stimulation does not work in all depressed people. The few studies have not always shown convincing results and the result are also variable. Even among psychiatrists, the therapy is not accepted and many health insurance companies do not cover the procedure. In addition, the costs of vagal nerve stimulation are not trivial- considering that it may not even work.

Vagus nerve stimulation for depression

Recently my doctor recommended a vagus nerve stimulation procedure to reverse depression. Does this work? Part 2

While the procedure is easy to perform, it does have side effects that range from neck pain, infection, damage to the vague nerve, difficulty breathing, nausea and slowing of heart rate. In rare cases, one may develop vocal cord paralysis, voice changes, persistent cough and throat pain. While most side effects are tolerable, many people find the side effects annoying in the long run. However, of more concern is that in a few cases, vagal nerve stimulation may also lead to worsening of depression, suicidal thoughts and anxiety.

The surgery for implantation of the device is done as an outpatient and done under local anesthesia. After implantation, the device is programmed to deliver electrical impulses at various frequencies. Most people are started at low electrical current, which is gradually increased to get the desired result. Each stimulation lasts 30 seconds and occurs every 5 minutes. During this period, the side effects are most common. All individuals are given a small hand-held magnet to control the device. The machine has to be turned off while eating or speaking.

The results of vagus nerve stimulation are not immediate and often take months before the desired electrical impulse is obtained. As soon as the stimulation stopped, the depressive symptoms return. The decision to undergo vagal nerve stimulation is difficult. The procedure is very costly and there is no guarantee it will work. So before you decide to get the procedure, speak to people who have had it done. Remember even after vagal stimulation, you may still need to take anti depressant medications and continue with psychotherapy.

Itchy nipples

I am 25 year old and have developed very itchy nipples. Can I apply something on them?

In young people, itchy nipples are nothing to worry about. The itching may be due to tight clothes or your nipple rubbing against your bra or under shirt. This can happen if you exercise without a bra. However, chronic itching can also be a sign of eczema. If the itching is bothersome, obtain hydrocortisone cream over the counter and apply it 3-4 times day. If this problem persists after application of hydrocortisone, it is wise to see your doctor. Another common cause of itching around the nipples is a fungal infection, which can also be easily treated with an anti fungal cream. If the itch is limited only to your nipples, perhaps a change of fabric or bra may be warranted

Erect nipples

Can you tell me why my nipples are erect all the time?

In most cases, nipple erection is associated with sexual arousal but in some women, nipples may remain erect without any sexual stimulation. Why this happens is not well known. Sometimes, nipples can be erect when they are excessively irritated like when you start to pluck hairs or wear tight clothing. Some women love to show of their erect nipples but for those who are shy, then there are a variety of padded bras which can be worn. If you constantly plucking your hair around the nipples, stop the habit and see what happens. If it is the clothes that cause erection of your nipples, start to wear a bra, change the fabric or wear loose clothing. In any case, erect nipples are treated conservatively and there is ZERO need for surgery- unless you love pain and have money to waste.

Stage 4 colon cancer and surgery

 My mother is 77 and very ill. She is barely able to walk and has been a heavy smoker all her life. Recently she was diagnosed with colon cancer that has spread to the liver. Her surgeon recommends surgery. I am not sure what to do.

The first thing is you need to get is a second opinion. Any surgeon who wants to operate on stage 4-colon cancer sick frail patient has very little clinical judgment. Colon cancer surgery in older age groups has its benefits but surgery is also of high risk. The general rule of surgery is that patients who are deemed to be at high risk for surgery need surgical clearance from other specialists. Finally, surgery for stage 4-colon cancer is never done as life expectancy is very poor and there is no chance of cure. Removing a mass from the liver is no piece of cake. With the quality of some surgeons we have, death is a high probability.

The best advice is to seek another medical opinion and still not undergo surgery – as surgery will not benefit your mother. Please dump this stupid doctor-there is something known as palliative care and this is what your mother needs.

PIP Breast Implants

Women who live in Europe, South and Central America continue to get confusing messages from their respective governments about their breast implants. The implants made by Poly Implant Prosthesis (PIP) were manufactured by a French medical company, which is now non-operational. The company made poor quality, cheap grade implants of silicone, but luckily, these implants never made it in the US.

In France alone, data indicate that at least 30,000 French patients (mostly women) will need to have the implants taken out and the government will pay for the cost of removal.

However, response from other governments is not consistent. In other European and South American countries, some women have been advised to have the implants removed but only at their own expense. In other cases, the government has offered to pay for the cost of removal if only the implant shows signs of leakage or is obviously defective. In most Central American countries, patients have simply been told to have their implant checked at their own expense.

In Brazil and Mexico the governments have advised women to have the implants evaluated but have not recommended removal. In Colombia, the government has promised to pay for the removal if there is an indication. In Britain, the National Health Service has advised against routine removal and only those which are found to be defective will be eligible for free removal. In Holland, the government has advised women to have their PIP implant removed. The cost of removal is enormous but for women, it is the disfigurement and emotional torment that also has caries a heavy burden.

Latest estimates indicate that PIP sold close to 400,000 implants worldwide before going out of business several years ago. For those American patients who had PIP breast implants done abroad because the price was cheap, they should be aware that they are at great risk and should see a plastic surgeon.

In the last few years, complaints about these implants had been rising and include breast pain, inflammation, irritation and asymmetry of the breast. Many other implants had leaked or burst because of the inferior grade silicone. Several patients have also died of cancer in France.

Recently the FDA indicated that a type of lymphoma was a cause of death in some of these women with silicone breast implants. Fortunately, the number of cancers has been very few and no definite link has yet been established to the silicone.

For women, breast implants can improve their body image, personality and enhance their sex life.  However, consumers have to know that every prosthesis, like an implant, only lasts for 10-15 years. There is no implant that lasts a lifetime. At some point in time, the implant has to be removed because like any mechanical item, the wear and tear will cause deterioration.

Therefore, while plastic surgery is a great way to enhance self-esteem and confidence, it also carries some unknown risk, especially when cheap quality materials are used. This alone should be one reason not to seek any type of healthcare abroad. Outside of North America, cutting corners in healthcare to make money is the name of the game. Trust me-i have worked in over 27 countries.

Vitamins for glaucoma

I have had glaucoma for years. I just saw an ad for eye vitamins. Can these vitamins improve my vision or protect me from further vision loss?

No, that is all BS. These vitamin ads are bogus. There is no vitamin that can reverse or cure glaucoma. We have a health supplement industry that is unregulated and continues to make unsubstantiated claims. The sad part is that it is supported by unscrupulous healthcare workers who are simply interested in scamming desperate patients. 

Unfortunately, we also have a lot of gullible, stupid and/or desperate people who believe this type of crap. If you have glaucoma, go and see a bona fide eye doctor.  If you muck around with glaucoma at home with this vitamin BS, you will end up blind.