You've never heard the term before because I just invented it.
But I don't have the time or interest required to trademark or patent or copyright it or whatever one does with a term.
Shrinkette, take it from here, would you?
You keep all the cash: I take no commission.
The term's gonna come into vogue real soon, because the F.D.A.'s on the verge of approving the use of Cyberonics' implantable vagal nerve stimulator for the treatment of depression.
Currently used in Europe for the treatment of seizures, the device, which costs $15,000, acts as a sort of pacemaker for the brain.
It's the size of a pocket watch and must be surgically implanted in the upper chest, then connected via thin wires to the vagus nerves in the neck.
It then sends pulses through the nerves into parts of the brain associated with depression.
Total cost for the device plus the surgical procedure is around $20,000.
Hey, stop, what's that sound?
Oh, yeah: "ka-ching."
Cyberonics estimates that 4.4. million Americans suffer from the severe and recurring type of depression that might be treated with its device, called the VNS [Vagal Nerve Stimulator] Pulse 102.
That's a lot of "ka-ching."
Robert P. Cummins, the chairman, CEO, and president of the company said in yesterday's New York Times story that "If it is adopted for depression at the same rate as it has been for epilepsy, we will pass $1 billion in sales by 2010."
Hey, you with the band, strike up "We're In The Money."
Here's what I don't understand: how is it, with all the wireless technology that's sweeping into wide use, both cardiac and now central nervous system pacemakers still rely on old-fashioned hard-wired technology requiring expensive, invasive surgical procedures, with all the complications that accompany such things?
Bleeding, infection, all manner of things happen when you go in surgically.
So why aren't these devices able to be worn outside the body, or at least inserted via a transcutaneous technique akin to that used for birth control with Norplant?
The signals could then be sent wirelessly to the heart or brain.
Couldn't be the juicy $5,000 fee the surgeon gets for the 15-minute implantation procedure, could it?
Nah - how could I think that?
If you've ever had any contact with depression - in yourself, a loved one, or a friend - you could not do any larger favor for the both of you than to buy and read William Styron's brief, overpoweringly affecting memoir of his own descent into a hell worse than any imaginable.
It's entitled - perfectly aptly, in my opinion - "Darkness Visible: A Memoir of Madness."
Article comments
1 - LifeTime
Dear Bookofjoe "the world's only blogging anesthesiologist,"
While I thought I was receiving another spam message in my E-mail and I was about to press the delete button, I noticed the letters "VNS" which immediately drew my attention and for many good reasons.
I shall presume my response is being directed to the correct party that issued his opinions in the following link:
http://blogcritics.org/archives/2005/02/05/120924.php#comments
If by some chance I'm in the wrong pew kindly forgive me and ignore my response.
I am a very long-time support person, caregiver and depression lay-expert to my spouse who has suffered TRD (Treatment Resistant Depression) and of the many hats I've worn, I've also been a former facilitator for a local chapter of the DBSA, a president and a board member as well as having an appointment in my state as a Guardian Advocate. While I do have some respect for you and other licensed medical professionals I strongly advocate for the education of the patient and/or their support persons and the need to collaborate with one's caring, compassionate, trusted, knowledgeable and licensed healthcare practitioner(s) when making un-coerced and informed medical decisions. This brings me to the fact from my experiences, research and knowledge over some 41 years of marriage that when a physician hangs their shingle out to practice it doesn't state whether they graduated first or last in their class. Along those same lines I am also cognizant of the fact that there are doctors, good doctors and those that scare the living daylight out me.
I have not yet made a determination as to where you fit on the scale as it takes more than one article for me to formulate an opinion as to whether we have here a trusted, caring, compassionate, knowledgeable and licensed healthcare practitioner. In any event my formulating an opinion of you is not what is important or at issue. What is important is the illness and its potential fatal consequences to individuals who otherwise maybe medically healthy and without medical issues other than the TRD.
Your remarks:
Hey, stop, what's that sound?
Oh, yeah: "ka-ching."
Hey, you with the band, strike up "We're In The Money."
These quotes hit a sour note with me. Am I missing something but are you more concerned with the money matters than this patient population or are you trying to stress they could have done a better job on the technology?
"Couldn't be the juicy $5,000 fee the surgeon gets for the 15-minute implantation procedure, could it?"
I personally believe from your opinions you are lacking information both as a physician and anesthesiologist. "15-minute implantation procedure," may I suggest you call Cyberonics clinical and technical service department at 800-332-1375 ext 7330, educate and bring yourself up to speed. While you're at it and if the replay of the surgical implantation web cast is still available, try timing the procedure and report back of your findings. Here's a link for you: http://www.or-live.com/met/1240/rams/vnr.ram
While on the call why not inquire about your suggestions of wireless technology but obviously you haven't taken into consider possible outside interference causing all kinds of problems. Then again I would guess you're not up-to-date on the all the security problems with wireless technology. We certainly wouldn't want a cardiac pacemaker patient having his device inadvertently or intentionally deactivated, would we? Since my lay-person expertise does not lie in this area, I'll leave it up to you to respond what you find.
By way of further disclosure my spouse has been and still is a 5 year participant in the original D-01 depression study utilizing the VNS as an adjunctive treatment for depression. As it has evolved she has greatly benefited from this new and innovative therapy in that she has been almost continuously depression free utilizing the therapy as a first line treatment without the use of psychotropic medications for purposes of depression. We have used a single out-patient maintenance ECT as the adjunctive therapy to successful abort a brief down cycle. I have also been responsible for forming a collaborative group of study subjects, who at the time were restricted from any public discussions regarding the studies but this did not dissuade me and others to discuss the subject privately. Although this treatment option is not a panacea, as are no others, it still affords a potential efficacy for a percentage of patients unable to obtain efficacy with other therapies. I am a vocal and outspoken healthcare advocate for my spouse and not intimidated by medical degrees or those holding such degrees in the belief they're deities.
Although I am in agreement with you and anyone advocating for less expensive medical treatments as well as medications etc I am aware of two individuals who have paid out of pocket for their loved one's as the this therapy has yet to be formally approved but their responses indicate any benefit is worth the price.
So ""the world's only blogging anesthesiologist" why not take your valuable time and efforts and direct them to the companies and FDA and with your presumed knowledge and expertise, put it to good use and educate those entities on how to reduce the expenses to the consumer.
Thank you for this opportunity to share with you. I'll post this same E-mail on your blog but I do ask that you respect my privacy on the Website by not sharing my personal E-mail address.
Warmly,
Herb
P.S. I am adding this postscript as I E-mailed to your personal address listed on the site. What bothers me is people put up websites and they allude to professionalism and knowledge and yet many are nothing but frauds and charlatans. How it is your posted E-mail address came back with the following information? It strikes me you have credibility issues:
----- The following addresses had permanent fatal errors -----
(reason: 550 5.7.2 This smells like Spam.)