Pain and Depression Sufferers Benefit from Breakthroughs in Neurostimulation

By R. C. Anderson, on September 19th, 2008

When Adam Hammond went skydiving in 2006, he thought it was something that was going to end the same way as the 1,000 jumps before. However, when this U.S. Army “Golden Knight” pulled his parachute, nothing happened. Hammond hit the ground at over 45 miles an hour and broke his leg, pelvis and spine. Hammond woke six weeks later in the hospital with his father by his side. He considers himself “very lucky to be alive, [for] no one expected [him] to live1.”

After two years of therapy and surgeries, the pain was still so intense it was hindering his recovery. To combat this, Hammond was recommended a spinal cord neurostimulator. This device is only the size of a U.S. silver dollar and emits an electrical pulse to the spinal cord, disrupting the pain signal and replacing it with a pleasant one. After using this for one week under trial conditions, Hammond said, “The week trial was amazing. I didn’t expect those results at all. The day I got back…I was walking twice as far…without any pain at all1.”

According to Dr. Tim Deer, the president and CEO of the Center for Pain Relief, this device could be described as “pacing the nerves of the spine like you would for a regular heart beat, [except] we are going to pace the nerves that control pain1.” With this stimulator now permanently in place under Hammond’s skin, Deer hopes to increase his activity and decrease his dependence on medication. “That’s our main goal, to get him to be vital in his own life and his family’s life,” Deer commented1.

A New Industry

More than 50 million people in the U.S. suffer from chronic pain like Hammond3, and almost 300 million suffer worldwide4. Yet, only 100,000 patients are using this type of spinal cord stimulation technology. Part of this is due to the fact that the medical device industry is only just coming online. Even though it is growing at 20% or more each year5, the industry is far from saturated and is expected to have room for growth of 90%6. By the end of 2008, 44,600 spinal cord stimulation devices are expected to be sold7, but that barely begins to help the millions of people that could benefit from it. Luckily, the medical device industry is predicted to grow from $1.7 billion in 2008 to $4.3 billion in 20128. Growth of this nature will ensure more chronic pain sufferers have access to this type of management system, especially since most health plans reimburse patients for this type of therapy5.

The widespread acceptance and use of this technology is even more desirable when one considers chronic pain costs the U.S. $100 billion annually from lost time at work, healthcare costs and lost productivity9. Of this, $2.6 billion was spent on over-the-counter pain medication and $14 billion in prescription medications in 20044.

Chronic pain due to spinal injuries is not the only problem that can be ameliorated with electrical pulses. Other problems such as severe depression, tremors, Parkinson’s Disease, epilepsy, pelvic pain, angina, vascular disease, occipital headache, obsessive-compulsive disorder, motor dysfunction, brain injury and cortical stimulation are all being studied as potential benefactors of electrical pulse therapy5. One human trial is already underway to see if deep brain stimulation can resolve severe and lasting depression in patients unable to find relief through other methods.

Hope for Depression Sufferers

On June 26, St. Jude Medical issued a press release stating that two patients with severe depression were to undergo surgery to implant a small device near their collarbones. This device will release electrical pulses near the collarbone and travel up wires that are connected to an area of the brain thought to control depression10. According to the National Institutes of Health, 21 million people in the U.S. are depressed in some way. Although mainstream treatments are effective for 80% of these, they fail for the other 4 million in our population. “This…is an important step in…a neuromodulation therapy that…will treat this debilitating form of depression,” stated Chris Chavez, president of the St. Jude Medical ANS (Advanced Neuromodulation Systems) Division.

If the study goes as hoped, it may mirror results found in a Canadian study of 20 patients. This found that, after six months, over half of the patients felt a 40% or greater decrease in their depression. Currently, almost 80% of the patients feel relief, and 40% have began participating in social activities such as employment, dating, education and travel10. Furthermore, 15% were medically deemed to be completely free from their depression.

The improvements made to this type of therapy along with its increased use has the possibility of helping billions of people whether they suffer from depression, pain or disease. In the future, the boom in this industry could lead to a boom in the economy, allowing those held back from work and productivity the ability to regain their life, employment and security.

References:

1 – Video with Adam Hammond and Tim Deer, M.D.


2 – Press Release: Former U.S. Army Parachutist Becomes First Person Implanted with the World’s Smallest Neurostimulator to Treat Chronic Pain. Sept. 17, 2008.

3 – National Institutes of Health; National Institute on Drug Abuse (NIDA) Notes, Vol 23, No. 3.


4 – National Institutes of Health Office of Technology Transfer (NIH-OTT)


5 – ANS Medical Implantable Therapies


6 – The Goldman Sachs Group. Americas: Healthcare, Medical Devices. New York, NY: February 2007.

7 – Millenium Research Group. U.S. Markets for Neuromodulation Devices. Toronto, Ontario: 2006.

8 –Neurotech Reports. The Market for Neurotechnology, 2008 – 2012, San Francisco, CA: 2007.

9 – NIH Guide: New Direction in Pain Research I. Sept 4, 1998


10 – Press Release: St. Jude Medical Announces First Patient Implants in Clinical Study Evaluating Deep Brain Stimulation for Depression. June 26, 2008.



3 comments   Healthcare   , , ,  

Health Insurance: The Greatest Flaw in Our Healthcare System

By J.C., on September 19th, 2008

I know this is going to be a controversial post, but I wanted to illustrate how silly our health insurance system has gotten.

Back in the old days, people did not have health insurance. Most hospitals were run on donations, and medical visits to the doctor were not so prohibitively expensive that you couldn’t see the doctor without insurance. But the concept of health insurance evolved to be a benefit for employees, almost like a recruiting perk. It got to the point where employees were needed so badly that it became a standard fringe benefit to get health insurance. To help justify the matter was the fact that medical costs rose so that it was almost prohibitive to see a doctor, let alone get a procedure or go to the hospital, without causing a huge financial setback.

Enter insurance companies. Insurance companies came into the picture to help contain costs. They started making sure that doctors did not order unnecessary tests. They started making sure that patients paid some copayments in order to provide a disincentive for overutilization of healthcare. Basically, they didn’t want you going to the doctor frivolously and wasting money.

In order to be financially solvent and even profitable, insurance companies started raising premiums very high. Thus, health insurance costs so much now that it is a huge percentage of payroll expenditure in the United States. Health insurance companies also started playing both sides – they charged patients more and reimbursed doctors less. Thus, as middlemen, they have found a way to save a lot of money and put it into the pockets of their MBA administrators.

But the problem with the system is that health insurance companies are so profit-driven that they actually penalize you for having pre-existing conditions, even if those conditions are pretty benign. They go through your doctor’s record, and anything that your doctor writes in it they will use against you and charge you a much higher premium.

An example of this is a friend’s son who has mild asthma and rarely uses an inhaler. When applying for insurance on his own, the insurance company wanted to raise his premium 50% higher than someone of the same age without asthma! Similarly, someone who has a resolved condition such as a psychiatric diagnosis can have a higher premium even if his or her disease is in remission.

So what happens if you are currently healthy and you do not tell your doctor that you have had these health issues before? You guessed it – you pay a lower premium.

It’s a really messed up system, kind of like not reporting your car accident to the insurer so your premiums don’t go up. But the difference is that health premiums are expensive and can easily become prohibitively expensive for the average family. I’m not suggesting that you be dishonest in any way. I am just illustrating that the system has some serious flaws that need to be corrected.



5 comments   Healthcare   ,  

“Black Monday,” Hurricane Ike, and Falling Oil Prices: What Is Going On in the Economy?

By J.D. Seagraves, on September 19th, 2008

On Monday, the Dow Jones Industrial Average – the bluest of Wall Street’s blue chips – lost 4.4% in a single day. Fannie Mae and Freddie Mac have been “seized” by the government. Oil continues to drop while gas prices rise. Inflation runs high while jobless claims continue to soar and gold falters. What a strange economic cocktail! Let’s look at the issues one by one:

First, “Black Monday.” It was prompted by the announcement that investment-banking giant Lehman Brothers would be filing for bankruptcy protection. This, after a weekend spent trying to negotiate a government bailout. For once, the government blinked. A week earlier, the markets soared on the news that the feds had “seized” control of the mortgage industry through Fannie Mae and Freddie Mac. Smart traders who hadn’t already taken the hint knew that those gains were illusory.

Now how is it that oil can continue to fall while gas prices have been on the rise? Two words: Hurricane Ike. It threatened refining capacity, which has nothing to do with the price of crude oil but everything to do with your pain at the pump. The real question is why does oil keep falling? That’s actually a troubling sign given the inflation being felt elsewhere in the economy. And the answer is: demand is softening…even in the face of monetary expansion. That does not bode well.

Is there really any question why consumer prices continue to rise? It can’t be blamed on OPEC (oil is dropping), or greedy corporations (profits are down), or labor unions (they hardly exist anymore), or the greatest scapegoat of them all, illegal immigrants (they’re moving back to Mexico!). No, instead, we’re finally confronted with the reality that the Federal Reserve creates “price inflation” (higher prices) through monetary inflation (creating new money). Just this past Tuesday, they unleashed another $70 billion into the economy. Think that won’t find its way into the price of your milk? Think again.

That jobless claims continue to rise shouldn’t confuse anyone unless they’ve had an economics class recently. Just three years ago, when I was taking introductory Micro- and Macroeconomics courses, my professors still taught the widely discredited Phillips Curve – the Keynesian idea that there’s a “trade-off” between inflation and unemployment (i.e., if you have high inflation you should have low unemployment and vice versa). Of course, this was objectively destroyed by the 70’s stagflation, and we’re headed there again.

But how is it that gold, presumably a measure of the dollar’s value, is falling even as dollar-denominated consumer prices rise? Well, as I stated earlier, it’s because gold was overbought – with Fed-created fiat money – and became its own bubble. As the Fed continues to inflate, though, look for gold to rise.



2 comments   Citizen Economists   , , , , , ,