Dr. Ron Hanson, MD answers the most frequently asked questions on SGB for PTSD

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Please provide your information below and the best time and method to reach you. Our Nurse Coordinators will reach out to you  to see if this procedure can help you and answer any questions. 

If SGB is such a good procedure, why hasn't my doctor (psychologist, psychiatrist, MD) talked to me about it?

SGB as a procedure has been around for decades. However, only in the last few years has it been studied extensively for PTSD. It is still not covered by most medical insurance. Perhaps, that's why your doctor has not talked with you about it. 

Why you should consider it? - SGB is valuable in not just improving PTSD but also PTSD-related clinical symptoms like depression, distress, anxiety, pain, and physical & mental functioning.The procedure is relatively simple (it takes less than 15 minutes). The results are relatively fast, within hours (Individual results may vary, but this is our observation for most patients), and for many, the positive effects are long-term.

Having said that, this procedure is not intended to replace other forms of therapy for PTSD.  It is an excellent addition to other therapeutic tools for PTSD. According to research, SGB is especially useful in patients having a hard time with conventional therapies such as talk therapy. In the clinical studies, patients report a better ability to participate in psychotherapy after SGB. The Providers also report improvement in patient adherence. Overall, the patients reported a faster return to relatively normal, everyday life with lasting results. 

We are happy to speak with your provider/doctor or you and answer any questions you may have about this procedure. We also go through an internal screening process for all our patients to ensure that this is the right procedure for you and your specific trauma and symptoms. 

Are services covered under my insurance?

This procedure is not covered by most insurance. It is however covered under HSA funds. Dr. Hanson's office does offer CareCredit for someone looking for financial aid. If you are interested in CareCredit, please explain your situation to staff when you're on the phone with them.

What is the cost of the procedure?

The standard procedure can vary slightly in cost, but typically very affordable for most patients. We prefer to discuss pricing over the phone and ask for serious inquires only. 
Dr. Hanson's office does use/offer CareCredit. In limited cases, we may at our discretion, offer a discount and/or travel stipends. If you're interested, please explain your situation to Dr. Hanson, or our staff, over the phone.

Is SGB useful in other mental health conditions?

SGB helps with PTSD and PTSD-related symptoms such as Anxiety, Depression, Nervousness, Startle Response, Hyperarousal, Hypervigilance, Trouble Sleeping, Chronic Pain, Trouble Concentration, Irritability, Outbursts or Aggressive Behavior, Overwhelming Guilt or Shame.

SGB DOES NOT TREAT Bipolar disorder, schizophrenia, seizure disorder or personality disorders, or other similar mental health conditions

If you experienced trauma and are wondering if this is the right solution for you, please feel free to fill out the form above and a Care Coordinator from Dr. Hanson's office will reach out to you. She should be able to answer any questions you have and even set up a call with Dr. Hanson, if need be.

I know another doctor that performs SGB using X-ray and one that uses Fluoroscopy. Dr. Hanson uses Ultrasound. What's the difference?

Ultrasound-Guided SGB was introduced in 1995. Ultrasound guidance can allow for better imaging and distinction of the anatomical structure of the neck. It allows for a more effective and precise sympathetic block with the use of a small injectate volume. Accordingly, the risk of vascular and soft tissue injury is minimized. Here are five key things you should know:

1. Dr. Hanson is not a supporter of "guessing" when it comes to your health: Under x-ray (fluoroscopic) guidance, only your bones are visible, and your nerves are not visible at all. Therefore, the position of the nerves can only be approximated. 

2. Dr. Hanson likes precision: Use of Ultrasound allows the needle to be safely guided around your nerves and blood vessels in the neck as it is placed next to the stellate ganglion. 

3. With an ultrasound, patients are not exposed to ionizing radiation like they would be from an X-ray.

4. Dr. Hanson does real-time Ultrasound Guidance to track the path and depth of the needle: Ultrasound-guided SGB is safer because it allows direct visualization of the multiple vulnerable soft tissue structures enclosed in a tight vascular space around the sympathetic chain. Ultrasound-guidance allows Dr. Hanson to carefully distinguish the cervical spine, vessels, soft tissue, and trachea. He also monitors the path and the depth of the needle in real-time during ultrasound-guided SGB. Identifying the correct fascial plane can be achieved with ultrasound guidance, thus facilitating the caudal spread of the injectate to reach the stellate ganglion at the C7 level.

5. Please note: Using ultrasound guidance to perform a Stellate Ganglion Block safely takes special, additional training and considerable skill, which many pain medicine-trained physicians do not have. Dr. Hanson insists all PTSD patients try and find an Ultrasound-Guided Procedure provider to avoid complications.

How many visits will I need before and after the procedure?

The number of visits recommended will depend on the type of injury/trauma you've sustained, the severity of your condition, whether your injury is acute versus chronic, or if you are being co-treated by another healthcare provider(s). Generally speaking, we do an over-the-phone screening followed by a consultation with Dr. Hanson. The procedure takes a day, and then there is some follow-up. Each case is different, but a lot of the follow-ups can generally happen over the phone. 

Do I need x-rays or an MRI, or brain scan?

In most situations, you do not. The final determination is made during or after your consultation.  A very important aspect of history and evaluation for sympathetic dysfunction are contributions from the cervical spine. If you have had injuries – – motor vehicle, falls, concussions etc., etc. – – instability in the cervical spine will significantly affect the effectiveness both short and long-term of stellate ganglion block. We strongly prefer to evaluate the cervical spine for stability if you have previous injury/symptoms and to contribute part of our care toward reestablishing cervical spine stability.

I have PTSD, but don't have a doctor or psychologist I work with. Talk therapy didn't help me. Will you accept me as a patient?

We believe that SGB is especially useful in PTSD and Trauma patients where other forms of treatments have failed, so absolutely, YES! Please feel free to reach out to us. This procedure has shown tremendous success and results in extreme PTSD and trauma patients. Having said that, we do have an internal screening process. Not all patients qualify for this procedure and it is not for everyone. 

I experienced trauma many years ago. Will this still work?

Absolutely. Many of Dr. Hanson's patients have dealt with trauma and PTSD for far too long, years and even decades. If your PTSD is due to "Stuck" and overactive Sympathetic Nervous System, this procedure can help you.

Do I need a psychologist or psychiatrist referral to book an appointment with Dr. Hanson?

You don't. Please provide your information in the form above, and our Patient Care Coordinator, Emilee, will reach out to you within 24 hours.

How do I determine this procedure is right for me?

Let us help you with that. Your first step is to talk with our nursing staff over the phone, to perform some initial screening. This is very useful to determine if this procedure is right for you. The screening should take about 30min. This screening is at No Cost to you. Please fill out your information to start the process!

I am experiencing extreme grief due to the passing of a loved one; can you help me?

Absolutely. Trauma comes in many different ways, and SGB shows promise in many different types. We can certainly help you. First steps; let's start an initial screening. The initial screening is at No Charge to you. Please fill out the form, and our Care Coordinator, Emilee, will reach out to you within 24 hours.

What other conditions does SGB help? Does Dr. Hanson perform SGB for other conditions as well.

Absolutely, yes. If you are suffering from other conditions such as Complex Regional Pain Syndrome, Hyperhidrosis, Hot flashes, and more, this procedure can help you. Please feel free to reach out to us using the same form above, and our Patient Care Coordinator, Emilee, can help you.

I have severe chronic pain and PTSD. Will this procedure help treat both my symptoms?

Many times, yes. It also depends on the type of pain you have. If you are suffering from Complex Regional Pain Syndrome, this procedure can definitely help you. Perhaps the best thing to do is to do a phone consultation with Dr. Hanson to assess further if this can also help your pain. The patient's video on our Home Page is of a patient receiving treatment for pain and PTSD.

My family experienced severe trauma in a horrific accident. Is this procedure recommended for all?

Good Question and the answer is "Maybe." Everyone processes trauma differently. We don't make blanket decisions and instead review each family member as an individual case. What symptoms are you and your family experiencing? How long ago was the accident? How long have these symptoms persisted? Several factors, including the individual patient's medical history, are taken into consideration too. What types of symptoms are you and your family members showing? Have you sought any other treatment? These are some of the questions we will ask as we do the initial screening with you. Depending on the findings, we will make recommendations for family members, individually. If you have had injuries – – motor vehicle, falls, concussions etc. – – instability in the cervical spine will significantly affect the effectiveness both short and long-term of stellate ganglion block. We strongly prefer to evaluate the cervical spine for stability with a specialized x-ray if you have previous injury/symptoms and to contribute part of our care toward reestablishing cervical spine stability.

How soon can I come in for this procedure? I am ready!

That's great. If you think you need this urgently, please say that in the comments section of the "Request Consultation Form". We will try our best to accommodate you as best as we can!
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Please note: SGB is not for everyone and not all ptsd patients are candidates. Individual results can vary. 
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