A procedure developed in the 1930s that shoots anesthetics into big nerve bodies found on each side of the neck? Does that sound sketchy or what? It’s reported, though, to be quite safe and it aims to do two potentially important things in long COVID, fibromyalgia, chronic fatigue syndrome, and related diseases: calm down the sympathetic nervous system and restore blood flows. It’s called stellate ganglion block (SGB) and it was just tried in long COVID.
The goal was to block fight/flight signals to the brain – allowing the system to reset itself.
The “fight or flight” response driven by the sympathetic nervous system appears to be on high alert in chronic fatigue syndrome (ME/CFS), fibromyalgia (FM), postural orthostatic tachycardia syndrome (POTS), and numerous inflammatory diseases. The corollary to that hyperactivation is an underactivation of the regulator of the sympathetic nervous system – the “rest and digest” or parasympathetic nervous system.
The potential ramifications of a chronically activated fight or flight response are many: impaired blood flows, inflammation, digestive problems, increased pain sensitivity, impaired viral defense, etc.
The Gist
- It’s new to long COVID, and it’s new to ME/CFS, and it’s pretty new to fibromyalgia, but the procedure under discussion – called stellate ganglion block – is not new at all. It’s was developed in the 1930s.
- The idea is simple – stun the nerve cell bodies that transmit sympathetic nervous system signals to the head and upper body – with an anesthetic – thus interrupting sympathetic nervous system (SNS) activity and producing an SNS reset which results in better blood flows.
- A chronically active SNS could reduce blood flows, increase inflammation, pain sensitivity, impair antiviral defenses, cause gut problems, and more.
- The procedure is done on both sides of the neck over 2 days and takes about 30 minutes. It’s reportedly quite safe.
- Doctors from a Neuroversion clinic in Anchorage, Alaska, reported that two long-term long COVID patients received substantial improvements from the injections. One woman, who had received “intensive physical, speech and occupational therapy” to cope with her debilitating cognitive and speech problems and fatigue, returned to work. Two months later she reported she was back to normal.
- While no SGB studies have been done in ME/CFS a 1988 fibromyalgia study found that SGB produced significant reductions in pain.
- SGB has been used to improve circulation in Raynaud’s phenomenon, reduce pain in chronic regional pain syndrome (CRPS), reduce phantom limb pain, and help with post-traumatic stress disorder (PTSD). It’s currently being trialed in post-menopausal syndrome, COVID-19, herpes zoster, severe brain injury, PTSD, and others.
- Randomized, placebo-controlled trials are needed to assess whether SGB can be helpful in long-COVID and other diseases.
- Once again, long-COVID has prompted investigations into treatment options that have been little or not tried at all in FM and ME/CFS.
Blocking Sympathetic Nervous System Activity
Various drugs and mindfulness/meditation techniques have been used in an attempt to calm the fight or flight response down in these diseases. One intriguing technique, though, called stellate ganglion block (SGB) has almost never popped up in the ME/CFS, FM, or POTS medical literature. Demonstrating again, long COVID’s ability to shake things up and get investigators peering into all sorts of corners, it just showed up in a case series report for long COVID.
This old technique – developed in the 1930s – essentially jams a central waypoint for sympathetic nervous system activity called the stellate ganglion. These nerve bodies transport fight or flight messages to the upper spinal cord and brain. The technique consists of injecting an anesthetic near this big nerve body to temporarily block the fight or flight messages and hopefully reset the system.
One side of the neck is usually done in one day and the other side the other day. The procedure usually takes about 30 minutes after which the patient can return home. Different patients require different protocols. From 2 to 10 injections can be done, and the risks are described as “very low”.
The Stellate Ganglion Long-COVID Case Reports
This recent paper, “Stellate ganglion block reduces symptoms of Long COVID: A case series” – from two doctors associated with the Neuroversion clinic in Anchorage, Alaska – described two people with long COVID who received positive long-term results from this procedure. The clinic – whose motto is “Break the cycle of pain” – states its goal is “resetting the nerves rather than hiding the symptoms with opioids”. It appears to specialize in injections and infusions of all kinds.
Patient Number One
Calming the sympathetic nerves leading to the neck and head – apparently increasing blood flows in the upper body – dramatically helped two people with long COVID.
Eight months after a relatively mild COVID-19 infection, a 42-year-old female experienced smell and taste problems, severe fatigue, cognitive problems, sleep difficulty, elevated heart rate, and other symptoms. She lost her full-time job and was struggling to keep up with a part-time job.
Her symptoms improved immediately after the block: smell and taste were restored, she was quickly able to drive again, her cognition dramatically improved, and she resumed longer working hours. Two months later her improvements remained.
Patient Number Two
Like patient number one, patient number two experienced a relatively mild case of COVID-19. Like patient one, though, she experienced severe cognitive difficulties and underwent “intense, occupational, physical, and speech” therapy for her “profound memory deficits”, her speech impediments, her inability to concentrate, coordination problems, and extreme fatigue. She also experienced significant body pain, headaches, and reported that mental or physical exertion would cause her symptoms to flare up.
Showing up at the Neurovision clinic about seven months after coming down with COVID-19, the second patient received the same set of injections on the right and left sides of her neck. Like the first patient, her taste and smell issues quickly disappeared. One week after the treatment she began teaching again. Two months later she reported she was back to normal – her fatigue and cognitive problems and PEM had all disappeared.
Other Diseases
Stellate ganglion blocks have been used to improve blood flows in Raynaud’s phenomenon, reduce pain in chronic regional pain syndrome (CRPS), reduce phantom limb pain, and help with post-traumatic stress disorder (PTSD). It’s currently being trialed in post-menopausal syndrome, COVID-19, herpes zoster, severe brain injury, PTSD, and others.
A recent review of stellate ganglion block studies focused on reducing sympathetic nervous system-driven pain disorders (which may include fibromyalgia) reported that the pain reduction achieved was “highly significant” and that the procedure was “safe and effective”.
Effects on Circulation
Increased sympathetic nervous system activity is believed to reduce blood flows by clamping down on the blood vessels. SGB’s ability to increase blood flows is well documented. Given all the interest in the microcirculation in ME/CFS, FM, and long COVID, it was eye-opening to see a 1988 fibromyalgia stellate ganglion block study “Regional sympathetic blockade in primary fibromyalgia” that attributed its positive results to improvements in the microcirculation. This study concluded, rather presciently, that increased sympathetic nervous system activity may contribute to fibromyalgia.
While SGB has not been studied in ME/CFS was featured prominently in a part of the discussion section focused on brain blood flows. Noting the Van Campen/Visser/Rowe ME/CFS findings of reduced blood flows to the brain, the authors reported that SGB has been shown to increase brain blood flows as well.
Just what exactly, happening, though, is unclear as the effects of SGB tend to last much longer than would be expected from the short-term use of this drug. The authors list three possibilities:
- a recalibration of regional sympathetic influence;
- central (brain) integration of the effects of increased CBF;
- rebalancing how the nervous and immune systems interact with each other.
Conclusion
Another long-COVID study has opened – or in the case of fibromyalgia reopened – a treatment possibility for diseases like ME/CFS, fibromyalgia, and one might guess POTS. The combination of a procedure that reduces sympathetic nervous activity (which we know is high), and has been shown to improve the circulation (apparently impaired to both the muscles and brain), is intriguing.
Whether doctors will want to try this approach is unclear, but the fact that a fibromyalgia study was done may help. Clinical studies report that the procedure is safe and takes about 30 minutes.
Until large, randomized, placebo-controlled trials are done, though, there’s no way to tell how representative these two successful case reports are. Doctors typically write case reports to get their findings into the medical literature and provide a basis for clinical trials. With an old but successful fibromyalgia clinical trial, and now these two cases reports, this procedure will hopefully get more study.
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I don’t know if you’ve ever heard of stellate ganglion blocks. I hardly had. Health Rising, though, keeps a close eye on the research literature, and when this report popped up, we checked it out only to find that this procedure may present a possible treatment option for these diseases.
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Thank you Cort again. Just when I was becoming convinced the autonomic dysfunction was secondary to vascular dysfunction (an adaptation), you gave some counter evidence 🙂
I got Covid in 2020. Been a Long Hauler everyday sense. All the normal symptoms, horrible fatigue, headaches, brutal anxiety, POTS, depression, Heart palpitations, etc. I was seeing a doctor for the brutal anxiety and he suggested a “stellate ganglion block”. I did some research and found a doctor in Chicago, Dr. Eugene Lipov who did these for PTSD/anxiety. I had a series of two injections in my neck, one on the left and one on the right. Not only did my anxiety and depression completely disappear, my heart palpitations went away, High blood pressure went away, and about 80% of the other symptoms I was having WENT AWAY. I had the shot done last November 2021. The two shots cost a couple thousand dollars. Insurance will not cover it for Anxiety. It was totally worth it for me. The doctors think it reset my autonomic nervous system that was out of balance after the Covid infection and was causing my Long Covid. I’m sure it won’t work for everyone, but it worked for me. They say it has about an 80% success rate for the anxiety.
Congratulations John! Thanks for sharing your experience and good luck in the future. 🙂
Thank you John! I’m getting the procedure next week and I’m a little bit scared but your post gave me hope, that at least I probably won’t get worse.. my main problems are the POTS and fatigue. I can’t walk without fainting and really bad crashes, why I’m housebound and in a wheelchair. How did it affect your POTS in the long run?
Hi Mary,
Looking into trying this for CFS.
Just wondering if you had good results?
Hi John. Any side affects? Are all symptoms still gone? Ty.
Thanks for posting. So happy for you. Can you tell me where I begin to find someone who does these injections?
Hello! How are you doing now, 2 years after the SGB? Are your symptoms still in remission?
SGB will be my next therapy. SCIG at high doses at 33G a week has raised my functioning significantly. I think most of my doctor’s patience find it helps POTS but my POTS did get worse. I have hyper-POTS and recent last 3-5 years in increasing abuse and an inner fallout. I am in constant C-PTSD that has hijacked my nervous system, but I also believe that a shock to the nervous system from our illness profile can do this. MCAS much better since moved from primary trigger (mold). PEM, exertion intolerance so so so much better. I push and use more exertion, think I’ve gone to far then recover. I’ve not tested my outer limit even. 17 years sofa bound.
What is SGIC please? Thank you!
SubQ IgG as opposed to IVIG.
I continue to find it the reception I get here and elsewhere (not you) regarding my recovery from ME-CFS which has remained stable for over 2 years. No one seems to give a flying flip. My doctor has recovered folks using this therapy up to 100%. I’m sitting around 70-80%. Why no interest, Cort? It almost seems like one needs to be a well known MECFS advocate to be (1) believed (2) significant. One one hand, I tell myself that it’s fine. I want to tell so many people but I also don’t want my doctor deluged. There is a type of MECFS profile responding and I am happy as hell to be functioning as if I skipped a 17year beat from my very active life and playing catch up physically at this point. I’m not going around enticing people with mold gurus and making them feel guilty for not leaving their children to do it like some folks did to me which only created more and more trauma. Yes, if I go down that rabbit hole, I can still feel the pull of trauma. I left the illness community because of the trauma. That’s fine. I found my doctor by a fluke and when I thought non hope at all for me, I responded. I think SGB may be key for some of us, especially those traumatized by the illness or the illness community, a subject, I think you Cort, might address. I can’t go there for long.
My keys are sticking. Sorry for typos.
Hi Robin,
So sorry to hear you’ve had such a traumatic time. I get where you’re coming from because I do sense and receive some hostility in connection to remarks I make, about things I’ve done to improve.
I do feel that Health Rising is a safer place to chat about things I’ve tried and found helpful. Thanks for sharing your experience. 🙂
Great to hear about yours and others success, Robin. I do believe a PTSD component is baked into ME/CFS – I don’t how that could be avoided given a) how traumatic the disease is and b) the fact that it impacts the sympathetic nervous system. That seems like a nice recipe for some form of biologically induced PTSD.
Thanks for poking your head back into the community to give the good news.
HR actually did a 3-blog series on IVIG! It started with someone who did great on it. We’ll have some more on it on a blog about autoantibody treatments.
https://www.healthrising.org/blog/2018/08/11/ivig-treatment-chronic-fatigue-syndrome-me-cfs-pots-success-story/
https://www.healthrising.org/blog/2018/08/13/chronic-fatigue-syndrome-pots-fibromyalgia-autoimmune-dysautonomias/
https://www.healthrising.org/blog/2018/09/13/ivig-chronic-fatigue-syndrome-pots-fibromyalgia/
i have read that anastatic is dangerous for me cvs
is that what happens with ganglion block?
i ask this to Robin
is it allowed where you got this treatment
i am afraid for the anastetic wich put they in the brain
@ Robin I looked up what SubQ IgG is. In Belgium no specialist or gp would give me this for ME/cfs. Long time ago one did for some patients in an ivig way and she was followed and convicted by cort. I do not know if there is in efacacy much difference between ivig and subQ but i saw a patient at that time that was not better with it. in any way, the 3 specialists who tryd to do something about ME in good or bad way (I declined dramaticly – mostly bedridden with way more symptoms) had to go to cort. Here goverment still states (ME does not excist, it is cfs) that the only prove therapy that works is get and cbt. Now even a few sessions of get and cbt. that’s it. I would not know who would give me subQ IgG???
Could you find an explanation of the treatment? I would try to find it in Spain but I do not understand what it is. Thank you!
I looked into this a few years ago. It’s used in PTSD too. Would love to try.
The only thing I would add is , it’s sympathetic overdominance meets tissue problems.
My brother has the same sympathetic state but runs 10 Kms most days as well as a stressful full time job.
He’s just a year younger than me.
His vasculature is visibly great. Mine isn’t.
Sadly it seems you bring the too states together , the vasculature with sympathetic overdrive and m.e. happens.
Of course anything to get us out of this sympathetic state may be enough to allow us to heal
Robin ..anyone who has any kind of improvement is interesting to me.
I second that..I’m all ears. What’s the protocol
Hi Robin. Hope all is going well! Did you try the SGB? Did it help at all with your heart rate/POTS issues? Thank you!
I hope there are follow up studies asap. This sounds similar to neural therapy. I wonder what type of MD would offer SGB
a dr in ohio taught me to do neural therapy on my son. up and down spine..What anesthetic is being used here?
SGB is used a lot for CPRS and mostly done by anesthetists who are specialized in chronic pain management. I will get it next week from such a specialist, I really wonder if it will work, no one has tried it before in my country for long covid/CFS and it was quite hard to find a hospital who would try it out. But given the small risks it definitely seems to be worth a try. I send them the paper and an explanation of why I wanted it.
Hi Mary, did you already had your SGB and can share your results with us?
Comment *¿Qie tal te fue con el SGB?
¿De dónde eres?
I read the case studies from Alaska on LC and was determined to try SGB for CFS, fibromyalgia, POTS and because of a history of trauma that I believe caused the other 3 issues.
I have had both sides injected one time in May, ’24. I have not noticed any change as of yet and am considering at least one more set of injections. I was hoping that, by decreasing sympathetic activation, it would lessen the profuse sweating that happens when my ANS is triggered… but nothing yet. The sweating is something that makes it impossible for me to work even if I had no CFS! I have done a lot of somatic work to calm my ANS and increase vagal tone, but I have had this hyper ANS since very early childhood, it is very hard wired in my body and I am not able to control it on my own with exercise to calm my nervous system, meds and supplements. Thus I was hoping the SGB would work! I had never been told by anyone who was treating me for trauma that SGB treatment was a thing!?!
I have not stopped taking my meds for POTS, so I don’t know if those symptoms have been affected. I recently developed atrial flutter also and am having a cardiac ablation soon, I’m very curious to see if that has any affect on the sweating, POTS, fatigue or any other symptoms!
Thanks for relaying your experience and good luck!
A description of the procedure is found here:
https://www.brighamandwomens.org/anesthesiology-and-pain-medicine/pain-management-center/stellate-ganglion-blocks
I hear that interventional pain docs can do this procedure.
Interesting study….I personally would find it scary to try, though, as I react extremely badly to anesthetics (anaphylaxis)….and since many of us with ME/FM/POTS, etc also have mast cell activation disorder, I’d think this could be a major issues for many
Interesting, now that you mention it, I have the opposite reaction to anesthetics – at least to dental anesthetics – they make me relaxed and give me a little energy boost. 🙂
For those seeking SGB treatment in the midwest, I highly recommend Dr. Lipov. I have ME/CFS but I pursued this treatment due to TBI and PTSD following severe head injuries. I had 2 injections in one session. It significantly reduced the hyper-reactivity of my sympathetic nervous system. Some people have immediate results. I improved over a period of weeks. Had there not been financial and logistical barriers, I likely would have gotten more injections over months or years.
Let’s hope this case report sparks some big studies so this can get covered.
Thanks for this, Cort. I think this is encouraging!
Thx, Toni. Did the benefits last a long time or were they short lived?
Just playing devil’s advocate about the safety of SGB’s;
https://pubmed.ncbi.nlm.nih.gov/1570888/
All in all, relatively safe… but…
Am interested in what additional studies will find.
Thx for posting that. An interesting excerpt from the above linked study: “The administration of very low doses of opioids to the stellate ganglion has been shown to have similar therapeutic results to local anaesthetic blocks, whereas the incidence of side effects and complications is lower. Therefore, the administration of opioids to sympathetic ganglia could provide an alternative therapeutic regimen for the future.”
Whoa! That would be interesting…Given those ganglia some opioids to calm them down. Just in a general sense I find that high THC cannabis – which is going to boost the endocannabinoid dramatically I would think – not only has helped my sleep, but removes my pain, calms my system down and allows me to exercise much more.
I take it judiciously – maybe twice a week so as not to build tolerance – and am amazed at how effective it can be.
Cort,
Which brand of THC cannabis do you use and how much? I have only used CBD and not found any relief except for when I was experiencing all over body pain, but I can’t say whether it was the CBD or the LDN as I ramped them both up at the time.
Also,
Thanks for all your hard work and dedication and Happy New Year.
I thought I had made this comment once before. Cort, what brand of THC are you using and in what amounts?
I tried a couple of things with very high THC and then settled on Wyld Marionbarry gummies – https://wyldcanna.com/products/marionberry-gummies. They have 10 mgs of THC and no CBD per serving. I don’t know what constitutes a serving. Just little bit off one of the gummies works for me.
Any candy or paste with high THC would work I would think. I woke up last night at 12am – took a little bit of a gummy at 2am and went to sleep about 30 minutes later and had a good sleep.
While CBD can help THC is actually the great pain
reliever – check out our cannabis series and other blogs on it here – https://www.healthrising.org/treating-chronic-fatigue-syndrome/drugs/cannabis-fibromyalgia/fibromyalgia-cannabis-resource-center/
This seems promising and I have scheduled an injection. In terms of larger studies, the SGB cannot be double blinded because if it is administered correctly it creates a short term condition called Horner’s syndrome. Patients will know whether they received the placebo or block.
John – I would love to know where and how you were able to schedule an injection – I have been living with my own version of all this for many years and willing to try anything.
Thanks
Earl
I didn’t have luck with PTSD clinics but pain clinics were receptive. I brought the manuscript to the consultation and after the doctor checked with management it was approved.
Where and How can one schedule an injection?
Its not cheap. I am trying to get them to do a Proof of Concept with me as a guinea pig. If I can convince them, then maybe we can have more guinea pigs. The cost is $2000+ for 1 treatment and $3000+ for 2 treatments or $2000 for 1 treatment + $1500 if you choose to do the second
https://stellacenter.com/how-sgb-works?utm_source=google&utm_medium=cpc&utm_campaign=national|ptsdtreatment|bmm&utm_content=ptsd_treatment&utm_term=stellate%20ganglion%20block%20sgb&campaign_id=14632163191&adgroupid=133919361024&adid=545506398953&matchtype=p&network=g&device=c&gclid=Cj0KCQiAq7COBhC2ARIsANsPATFCcoP8vbF4cb4A_xtlXgSD45ekdP7P9lur2JDqrZQCEZ_kL-BklV0aAr1qEALw_wcB
Chris,
Wondering if you were able to get some injections?
I’m looking into the same clinics you mentioned here.
It is a significant amount of money, and knowing it helped someone would not make me so wary to try it.
Thanks!
Yes,
I did get it done and after the initial day of recovery, I had this wonderful sense of peace. However, the effects did not last that long and it did not really do anything for my CFS.
John, please let us know how you do with this procedure. I’m considering looking in to it myself.
The PTSD clinics are expensive as documented in Chris Pfeiffer’s post. My self pay rate at a pain clinic is $650 per injection. Still not cheap but much better than $2000. I’ve seen rates from $500 – 700 so use that as a guide.
:Thank you for your reply!
I appreciate it!
Hi John,
I wonder if you have had the procedure yet? If so, any experiences/observations/advice would be very much appreciated. I am considering doing it and trying to gather as much information as possible.
Many thanks for anything you can share.
That’s fascinating! I had several stellate ganglion blocks early on in my ME/CFS because I had CRPS on my left arm (although this was the 1990s – it was called Reflex Sympathetic Dystrophy back then).
They didn’t help the CRPS very much or for long, and they definitely didn’t help the ME/CFS at all – but they were just on the left and not bilaterally as is described here. Fascinating that things have come full circle back to the same treatment that was going on right as I got sick!!
Argh *right* not left. Not that it matters – blame it on the brain fog!
Over the years I think not only focusing on calming my sympathetic nervous system but also trying to consciously enhance my parasympathetic nervous system as much as possible, has probably been central to the steady improvements I’ve made.
I’m also intolerant to most food and if I eat something I can’t process (liver?) then my sns gets set off. About a month ago I ate some ginger biscuits and they were enough to make me very unwell for days and I was completely wired, waking up at 2.30am.
I feel that when the fight/flight/freeze response is mentioned, then that can be mistakenly associated with CBT and the biopsychosocial crowd – as in it’s all in your head – and people are then incensed. But I think it’s completely different and more similar to PTSD.
I’ve improved over the years and I’m aware of what I’m doing and I learn new things all the time. I think being perpetually in sns mode was exhausting and completely changed how my body functioned. What I’ve tried to do is re-stabilise my body into a more normal pattern of functioning – like sleeping better, digesting my food, assisting my gut health, taking supplements etc. But none of that was going to happen when my sns was dominating everything.
I think everyone has their own set of symptoms and what I’ve done may not be relevant to others.
I don’t know exactly what PTSD is but I can tell my SNS goes off like a shot in response to all sorts of small stressors. Calming that thing down is a big goal for me. I am starting to do that and it is helping with sleep, exercise and overall well-being.
I suppose in this context, for me, I find having some poorly understood, vastly underfunded and marginalised kind of illness, traumatising in itself. Neither my family nor the doctors I’ve seen have understood, or even attempted to understand the debilitating and frightening list of symptoms that I’ve experienced over the years. Instead they’ve mocked me and sometimes harrassed me – a lone parent, with little money or support. Add to that, definite changes to my brain after a very high temp, nearly five years ago. I’ve had to research and try things out myself, with a brain that could hardly think or remember anything.
I’ve actually been thinking about all of this recently and wondering how to deal with it all. I sometimes feel like I live in a kind of warzone and Covid just adds another layer, on top of all the rest.
So, my SNS is hypervigilant and very reactive and that’s what I’m referring to in relation to PTSD. So, what I’ve been trying to do, with quite a bit of success (despite my circumstances/Covid etc.,) is to try and calm the fight/flight/freeze and enhance the rest, digest, relax and heal as much as I can.
I would add that food acts as a stressor too, as with the ginger biscuits or other food I can’t digest easily and that will also set off my SNS. I often think of Darden Burns and how she became so wired she couldn’t sleep, after the bee ‘therapy’.
Tracey and Cort, how are you relaxing your SNS?
So much interesting information. Just wondering: The use of anesthetics for SBG, is that similar to the use of anesthetics prior to operations for spinal cord and neck injuries? Does anyone know?
I don’t know but I would think not – unless they do localized shots in those operations (?). They put the anesthetics near the nerve bodies if I read it right and use different means to place them.
I would be really interested in this treatment. I had a full nephrectomy last year & was full of energy for about 3 weeks afterwards. I was wondering if it was the anaesthetic I got or the morphine & I have always said that I would happily take another anaesthetic regularly if it gave me that energy boost (which I haven’t had in years). This study may have answered my question!!
Interesting – check out a story of a person for whom a long surgical experience resulted in a dramatic but temporary resolution of her symptoms
https://www.healthrising.org/blog/2020/01/17/temporary-chronic-fatigue-syndrome-fibromyalgia-recovery-stories/
Did somebody say “anesthetics”? I did the big dose of ketamine to address CFS pain and it helped for weeks (and longer). It helped with what my doc calls the “perception of pain.” (And I had already been waist-deep in the worlds of mindfulness and Buddhism the past few years, and already had gotten much relief from those practices.) For weeks after the ketamine, I felt an unprecedented calm/acceptance. I encourage folks to give it a look.
(Cort, keep up the good work!!!)
Did you say ketamine? It’s a fascinating drug and we have several blogs on ketamine.
https://www.healthrising.org/?s=ketamine
including this one which describes one patients experience with it
https://www.healthrising.org/blog/2015/05/10/the-ketamine-question-in-fibromyalgia-and-chronic-fatigue-syndrome/
Glad to hear the Buddhist practices helped. I’m doing an MBSR course right now.
Irene’s comment reminds me that after 2 surgeries that I’ve had in the last 15 years I felt great for a couple of weeks each time and wondered if it had anything to do with the anesthesia! Have had my thing so long that its hard to get my hopes up – but I will try to pursue this when covid calms down and will post if of any consequence. thanks
I wonder how this would work with those who also have hEDS because many with this connective tissue disorder have anesthetic resistance. (Anesthetics like lidocaine don’t work, and bupivacaine, etc last mere hours, even with the added steroids.)
If this works, even temporarily, it would seem to fit well with the unifying theory that ME could be caused by dysfunction of the hypothalamic PVN?
See https://www.frontiersin.org/articles/10.3389/fneur.2021.701419/full
Anyone know what happened to the stuff that Issie and Dejurgen were watching eking on earlier this year? Thought 💭 t was announced there would be a blog detailing some useful stuff they had found and/or were constructing hypothesis around…
Curious about any updates for those that have gotten this in the last few months. I myself have it scheduled for March 28 and will come back to update how it goes.
OK – so why aren’t my comments appearing?
I know! It sucks when you do like 5 comments and none of them show up (lol). They were stuck in the comment moderation queue yet. Theoretically they shouldn’t have been. Because you’ve commented many times before they should go straight through but the comment filtering program sometimes has a mind of its own.
Is this a treatment that I could request from my GP, who has been looking after my ME/CFS for the 11 years I have had it?
I was wondering this same thing, due to connective tissue issues in my sons and I. I can’t remember the last time I was so blown away by a procedure having never heard of it in my 51yrs, despite complex PTSD, FM dx, and dysautonomia’s. I am certain my sons and I also deal with MCAS, myositis’s and AE/PANS. Its hard when you know if it was all mind over matter, you would have things well under control, how else can you make it 51 yrs, despite added trauma and doing so much to help self, but immune system hit and it calls the shots, because then its your primal autonomous system misfiring, due to immune system triggered to go awry, as is the case for us.
Robin could you contact me? My son andI have the same triggers, Thank you.
This seems very interesting. I found a connection of stellate ganglion activation related to fibrinolysis and microclots which Dr. Pretorius has identified in LongCOVID patients. Mast Cells, T-Cell activation also related.
Reference :
https://www.sciencedirect.com/science/article/pii/S1566070221001338
Very interesting. I’ve been planning to get a stellate ganglion block. I thought I posted on the forums here asking if anyone had experience with but I can’t find post. I brought it up to pain management bc of info I read seems like it would target exactly what is going on which for me seems to be autonomic system imbalance, veins spasm closed and lack of blood flow from chest up causing pain and coldness, symptoms triggered by weather changes. My coat hanger area is severely affected. Pain management seems willing, I just have to schedule appt to discuss with them further.
I hate to be a downer but this says it’s no better than placebo: https://www.neurologyadvisor.com/topics/neurobehavioral-disorders/stellate-ganglion-block-may-promote-placebo-effect-in-ptsd/
I’m not saying placebo is bad, if it works, great! But, I would like to see how this holds up against repeated studies.
As usual, there’s a tiny little contradiction to the researchers’ conclusion about SGB being no better than placebo:
“Although PTSD symptoms significantly improved for both groups after treatment, there was no statistical difference between stellate ganglion block and the sham injection. However, researchers did note that even greater improvements were recorded in patients who received a second stellate ganglion block. ”
Really? There are “even greater improvements” with a second SGB, but you’re still going to conclude it’s no better than placebo? That would mean the first block wasn’t as good as a placebo, and a second block put it on par with a placebo. What about a third or fourth block? Maybe that would have surpassed a placebo. Why didn’t the researchers try that, given the gains from the second block?
Methinks there was a hidden agenda to disprove the efficacy of SGB from the onset. Makes no sense to me that the researchers wouldn’t keep going with additional blocks if the second one showed improvement.
Is there any info about how these 2 patients were chosen for the paper? I’m curious if they are representative or if they were cherry-picked as good responders.
I have HEDS/POTS/MCAS and have been researching the mechanisms behind the SGB in the literature. The science does seem to make sense. Purinergic receptors are “reset” it seems with the SGB. These are triggered by Extracellular ATP and Can be hyper stimulated it seems, causing much disruption. Magnesium is needed to convert extra cellular ATP and so this may explain why it works in CFS. It helps to reduce the extra cellular ATP that triggers all these machanisms, immunomodulatory, cardiac, CNS, metabolic. I think it all ends up in a feedback loop messing up cellular metabolism. Researching Purinergic receptors uncovered a lot. And the stellate ganglion block targets them.
Guys, please, let us know if you had the procedure and how it worked for you : )
I had the Stellate Ganglion shots June 20 & 22. I had Covid Delta and Covid Omicron (the first one) and long Covid symptoms for 18 months before treatment: mainly loss of taste (Delta) and smell, brain fog, word loss, fatigue, and a few others.
After two CT guided shots – from Dr. Liu in Anchorage – I am much improved. Brain fog – gone. Word loss – gone. Some recovery of taste & smell. unexpected benefits: My balance improved, I need less anti-acids, and I feel much better. Improvements noted on the day I got first shot.
Contacte con la clínica Stella de Chicago donde el Dr. Lipov trabaja
Fueron muy amables y me facilitaron toda la información que pedi.
El Dr. Lipov al parecer punciona el ganglio estrellado mediante control de fluoroscopia.
Hace una primera puncion en el ganglio del lado derecho, porque cree que es la amígdala de ese lado la que está hiperactiva (huida/lucha) con un anestésico local bupivacaina o ropivacaina unos 6-8 cc a nivel de C6.
Luego hace una segunda puncion en el lado derecho a nivel de C4 con entre 3-5 cc.
Esperan entre 30-45 minutos para ver si ha sido efectivo.
De no haberlo sido en un plazo de 24 horas repiten el procedimiento pero esta vez a nivel del lado izquierdo del cuello.
Al parecer el estado de ansiedad, estrés… Hace que el ganglio genere una sustancia que provoca un aumento de las fibras simpáticas que conectan el ganglio con la amígdala, con el SGB se reduce dicha sustancia y por ende el número de dichas fibras.
Es la amígdala a través del ganglio la que se comunica con las suprarrenales para que estas liberen cortisol y noradrenalina.
Lipov se dio cuenta que tras recibir a un paciente con síndrome regional complejo y TEP, y puncionar el ganglio el paciente se curo de sus dos problemas
Luego lo uso en mujeres menopausicas con ansiedad
En un señor que sufrió un atraco y tenía una ansiedad extrema
En otro que sufrió un accidente de tráfico
Todos mejoraron
El propio Obama se interesó por esta técnica y su aplicación a veteranos de guerra.
Stella me dijeron que planteaban abrir nuevas clínicas en Australia e Israel.
What do you mean by “CT guided” shots? If you got the Stellate Ganglion Block, did it improve your sleep by chance? I hope you continue to do well.
I think it just means that Dr. Liu used CT scan to get a better visual on where to insert the needle. Some clinics use ultrasound or fluoroscopy instead of CT scans.
En mi país (España) solo algunos anestesiólogos están familiarizados con dicha puncion para tratar esa respuesta de huida/lucha
Uno de ellos en Madrid me indicó que el 70% de los pacientes mejoraba
Stella habla del 80%
A finales de mes tengo cita con un anestesiólogo
Ayer estuve en la consulta del anestesiólogo.
Me hablo que su información viene dada por un militar del ejercicio de los Estados Unidos que todos los años da un cursado formación en Barcelona (España) , al parecer en el ejército norteamericano se utiliza la puncion del ganglio estrellado de forma profiláctica en todos los soldados .
El anestesiólogo de España prefiere localizar el ganglio a través de ecografía color mejor que con RX.
Me hizo una ecografía y pude ver el lugar exacto donde se debe depositar el anestésico.
Le deje información sobre las clínicas Stella donde se practica.
Pronto recibiré mi tratamiento .
Please help me out, I have studied everything I can find on the SGB and vagus nerve treatment.
I am having so many nerve related symptoms. Scary ones like dizzy, nauseous,sweating out my head like a faucet, then total wipe out. Dysautonia maybe whatever, it fits! But circulation and physical jolts, and nerve pain. Sudden “switch’s” causing weakness, dizziness, speech interruption, heat and cold intolerable.
Where are new comments and info on SGB
Plz. I ll volunteer if u need me too. It’s worth any risk and I have only found hope!
Gail, I feel the same way – looking for SGB comments from those who have had the procedure done as it sounds promising. As someone with ME/CFS I am concerned if there is a possibility of it initiating a crash.