Forums Nd:YAG lasers General Nd:YAG Forum Parathesia Reversal

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  • #5903 Reply

    BNelson
    Spectator

    Hey all,
    Just back from two weeks in BC. Couldn’t find van As’s phone number in the book. Guess the guy is so famous he isn’t listed! Had a brief chat with Andrew. My daughters wanted to see so much of the beautiful scenery I didn’t have time to talk dentistry!
    The lady I’ve been treating has decided she is finished. Last appt 2wks ago, she has a 3-4 mm diameter area at the midline of her chin that still feels numb. All other feeling has returned. Needless to say, she is very happy! The appts were 1wk appart, 7000-8500j each (approx 20-30 minutes) I explained the experimental nature and she paid &#36150US per appt. I treated the length of the IAN from just distal to the injury area to the midline. It really does seem amazing that the results were obtained that easily, just as Del had said it probably would.
    Better living through science!

    #5909 Reply

    Glenn van As
    Spectator

    Wow I am in the phone book……..too bad Bruce because I was in town.

    In addition I have a patient with a lingual tongue parasthesia from a month ago. No NdYAG available here.

    ANy ideas on what I might do for him with a diode or other wavelengths.

    Glenn

    #5901 Reply

    BNelson
    Spectator

    Hey Glenn
    Sorry I missed you.
    Best suggestion is to buy a new laser, or send patient to Bob or me to treat(Ha!)

    #5879 Reply

    Anonymous
    Guest
    QUOTE
    Quote: from Glenn van As on 2:00 am on July 14, 2005

    In addition I have a patient with a lingual tongue parasthesia from a month ago.  No NdYAG available here.

    ANy ideas on what I might do for him with a diode or other wavelengths.

    Glenn

    Glenn, Tuner and Hode have several studies in their book regarding diode and parasthesia. Most used between 6-9 J per spot (length of nerve usually treated in 4 spots). The other parameter used was 6 J/cm. Most biostim studies I’ve read say 4J/cm is ideal.
    Almost all the studies were tx pretty close to the time of injury followed by consecutive days, for 7 days. I think Del and some others prefer at least 24 hours between tx. My tx were actually 1 week apart.

    Hope that helps,

    #5898 Reply

    mkatz
    Spectator

    With respect to the reference of studied treatment being relatively clos to the time of injury, is there evidence ot efficacy for treatment rendered long after injury? Small studies of treatment rendered a short time after injury can appropriately be criticized as not adequately compensating for the recovery that might have occured without treatment. I’m interested in the cases in which a persistant disesthesia/parasthesis/anesthesia is treated with laser irradiation…

    By the way, my local neurologist has described laser induced nerve function recovery as being “a lot of hooey”….In spite of his assessment, I’ve got a couple of cases that I am looking forward to treating after I receive my periolase.

    By the way, Bob, how long after the course should I receive the laser? I’d like to start scheduling cases.

    #5921 Reply

    Robert Gregg DDS
    Spectator

    Hey Mark,

    With respect to the reference of studied treatment  being relatively close to the time of injury, is there evidence ot efficacy for treatment rendered long after injury?

    Good point.  The answer is a resounding Yes.  We have reports of 16 and 20 years post extraction site nerve damage successfully reversed.

    Small studies of treatment rendered a short time after injury can appropriately be criticized as not adequately compensating for the recovery that might have occured without treatment.

    Yep, well stated.  Much appreciated…….

    I’m interested in the cases in which a persistant disesthesia/parasthesis/anesthesia is treated with laser irradiation…

    I will get you the doctors’ names and the incidents when you come to training.  Del has kept better track of those reports than I have.

    By the way, my local neurologist has described laser induced nerve function recovery as being “a lot of hooey”….

    As would be expected.  Does he have anything other than uneducated ignorance and non experience to support his OPINION?

    In spite of his assessment, I’ve got a couple of cases that I am looking forward to treating  after I receive my periolase.

    Have your neurologist do a pre-treatment assessment.  I bet he doesn’t have the guts…….

    My MD Dad was not too impressed with nerve or pain reduction by laser either.  Nor was his neurologist “pain” doctor.  Then my Dad suffered from Spinal Stenosis.  Repeated epidural injections did little.

    One treatment with the FRP Nd:YAG and Dad now has relief–the only durable relief he has obtained.  Now Dad has a old FRP Nd:YAG at home for his nurse to use when he is hurting.  But his nurse reports improved walking, sitting, movement and posture……Dad report significant pain reduction. Who’s your Daddy’s pain therapist!?

    Lack of scientific evidence is not the same as hooey. It’s called anecdotal. Anecdotes are not hooey. They lack controls and other parameters of scientific scrutiny for generalizations. But many accepted therapeutic treatments fisrt began as anecdotal reports.

    By the way, Bob, how long after the course should I receive the laser? I’d like to start scheduling cases.

    Are you driving to BootCamp? It might be ready Saturday for you to drive it home. But we need to check with Del. Last months course was delayed a day due to one platic part not arrived.

    See you soon!

    Bob

    (Edited by Robert Gregg DDS at 2:37 pm on July 17, 2005)

    #5910 Reply

    Glenn van As
    Spectator

    Was it the plastic part that didnt arrive or the Krispy Kremes in a plastic part?

    PS do Krispy Kremes have any role in parasthesia reversals because I know we have those in Canada…….now as for the Periolase………

    You know the story.

    Glenn

    #5891 Reply

    jetsfan
    Spectator

    parasthesia reversal going well. Patient is thrilled and said if there were no more improvement it would still be a great result.
    Can anyone explain how this actually works?
    Anyone try this for Bell’s Palsey?

    Robert

    #5919 Reply

    Robert Gregg DDS
    Spectator

    Robert,

    Yes, it works just fine for Bell’s Palsey. Of course, the earlier it is treated the easier it is to reverse.

    The mechanism is pure speculation:

    1. Anti-inflamatory
    2. Cell membrane absorption increasing the ion transport capability
    3. Mitochondrial absorption = ATP systhesis and increased cell function/respiration.
    4. A primitive “TriCorder” device???

    Bob

    #5902 Reply

    BNelson
    Spectator

    The lady I treated with dysesthesia had no feeling for 11 yrs post injury and now has almost complete rehab. I biostim family and friends with plantar fasciititis with consistently good results and one friend had a rotator cuff injury- 6-8 months of meds and pt and couldn’t lift his arm past horizontal. 6 months after biostim, still has full range of motion and on no meds. All anecdotal, but it sure consistently works.

    #5906 Reply

    Glenn van As
    Spectator

    My patient is coming in today with the tongue parasthesia and I was just wondering how to figure out the Joules setting to treat him with a DIODE.

    I dont have the NdYAG and so after 3 months of healing on his own , I am going to go in there and treat the dorsum of the tongue and the lingual tissue to see if I can get some improvement in the area.

    I wanted to know about treatment regimens for this. I plan to treat him 1 week apart for a total of 4 weeks. At the end of 4 weeks if no improvement then I will refer him to the OS or to a neurologist.

    Thanks in advance.

    Glenn

    #5917 Reply

    Robert Gregg DDS
    Spectator

    HEy Glenn,

    Keep it light at say 1 watt of less and lase the base of the tongue as well as he distal areas you have mapped as numb.

    Try to find the “hot spots” anteriorly, and keep it in the “warm” at the base of the tongue….

    10 to 15 minutes will get you a couple of thousand joules.

    Anyone else, did I miss anything??

    Bob

    #5908 Reply

    Glenn van As
    Spectator

    Bob…….1 watt seems like alot (not really LLLT then). Yesterday I used .2w very close to the dorsum of the tongue, side and and the lingual nerve injury site as well as the lingual tissue. 2 min per site. 8 min total.

    YOu are suggesting 1 watt which obviously is defocussed or it will cut. It wouldnt hurt because patient has no sensation in those areas. Do you worry about thermal burning of the tissue which of course due to the parasthesia the patient cant tell when its hot.

    I know and understand that NDYAG might be better for this case but I dont have that choice. Patient is looking for ANY improvement.

    How do the Joules formula work………

    is 1 watt =1000 J/min

    Just wondering out loud what settings, how defocussed it should be and how to tell when enough is enough.

    THanks for the advice, I have to phone the patient tomorrow….. I sense at .2w I may have been too low but I told him we may need to do it several times.

    Thanks

    Glenn

    #5922 Reply

    Robert Gregg DDS
    Spectator

    Aaaahhh Glenn,

    You’re making me THINK! Don’t make me do the math.

    Who do you think I am Eric Bornstein?!

    OK, use .5 watt.

    I suggested 1 Watt or less–and YES defocused–Waaay defocused.

    You really need to use an explorer and map the area of numbess in percent or scale of 1 to 10 so that you can document progress as the reversal of tongue is often subjective.

    Draw a picture of a tongue, draw a line down the middle, then an area on the lateral border, up to the anterior 1/3, then an area on the tip of the tongue.

    Then probe those areas and ask for sensation feedback.

    I can scan a patient chart tomorrow when I’m at the office again.

    Bob

    #5907 Reply

    Glenn van As
    Spectator

    Hey Bob if you can scan the patient chart and fax it to 604 985 1732 that would be awesome.

    I doubt I made much of a difference and so I will bump up the energy settings. 1 watt is what I use with troughing , its in contact but I am sure that it will heat up the tongue if not defocussed.

    Oh I wish Eric the mighty bright one was here to help out.

    ERic if you are scrounging around, email me with some settings you would use with the diode at glennvanas@yahoo.com

    Thanks guys…….gotta phone him tomorrow.

    Glenn

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