Tyna Horn

My name is Tyna Horn, December 8, 2005, at age 49, I was diagnosed with breast cancer. After three surgeries, eight rounds of chemotherapy, and six plus weeks of radiation, I am blessed to say I am a two year survivor. One of the side effects of treatment is hot flashes.

They progressively were more frequent and mor severe. I was awakened several times a night, soaking wet, which, after some time took its toll. I was always tired, I wasn't able to do a lot of the things I normally would otherwise do. I was short tempered and irritable.

It was becoming more difficult for me to do my job, and just enjoy some sort of normalcy. I was telling my regular physician, Dr. Barbara Opalka, about my dilemma and she referred me to Dr. Lipov. She knew of his study and thought I might be a good candidate. I called his office the next day. After my initial consultation, it was an easy decision to make to agree to an injection.

The procedure was painless.

The first few days, the flashes were less severe. As time went on, they became less frequent. I was actually sleeping all night. I have had a second injection since and have had very noticeable results. I still have hot flashes, but not near as many, nor near as severe. They still wake me up occasionally, but I would definitely have the injections again to achieve the results I have.

Mary Wilson

Recently I traveled to Chicago, Illinois for a new procedure by Dr. Eugene Lipov.

Almost five and a half years ago I was diagnosed with stage I breast cancer. I had a lumpectomy, four chemotherapy treatments and followed that with radiation. I was 52 years old at the time and had not started menopause. During chemotherapy my periods stopped and the hot flashes began. Suddenly I was thrown into a menopausal state.

Now, five and a half years later, I still suffer from horrible hot flashes. Of course, I have tried everything that might help, but nothing did. I usually have between ten to twenty per day. It has deeply affected my well being and quality of life.

So, when I heard about Dr. Lipov's study I contacted his office. From the beginning, everyone was very nice and professional. I was able to speak with Dr. Lipov personally about the procedure. After finding out that I met the criteria for the study, I immediately made travel arrangements.

I live in Pass Christian, Mississippi. I was able to catch a flight to O'Hare International airport out of Gulfport, Mississipi, arranged for a shuttle service to pick me up at the airport, and was dropped off at the front door of my hotel. I chose to stay at La Quinta, which is less than a mile from Dr. Lipov's office. The next morning the hotel provided me a shuttle service to the office.

The entire experience at Dr. Lipov's office could not have been better. The staff immediately put me at ease. Dr. Lipov spent a lot of time with me, explaining the procedure and answering my questions. I felt everything was handled competently and professionally. I chose to have a local anesthetic instead of sedation and suffered minimal discomfort and no pain whatsoever. I had no side effects afterwards.

When I was ready to go, the hotel sent the complimentary shuttle to pick me up. I went back to the hotel, called my family, rested for a while, then had an early dinner at a restaurant next to the hotel.

The next morning the airport shuttle picked me up, drove me to the airport, and I was home by four in the afternoon. It was a smooth and easy trip in all respects.

I am very hopeful that this new procedure by Dr. Lipov will help my relentless hot flashes. After one treatment I notice improvement in the intensity and duration of the flashes. I think that with one or two more that I can finally be free and live my life normally again.

Jill McFall

My hot flashes were uncontrollable in the summer heat. I am currently taking Effexor every other day and would love to discontinue the use as it has caused a weight gain of 10 pounds. I have hot flashes all year around so that I perspire at an embarrassing rate. I have a moderate hot flash once an hour in cooler temperatures. This summer with the hot temperatures my hot flashes are severe once an hour or more and the perspiration is extremely uncomfortable.

I saw Dr. Joshi at the end of June 2007. I had my first injection in my neck without anesthesia. I really was only uncomfortable with some burning. I did have a sore throat for a day and a slight eye swelling. I went home and put the injection to the test. I cut my 1/2 acre yard in 90 degree heat and ran in the house to call Dr. Joshi as I not only did not perspire but felt great. Not one hot flash. I cannot tell you how excited I was. This continued for a period of 2 weeks. And the hot flashes started back just slightly at first. I am not back to the severity that I had before but am looking forward to an additional block. W hat a miracle this would be. I felt so good the first week after the block. I forgot how good that was not to worry about the hot flashes.

Bianca Kennedy, Breast Cancer Survivor: Q&A Regarding Procedure and Explanations

Q: Where on the body is the injection given and why?

A:  The injection is administered into the side of the neck. The reason for this is that at this precise location on the side of the neck lies a grouping of nerves called the Stellate Ganglia. These particular nerves perform important functions such as regulating blood flow and sweating. When these nerves are over stimulated, above and beyond normal activity, the result is a sharp rise in the body’s temperature creating what we know as hot flashes. Though for some women, hot flashes are mild, for others they are so severe that they become unbearable. The remedy used by Dr. Lipov is actually a nerve block injection. When administered into the Stellate Ganglia, it has the affect of numbing this area, much like a dentist’s use of a Novocain shot, thus reducing its level of over activity. This, in turn, reduces the quick escalations of blood flow and sweating, thus reducing hot flashes.

Q: How long does the procedure take?

A:  The procedure is typically completed within about five minutes. It is a very short procedure.

Q: How is precision determined and achieved when the injection is given?

A: Precision of location of the injection is not only important for safety, but for overall efficacy of the treatment as well. Therefore, to ensure complete precision of where the injection needle is placed, Dr. Lipov insists on always performing this procedure through X-Ray machine guidance. Through X-ray guidance, Dr. Lipov can easily locate the proper and precise location of where to administer the injection. To do so without this type of guidance would not be as simple or safe. With this “fool-proofing” technique, however, and the years of experience Dr. Lipov has had not only in giving this treatment, but also in teaching fellow physicians how to administer it safely, he has never had one incidence of performing it incorrectly. He has a solid track record of having done this procedure safely and satisfactorily over his entire tenure in pain management medicine.

Q: Does the injection hurt?

A: The injection does not cause pain. It creates a sensation of pressure during the brief   time that it is being administered. It can also produce a brief flush of warmth  in the arm on the side where the injection is being given. Though not necessary, some patients request that the injection be given under a momentary dose of anesthetic, in which case, patients do not feel anything and are “out” for only a matter of minutes.

Q: What are the immediate side effects and how will I feel afterward?

A: Patients report that the side effects they experienced immediately following  the injection include a droopy eyelid on the side that the injection was administered and a bit of numbness of the throat on that side. For that reason, it may be preferable to wait until several hours after the procedure to plan anything social or to eat your next meal. Please note that these side effects always reverse and typically disappear within a matter of six to eight hours after the procedure. Many
patients go home and take a long nap and awake with the side effects greatly diminished or completely gone.

Q: What should I expect on the day of my appointment?

A: When it is your turn to see the doctor, you will be given a typical hospital gown to wear to preserve your clothing. You will then be given an IV for use of either mild sedation or a requested anesthetic, to be administered during the procedure. You will be asked to lie on a medical bed with your neck over a small pillow. When the doctor begins the procedure, he will at this time administer the anesthetic, if requested, in which case you will awake within approximately 5 minutes and the procedure will already be over. If an anesthetic is not used, you can expect that the doctor will proceed by using the X-ray monitor to help him to determine the exact location of the injection site. He will begin to administer the injection and you will feel pressure upon application at the site of the injection. Throughout the procedure, your blood pressure and vital signs are closely monitored. Within a short time the procedure will be completed.
   
Once the procedure it complete, whether sedation or anesthetic is used, you will be guided to gently get up and move to a recliner to rest for a short time, before you leave the office. You will be fully awake; the doctor simply wishes to ensure that are not too “woozy” before leaving. If you have chosen to use an anesthetic, you may wish to have someone come with you to drive you back home or to arrange to take public transportation to get back home. This is only precautionary. You will be awake; however, your reflexes may be a little slower if you have any residual grogginess. If you do experience grogginess, it typically is only for a very brief time after the procedure. You should feel back to your normal state of alertness within a couple of hours if not sooner.

Q: How soon will the injection start working to oppose hot flashes?

A: Patients often experience an immediate change in their “body thermometer.” It can take anywhere from a matter of hours to a few days to experience the full effect.

Q: How much does the injection actually reduce or eliminate hot flashes?

A: This can vary somewhat from person to person, but on average, hot flashes are reduced significantly or eliminated altogether.

Q: How long does the effect on hot flashes last after the injection?

A: After the initial injection, relief from hot flashes usually last for weeks or months. It is common for a follow-up shot to be needed at some point to continue relief. With each subsequent shot, however, the duration of the benefit derived from the injection is greatly increased. So, a subsequent injection will last many times longer than the previous treatment.

Q: How many subsequent injections are typically required for the long-term management of hot flashes?

A: Studies of this treatment have demonstrated that, typically, a series of two or three injections will be all that is needed to achieve long-term benefit, with some patients requiring a yearly injection, for several years, to maintain optimal results. Results can vary from patient to patient, but on average, the benefits from the first injection will usually last for a month or more. A second injection will often yield relief for many months and a third injection, if necessary, can be given and will typically provide long-lasting if not permanent relief from the hot flashes.

Q: Is any follow-up care required?

A: A band-aid will be placed on your neck at the site of the injection. No further follow-up care to the procedure site is required.

Q: What is the cost for the procedure?

A:  Please contact the doctor’s office for all pricing information. Pricing can vary depending on the choice of sedation or anesthetic for use with the procedure.

Q: Will my insurance cover this procedure?

A:  Please ask the doctor’s office for assistance in dealing with your insurance company. Some insurance companies have paid for this injection, though not all do. Payment arrangements can often be worked out.

Q: Can I get this type of injection at any doctor’s office?

A:  No. It is important to note that this is a procedure which, while new in relation to  its shift in use from pain management to the use for hot flash management, is a procedure that has been practiced safely at pain management facilities for over 25 years. The nature of this type of injection necessitates that it must be given only by a physician experienced in administering such nerve block injections, widely-
 used in pain management clinics.
 
Q: What are the risks involved in this procedure?

A:  With any medical procedure, there are potential risks associated. The risks  involved with this injection include possible seizures, infection, epidural block, or  the injection striking a blood vessel or surrounding organ. Done properly, through use of X-Ray guidance, those risks are minimized dramatically and the likelihood  of developing such risks is remote. Again, in the seventeen years Dr. Lipov has administered this treatment, there has never been one case with such an outcome.

Q: How exactly does the injection work to oppose hot flashes?

A: The injection works by impairing the activity of the group of nerves that the nerve block agent is injected into. These particular nerves are the Stellate Ganglia nerves, which can send temperature impulses, or hot flashes, through the body, if over-stimulated. The injection acts to counter this effect by numbing these nerves.

Q: What is the best way to ensure that the optimal effect of eliminating hot flashes is  achieved?

A:  While a marked improvement has been documented in all patients who have participated in Dr. Lipov’s study of the use of the Stellate Ganglion Nerve Block, the understanding is that optimal results will occur if the patient seeks this treatment as close to the onset of hot flashes as possible. Those who are several years into their menopausal hot flashes can certainly obtain benefit as well, though it may require additional treatments to reach the optimal therapeutic effect.

Q: Is there anything else I should know? 

A: You should know that Dr. Lipov employs exacting standards for care and safety in his practice. His credentials includes Board Certification in Anesthesiology and Pain Management and he earned his medical degree at Northwestern University in 1984. Since that time, he has spent the last 22 years making his life’s work a mission to help others cope with pain. He now is recognizing the need for and
pioneering a remedy for helping patients cope with quality-of-life impairing hot
flashes.

Tammy Bengston, Breast Cancer Survivor, is Kind Enough to Take Potential Emails

Bengs8@aol.com

I have had many miserable days along with much more unbearable nights. My life has been ruled for many years by hot flashes, which unfortunately was accompanied by mood swings. My hot flashes had gotten so bad that I was constantly tearing clothes off, just to feel comfortable in my own skin. As for the mood swings, I found myself desperate just to be happy.

When I was just thirty years old, I had my hysterectomy. My doctor started me on Estrogen in which I continued for twelve years. Unfortunately in 2003 I was diagnosed with breast cancer. I was immediately taken off the Estrogen and had a double mastectomy. That’s when my own personal hell set in as the hot flashes went crazy. During the hot flashes my mood swings had me on a never ending emotional roller coaster.

In 2005, Dr. Eugene Lipov came to me with what I see now as my miracle. Being a breast cancer survivor I could never be put on hormones again, and other things like low dosed antidepressants never came through. But, Dr. Lipovs’ new procedure brought women hope, and yes, even to us survivors. The Stellate Ganglion Block (injection) is just that, an easy, painless injection to the neck. I had chosen to have the procedure under a local sedation. A needle was injected into the right side of my neck, and then a very small pinch with Novocain numbs the area. Once that part was over the procedure painlessly flies by in just about ten minutes.

The entire procedure is done under the Fluoroscope x-ray machine which enables Dr. Lipov to find the precise location. Once injected my eye on the side of the injection becomes bloodshot and droopy. But it always goes away soon after (few hours), and trust me it’s the smallest price to pay. My relief lasts up to and sometimes over four months! I have no more hot flashes and I’m actually able to sleep at night, also my mood swings have seemed to diminish.

I’ve found myself to be much happier now and the once horrible mood swings don’t so much even exist anymore. I do and will always be grateful to Dr. Lipov for giving me my life back. To all of you who are going through your lives suffering from hot flashes, there is hope and most of all there is help. Please, e-mail me with any questions you may at all have. My relief can be yours!

Patricia S. Lucas, Retired R.N., Menopause Patient (not a Breast Cancer Patient)

This was our first patient treated with this procedure 6 years ago.

Having been a patient of Eugene Lipov, M.D. for over ten(10) years, I was extremely pleased when he began offering a treatment for excessive sweating and hot flashes called the Stellate Ganglion Block. After the first few injections, spaced approximately a month apart, I began to have a lessening of my symptoms. By the third to the fourth injection, most if not all episodes of intense drenching sweats had stopped.

The time between each treatment continued to lengthen, until I was virtually symptom-free for as long as a year. The injections appear to have an accumulative effect, and only because I have moved out of state, and did not continue with the regularly spaced injections I have had recurrence of flashes and night sweating. Just last month I returned to Illinois for another treatment, and have had immediate and lasting results as of this writing, and will plan to have another injection in a few months if and when needed. Patricia S. Lucas, retired R.N. Henderson, NV